& PHARMACOLOGY EXAM AND
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180 Questions with Answers and Detailed Rationales
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NRSG 2350 PATHOPHYSIOLOGY & PHARMACOLOGY EXAM AND CORRECT ANSWERS WITH
RATIONALES.PDF. It contains 180 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.
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identify areas requiring further question format and content
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Review Summary 180 Questions
Foundations - Application - NRSG 2350 Pathophysiology & Pharmacology AND Correct WITH Rationales
PDF Pathophysiology & Pharmacology Undergraduate YEAR 3
All answers with rationales
,Table of Contents
Section A - Mechanism Section B - Prescribed
Questions 1 to 45 Questions 46 to 90
Section C - Chronic Section D - Heart
Questions 91 to 135 Questions 136 to 180
,Section A - Mechanism
Q1.
A patient with chronic heart failure is prescribed a beta-blocker. Which property of
beta-blockers is most critical for improving survival in this population?
A. Cardioselectivity (1 selectivity) B. Lipophilicity
C. Vasodilatory action D. Intrinsic sympathomimetic activity
Correct: C - Vasodilatory action
Rationale:Beta-blockers with vasodilatory action (e.g., carvedilol) have been shown to reduce
mortality in heart failure more than non-vasodilating agents. Cardioselectivity and lipophilicity
are less critical for survival benefit. Intrinsic sympathomimetic activity is actually detrimental in
heart failure.
Q2.
In a patient with type 2 diabetes and chronic kidney disease (eGFR 30 mL/min), which
medication class is preferred as first-line therapy to reduce cardiovascular risk and slow
CKD progression?
A. Sulfonylureas B. DPP-4 inhibitors
C. SGLT2 inhibitors D. Thiazolidinediones
Correct: C - SGLT2 inhibitors
Rationale:SGLT2 inhibitors (e.g., empagliflozin, dapagliflozin) have shown renoprotective and
cardioprotective effects in patients with diabetic kidney disease, irrespective of glycemic
control. Sulfonylureas and DPP-4 inhibitors lack these benefits. Thiazolidinediones may
cause fluid retention and are less preferred in CKD.
Q3.
A patient on warfarin develops a supratherapeutic INR of 6.5 without major bleeding. What
is the most appropriate next step?
A. Administer vitamin K 10 mg IV B. Administer fresh frozen plasma
C. Hold warfarin and administer vitamin K D. Administer prothrombin complex
1-2 mg orally concentrate
Correct: C - Hold warfarin and administer vitamin K 1-2 mg orally
Page 3
, Section A - Mechanism
Rationale: For a supratherapeutic INR without major bleeding, holding warfarin and giving
low-dose oral vitamin K is recommended per guidelines. IV vitamin K or FFP is reserved for
major bleeding. Prothrombin complex concentrate is for life-threatening bleeding.
Q4.
Which of the following mechanisms best explains the development of drug-induced lupus
erythematosus with procainamide?
A. Direct DNA damage leading to apoptosis B. Inhibition of central T-cell tolerance
C. Blockade of acetylcholine receptors D. Stimulation of anti-dsDNA antibody
production
Correct: B - Inhibition of central T-cell tolerance
Rationale:Drug-induced lupus is thought to result from inhibition of central T-cell tolerance,
allowing autoreactive T-cells to escape deletion. Procainamide and hydralazine are common
triggers. Anti-dsDNA antibodies are less common than in idiopathic SLE. Acetylcholine
receptor blockade is unrelated.
Q5.
A patient with severe sepsis and hypotension is started on norepinephrine. What is the
primary mechanism by which norepinephrine increases mean arterial pressure?
A. Activation of 2-adrenergic receptors B. Stimulation of 1-adrenergic receptors
causing bronchodilation causing vasoconstriction
C. Inhibition of phosphodiesterase D. Blockade of nitric oxide synthase
increasing cAMP in cardiac muscle reducing vasodilation
Correct: B - Stimulation of 1-adrenergic receptors causing vasoconstriction
Rationale:Norepinephrine primarily acts on ±1-adrenergic receptors on vascular smooth
muscle, causing vasoconstriction and increasing systemic vascular resistance and MAP. It
has minimal 2 effects. Phosphodiesterase inhibition is seen with milrinone, and nitric oxide
synthase blockade is not a major mechanism.
Q6.
Which of the following is the most likely cause of drug-induced QT prolongation leading
to torsades de pointes?
A. Blockade of voltage-gated sodium B. Inhibition of the hERG potassium channel
channels
C. Activation of L-type calcium channels D. Stimulation of 1-adrenergic receptors
Correct: B - Inhibition of the hERG potassium channel
Page 4