NUR 600 - ADVANCED CLINICAL PHARMACOLOGY –
(LATEST ) ACTUAL QUESTIONS & ANSWERS
WITH RATIONALES | UNIVERSITY OF ST. THOMAS
Question 1
A nurse practitioner prescribes an ACE inhibitor for a patient with hypertension and
heart failure. What is the primary mechanism of action of ACE inhibitors?
A. Blocking beta-1 receptors in the heart
B. Preventing conversion of angiotensin I to angiotensin II
C. Blocking aldosterone receptors directly
D. Increasing sodium retention in the kidneys
Correct Answer: B
Rationale:
ACE inhibitors inhibit angiotensin-converting enzyme, decreasing angiotensin II
formation. This causes vasodilation, reduced aldosterone secretion, decreased blood
pressure, and reduced cardiac workload.
Question 2
A patient taking warfarin begins therapy with trimethoprim-sulfamethoxazole. Which
laboratory value requires close monitoring?
A. Serum sodium
B. INR
C. Hemoglobin A1c
D. Thyroid-stimulating hormone
Correct Answer: B
Rationale:
Many antibiotics increase warfarin effects by reducing vitamin K production and
metabolism of warfarin, increasing bleeding risk. INR monitoring is essential.
Question 3
,A patient asks why two medications with the same dose produce different effects in
different people. The best pharmacologic explanation is:
A. All patients metabolize medications identically
B. Pharmacokinetics and pharmacodynamics vary among individuals
C. Medication response depends only on dosage
D. Drug receptors do not influence response
Correct Answer: B
Rationale:
Individual differences in absorption, distribution, metabolism, elimination, receptor
sensitivity, genetics, age, and disease states influence medication response.
Question 4
Which adverse effect should a provider monitor for in a patient taking a beta-blocker?
A. Tachycardia
B. Hypertension
C. Bradycardia
D. Hyperactivity
Correct Answer: C
Rationale:
Beta-blockers reduce sympathetic stimulation of the heart, which may cause decreased
heart rate, hypotension, fatigue, and dizziness.
Question 5
A patient taking metformin has worsening kidney function. Why should the provider
reassess this medication?
A. Metformin increases potassium levels
B. Metformin can accumulate with renal impairment
C. Metformin causes severe hypertension
D. Metformin blocks insulin receptors
Correct Answer: B
Rationale:
Metformin is eliminated through the kidneys. Reduced renal function increases risk of
accumulation and rare but serious lactic acidosis.
, Question 6
A patient receiving corticosteroid therapy for several months should be monitored for:
A. Hypoglycemia
B. Osteoporosis and hyperglycemia
C. Decreased infection risk
D. Severe bradycardia
Correct Answer: B
Rationale:
Long-term corticosteroids increase glucose levels, suppress immune function, and
contribute to bone loss.
Question 7
Which medication class is considered first-line therapy for many patients with type 2
diabetes?
A. Metformin
B. Insulin only
C. Sulfonamides
D. Corticosteroids
Correct Answer: A
Rationale:
Metformin is commonly recommended as initial pharmacologic therapy because it
decreases hepatic glucose production and improves insulin sensitivity.
Question 8
A patient taking an SSRI reports agitation, fever, sweating, and muscle rigidity. The
provider should suspect:
A. Hypoglycemia
B. Serotonin syndrome
C. Renal failure
D. Anticholinergic toxicity
Correct Answer: B
(LATEST ) ACTUAL QUESTIONS & ANSWERS
WITH RATIONALES | UNIVERSITY OF ST. THOMAS
Question 1
A nurse practitioner prescribes an ACE inhibitor for a patient with hypertension and
heart failure. What is the primary mechanism of action of ACE inhibitors?
A. Blocking beta-1 receptors in the heart
B. Preventing conversion of angiotensin I to angiotensin II
C. Blocking aldosterone receptors directly
D. Increasing sodium retention in the kidneys
Correct Answer: B
Rationale:
ACE inhibitors inhibit angiotensin-converting enzyme, decreasing angiotensin II
formation. This causes vasodilation, reduced aldosterone secretion, decreased blood
pressure, and reduced cardiac workload.
Question 2
A patient taking warfarin begins therapy with trimethoprim-sulfamethoxazole. Which
laboratory value requires close monitoring?
A. Serum sodium
B. INR
C. Hemoglobin A1c
D. Thyroid-stimulating hormone
Correct Answer: B
Rationale:
Many antibiotics increase warfarin effects by reducing vitamin K production and
metabolism of warfarin, increasing bleeding risk. INR monitoring is essential.
Question 3
,A patient asks why two medications with the same dose produce different effects in
different people. The best pharmacologic explanation is:
A. All patients metabolize medications identically
B. Pharmacokinetics and pharmacodynamics vary among individuals
C. Medication response depends only on dosage
D. Drug receptors do not influence response
Correct Answer: B
Rationale:
Individual differences in absorption, distribution, metabolism, elimination, receptor
sensitivity, genetics, age, and disease states influence medication response.
Question 4
Which adverse effect should a provider monitor for in a patient taking a beta-blocker?
A. Tachycardia
B. Hypertension
C. Bradycardia
D. Hyperactivity
Correct Answer: C
Rationale:
Beta-blockers reduce sympathetic stimulation of the heart, which may cause decreased
heart rate, hypotension, fatigue, and dizziness.
Question 5
A patient taking metformin has worsening kidney function. Why should the provider
reassess this medication?
A. Metformin increases potassium levels
B. Metformin can accumulate with renal impairment
C. Metformin causes severe hypertension
D. Metformin blocks insulin receptors
Correct Answer: B
Rationale:
Metformin is eliminated through the kidneys. Reduced renal function increases risk of
accumulation and rare but serious lactic acidosis.
, Question 6
A patient receiving corticosteroid therapy for several months should be monitored for:
A. Hypoglycemia
B. Osteoporosis and hyperglycemia
C. Decreased infection risk
D. Severe bradycardia
Correct Answer: B
Rationale:
Long-term corticosteroids increase glucose levels, suppress immune function, and
contribute to bone loss.
Question 7
Which medication class is considered first-line therapy for many patients with type 2
diabetes?
A. Metformin
B. Insulin only
C. Sulfonamides
D. Corticosteroids
Correct Answer: A
Rationale:
Metformin is commonly recommended as initial pharmacologic therapy because it
decreases hepatic glucose production and improves insulin sensitivity.
Question 8
A patient taking an SSRI reports agitation, fever, sweating, and muscle rigidity. The
provider should suspect:
A. Hypoglycemia
B. Serotonin syndrome
C. Renal failure
D. Anticholinergic toxicity
Correct Answer: B
