NURS 6521 WEEK 5 STUDY GUIDE
QUESTIONS
LATEST MOCK PRACTICE SET
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NURS 6521 WEEK 5 STUDY GUIDE QUESTIONS. It contains 190 carefully selected questions that reflect the
most current exam content and testing strategies. Each question is accompanied by a correct answer and a
detailed rationale that explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NURS 6521 WEEK 5 Study Guide NURS 6521 WEEK 5 Study Guide University
All answers with rationales
,Table of Contents
Section A - Pharmacokinetics AND Section B - DRUG Interactions AND
Pharmacodynamics Adverse Effects
Questions 1 to 48 Questions 49 to 96
Section C - Medication Administration Section D - PAIN Management AND
AND Safety Analgesics
Questions 97 to 144 Questions 145 to 190
,Section A - Pharmacokinetics AND Pharmacodynamics
Q1.
A patient with type 2 diabetes and stage 3 chronic kidney disease (eGFR 35 mL/min) is
prescribed metformin. Which pharmacodynamic consideration is most critical before
initiating therapy?
A. Metformin increases hepatic B. Metformin is primarily excreted
gluconeogenesis, worsening hyperglycemia. unchanged by the kidneys, increasing risk of
lactic acidosis.
C. Metformin requires dose adjustment only D. Metformin stimulates insulin secretion
when eGFR falls below 15 mL/min. from pancreatic beta cells.
Correct: B - Metformin is primarily excreted unchanged by the kidneys, increasing risk of
lactic acidosis.
Rationale:Metformin is contraindicated when eGFR <30 mL/min and should be used with
caution at 30-45 mL/min due to accumulation and lactic acidosis risk. Option A is false
(metformin decreases gluconeogenesis). Option C is incorrect because current guidelines
recommend reassessing at eGFR <45. Option D describes sulfonylureas, not metformin.
Q2.
A patient on warfarin for atrial fibrillation develops an INR of 5.2 without bleeding. Which
intervention aligns with current anticoagulation reversal guidelines?
A. Administer vitamin K 10 mg intravenously B. Administer fresh frozen plasma (FFP) 15
and repeat INR in 6 hours. mL/kg immediately.
C. Hold warfarin and give vitamin K 1-2 mg D. Administer prothrombin complex
orally. concentrate (PCC) 50 units/kg.
Correct: C - Hold warfarin and give vitamin K 1-2 mg orally.
Rationale:For supratherapeutic INR (4.5-10) without bleeding, guidelines recommend holding
warfarin and giving low-dose oral vitamin K (1-2.5 mg). Option A (IV 10 mg) is for major
bleeding. FFP (B) and PCC (D) are reserved for life-threatening bleeding or emergency
reversal.
Q3.
A patient with heart failure with reduced ejection fraction (HFrEF) is started on
sacubitril/valsartan. Which laboratory monitoring is most essential within the first month?
A. Serum potassium and renal function. B. Liver transaminases and bilirubin.
C. Hemoglobin A1c and fasting glucose. D. Thyroid-stimulating hormone and free T4.
Page 3
, Section A - Pharmacokinetics AND Pharmacodynamics
Correct: A - Serum potassium and renal function.
Rationale:Sacubitril/valsartan, an ARNI, can cause hyperkalemia and acute kidney injury,
especially in patients with preexisting renal impairment or on potassium-sparing diuretics.
Monitoring potassium and creatinine is standard. Liver function (B) is not a primary concern.
Glucose (C) and thyroid (D) are unrelated.
Q4.
Which drug-drug interaction mechanism explains the reduced efficacy of oral
contraceptives when coadministered with rifampin?
A. Rifampin inhibits the metabolism of B. Rifampin induces the metabolism of
ethinyl estradiol via CYP3A4. ethinyl estradiol via CYP3A4.
C. Rifampin increases the protein binding of D. Rifampin competes with ethinyl estradiol
ethinyl estradiol. for renal tubular secretion.
Correct: B - Rifampin induces the metabolism of ethinyl estradiol via CYP3A4.
Rationale:Rifampin is a potent inducer of CYP3A4, accelerating the metabolism of ethinyl
estradiol and reducing its plasma concentration, leading to contraceptive failure. Option A
(inhibition) would increase efficacy. Options C and D are not clinically relevant for this
interaction.
Q5.
A patient on lithium for bipolar disorder develops polyuria and polydipsia after 6 months
of therapy. What is the most likely mechanism?
A. Lithium-induced nephrogenic diabetes B. Lithium-induced central diabetes
insipidus due to downregulation of insipidus due to decreased ADH secretion.
aquaporin-2 channels.
C. Lithium-induced osmotic diuresis from D. Lithium-induced hypercalcemia causing
increased serum osmolality. polyuria.
Correct: A - Lithium-induced nephrogenic diabetes insipidus due to downregulation of
aquaporin-2 channels.
Rationale:Lithium commonly causes nephrogenic diabetes insipidus by interfering with
ADH-mediated water reabsorption (downregulating aquaporin-2). Central DI (B) involves
pituitary ADH deficiency, not lithium's effect. Osmotic diuresis (C) is not typical.
Hypercalcemia (D) can cause polyuria but is less common with lithium.
Q6.
A patient on long-term omeprazole for GERD develops iron deficiency anemia. Which
pharmacokinetic mechanism is most responsible?
