NSG 533 Advanced Pharmacology Exam (2026) Exam
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EP is a 38-year-old female patient that comes in for Exenatide - Exenatide (Bydureon) once weekly has been able to demonstrate
diabetes education and management. She was diagnosed weight loss and decrease A1C% by 0.7% to 1.2% in clinical trials; however it is
12 years ago and states lately she is not able to control contraindicated for EP due to the self-reported history of thyroid cancer.
her diet although she continues a 1600 calorie diet with Dapagliflozin - Dapagliflozin (Farxiga) is contraindicated in this patient due to
appropriate daily carbohydrate intake (per dietitian hyperkalemia which could be made worse by this drug. The package insert does
prescription) and walks 40 minutes every day of the not indicate a specific potassium concentration cut off to no longer use this
week. She states compliance with all medications. She medication; however, there are better choices in this patient.
denies any history of hypoglycemia despite being able to Sitagliptin - Sitagliptin (Januvia) is able to obtain an A1C goal of less than 7%
identify signs and symptoms and describe appropriate based on clinical trials and currently the patient does not have any cautionary
treatment strategies. objective measures to not use this medication. DPP-IV inhibitors are weight
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomy neutral. DPP-IV inhibitors can be used in patients taking sulfonylureas; however, it
due to thyroid cancer may be recommended to reduce or stop the sulfonylurea dose.
FmHx: Noncontributory Acarbose - Acarbose (Precose) is not recommended for initial management and
SHx: (−) Smoking, alcohol use, past marijuana use while in is associated with significant GI side effects. More information would be needed
high school regarding fasting and post-prandial numbers. In addition, adding acarbose would
Medications: Metformin 850 mg tid, glipizide 20 mg bid, only lower A1c by 0.8% at best and therefore would not achieve the desired A1C
lisinopril 20 mg daily, sertraline 100 mg daily, multivitamin goal of <7%
daily
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl 106
mEq/L, BUN
, JR is a 68-year-old African American man with a new Metformin is the drug of choice recommended for most patients with diabetes in
diagnosis of T2DM. He was classified as having addition to lifestyle modifications assuming no contraindications or intolerabilities
prediabetes (at risk for developing diabetes) 5 years are present upon evaluation. Metformin has also shown to provide positive weight
before the diagnosis and has a strong family history of neutral/loss effects in obese patients. It is crucial to know the renal status of
type 2 diabetes. JR's blood pressure was 150/92 mm Hg. patients commencing metformin therapy to limit the risk of lactic acidosis (JR is
His laboratory results revealed an A1C of 8.1%, normal without contraindication).
cholesterol panel, and normal renal/hepatic function Since his entry A1C is >7.5%, dual therapy is indicated. There are several potential
were noted with today's laboratory test results. choices. The second step can be a dipeptidyl peptidase-4 inhibitor, it can be a
Past medical history: Hypertension (diagnosed 4 y ago) glucagon-like peptide-1 (GLP-1) receptor agonist, it can be a TZD, it can be a
Hyperlipidemia (diagnosed 2 y ago) Pancreatitis sulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal insulin.
(idiopathic) (acute hospitalization 3 y ago) Anything next can be tried depending on what suits the circumstance
Family history: Type 2 diabetes DPP4 inhibitors are weight neutral bet relatively benign side effect profile.
Medication: HCTZ 25 mg daily, simvastatin 10 mg daily Sitagliptin has been associated with case reports of pancreatitis, so this specific
Allergies: SMZ/TMP agent should be avoided. $$$
Vitals: BP: 150/92 mm Hg P: 78 beats/min RR: 12 rpm Waist GLP-1 analog and has data to support an A1C reduction necessary to gain
Circumference: 46 in Weight: 267 lb Height: 5 ′ 6 ″ BMI: glycemic control and may assist with weight loss goals for this patient. New
43.1 kg/m 2 information suggests these agents may provide benefits in those with ASCVD. JR
has a past history of pancreatitis and GLP-1 analogs are not recommended due to
this contraindication
Despite improvements in the past six weeks due to TZDs have data to support an A1C reduction necessary to gain glycemic control,
lifestyle changes and exercise, drug therapy is to be but are associated with weight gain, negative effects on lipids and increased risk
started for JR's diabet of fracture. Until recently, TZDs have also been linked to increased CV events and
use has fallen out of favor
Sulfonylureas provide excellent A1C lowering, but are also associated with weight
gain. They also have the potential to cause hypoglycemia, so patient education is
crucial. Because of his allergies to "sulfa", use would be contr
A patient with type 1 diabetes reports taking propranolol A patient with Type 1 DM is insulin dependent for glucose control and at high risk
for hypertension. What concern does this information for hypoglycemic episodes. Propanolol causes prolonged hypoglycemic
present for the provider? episodes. Needs to switch to ACE or ARB.
