NURS 617 EXAM 3
PHARMACOTHERAPEUTICS
ACTUAL EXAM 2026/2027 - 100%
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 617 EXAM 3 PHARMACOTHERAPEUTICS ACTUAL EXAM 2026/2027 - 100% VERIFIED | DETAILED
RATIONALES - PASS GUARANTEED - A+ GRADED. 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 617 3 Pharmacotherapeutics Actual 2026/2027 100 Detailed Rationales
PASS Guaranteed A Pharmacotherapeutics Graduate
All answers with rationales
,Table of Contents
Section A - Requires Section B - Prescribed
Questions 1 to 48 Questions 49 to 96
Section C - Appropriate Section D - Chronic
Questions 97 to 144 Questions 145 to 190
,Section A - Requires
Q1.
A patient with type 2 diabetes and stage 3b chronic kidney disease (eGFR 38
mL/min/1.73m²) is currently on metformin 1000 mg BID and insulin glargine. HbA1c is
8.9%. Which pharmacotherapeutic adjustment is MOST appropriate?
A. Add dapagliflozin to improve glycemic B. Increase metformin to 1500 mg BID to
control and slow CKD progression. intensify glycemic control.
C. Add pioglitazone, as it is safe in D. Switch insulin glargine to insulin degludec
advanced CKD and reduces insulin to reduce hypoglycemia risk.
resistance.
Correct: A - Add dapagliflozin to improve glycemic control and slow CKD progression.
Rationale:Dapagliflozin is preferred in T2DM with CKD (eGFR >25) due to cardiorenal
benefits; metformin dose cap at eGFR <45 is 1000 mg/day, so increasing is unsafe.
Pioglitazone can cause fluid retention and is not first-line in CKD. Insulin degludec is not the
primary issue here; adding SGLT2 inhibitor addresses both glucose and renal outcomes.
Q2.
Which pharmacokinetic principle best explains the need for dose adjustment of renally
cleared drugs in older adults, even when serum creatinine is within normal range?
A. Decreased hepatic blood flow reduces B. Decreased lean body mass lowers
first-pass metabolism. volume of distribution for hydrophilic drugs.
C. Increased body fat increases volume of D. Reduced glomerular filtration rate is not
distribution for lipophilic drugs. accurately reflected by serum creatinine due
to decreased muscle mass.
Correct: D - Reduced glomerular filtration rate is not accurately reflected by serum
creatinine due to decreased muscle mass.
Rationale:In older adults, muscle mass declines, so serum creatinine may be low despite
reduced GFR, masking renal impairment. This necessitates estimating GFR via equations like
Cockcroft-Gault or CKD-EPI. The other options describe age-related changes but do not
directly explain the creatinine discrepancy.
Q3.
A patient on warfarin for atrial fibrillation is started on amiodarone for recurrent
ventricular tachycardia. How should the warfarin dose be managed in the first week of
concurrent therapy?
Page 3
, Section A - Requires
A. Increase warfarin dose by 25% to B. Maintain the current warfarin dose and
counteract amiodarone's enzyme induction. monitor INR weekly.
C. Reduce warfarin dose by 30-50% and D. Discontinue warfarin and switch to a
monitor INR closely. direct oral anticoagulant.
Correct: C - Reduce warfarin dose by 30-50% and monitor INR closely.
Rationale:Amiodarone inhibits CYP2C9, the enzyme that metabolizes S-warfarin, leading to
increased warfarin levels and INR. The warfarin dose should be reduced by 30-50% to avoid
bleeding. Monitoring INR closely is essential; the other options either ignore the interaction or
are not the standard of care.
Q4.
A patient with heart failure with reduced ejection fraction (HFrEF) is on
sacubitril/valsartan, metoprolol succinate, and spironolactone. Which laboratory finding
requires immediate intervention?
A. Serum potassium 5.6 mEq/L B. eGFR 55 mL/min/1.73m²
C. BNP 800 pg/mL D. Blood pressure 110/70 mmHg
Correct: A - Serum potassium 5.6 mEq/L
Rationale:Hyperkalemia (K+ >5.5) is a serious adverse effect of sacubitril/valsartan and
spironolactone, increasing arrhythmia risk. Immediate intervention includes holding
spironolactone and assessing renal function. The other findings are common in HFrEF and
may be acceptable; BP 110/70 is within goal for HFrEF.
Q5.
A patient with major depressive disorder is on fluoxetine 40 mg daily. After 6 weeks,
depression symptoms are unchanged. Which strategy is MOST appropriate?
A. Add a monoamine oxidase inhibitor B. Increase fluoxetine dose to 80 mg daily.
(MAOI) to augment fluoxetine.
C. Switch to a different SSRI with a shorter D. Augment with bupropion XL 150 mg daily.
half-life.
Correct: D - Augment with bupropion XL 150 mg daily.
Rationale:Augmentation with bupropion is a common evidence-based strategy for SSRI
non-response. Adding an MAOI is contraindicated due to risk of serotonin syndrome.
Fluoxetine has a long half-life and dose 80 mg is above maximum; switching to another SSRI
may be considered but augmentation is preferred in partial response.
