Pharmacology MN 553 MN553
final EXAM Part2 Gold level expert
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Course
MN 553 (PHARMACOLOGYMN553)
1. A 68-year-old patient with atrial fibrillation is prescribed apixaban. Which statement by the
patient indicates a need for further teaching?
A. "I'll report unusual bruising or bleeding."
B. "I'll tell all healthcare providers I'm taking apixaban."
C. "I'll double my next dose if I miss one."
D. "I'll avoid taking NSAIDs unless approved."
✅ Correct Answer: C. "I'll double my next dose if I miss one."
Rationale
Direct oral anticoagulants (DOACs) should not be doubled after a missed dose because doing so
increases bleeding risk. Patients should follow the specific missed-dose instructions for the
medication.
2. Which medication is the preferred first-line treatment for anaphylaxis?
A. Diphenhydramine
B. Epinephrine IM
C. Hydrocortisone
D. Albuterol
✅ Correct Answer: B. Epinephrine IM
Rationale
Intramuscular epinephrine administered into the anterolateral thigh is the first-line treatment
because it rapidly reverses airway edema, bronchospasm, and hypotension.
,3. A patient taking lisinopril develops facial swelling and difficulty swallowing. What is the
priority action?
A. Discontinue lisinopril immediately and treat as angioedema
B. Reduce the dose
C. Continue therapy
D. Add hydrochlorothiazide
✅ Correct Answer: A. Discontinue lisinopril immediately and treat as angioedema
Rationale
ACE inhibitor-induced angioedema is a potentially life-threatening adverse effect that requires
immediate discontinuation and airway evaluation.
4. Which adverse effect is most commonly associated with spironolactone?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
✅ Correct Answer: A. Hyperkalemia
Rationale
Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, increasing the risk of
elevated serum potassium.
5. Which laboratory value should be monitored most closely in patients taking
spironolactone?
A. Serum potassium
B. Hemoglobin
C. Calcium
D. Platelet count
,✅ Correct Answer: A. Serum potassium
Rationale
Hyperkalemia can lead to dangerous cardiac dysrhythmias, making potassium monitoring
essential.
6. A patient with type 2 diabetes and chronic kidney disease would benefit most from which
medication because of proven renal and cardiovascular protection?
A. Empagliflozin
B. Glyburide
C. Repaglinide
D. Acarbose
✅ Correct Answer: A. Empagliflozin
Rationale
SGLT2 inhibitors such as empagliflozin reduce progression of chronic kidney disease and lower
cardiovascular event risk in appropriate patients.
7. Which serious adverse effect should patients taking SGLT2 inhibitors be educated about?
A. Euglycemic diabetic ketoacidosis
B. Hyperthyroidism
C. Peptic ulcer disease
D. Hearing loss
✅ Correct Answer: A. Euglycemic diabetic ketoacidosis
Rationale
Patients may develop ketoacidosis despite normal or only mildly elevated glucose levels.
8. Which GLP-1 receptor agonist benefit has been consistently demonstrated?
A. Weight reduction
, B. Increased insulin resistance
C. Hyperkalemia
D. Severe hypertension
✅ Correct Answer: A. Weight reduction
Rationale
GLP-1 receptor agonists improve glycemic control while promoting weight loss and reducing
cardiovascular risk in selected patients.
9. Which medication should never be crushed because of modified-release properties?
A. Extended-release metformin
B. Vitamin C
C. Calcium carbonate
D. Acetaminophen immediate-release
✅ Correct Answer: A. Extended-release metformin
Rationale
Crushing extended-release formulations can cause dose dumping and increase adverse effects.
10. Which antihypertensive medication is contraindicated during pregnancy?
A. Losartan
B. Labetalol
C. Nifedipine
D. Methyldopa
✅ Correct Answer: A. Losartan
Rationale
ACE inhibitors and ARBs are teratogenic and should be avoided during pregnancy.
final EXAM Part2 Gold level expert
recommends
Course
MN 553 (PHARMACOLOGYMN553)
1. A 68-year-old patient with atrial fibrillation is prescribed apixaban. Which statement by the
patient indicates a need for further teaching?
A. "I'll report unusual bruising or bleeding."
B. "I'll tell all healthcare providers I'm taking apixaban."
C. "I'll double my next dose if I miss one."
D. "I'll avoid taking NSAIDs unless approved."
✅ Correct Answer: C. "I'll double my next dose if I miss one."
Rationale
Direct oral anticoagulants (DOACs) should not be doubled after a missed dose because doing so
increases bleeding risk. Patients should follow the specific missed-dose instructions for the
medication.
2. Which medication is the preferred first-line treatment for anaphylaxis?
A. Diphenhydramine
B. Epinephrine IM
C. Hydrocortisone
D. Albuterol
✅ Correct Answer: B. Epinephrine IM
Rationale
Intramuscular epinephrine administered into the anterolateral thigh is the first-line treatment
because it rapidly reverses airway edema, bronchospasm, and hypotension.
,3. A patient taking lisinopril develops facial swelling and difficulty swallowing. What is the
priority action?
A. Discontinue lisinopril immediately and treat as angioedema
B. Reduce the dose
C. Continue therapy
D. Add hydrochlorothiazide
✅ Correct Answer: A. Discontinue lisinopril immediately and treat as angioedema
Rationale
ACE inhibitor-induced angioedema is a potentially life-threatening adverse effect that requires
immediate discontinuation and airway evaluation.
4. Which adverse effect is most commonly associated with spironolactone?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
✅ Correct Answer: A. Hyperkalemia
Rationale
Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, increasing the risk of
elevated serum potassium.
5. Which laboratory value should be monitored most closely in patients taking
spironolactone?
A. Serum potassium
B. Hemoglobin
C. Calcium
D. Platelet count
,✅ Correct Answer: A. Serum potassium
Rationale
Hyperkalemia can lead to dangerous cardiac dysrhythmias, making potassium monitoring
essential.
6. A patient with type 2 diabetes and chronic kidney disease would benefit most from which
medication because of proven renal and cardiovascular protection?
A. Empagliflozin
B. Glyburide
C. Repaglinide
D. Acarbose
✅ Correct Answer: A. Empagliflozin
Rationale
SGLT2 inhibitors such as empagliflozin reduce progression of chronic kidney disease and lower
cardiovascular event risk in appropriate patients.
7. Which serious adverse effect should patients taking SGLT2 inhibitors be educated about?
A. Euglycemic diabetic ketoacidosis
B. Hyperthyroidism
C. Peptic ulcer disease
D. Hearing loss
✅ Correct Answer: A. Euglycemic diabetic ketoacidosis
Rationale
Patients may develop ketoacidosis despite normal or only mildly elevated glucose levels.
8. Which GLP-1 receptor agonist benefit has been consistently demonstrated?
A. Weight reduction
, B. Increased insulin resistance
C. Hyperkalemia
D. Severe hypertension
✅ Correct Answer: A. Weight reduction
Rationale
GLP-1 receptor agonists improve glycemic control while promoting weight loss and reducing
cardiovascular risk in selected patients.
9. Which medication should never be crushed because of modified-release properties?
A. Extended-release metformin
B. Vitamin C
C. Calcium carbonate
D. Acetaminophen immediate-release
✅ Correct Answer: A. Extended-release metformin
Rationale
Crushing extended-release formulations can cause dose dumping and increase adverse effects.
10. Which antihypertensive medication is contraindicated during pregnancy?
A. Losartan
B. Labetalol
C. Nifedipine
D. Methyldopa
✅ Correct Answer: A. Losartan
Rationale
ACE inhibitors and ARBs are teratogenic and should be avoided during pregnancy.