A provider teaches a patient who has been diagnosed D. Calcium may reduce levothyroxine absorption. Further education is needed if
with hypothyroidism about a new prescription for the patient feels she can take half of a prescribed medication.
levothyroxine. Which statement by the patient indicates a
need for further teaching?
a. "I should not take heartburn medication without
consulting my provider first."
b. "I should report insomnia, tremors, and an increased
heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours
after the levothyroxine."
d. "If I take calcium supplements, I may need to decrease
my dose of levothyroxine."
understanding of business principles.1.4. Preparing for Business ExamsPreparing for business exams involves mastering both conceptual
understanding and practical application. Students are encouraged to study theories and frameworks but also to keep up-to-date
, MC has undiagnosed multiple gastric ulcers. Shortly after I would accept Alka-Selzer. I contains NaHCO3 (as well as ASA). In the presence
consuming a large meal and alcohol he experiences of HCL it Liberates CO2, that can cause gastric distention, belching and nausea.
significant GI distress. He takes an OTC heartburn The reaction is fairly swift allowing little time for dissipation. Tums, its primary
remedy. Within a minute or two he develops what he will ingredient calcium carbonate which when taken cause a reaction with the
later describe as "belching, nausea and a bad bloated stomach acid such as production of carbon dioxide gas which can cause bloating
feeling". Several of the ulcers began to bleed and he and the stomach to stretch to tear the ulcers open.
becomes profoundly hypotensive from the blood loss
and is taken to the ED. Endoscopy confirms multiple
bleeds; the endoscopist remarks that it appears as if the
lesions had been literally stretched apart causing
additional tissue damage. What did the patient most likely
take (i.e. what was the OTC remedy)?
On your way to this examination, you experience the Loperamide
vulnerable feeling that an attack of acute diarrhea is
imminent! If you stop at a drug store, which anti-diarrheal
drugs could you buy without a prescription even though
it is chemically related to the strong opioid analgesic
meperidine (but acts only on the peripheral opioid
receptor)?
JA has multiple medical problems and is taking several Cimetidine
drugs including theophylline, warfarin and phenytoin. His
conditions were well controlled, but recently he started
to experience some GI distress for which of his "well
intentioned friends" gave him some medication. He
presents to you with toxic effects of all his other
medications and plasma levels of those medications
elevated. What was most likely the medication he took?
What lifestyle modifications should be recommended? -losing weight if overweight
-elevating head of bed while asleep
-eating smaller meals
-avoid foods/meds that exacerbate gerd
-stop smoking
-stop drinking alcohol
What medications / foods can contribute to GERD? -Medications: anticholinergics, barbituates, dopamine, estrogen, opioids,
progesterone, theophylline, nitrates
-Foods: cirus fruits/juices, coffee, tomatoes, spicy food, carbonated drinks
Fried/fatty foods, garlic, onions, chocolate
What is the most effective PPI or H2RA within each of -PPI- bismuth quadruple therapy combined with proton pump inhibitors
these classes? -H2RA- Famotidine 80mg
Other products such as antacids are also available. What -Reflux symptoms <2 times a week (infrequent)
are some of these and what is their place in therapy? -Effective for immediate relief
-Magnesium/Aluminum Hydroxide (Maalox)- can cause constipation
-Alginic Acid
understanding of business principles.1.4. Preparing for Business ExamsPreparing for business exams involves mastering both conceptual
understanding and practical application. Students are encouraged to study theories and frameworks but also to keep up-to-date
Questions & Answers | Latest Already Graded A+
UPDATE|2026!! STUDY GUIDE EXAM Advanced
Pharmacology NSG 533
understanding of business principles.1.4. Preparing for Business ExamsPreparing for business exams involves mastering both conceptual understanding and practical application. Students are
encouraged to study theories and frameworks but also to keep up-to-date
Leave the first rating
Save
Students also studied
Advanced Pharmacology midterm 4 NSG52
terms terms term
Preview Preview PaintedR0se Preview Pai
C
Terms in this set (86)
EP is a 38-year-old female patient that comes in for Exenatide - Exenatide (Bydureon) once weekly has been able to demonstrate
diabetes education and management. She was diagnosed weight loss and decrease A1C% by 0.7% to 1.2% in clinical trials; however it is
12 years ago and states lately she is not able to control contraindicated for EP due to the self-reported history of thyroid cancer.