Page 4
PHARMACOTHERAPEUTICS
ACTUAL EXAM 2026/2027 - 100%
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 617 EXAM 3 PHARMACOTHERAPEUTICS ACTUAL EXAM 2026/2027 - 100% VERIFIED | DETAILED
RATIONALES - PASS GUARANTEED - A+ GRADED. 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 617 3 Pharmacotherapeutics Actual 2026/2027 100 Detailed Rationales
PASS Guaranteed A Pharmacotherapeutics Graduate
All answers with rationales
,Table of Contents
Section A - Requires Section B - Prescribed
Questions 1 to 48 Questions 49 to 96
Section C - Appropriate Section D - Chronic
Questions 97 to 144 Questions 145 to 190
,Section A - Requires
Q1.
A patient with type 2 diabetes and stage 3b chronic kidney disease (eGFR 38
mL/min/1.73m²) is currently on metformin 1000 mg BID and insulin glargine. HbA1c is
8.9%. Which pharmacotherapeutic adjustment is MOST appropriate?
A. Add dapagliflozin to improve glycemic B. Increase metformin to 1500 mg BID to
control and slow CKD progression. intensify glycemic control.
C. Add pioglitazone, as it is safe in D. Switch insulin glargine to insulin degludec
advanced CKD and reduces insulin to reduce hypoglycemia risk.
resistance.
Correct: A - Add dapagliflozin to improve glycemic control and slow CKD progression.
Rationale:Dapagliflozin is preferred in T2DM with CKD (eGFR >25) due to cardiorenal
benefits; metformin dose cap at eGFR <45 is 1000 mg/day, so increasing is unsafe.
Pioglitazone can cause fluid retention and is not first-line in CKD. Insulin degludec is not the
primary issue here; adding SGLT2 inhibitor addresses both glucose and renal outcomes.
Q2.
Which pharmacokinetic principle best explains the need for dose adjustment of renally
cleared drugs in older adults, even when serum creatinine is within normal range?
A. Decreased hepatic blood flow reduces B. Decreased lean body mass lowers
first-pass metabolism. volume of distribution for hydrophilic drugs.
C. Increased body fat increases volume of D. Reduced glomerular filtration rate is not
distribution for lipophilic drugs. accurately reflected by serum creatinine due
to decreased muscle mass.
Correct: D - Reduced glomerular filtration rate is not accurately reflected by serum
creatinine due to decreased muscle mass.
Rationale:In older adults, muscle mass declines, so serum creatinine may be low despite
reduced GFR, masking renal impairment. This necessitates estimating GFR via equations like
Cockcroft-Gault or CKD-EPI. The other options describe age-related changes but do not
directly explain the creatinine discrepancy.
Q3.
A patient on warfarin for atrial fibrillation is started on amiodarone for recurrent
ventricular tachycardia. How should the warfarin dose be managed in the first week of
concurrent therapy?
Page 3
, Section A - Requires
A. Increase warfarin dose by 25% to B. Maintain the current warfarin dose and
counteract amiodarone's enzyme induction. monitor INR weekly.
C. Reduce warfarin dose by 30-50% and D. Discontinue warfarin and switch to a
monitor INR closely. direct oral anticoagulant.
Correct: C - Reduce warfarin dose by 30-50% and monitor INR closely.
Rationale:Amiodarone inhibits CYP2C9, the enzyme that metabolizes S-warfarin, leading to
increased warfarin levels and INR. The warfarin dose should be reduced by 30-50% to avoid
bleeding. Monitoring INR closely is essential; the other options either ignore the interaction or
are not the standard of care.
Q4.
A patient with heart failure with reduced ejection fraction (HFrEF) is on
sacubitril/valsartan, metoprolol succinate, and spironolactone. Which laboratory finding
requires immediate intervention?
A. Serum potassium 5.6 mEq/L B. eGFR 55 mL/min/1.73m²
C. BNP 800 pg/mL D. Blood pressure 110/70 mmHg
Correct: A - Serum potassium 5.6 mEq/L
Rationale:Hyperkalemia (K+ >5.5) is a serious adverse effect of sacubitril/valsartan and
spironolactone, increasing arrhythmia risk. Immediate intervention includes holding
spironolactone and assessing renal function. The other findings are common in HFrEF and
may be acceptable; BP 110/70 is within goal for HFrEF.
Q5.
A patient with major depressive disorder is on fluoxetine 40 mg daily. After 6 weeks,
depression symptoms are unchanged. Which strategy is MOST appropriate?
A. Add a monoamine oxidase inhibitor B. Increase fluoxetine dose to 80 mg daily.
(MAOI) to augment fluoxetine.
C. Switch to a different SSRI with a shorter D. Augment with bupropion XL 150 mg daily.
half-life.
Correct: D - Augment with bupropion XL 150 mg daily.
Rationale:Augmentation with bupropion is a common evidence-based strategy for SSRI
non-response. Adding an MAOI is contraindicated due to risk of serotonin syndrome.
Fluoxetine has a long half-life and dose 80 mg is above maximum; switching to another SSRI
may be considered but augmentation is preferred in partial response.
Page 4
