Nsg 5240 Comprehensive Exam: Advanced Pharmacology & Pathophysiology Complete Questions With 100% Verified Answers

NSG 5240 COMPREHENSIVE EXAM: ADVANCED PHARMACOLOGY & PATHOPHYSIOLOGY COMPLETE QUESTIONS WITH 100% VERIFIED ANSWERS 1. A patient with myasthenia gravis is prescribed pyridostigmine. Which statement best describes its mechanism of action? A. Blocks nicotinic receptors at the neuromuscular junction B. Inhibits acetylcholinesterase, increasing acetylcholine availability C. Promotes acetylcholine release from presynaptic neurons D. Antagonizes muscarinic receptors in smooth muscle Rationale: Pyridostigmine is a cholinesterase inhibitor; it prevents breakdown of ACh, improving neuromuscular transmission. ________________________________________ 2. A 45-year-old with hypertension is started on lisinopril. Which adverse effect is most specific to this drug class? A. Hypokalemia B. Dry cough C. Peripheral edema D. Bradycardia Rationale: ACE inhibitors cause dry cough due to increased bradykinin levels; not seen with ARBs. ________________________________________ 3. A patient with Parkinson’s disease on carbidopa-levodopa develops dyskinesias. Which medication is most appropriate to manage this complication? A. Increase levodopa dose B. Amantadine C. Benztropine D. Selegiline Rationale: Amantadine reduces levodopa-induced dyskinesias via NMDA antagonism. ________________________________________ 4. A 30-year-old with asthma uses albuterol 2 puffs daily, has nighttime symptoms twice weekly, and FEV1 85% predicted. According to GINA guidelines, which step is most appropriate? A. Step 1: As-needed low-dose ICS-formoterol B. Step 2: Low-dose inhaled corticosteroid daily C. Step 3: Low-dose ICS-LABA D. Step 4: Medium-dose ICS-LABA Rationale: Symptoms 2+ times/week but not daily → step 2 (low-dose ICS). ________________________________________ 5. A patient is prescribed a drug with a half-life of 12 hours. Approximately how many hours until steady state is achieved? A. 24 hours B. 36 hours C. 60 hours D. 120 hours Rationale: Steady state reached in 4–5 half-lives → 4–5 × 12 = 48–60 hours. ________________________________________ 6. A 55-year-old with type 2 diabetes and CKD (eGFR 35 mL/min) has BP 150/90. Which antihypertensive class slows CKD progression most effectively? A. Beta-blocker B. ACE inhibitor C. Thiazide diuretic D. Direct vasodilator Rationale: ACEi/ARB reduce intraglomerular pressure and albuminuria, slowing diabetic nephropathy. ________________________________________ 7. A patient with Alzheimer’s disease is started on donepezil. Which expected benefit best describes its action? A. Cure of Alzheimer’s pathology B. Temporary improvement in cognitive symptoms C. Reduction in brain amyloid plaques D. Prevention of disease progression Rationale: Cholinesterase inhibitors provide modest symptomatic benefit; do not alter underlying disease. ________________________________________ 8. A 70-year-old with heart failure (EF 30%) on carvedilol, lisinopril, and furosemide has K+ 5.8 mEq/L. Which medication should be held first? A. Carvedilol B. Lisinopril C. Furosemide D. All should be continued Rationale: ACE inhibitor hyperkalemia → hold or reduce ACEi, check renal function. ________________________________________ 9. A patient is brought to the ED after ingesting an unknown quantity of a drug that causes miosis, respiratory depression, and coma. Which antidote is most appropriate? A. Flumazenil B. Naloxone C. Atropine D. Activated charcoal Rationale: Opioid toxidrome (miosis, respiratory depression) → naloxone. ________________________________________ 10. Which drug characteristic determines the amount needed to produce a given effect? A. Efficacy B. Potency C. Affinity D. Therapeutic index Rationale: Potency refers to the dose required to achieve a specific effect. ________________________________________