her diet although she continues a 1600 calorie diet with Dapagliflozin - Dapagliflozin (Farxiga) is contraindicated in this patient due to
appropriate daily carbohydrate intake (per dietitian hyperkalemia which could be made worse by this drug. The package insert does
prescription) and walks 40 minutes every day of the not indicate a specific potassium concentration cut off to no longer use this
week. She states compliance with all medications. She medication; however, there are better choices in this patient.
denies any history of hypoglycemia despite being able to Sitagliptin - Sitagliptin (Januvia) is able to obtain an A1C goal of less than 7%
identify signs and symptoms and describe appropriate based on clinical trials and currently the patient does not have any cautionary
treatment strategies. objective measures to not use this medication. DPP-IV inhibitors are weight
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomy neutral. DPP-IV inhibitors can be used in patients taking sulfonylureas; however, it
due to thyroid cancer may be recommended to reduce or stop the sulfonylurea dose.
FmHx: Noncontributory Acarbose - Acarbose (Precose) is not recommended for initial management and
SHx: (−) Smoking, alcohol use, past marijuana use while in is associated with significant GI side effects. More information would be needed
high school regarding fasting and post-prandial numbers. In addition, adding acarbose would
Medications: Metformin 850 mg tid, glipizide 20 mg bid, only lower A1c by 0.8% at best and therefore would not achieve the desired A1C
lisinopril 20 mg daily, sertraline 100 mg daily, multivitamin goal of <7%
daily
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl 106
mEq/L, BUN
, JR is a 68-year-old African American man with a new Metformin is the drug of choice recommended for most patients with diabetes in
diagnosis of T2DM. He was classified as having addition to lifestyle modifications assuming no contraindications or intolerabilities
prediabetes (at risk for developing diabetes) 5 years are present upon evaluation. Metformin has also shown to provide positive weight
before the diagnosis and has a strong family history of neutral/loss effects in obese patients. It is crucial to know the renal status of
type 2 diabetes. JR's blood pressure was 150/92 mm Hg. patients commencing metformin therapy to limit the risk of lactic acidosis (JR is
His laboratory results revealed an A1C of 8.1%, normal without contraindication).
cholesterol panel, and normal renal/hepatic function Since his entry A1C is >7.5%, dual therapy is indicated. There are several potential
were noted with today's laboratory test results. choices. The second step can be a dipeptidyl peptidase-4 inhibitor, it can be a
Past medical history: Hypertension (diagnosed 4 y ago) glucagon-like peptide-1 (GLP-1) receptor agonist, it can be a TZD, it can be a
Hyperlipidemia (diagnosed 2 y ago) Pancreatitis sulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal insulin.
(idiopathic) (acute hospitalization 3 y ago) Anything next can be tried depending on what suits the circumstance
Family history: Type 2 diabetes DPP4 inhibitors are weight neutral bet relatively benign side effect profile.
