NUR 6011/NUR6011 Final Exam V3 |
Advance Pharmacology Q&A with
Rationale | William Paterson University
1. A patient is prescribed Lisinopril for hypertension. Which electrolyte abnormality should
the nurse practitioner monitor most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
Rationale: ACE inhibitors like Lisinopril can cause hyperkalemia by inhibiting aldosterone
secretion, which leads to potassium retention. This is particularly concerning in patients
with renal impairment or those taking potassium-sparing diuretics. Monitoring serum
potassium levels is essential to prevent cardiac arrhythmias associated with high
potassium.
2. When prescribing Warfarin, which laboratory value is used to monitor the therapeutic
effect and adjust the dosage?
A. aPTT
B. INR
,C. Platelet count
D. Serum creatinine
Answer: B
Rationale: The International Normalized Ratio (INR) is the standard tool for monitoring
the anticoagulant effect of Warfarin. Maintaining the INR within a specific target range,
usually 2.0 to 3.0, ensures efficacy while minimizing bleeding risks. Frequent monitoring is
required due to the narrow therapeutic index and numerous drug-food interactions.
3. A patient with a history of asthma is diagnosed with hypertension. Which class of beta-
blockers is generally preferred in this population?
A. Non-selective beta-blockers
B. Beta-blockers with ISA
C. Cardioselective beta-blockers
D. Alpha-beta blockers
Answer: C
Rationale: Cardioselective beta-blockers, such as Metoprolol or Atenolol, preferentially
block Beta-1 receptors in the heart rather than Beta-2 receptors in the lungs. This
selectivity reduces the risk of inducing bronchospasm in patients with reactive airway
diseases like asthma. However, selectivity is dose-dependent and can be lost at higher
concentrations.
, 4. What is the primary mechanism of action of Metformin in the treatment of Type 2
Diabetes?
A. Stimulating insulin secretion from the pancreas
B. Increasing glucose excretion via the kidneys
C. Increasing dietary glucose absorption
D. Reducing hepatic glucose production
Answer: D
Rationale: Metformin primarily works by decreasing gluconeogenesis in the liver and
improving insulin sensitivity in peripheral tissues. Unlike sulfonylureas, it does not
stimulate insulin release, which significantly reduces the risk of hypoglycemia. It is
considered first-line therapy for most patients with Type 2 Diabetes unless contraindicated
by renal failure.
5. Which of the following is a classic sign of Digoxin toxicity that a patient should be educated
to report?
A. Peripheral edema
B. Yellow-green halos around lights
C. Increased appetite
D. Tinnitus
Answer: B
Advance Pharmacology Q&A with
Rationale | William Paterson University
1. A patient is prescribed Lisinopril for hypertension. Which electrolyte abnormality should
the nurse practitioner monitor most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
Rationale: ACE inhibitors like Lisinopril can cause hyperkalemia by inhibiting aldosterone
secretion, which leads to potassium retention. This is particularly concerning in patients
with renal impairment or those taking potassium-sparing diuretics. Monitoring serum
potassium levels is essential to prevent cardiac arrhythmias associated with high
potassium.
2. When prescribing Warfarin, which laboratory value is used to monitor the therapeutic
effect and adjust the dosage?
A. aPTT
B. INR
,C. Platelet count
D. Serum creatinine
Answer: B
Rationale: The International Normalized Ratio (INR) is the standard tool for monitoring
the anticoagulant effect of Warfarin. Maintaining the INR within a specific target range,
usually 2.0 to 3.0, ensures efficacy while minimizing bleeding risks. Frequent monitoring is
required due to the narrow therapeutic index and numerous drug-food interactions.
3. A patient with a history of asthma is diagnosed with hypertension. Which class of beta-
blockers is generally preferred in this population?
A. Non-selective beta-blockers
B. Beta-blockers with ISA
C. Cardioselective beta-blockers
D. Alpha-beta blockers
Answer: C
Rationale: Cardioselective beta-blockers, such as Metoprolol or Atenolol, preferentially
block Beta-1 receptors in the heart rather than Beta-2 receptors in the lungs. This
selectivity reduces the risk of inducing bronchospasm in patients with reactive airway
diseases like asthma. However, selectivity is dose-dependent and can be lost at higher
concentrations.
, 4. What is the primary mechanism of action of Metformin in the treatment of Type 2
Diabetes?
A. Stimulating insulin secretion from the pancreas
B. Increasing glucose excretion via the kidneys
C. Increasing dietary glucose absorption
D. Reducing hepatic glucose production
Answer: D
Rationale: Metformin primarily works by decreasing gluconeogenesis in the liver and
improving insulin sensitivity in peripheral tissues. Unlike sulfonylureas, it does not
stimulate insulin release, which significantly reduces the risk of hypoglycemia. It is
considered first-line therapy for most patients with Type 2 Diabetes unless contraindicated
by renal failure.
5. Which of the following is a classic sign of Digoxin toxicity that a patient should be educated
to report?
A. Peripheral edema
B. Yellow-green halos around lights
C. Increased appetite
D. Tinnitus
Answer: B
