NUR 6011/NUR6011 Final Exam V2 |
Advance Pharmacology Q&A with
Rationale | William Paterson University
1. Which of the following is the most appropriate action for a patient on Metformin
scheduled for a CT scan with IV contrast?
A. Continue Metformin as usual.
B. Double the dose the day before the scan.
C. Switch to insulin for one week before the scan.
D. Hold Metformin 48 hours before and after the scan.
Answer: D
Rationale: Metformin must be withheld during and for 48 hours after procedures
involving iodinated contrast media. This precaution is necessary because contrast dye can
cause acute renal failure, which increases the risk of metformin-induced lactic acidosis.
Normal renal function must be confirmed before resuming the medication.
2. A patient taking Lisinopril develops a persistent dry cough. What is the physiological cause
of this side effect?
A. Decrease in pulmonary surfactant production.
B. Increased levels of bradykinin in the lungs.
C. Allergic reaction to the ACE inhibitor compound.
,D. Direct irritation of the bronchial mucosa by the drug.
Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This buildup of bradykinin is responsible for the
characteristic dry, non-productive cough seen in many patients. Switching the patient to an
Angiotensin II Receptor Blocker (ARB) usually resolves this issue.
3. Which laboratory value is used to monitor the therapeutic effect of Warfarin?
A. Activated partial thromboplastin time (aPTT).
B. Serum creatinine and GFR.
C. International Normalized Ratio (INR).
D. Complete blood count (CBC).
Answer: C
Rationale: The International Normalized Ratio (INR) is the standard test for monitoring
warfarin therapy. It ensures that the patient’s blood is within a safe therapeutic range to
prevent both clotting and excessive bleeding. Monitoring is essential due to the drug’s
narrow therapeutic index and numerous drug-food interactions.
4. A patient presents with visual disturbances (yellow halos) and nausea while taking Digoxin.
What is the most likely cause?
A. Acute myocardial infarction.
, B. Digoxin toxicity.
C. Normal side effects of the medication.
D. Development of glaucoma.
Answer: B
Rationale: Visual changes and gastrointestinal distress are classic early signs of digoxin
toxicity. These symptoms often occur when the serum digoxin level exceeds the therapeutic
range or when hypokalemia is present. Immediate assessment of serum levels and
electrolytes is required to manage the patient safely.
5. Why should Furosemide (Lasix) be administered slowly when given intravenously?
A. To prevent rapid hypotension.
B. To avoid permanent ototoxicity.
C. To maximize the diuretic effect.
D. To prevent rebound hypernatremia.
Answer: B
Rationale: Rapid intravenous administration of high-dose loop diuretics like furosemide
can cause transient or permanent hearing loss. This risk is particularly high when the drug
is given faster than 4 mg per minute. Slow infusion helps mitigate the risk of damage to the
inner ear’s hair cells.
Advance Pharmacology Q&A with
Rationale | William Paterson University
1. Which of the following is the most appropriate action for a patient on Metformin
scheduled for a CT scan with IV contrast?
A. Continue Metformin as usual.
B. Double the dose the day before the scan.
C. Switch to insulin for one week before the scan.
D. Hold Metformin 48 hours before and after the scan.
Answer: D
Rationale: Metformin must be withheld during and for 48 hours after procedures
involving iodinated contrast media. This precaution is necessary because contrast dye can
cause acute renal failure, which increases the risk of metformin-induced lactic acidosis.
Normal renal function must be confirmed before resuming the medication.
2. A patient taking Lisinopril develops a persistent dry cough. What is the physiological cause
of this side effect?
A. Decrease in pulmonary surfactant production.
B. Increased levels of bradykinin in the lungs.
C. Allergic reaction to the ACE inhibitor compound.
,D. Direct irritation of the bronchial mucosa by the drug.
Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This buildup of bradykinin is responsible for the
characteristic dry, non-productive cough seen in many patients. Switching the patient to an
Angiotensin II Receptor Blocker (ARB) usually resolves this issue.
3. Which laboratory value is used to monitor the therapeutic effect of Warfarin?
A. Activated partial thromboplastin time (aPTT).
B. Serum creatinine and GFR.
C. International Normalized Ratio (INR).
D. Complete blood count (CBC).
Answer: C
Rationale: The International Normalized Ratio (INR) is the standard test for monitoring
warfarin therapy. It ensures that the patient’s blood is within a safe therapeutic range to
prevent both clotting and excessive bleeding. Monitoring is essential due to the drug’s
narrow therapeutic index and numerous drug-food interactions.
4. A patient presents with visual disturbances (yellow halos) and nausea while taking Digoxin.
What is the most likely cause?
A. Acute myocardial infarction.
, B. Digoxin toxicity.
C. Normal side effects of the medication.
D. Development of glaucoma.
Answer: B
Rationale: Visual changes and gastrointestinal distress are classic early signs of digoxin
toxicity. These symptoms often occur when the serum digoxin level exceeds the therapeutic
range or when hypokalemia is present. Immediate assessment of serum levels and
electrolytes is required to manage the patient safely.
5. Why should Furosemide (Lasix) be administered slowly when given intravenously?
A. To prevent rapid hypotension.
B. To avoid permanent ototoxicity.
C. To maximize the diuretic effect.
D. To prevent rebound hypernatremia.
Answer: B
Rationale: Rapid intravenous administration of high-dose loop diuretics like furosemide
can cause transient or permanent hearing loss. This risk is particularly high when the drug
is given faster than 4 mg per minute. Slow infusion helps mitigate the risk of damage to the
inner ear’s hair cells.
