[NSG 5240 ADVANCED PHARMACOLOGY FINAL PRACTICE
EXAM] – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS
| LATEST EXAM UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST
1. A nurse practitioner is prescribing lisinopril for a patient newly diagnosed with
hypertension. Which laboratory value should be monitored most closely after initiating
therapy?
A. Hemoglobin
B. Serum potassium
C. Platelet count
D. Total bilirubin
════════════════════
Correct Answer: B. Serum potassium
Rationale:
ACE inhibitors such as lisinopril can cause potassium retention, increasing the risk of
hyperkalemia. Monitoring serum potassium and renal function is essential after initiating
therapy. Hemoglobin, platelet count, and bilirubin are not primary concerns associated with
ACE inhibitor therapy.
════════════════════
2. A 68-year-old patient with atrial fibrillation is prescribed warfarin therapy. Which
medication would most likely increase the patient's bleeding risk when taken concurrently?
A. Acetaminophen
B. Metformin
C. Ibuprofen
D. Famotidine
════════════════════
Correct Answer: C. Ibuprofen
Rationale:
,NSAIDs such as ibuprofen increase bleeding risk when combined with warfarin because they
inhibit platelet aggregation and can irritate the gastrointestinal lining. Acetaminophen may
affect INR in large doses but is less significant. Metformin and famotidine do not substantially
increase bleeding risk.
════════════════════
3. A patient taking nitroglycerin for chronic stable angina reports persistent headaches. What
is the best response by the provider?
A. Discontinue the medication immediately
B. Reduce the dose by half permanently
C. Advise the patient that headaches are a common adverse effect
D. Recommend taking the medication only during chest pain episodes
════════════════════
Correct Answer: C. Advise the patient that headaches are a common adverse effect
Rationale:
Headaches are a common vasodilatory effect of nitroglycerin and often diminish with
continued therapy. Abrupt discontinuation may worsen angina symptoms. Dose reductions
should only occur after provider assessment. Nitroglycerin for chronic stable angina should be
taken as prescribed, not only during acute episodes.
════════════════════
4. A diabetic patient receiving insulin glargine asks when the medication reaches peak effect.
What is the most appropriate response?
A. It peaks in approximately 2 hours
B. It has no pronounced peak
C. It peaks between meals
D. It peaks at bedtime only
════════════════════
Correct Answer: B. It has no pronounced peak
Rationale:
Insulin glargine is a long-acting basal insulin with relatively constant activity and no
significant peak. This characteristic reduces fluctuations in glucose levels. Rapid-acting and
intermediate-acting insulins have more defined peak times.
,════════════════════
5. A patient with asthma is prescribed albuterol via metered-dose inhaler. Which instruction
should the provider include?
A. Use the inhaler once weekly
B. Inhale rapidly while activating the device
C. Wait at least one minute between puffs
D. Exhale into the inhaler before inhalation
════════════════════
Correct Answer: C. Wait at least one minute between puffs
Rationale:
Waiting one minute between puffs improves bronchodilation and medication delivery.
Patients should inhale slowly and deeply, not rapidly. Exhaling into the inhaler may interfere
with dosing accuracy. Albuterol is typically used as needed or before exercise, not once
weekly.
════════════════════
6. A patient receiving digoxin develops nausea, blurred vision, and bradycardia. What should
the provider suspect first?
A. Hyperthyroidism
B. Drug tolerance
C. Digoxin toxicity
D. Acute infection
════════════════════
Correct Answer: C. Digoxin toxicity
Rationale:
Classic manifestations of digoxin toxicity include nausea, visual disturbances such as yellow or
blurred vision, and bradycardia. Electrolyte imbalances, especially hypokalemia, increase the
risk. The symptoms are not consistent with drug tolerance or infection.
════════════════════
7. Which patient is at greatest risk for developing lactic acidosis while taking metformin?
A. A healthy 30-year-old athlete
B. A patient with severe renal impairment
, C. A patient taking vitamin supplements
D. A patient with seasonal allergies
════════════════════
Correct Answer: B. A patient with severe renal impairment
Rationale:
Metformin is contraindicated in severe renal impairment because reduced drug clearance
increases the risk of lactic acidosis, a rare but serious adverse effect. Healthy adults and
patients with allergies are not at significant risk solely from metformin use.
════════════════════
8. A patient taking levothyroxine should be instructed to take the medication at what time?
A. With calcium supplements
B. Immediately after dinner
C. At bedtime with food
D. On an empty stomach in the morning
════════════════════
Correct Answer: D. On an empty stomach in the morning
Rationale:
Levothyroxine absorption is best when taken on an empty stomach 30–60 minutes before
breakfast. Calcium and food can significantly impair absorption. Consistency in timing is
important for stable thyroid hormone levels.
════════════════════
9. A provider prescribes ciprofloxacin for a urinary tract infection. Which teaching point is
most important?
