,UTA CP2 NURS 5338 final
Question 1
A 58-year-old female with hypertension and diabetes is prescribed
lisinopril. She develops a persistent dry cough. What is the mechanism of
this adverse effect?
A. Increased bradykinin levels
B. Increased angiotensin II levels
C. Decreased aldosterone secretion
D. Increased prostaglandin synthesis
Correct Answer: A. Increased bradykinin levels
Rationale: ACE inhibitors like lisinopril inhibit the breakdown of bradykinin,
leading to its accumulation. Bradykinin causes bronchial hyperreactivity and
a characteristic dry cough. This effect is not seen with ARBs, making them a
suitable alternative.
Question 2
A 72-year-old male with heart failure and preserved ejection fraction is
started on spironolactone. Which laboratory value requires close
monitoring?
A. Serum sodium
B. Serum potassium
C. Serum magnesium
D. Serum calcium
Correct Answer: B. Serum potassium
,Rationale: Spironolactone is a potassium-sparing diuretic that blocks
aldosterone receptors. It can cause hyperkalemia, especially in patients with
renal impairment, diabetes, or those taking ACE inhibitors/ARBs. Potassium
levels should be monitored regularly.
Question 3
A patient with bipolar disorder is prescribed lithium. Which baseline test is
essential before initiating therapy?
A. Thyroid function tests and renal function tests
B. Liver function tests
C. Complete blood count
D. Electrocardiogram
Correct Answer: A. Thyroid function tests and renal function tests
Rationale: Lithium can cause hypothyroidism and nephrogenic diabetes
insipidus. Baseline thyroid and renal function tests are essential, with periodic
monitoring during therapy. Lithium has a narrow therapeutic index and
requires serum level monitoring.
Question 4
A 65-year-old male with benign prostatic hyperplasia is started on
tamsulosin. What adverse effect should the patient be educated about?
A. Orthostatic hypotension
B. Urinary retention
C. Gynecomastia
D. Bradycardia
Correct Answer: A. Orthostatic hypotension
, Rationale: Tamsulosin is an alpha-1 blocker that causes vasodilation, leading
to orthostatic hypotension, especially with the first dose or dose increase.
Patients should be advised to take it at bedtime and rise slowly from sitting
or lying positions.
Question 5
A patient with type 2 diabetes is started on dapagliflozin. What is the
mechanism of action?
A. Increases insulin secretion
B. Reduces hepatic glucose production
C. Blocks glucose reabsorption in the proximal renal tubule
D. Increases GLP-1 levels
Correct Answer: C. Blocks glucose reabsorption in the proximal renal
tubule
Rationale: Dapagliflozin is an SGLT2 inhibitor that blocks sodium-glucose
cotransporter 2 in the proximal renal tubule, reducing glucose reabsorption
and increasing urinary glucose excretion. It also offers cardiovascular and
renal protective benefits.
Question 6
A 45-year-old female with rheumatoid arthritis is started on methotrexate.
Which supplement should be co-prescribed to reduce toxicity?
A. Vitamin B12
B. Folic acid
C. Vitamin D
D. Iron
Question 1
A 58-year-old female with hypertension and diabetes is prescribed
lisinopril. She develops a persistent dry cough. What is the mechanism of
this adverse effect?
A. Increased bradykinin levels
B. Increased angiotensin II levels
C. Decreased aldosterone secretion
D. Increased prostaglandin synthesis
Correct Answer: A. Increased bradykinin levels
Rationale: ACE inhibitors like lisinopril inhibit the breakdown of bradykinin,
leading to its accumulation. Bradykinin causes bronchial hyperreactivity and
a characteristic dry cough. This effect is not seen with ARBs, making them a
suitable alternative.
Question 2
A 72-year-old male with heart failure and preserved ejection fraction is
started on spironolactone. Which laboratory value requires close
monitoring?
A. Serum sodium
B. Serum potassium
C. Serum magnesium
D. Serum calcium
Correct Answer: B. Serum potassium
,Rationale: Spironolactone is a potassium-sparing diuretic that blocks
aldosterone receptors. It can cause hyperkalemia, especially in patients with
renal impairment, diabetes, or those taking ACE inhibitors/ARBs. Potassium
levels should be monitored regularly.
Question 3
A patient with bipolar disorder is prescribed lithium. Which baseline test is
essential before initiating therapy?
A. Thyroid function tests and renal function tests
B. Liver function tests
C. Complete blood count
D. Electrocardiogram
Correct Answer: A. Thyroid function tests and renal function tests
Rationale: Lithium can cause hypothyroidism and nephrogenic diabetes
insipidus. Baseline thyroid and renal function tests are essential, with periodic
monitoring during therapy. Lithium has a narrow therapeutic index and
requires serum level monitoring.
Question 4
A 65-year-old male with benign prostatic hyperplasia is started on
tamsulosin. What adverse effect should the patient be educated about?
A. Orthostatic hypotension
B. Urinary retention
C. Gynecomastia
D. Bradycardia
Correct Answer: A. Orthostatic hypotension
, Rationale: Tamsulosin is an alpha-1 blocker that causes vasodilation, leading
to orthostatic hypotension, especially with the first dose or dose increase.
Patients should be advised to take it at bedtime and rise slowly from sitting
or lying positions.
Question 5
A patient with type 2 diabetes is started on dapagliflozin. What is the
mechanism of action?
A. Increases insulin secretion
B. Reduces hepatic glucose production
C. Blocks glucose reabsorption in the proximal renal tubule
D. Increases GLP-1 levels
Correct Answer: C. Blocks glucose reabsorption in the proximal renal
tubule
Rationale: Dapagliflozin is an SGLT2 inhibitor that blocks sodium-glucose
cotransporter 2 in the proximal renal tubule, reducing glucose reabsorption
and increasing urinary glucose excretion. It also offers cardiovascular and
renal protective benefits.
Question 6
A 45-year-old female with rheumatoid arthritis is started on methotrexate.
Which supplement should be co-prescribed to reduce toxicity?
A. Vitamin B12
B. Folic acid
C. Vitamin D
D. Iron
