, NR 565 Advanced Pharmacology
Midterm Exam (2026/2027) Questions
with Answers & Detailed Rationales
Question 1
A 68-year-old client with hypertension and diabetes is
prescribed lisinopril. Which laboratory value should be
monitored most closely after initiation?
A. Serum potassium and creatinine
B. Hemoglobin A1c
C. Platelet count
D. Serum calcium
Correct Answer: A
Rationale:
ACE inhibitors can increase serum potassium and may cause a
transient rise in serum creatinine. Baseline and follow-up renal
function and potassium should be monitored, particularly in
patients with chronic kidney disease or those taking potassium-
sparing medications.
Question 2
A client taking warfarin is prescribed trimethoprim-
sulfamethoxazole. Which nursing action is most appropriate?
,A. Monitor closely for bleeding and notify the prescriber about
the potential interaction.
B. Double the warfarin dose.
C. Stop the antibiotic immediately.
D. Advise the client to increase vitamin K intake without
provider guidance.
Correct Answer: A
Rationale:
Trimethoprim-sulfamethoxazole can increase warfarin's
anticoagulant effect, raising the risk of bleeding. Additional INR
monitoring and dose adjustments may be needed.
Question 3
Which medication is considered first-line for most patients with
newly diagnosed type 2 diabetes who have no contraindications?
A. Metformin
B. Regular insulin
C. Glyburide
D. Pioglitazone
Correct Answer: A
Rationale:
Metformin is generally recommended as initial pharmacologic
therapy because it improves insulin sensitivity, lowers A1C
effectively, has a favorable safety profile, and does not usually
cause hypoglycemia when used alone.
, Question 4
Which adverse effect is most characteristic of opioid therapy?
A. Constipation
B. Hyperreflexia
C. Hypertension
D. Hyperglycemia
Correct Answer: A
Rationale:
Constipation is one of the most common opioid adverse effects
and usually persists throughout therapy. Preventive bowel
regimens are often recommended for patients receiving chronic
opioids.
Question 5
A patient receiving heparin develops sudden thrombocytopenia.
Which complication should be suspected?
A. Heparin-induced thrombocytopenia (HIT)
B. Iron-deficiency anemia
C. Disseminated candidiasis
D. Acute pancreatitis
Correct Answer: A
Midterm Exam (2026/2027) Questions
with Answers & Detailed Rationales
Question 1
A 68-year-old client with hypertension and diabetes is
prescribed lisinopril. Which laboratory value should be
monitored most closely after initiation?
A. Serum potassium and creatinine
B. Hemoglobin A1c
C. Platelet count
D. Serum calcium
Correct Answer: A
Rationale:
ACE inhibitors can increase serum potassium and may cause a
transient rise in serum creatinine. Baseline and follow-up renal
function and potassium should be monitored, particularly in
patients with chronic kidney disease or those taking potassium-
sparing medications.
Question 2
A client taking warfarin is prescribed trimethoprim-
sulfamethoxazole. Which nursing action is most appropriate?
,A. Monitor closely for bleeding and notify the prescriber about
the potential interaction.
B. Double the warfarin dose.
C. Stop the antibiotic immediately.
D. Advise the client to increase vitamin K intake without
provider guidance.
Correct Answer: A
Rationale:
Trimethoprim-sulfamethoxazole can increase warfarin's
anticoagulant effect, raising the risk of bleeding. Additional INR
monitoring and dose adjustments may be needed.
Question 3
Which medication is considered first-line for most patients with
newly diagnosed type 2 diabetes who have no contraindications?
A. Metformin
B. Regular insulin
C. Glyburide
D. Pioglitazone
Correct Answer: A
Rationale:
Metformin is generally recommended as initial pharmacologic
therapy because it improves insulin sensitivity, lowers A1C
effectively, has a favorable safety profile, and does not usually
cause hypoglycemia when used alone.
, Question 4
Which adverse effect is most characteristic of opioid therapy?
A. Constipation
B. Hyperreflexia
C. Hypertension
D. Hyperglycemia
Correct Answer: A
Rationale:
Constipation is one of the most common opioid adverse effects
and usually persists throughout therapy. Preventive bowel
regimens are often recommended for patients receiving chronic
opioids.
Question 5
A patient receiving heparin develops sudden thrombocytopenia.
Which complication should be suspected?
A. Heparin-induced thrombocytopenia (HIT)
B. Iron-deficiency anemia
C. Disseminated candidiasis
D. Acute pancreatitis
Correct Answer: A