Page 4
QUESTIONS
LATEST MOCK PRACTICE SET
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NURS 6521 WEEK 5 STUDY GUIDE QUESTIONS. It contains 190 carefully selected questions that reflect the
most current exam content and testing strategies. Each question is accompanied by a correct answer and a
detailed rationale that explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NURS 6521 WEEK 5 Study Guide NURS 6521 WEEK 5 Study Guide University
All answers with rationales
,Table of Contents
Section A - Pharmacokinetics AND Section B - DRUG Interactions AND
Pharmacodynamics Adverse Effects
Questions 1 to 48 Questions 49 to 96
Section C - Medication Administration Section D - PAIN Management AND
AND Safety Analgesics
Questions 97 to 144 Questions 145 to 190
,Section A - Pharmacokinetics AND Pharmacodynamics
Q1.
A patient with type 2 diabetes and stage 3 chronic kidney disease (eGFR 35 mL/min) is
prescribed metformin. Which pharmacodynamic consideration is most critical before
initiating therapy?
A. Metformin increases hepatic B. Metformin is primarily excreted
gluconeogenesis, worsening hyperglycemia. unchanged by the kidneys, increasing risk of
lactic acidosis.
C. Metformin requires dose adjustment only D. Metformin stimulates insulin secretion
when eGFR falls below 15 mL/min. from pancreatic beta cells.
Correct: B - Metformin is primarily excreted unchanged by the kidneys, increasing risk of
lactic acidosis.
Rationale:Metformin is contraindicated when eGFR <30 mL/min and should be used with
caution at 30-45 mL/min due to accumulation and lactic acidosis risk. Option A is false
(metformin decreases gluconeogenesis). Option C is incorrect because current guidelines
recommend reassessing at eGFR <45. Option D describes sulfonylureas, not metformin.
Q2.
A patient on warfarin for atrial fibrillation develops an INR of 5.2 without bleeding. Which
intervention aligns with current anticoagulation reversal guidelines?
A. Administer vitamin K 10 mg intravenously B. Administer fresh frozen plasma (FFP) 15
and repeat INR in 6 hours. mL/kg immediately.
C. Hold warfarin and give vitamin K 1-2 mg D. Administer prothrombin complex
orally. concentrate (PCC) 50 units/kg.
Correct: C - Hold warfarin and give vitamin K 1-2 mg orally.
Rationale:For supratherapeutic INR (4.5-10) without bleeding, guidelines recommend holding
warfarin and giving low-dose oral vitamin K (1-2.5 mg). Option A (IV 10 mg) is for major
bleeding. FFP (B) and PCC (D) are reserved for life-threatening bleeding or emergency
reversal.
Q3.
A patient with heart failure with reduced ejection fraction (HFrEF) is started on
sacubitril/valsartan. Which laboratory monitoring is most essential within the first month?
A. Serum potassium and renal function. B. Liver transaminases and bilirubin.
C. Hemoglobin A1c and fasting glucose. D. Thyroid-stimulating hormone and free T4.
Page 3
, Section A - Pharmacokinetics AND Pharmacodynamics
Correct: A - Serum potassium and renal function.
Rationale:Sacubitril/valsartan, an ARNI, can cause hyperkalemia and acute kidney injury,
especially in patients with preexisting renal impairment or on potassium-sparing diuretics.
Monitoring potassium and creatinine is standard. Liver function (B) is not a primary concern.
Glucose (C) and thyroid (D) are unrelated.
Q4.
Which drug-drug interaction mechanism explains the reduced efficacy of oral
contraceptives when coadministered with rifampin?
A. Rifampin inhibits the metabolism of B. Rifampin induces the metabolism of
ethinyl estradiol via CYP3A4. ethinyl estradiol via CYP3A4.
C. Rifampin increases the protein binding of D. Rifampin competes with ethinyl estradiol
ethinyl estradiol. for renal tubular secretion.
Correct: B - Rifampin induces the metabolism of ethinyl estradiol via CYP3A4.
Rationale:Rifampin is a potent inducer of CYP3A4, accelerating the metabolism of ethinyl
estradiol and reducing its plasma concentration, leading to contraceptive failure. Option A
(inhibition) would increase efficacy. Options C and D are not clinically relevant for this
interaction.
Q5.
A patient on lithium for bipolar disorder develops polyuria and polydipsia after 6 months
of therapy. What is the most likely mechanism?
A. Lithium-induced nephrogenic diabetes B. Lithium-induced central diabetes
insipidus due to downregulation of insipidus due to decreased ADH secretion.
aquaporin-2 channels.
C. Lithium-induced osmotic diuresis from D. Lithium-induced hypercalcemia causing
increased serum osmolality. polyuria.
Correct: A - Lithium-induced nephrogenic diabetes insipidus due to downregulation of
aquaporin-2 channels.
Rationale:Lithium commonly causes nephrogenic diabetes insipidus by interfering with
ADH-mediated water reabsorption (downregulating aquaporin-2). Central DI (B) involves
pituitary ADH deficiency, not lithium's effect. Osmotic diuresis (C) is not typical.
Hypercalcemia (D) can cause polyuria but is less common with lithium.
Q6.
A patient on long-term omeprazole for GERD develops iron deficiency anemia. Which
pharmacokinetic mechanism is most responsible?
Page 4
