NUR 2474 Pharmacology Exam
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Latest Topic Test (2026 Update)
85 Questions | Highlighted Answers with Rationales
Section 1: Cardiovascular Pharmacology (15 Questions)
1. A patient with heart failure (HFrEF) is prescribed sacubitril/valsartan.
Which lab value requires immediate notification of the provider?
• A. Serum potassium 4.0 mEq/L
• B. Serum potassium 5.8 mEq/L *Rationale: Sacubitril/valsartan
(Entresto) can cause hyperkalemia. K+ >5.5 mEq/L increases risk of
arrhythmias.*
• C. BNP 150 pg/mL
• D. Creatinine 0.9 mg/dL
2. Which medication is first-line for rate control in atrial fibrillation with
rapid ventricular response and heart failure with reduced ejection fraction
(HFrEF)?
• A. Diltiazem
• B. Metoprolol tartrate
• C. Digoxin *Rationale: Digoxin is preferred in HFrEF + AFib when
beta-blockers/CCBs are contraindicated. 2026 guidelines recommend low-
dose digoxin (0.125 mg) for safety.*
, • D. Amiodarone
3. A patient on warfarin has an INR of 4.5 without bleeding. What is the
appropriate action?
• A. Administer vitamin K 10 mg IV
• B. Hold warfarin and recheck INR in 24 hours *Rationale: For INR
4.5–5.0 without bleeding, hold next dose and monitor. High-dose vitamin K
is for major bleeding.*
• C. Increase warfarin dose
• D. Administer fresh frozen plasma
4. Which direct oral anticoagulant (DOAC) is FDA-approved for patients with
mechanical heart valves?
• A. Apixaban
• B. Rivaroxaban
• C. Edoxaban
• D. None of the above Rationale: DOACs are contraindicated in
mechanical heart valves due to increased thromboembolism and bleeding.
Warfarin remains the only approved agent.
5. A patient taking amiodarone develops blue-gray skin discoloration, tremor,
and pulmonary fibrosis. Which strategy minimizes toxicity?
• A. Use lowest effective dose and monitor chest imaging Rationale:
Amiodarone toxicity is dose/duration-related. Lung injury is irreversible;
baseline and annual CXR or HRCT recommended.
• B. Discontinue statin immediately
• C. Add potassium supplements
• D. Switch to IV form only
6. Which medication is preferred for hypertensive urgency (BP 195/110,
asymptomatic) in a patient with chronic kidney disease?
• A. Clonidine 0.2 mg PO
, • B. Amlodipine 5 mg PO Rationale: Oral amlodipine is safe for gradual
BP reduction. Clonidine risks rebound hypertension. No IV agents needed in
urgency.
• C. Nitroprusside IV
• D. Hydralazine 20 mg IV
7. A patient on spironolactone for heart failure reports breast tenderness and
gynecomastia. Which alternative is equally effective?
• A. Hydrochlorothiazide
• B. Furosemide
• C. Eplerenone Rationale: Eplerenone is a selective aldosterone
antagonist with less gynecomastia (lower androgen receptor affinity).
• D. Metolazone
8. Which antiarrhythmic drug requires monitoring for corneal microdeposits
and thyroid dysfunction?
• A. Flecainide
• B. Dofetilide
• C. Amiodarone Rationale: Amiodarone deposits in cornea (usually
benign) and affects thyroid (hypo or hyper). Annual eye and thyroid checks
required.
• D. Sotalol
9. A patient with heparin-induced thrombocytopenia (HIT) needs
anticoagulation. Which drug is safe?
• A. Enoxaparin
• B. Fondaparinux
• C. Argatroban Rationale: Argatroban (direct thrombin inhibitor) does
not cross-react with HIT antibodies. Fondaparinux is second-line but not
FDA-approved for HIT.
• D. Dalteparin
2|||questions and answers with
rationales/graded A+/2026
update/100% correct /instant
download
Latest Topic Test (2026 Update)
85 Questions | Highlighted Answers with Rationales
Section 1: Cardiovascular Pharmacology (15 Questions)
1. A patient with heart failure (HFrEF) is prescribed sacubitril/valsartan.
Which lab value requires immediate notification of the provider?
• A. Serum potassium 4.0 mEq/L
• B. Serum potassium 5.8 mEq/L *Rationale: Sacubitril/valsartan
(Entresto) can cause hyperkalemia. K+ >5.5 mEq/L increases risk of
arrhythmias.*
• C. BNP 150 pg/mL
• D. Creatinine 0.9 mg/dL
2. Which medication is first-line for rate control in atrial fibrillation with
rapid ventricular response and heart failure with reduced ejection fraction
(HFrEF)?
• A. Diltiazem
• B. Metoprolol tartrate
• C. Digoxin *Rationale: Digoxin is preferred in HFrEF + AFib when
beta-blockers/CCBs are contraindicated. 2026 guidelines recommend low-
dose digoxin (0.125 mg) for safety.*
, • D. Amiodarone
3. A patient on warfarin has an INR of 4.5 without bleeding. What is the
appropriate action?
• A. Administer vitamin K 10 mg IV
• B. Hold warfarin and recheck INR in 24 hours *Rationale: For INR
4.5–5.0 without bleeding, hold next dose and monitor. High-dose vitamin K
is for major bleeding.*
• C. Increase warfarin dose
• D. Administer fresh frozen plasma
4. Which direct oral anticoagulant (DOAC) is FDA-approved for patients with
mechanical heart valves?
• A. Apixaban
• B. Rivaroxaban
• C. Edoxaban
• D. None of the above Rationale: DOACs are contraindicated in
mechanical heart valves due to increased thromboembolism and bleeding.
Warfarin remains the only approved agent.
5. A patient taking amiodarone develops blue-gray skin discoloration, tremor,
and pulmonary fibrosis. Which strategy minimizes toxicity?
• A. Use lowest effective dose and monitor chest imaging Rationale:
Amiodarone toxicity is dose/duration-related. Lung injury is irreversible;
baseline and annual CXR or HRCT recommended.
• B. Discontinue statin immediately
• C. Add potassium supplements
• D. Switch to IV form only
6. Which medication is preferred for hypertensive urgency (BP 195/110,
asymptomatic) in a patient with chronic kidney disease?
• A. Clonidine 0.2 mg PO
, • B. Amlodipine 5 mg PO Rationale: Oral amlodipine is safe for gradual
BP reduction. Clonidine risks rebound hypertension. No IV agents needed in
urgency.
• C. Nitroprusside IV
• D. Hydralazine 20 mg IV
7. A patient on spironolactone for heart failure reports breast tenderness and
gynecomastia. Which alternative is equally effective?
• A. Hydrochlorothiazide
• B. Furosemide
• C. Eplerenone Rationale: Eplerenone is a selective aldosterone
antagonist with less gynecomastia (lower androgen receptor affinity).
• D. Metolazone
8. Which antiarrhythmic drug requires monitoring for corneal microdeposits
and thyroid dysfunction?
• A. Flecainide
• B. Dofetilide
• C. Amiodarone Rationale: Amiodarone deposits in cornea (usually
benign) and affects thyroid (hypo or hyper). Annual eye and thyroid checks
required.
• D. Sotalol
9. A patient with heparin-induced thrombocytopenia (HIT) needs
anticoagulation. Which drug is safe?
• A. Enoxaparin
• B. Fondaparinux
• C. Argatroban Rationale: Argatroban (direct thrombin inhibitor) does
not cross-react with HIT antibodies. Fondaparinux is second-line but not
FDA-approved for HIT.
• D. Dalteparin
