NR 567 FINAL EXAM – ADVANCED PHARMACOLOGY FOR THE
AGACNP | 2 VERSIONS EACH 100 Questions with Answers &
Rationales | instant pdf download
1. A 35-year-old female with anxiety treated with diazepam (Valium) triples her
daily dose and is found lethargic and obtunded. Which agent should be
administered?
A. Naloxone
B. Protamine sulfate
C. Flumazenil
D. Activated charcoal
Correct Answer: C
Rationale: Flumazenil is a competitive benzodiazepine receptor antagonist used
to reverse the sedative effects of diazepam overdose .
2. Which of the following medications is indicated for patients presenting with
altered mental status and seizures if Wernicke-Korsakoff syndrome is a
concern?
A. Folate (Folic acid)
B. Chlordiazepoxide (Librium)
C. Thiamine (Vitamin B1)
D. Lorazepam (Ativan)
Correct Answer: C
Rationale: Thiamine is the essential treatment for Wernicke-Korsakoff syndrome
to prevent or reverse neurological damage caused by thiamine deficiency .
3. Which class of antihypertensives should be avoided in pregnancy?
A. Calcium channel blockers
B. ACE inhibitors and ARBs
C. Methyldopa
D. Hydralazine
,Correct Answer: B
Rationale: ACE inhibitors and ARBs are teratogenic and are contraindicated
during pregnancy due to the risk of fetal renal damage and other birth defects .
4. Which medication is associated with tendon rupture, especially in older
adults?
A. Fluoroquinolones (e.g., ciprofloxacin)
B. Penicillins
C. Macrolides
D. Cephalosporins
Correct Answer: A
Rationale: Fluoroquinolones are known to increase the risk of tendonitis and
tendon rupture, particularly in elderly patients and those concurrently using
corticosteroids .
5. What is the first-line IV vasopressor for septic shock to restore mean arterial
pressure (MAP)?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
Correct Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock because it
effectively increases systemic vascular resistance and MAP .
6. Which laboratory test is used to monitor unfractionated heparin therapy?
A. Prothrombin time (PT) / INR
B. Activated partial thromboplastin time (aPTT)
C. Thrombin time
D. D-dimer
, Correct Answer: B
Rationale: The aPTT is the standard test for monitoring unfractionated heparin,
with a therapeutic goal typically 1.5–2.5 times the normal control value .
7. A patient on chronic prednisone presents with hyperglycemia. What is the
mechanism?
A. Prednisone increases insulin secretion
B. Prednisone causes insulin resistance and increases gluconeogenesis
C. Prednisone lowers hepatic glucose production
D. Prednisone causes hypoglycemia
Correct Answer: B
Rationale: Glucocorticoids cause hyperglycemia via increased gluconeogenesis in
the liver and induction of peripheral insulin resistance .
8. Which antiarrhythmic drug is known to cause pulmonary fibrosis and blue-
gray skin discoloration?
A. Amiodarone
B. Digoxin
C. Procainamide
D. Quinidine
Correct Answer: A
Rationale: Amiodarone has a long half-life and accumulates in tissues, leading to
pulmonary toxicity (fibrosis) and blue-gray skin discoloration .
9. What is the mechanism of action of warfarin?
A. Direct thrombin inhibition
B. Blockade of vitamin K-dependent carboxylation of clotting factors II, VII, IX, X
C. Inhibition of factor Xa
D. Activation of antithrombin III
Correct Answer: B
Rationale: Warfarin is a vitamin K antagonist that prevents the gamma-
AGACNP | 2 VERSIONS EACH 100 Questions with Answers &
Rationales | instant pdf download
1. A 35-year-old female with anxiety treated with diazepam (Valium) triples her
daily dose and is found lethargic and obtunded. Which agent should be
administered?
A. Naloxone
B. Protamine sulfate
C. Flumazenil
D. Activated charcoal
Correct Answer: C
Rationale: Flumazenil is a competitive benzodiazepine receptor antagonist used
to reverse the sedative effects of diazepam overdose .
2. Which of the following medications is indicated for patients presenting with
altered mental status and seizures if Wernicke-Korsakoff syndrome is a
concern?
A. Folate (Folic acid)
B. Chlordiazepoxide (Librium)
C. Thiamine (Vitamin B1)
D. Lorazepam (Ativan)
Correct Answer: C
Rationale: Thiamine is the essential treatment for Wernicke-Korsakoff syndrome
to prevent or reverse neurological damage caused by thiamine deficiency .
3. Which class of antihypertensives should be avoided in pregnancy?
A. Calcium channel blockers
B. ACE inhibitors and ARBs
C. Methyldopa
D. Hydralazine
,Correct Answer: B
Rationale: ACE inhibitors and ARBs are teratogenic and are contraindicated
during pregnancy due to the risk of fetal renal damage and other birth defects .
4. Which medication is associated with tendon rupture, especially in older
adults?
A. Fluoroquinolones (e.g., ciprofloxacin)
B. Penicillins
C. Macrolides
D. Cephalosporins
Correct Answer: A
Rationale: Fluoroquinolones are known to increase the risk of tendonitis and
tendon rupture, particularly in elderly patients and those concurrently using
corticosteroids .
5. What is the first-line IV vasopressor for septic shock to restore mean arterial
pressure (MAP)?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
Correct Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock because it
effectively increases systemic vascular resistance and MAP .
6. Which laboratory test is used to monitor unfractionated heparin therapy?
A. Prothrombin time (PT) / INR
B. Activated partial thromboplastin time (aPTT)
C. Thrombin time
D. D-dimer
, Correct Answer: B
Rationale: The aPTT is the standard test for monitoring unfractionated heparin,
with a therapeutic goal typically 1.5–2.5 times the normal control value .
7. A patient on chronic prednisone presents with hyperglycemia. What is the
mechanism?
A. Prednisone increases insulin secretion
B. Prednisone causes insulin resistance and increases gluconeogenesis
C. Prednisone lowers hepatic glucose production
D. Prednisone causes hypoglycemia
Correct Answer: B
Rationale: Glucocorticoids cause hyperglycemia via increased gluconeogenesis in
the liver and induction of peripheral insulin resistance .
8. Which antiarrhythmic drug is known to cause pulmonary fibrosis and blue-
gray skin discoloration?
A. Amiodarone
B. Digoxin
C. Procainamide
D. Quinidine
Correct Answer: A
Rationale: Amiodarone has a long half-life and accumulates in tissues, leading to
pulmonary toxicity (fibrosis) and blue-gray skin discoloration .
9. What is the mechanism of action of warfarin?
A. Direct thrombin inhibition
B. Blockade of vitamin K-dependent carboxylation of clotting factors II, VII, IX, X
C. Inhibition of factor Xa
D. Activation of antithrombin III
Correct Answer: B
Rationale: Warfarin is a vitamin K antagonist that prevents the gamma-