Medication: HCTZ 25 mg daily, simvastatin 10 mg daily Sitagliptin has been associated with case reports of pancreatitis, so this specific
Allergies: SMZ/TMP agent should be avoided. $$$
Vitals: BP: 150/92 mm Hg P: 78 beats/min RR: 12 rpm Waist GLP-1 analog and has data to support an A1C reduction necessary to gain
Circumference: 46 in Weight: 267 lb Height: 5 ′ 6 ″ BMI: glycemic control and may assist with weight loss goals for this patient. New
43.1 kg/m 2 information suggests these agents may provide benefits in those with ASCVD. JR
has a past history of pancreatitis and GLP-1 analogs are not recommended due to
this contraindication
Despite improvements in the past six weeks due to TZDs have data to support an A1C reduction necessary to gain glycemic control,
lifestyle changes and exercise, drug therapy is to be but are associated with weight gain, negative effects on lipids and increased risk
started for JR's diabet of fracture. Until recently, TZDs have also been linked to increased CV events and
use has fallen out of favor
Sulfonylureas provide excellent A1C lowering, but are also associated with weight
gain. They also have the potential to cause hypoglycemia, so patient education is
crucial. Because of his allergies to "sulfa", use would be contr
A patient with type 1 diabetes reports taking propranolol A patient with Type 1 DM is insulin dependent for glucose control and at high risk
for hypertension. What concern does this information for hypoglycemic episodes. Propanolol causes prolonged hypoglycemic
present for the provider? episodes. Needs to switch to ACE or ARB.
A provider teaches a patient who has been diagnosed D. Calcium may reduce levothyroxine absorption. Further education is needed if
with hypothyroidism about a new prescription for the patient feels she can take half of a prescribed medication.
levothyroxine. Which statement by the patient indicates a
need for further teaching?
a. "I should not take heartburn medication without
consulting my provider first."
b. "I should report insomnia, tremors, and an increased
heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours
after the levothyroxine."
d. "If I take calcium supplements, I may need to decrease
my dose of levothyroxine."
understanding of business principles.1.4. Preparing for Business ExamsPreparing for business exams involves mastering both conceptual
understanding and practical application. Students are encouraged to study theories and frameworks but also to keep up-to-date
, MC has undiagnosed multiple gastric ulcers. Shortly after I would accept Alka-Selzer. I contains NaHCO3 (as well as ASA). In the presence
consuming a large meal and alcohol he experiences of HCL it Liberates CO2, that can cause gastric distention, belching and nausea.
significant GI distress. He takes an OTC heartburn The reaction is fairly swift allowing little time for dissipation. Tums, its primary
remedy. Within a minute or two he develops what he will ingredient calcium carbonate which when taken cause a reaction with the
later describe as "belching, nausea and a bad bloated stomach acid such as production of carbon dioxide gas which can cause bloating
feeling". Several of the ulcers began to bleed and he and the stomach to stretch to tear the ulcers open.
becomes profoundly hypotensive from the blood loss
and is taken to the ED. Endoscopy confirms multiple
bleeds; the endoscopist remarks that it appears as if the
lesions had been literally stretched apart causing
additional tissue damage. What did the patient most likely
take (i.e. what was the OTC remedy)?
On your way to this examination, you experience the Loperamide
vulnerable feeling that an attack of acute diarrhea is
imminent! If you stop at a drug store, which anti-diarrheal
drugs could you buy without a prescription even though
it is chemically related to the strong opioid analgesic
meperidine (but acts only on the peripheral opioid
receptor)?
JA has multiple medical problems and is taking several Cimetidine
drugs including theophylline, warfarin and phenytoin. His
conditions were well controlled, but recently he started
to experience some GI distress for which of his "well
intentioned friends" gave him some medication. He
presents to you with toxic effects of all his other
medications and plasma levels of those medications
elevated. What was most likely the medication he took?
What lifestyle modifications should be recommended? -losing weight if overweight
-elevating head of bed while asleep
-eating smaller meals
-avoid foods/meds that exacerbate gerd
-stop smoking
-stop drinking alcohol
What medications / foods can contribute to GERD? -Medications: anticholinergics, barbituates, dopamine, estrogen, opioids,
progesterone, theophylline, nitrates
-Foods: cirus fruits/juices, coffee, tomatoes, spicy food, carbonated drinks
Fried/fatty foods, garlic, onions, chocolate
What is the most effective PPI or H2RA within each of -PPI- bismuth quadruple therapy combined with proton pump inhibitors
these classes? -H2RA- Famotidine 80mg
Other products such as antacids are also available. What -Reflux symptoms <2 times a week (infrequent)
are some of these and what is their place in therapy? -Effective for immediate relief
-Magnesium/Aluminum Hydroxide (Maalox)- can cause constipation
-Alginic Acid
understanding of business principles.1.4. Preparing for Business ExamsPreparing for business exams involves mastering both conceptual
understanding and practical application. Students are encouraged to study theories and frameworks but also to keep up-to-date
