NURS 6521N Exam 2 V1 | NURS 6521N
Advanced Pharmacology | Actual Q&A
with Rationale (NURS6521N Exam 2) |
Walden University
1. A 55-year-old patient is started on Lisinopril for hypertension. Which electrolyte
abnormality should the nurse practitioner monitor most closely?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
D. Hypomagnesemia
Answer: B
Rationale: ACE inhibitors like Lisinopril reduce the secretion of aldosterone by blocking
the conversion of Angiotensin I to Angiotensin II. This reduction in aldosterone leads to
potassium retention in the kidneys. Consequently, patients must be monitored for
hyperkalemia, especially if they are also taking potassium supplements or potassium-
sparing diuretics.
2. A patient with chronic obstructive pulmonary disease (COPD) is prescribed Tiotropium.
What is the mechanism of action of this medication?
A. Anticholinergic antagonist at muscarinic receptors
,B. Beta-2 adrenergic agonist
C. Inhaled corticosteroid
D. Leukotriene receptor antagonist
Answer: A
Rationale: Tiotropium is a long-acting antimuscarinic agent (LAMA) that works by
blocking M3 muscarinic receptors in the smooth muscle of the airways. This action
prevents acetylcholine from binding, thereby causing bronchodilation. It is primarily used
for the long-term maintenance treatment of bronchospasm associated with COPD.
3. When prescribing Warfarin for a patient with atrial fibrillation, which lab value is used to
adjust the dosage?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Rationale: The International Normalized Ratio (INR) is the standard metric used to
monitor the effectiveness of Warfarin therapy. It provides a consistent measurement across
different laboratories regardless of the thromboplastin reagent used. For most patients
with atrial fibrillation, the therapeutic goal is an INR between 2.0 and 3.0.
, 4. A patient is admitted with a deep vein thrombosis and started on a Heparin infusion.
Which medication should be readily available in case of life-threatening bleeding?
A. Vitamin K
B. Aminocaproic acid
C. Protamine sulfate
D. Idarucizumab
Answer: C
Rationale: Protamine sulfate is the specific reversal agent for Heparin-induced
anticoagulation. It works by forming a stable salt complex with the strongly acidic heparin
molecule, neutralizing its anticoagulant effects. Nurses must monitor for bradycardia and
hypotension during rapid administration of this antidote.
5. A patient taking Atorvastatin for hyperlipidemia reports new-onset muscle pain and
weakness. Which laboratory test is the priority?
A. Creatine Kinase (CK) level
B. Alkaline phosphatase
C. Serum albumin
D. Blood Urea Nitrogen (BUN)
Answer: A
Advanced Pharmacology | Actual Q&A
with Rationale (NURS6521N Exam 2) |
Walden University
1. A 55-year-old patient is started on Lisinopril for hypertension. Which electrolyte
abnormality should the nurse practitioner monitor most closely?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
D. Hypomagnesemia
Answer: B
Rationale: ACE inhibitors like Lisinopril reduce the secretion of aldosterone by blocking
the conversion of Angiotensin I to Angiotensin II. This reduction in aldosterone leads to
potassium retention in the kidneys. Consequently, patients must be monitored for
hyperkalemia, especially if they are also taking potassium supplements or potassium-
sparing diuretics.
2. A patient with chronic obstructive pulmonary disease (COPD) is prescribed Tiotropium.
What is the mechanism of action of this medication?
A. Anticholinergic antagonist at muscarinic receptors
,B. Beta-2 adrenergic agonist
C. Inhaled corticosteroid
D. Leukotriene receptor antagonist
Answer: A
Rationale: Tiotropium is a long-acting antimuscarinic agent (LAMA) that works by
blocking M3 muscarinic receptors in the smooth muscle of the airways. This action
prevents acetylcholine from binding, thereby causing bronchodilation. It is primarily used
for the long-term maintenance treatment of bronchospasm associated with COPD.
3. When prescribing Warfarin for a patient with atrial fibrillation, which lab value is used to
adjust the dosage?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Rationale: The International Normalized Ratio (INR) is the standard metric used to
monitor the effectiveness of Warfarin therapy. It provides a consistent measurement across
different laboratories regardless of the thromboplastin reagent used. For most patients
with atrial fibrillation, the therapeutic goal is an INR between 2.0 and 3.0.
, 4. A patient is admitted with a deep vein thrombosis and started on a Heparin infusion.
Which medication should be readily available in case of life-threatening bleeding?
A. Vitamin K
B. Aminocaproic acid
C. Protamine sulfate
D. Idarucizumab
Answer: C
Rationale: Protamine sulfate is the specific reversal agent for Heparin-induced
anticoagulation. It works by forming a stable salt complex with the strongly acidic heparin
molecule, neutralizing its anticoagulant effects. Nurses must monitor for bradycardia and
hypotension during rapid administration of this antidote.
5. A patient taking Atorvastatin for hyperlipidemia reports new-onset muscle pain and
weakness. Which laboratory test is the priority?
A. Creatine Kinase (CK) level
B. Alkaline phosphatase
C. Serum albumin
D. Blood Urea Nitrogen (BUN)
Answer: A