A. Take the medication with antacids
B. Avoid excessive sun exposure
C. Restrict fluid intake
D. Stop the medication once symptoms improve
════════════════════
Correct Answer: B. Avoid excessive sun exposure
Rationale:
EXAM] – QUESTIONS AND ANSWERS | VERIFIED AND WELL
DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS
| LATEST EXAM UPDATE | EXAM PREP | STUDY GUIDE |
PRACTICE TEST
1. A nurse practitioner is prescribing lisinopril for a patient newly diagnosed with
hypertension. Which laboratory value should be monitored most closely after initiating
therapy?
A. Hemoglobin
B. Serum potassium
C. Platelet count
D. Total bilirubin
════════════════════
Correct Answer: B. Serum potassium
Rationale:
ACE inhibitors such as lisinopril can cause potassium retention, increasing the risk of
hyperkalemia. Monitoring serum potassium and renal function is essential after initiating
therapy. Hemoglobin, platelet count, and bilirubin are not primary concerns associated with
ACE inhibitor therapy.
════════════════════
2. A 68-year-old patient with atrial fibrillation is prescribed warfarin therapy. Which
medication would most likely increase the patient's bleeding risk when taken concurrently?
A. Acetaminophen
B. Metformin
C. Ibuprofen
D. Famotidine
════════════════════
Correct Answer: C. Ibuprofen
Rationale:
,NSAIDs such as ibuprofen increase bleeding risk when combined with warfarin because they
inhibit platelet aggregation and can irritate the gastrointestinal lining. Acetaminophen may
affect INR in large doses but is less significant. Metformin and famotidine do not substantially
increase bleeding risk.
════════════════════
3. A patient taking nitroglycerin for chronic stable angina reports persistent headaches. What
is the best response by the provider?
A. Discontinue the medication immediately
B. Reduce the dose by half permanently
C. Advise the patient that headaches are a common adverse effect
D. Recommend taking the medication only during chest pain episodes
════════════════════
Correct Answer: C. Advise the patient that headaches are a common adverse effect
Rationale:
Headaches are a common vasodilatory effect of nitroglycerin and often diminish with
continued therapy. Abrupt discontinuation may worsen angina symptoms. Dose reductions
should only occur after provider assessment. Nitroglycerin for chronic stable angina should be
taken as prescribed, not only during acute episodes.
════════════════════
4. A diabetic patient receiving insulin glargine asks when the medication reaches peak effect.
What is the most appropriate response?
A. It peaks in approximately 2 hours
B. It has no pronounced peak
C. It peaks between meals
D. It peaks at bedtime only
════════════════════
Correct Answer: B. It has no pronounced peak
Rationale:
Insulin glargine is a long-acting basal insulin with relatively constant activity and no
significant peak. This characteristic reduces fluctuations in glucose levels. Rapid-acting and
intermediate-acting insulins have more defined peak times.
,════════════════════
5. A patient with asthma is prescribed albuterol via metered-dose inhaler. Which instruction
should the provider include?
A. Use the inhaler once weekly
B. Inhale rapidly while activating the device
C. Wait at least one minute between puffs
D. Exhale into the inhaler before inhalation
════════════════════
Correct Answer: C. Wait at least one minute between puffs
Rationale:
Waiting one minute between puffs improves bronchodilation and medication delivery.
Patients should inhale slowly and deeply, not rapidly. Exhaling into the inhaler may interfere
with dosing accuracy. Albuterol is typically used as needed or before exercise, not once
weekly.
════════════════════
6. A patient receiving digoxin develops nausea, blurred vision, and bradycardia. What should
the provider suspect first?
A. Hyperthyroidism
B. Drug tolerance
C. Digoxin toxicity
D. Acute infection
════════════════════
Correct Answer: C. Digoxin toxicity
Rationale:
Classic manifestations of digoxin toxicity include nausea, visual disturbances such as yellow or
blurred vision, and bradycardia. Electrolyte imbalances, especially hypokalemia, increase the
risk. The symptoms are not consistent with drug tolerance or infection.
════════════════════
7. Which patient is at greatest risk for developing lactic acidosis while taking metformin?
A. A healthy 30-year-old athlete
B. A patient with severe renal impairment
, C. A patient taking vitamin supplements
D. A patient with seasonal allergies
════════════════════
Correct Answer: B. A patient with severe renal impairment
Rationale:
Metformin is contraindicated in severe renal impairment because reduced drug clearance
increases the risk of lactic acidosis, a rare but serious adverse effect. Healthy adults and
patients with allergies are not at significant risk solely from metformin use.
════════════════════
8. A patient taking levothyroxine should be instructed to take the medication at what time?
A. With calcium supplements
B. Immediately after dinner
C. At bedtime with food
D. On an empty stomach in the morning
════════════════════
Correct Answer: D. On an empty stomach in the morning
Rationale:
Levothyroxine absorption is best when taken on an empty stomach 30–60 minutes before
breakfast. Calcium and food can significantly impair absorption. Consistency in timing is
important for stable thyroid hormone levels.
════════════════════
9. A provider prescribes ciprofloxacin for a urinary tract infection. Which teaching point is
most important?
A. Take the medication with antacids
B. Avoid excessive sun exposure
C. Restrict fluid intake
D. Stop the medication once symptoms improve
════════════════════
Correct Answer: B. Avoid excessive sun exposure
Rationale:
