NURS 5334 ADVANCED
PHARMACOLOGY FINAL
EXAMINATION V2 QUESTIONS AND
ANSWERS
1. Which of the following physiological changes in geriatric patients most significantly impacts
the distribution of highly lipophilic drugs?
A. Decreased total body water
B. Reduced serum albumin levels
C. Increased percentage of body fat
D. Increased gastric pH
Answer: C
Conceptual Explanation: As patients age, the percentage of body fat increases, which
increases the volume of distribution for lipophilic drugs, potentially leading to a longer
half-life and prolonged effect.
,2. A patient is prescribed an ACE inhibitor for hypertension. What is the primary mechanism
by which these drugs can cause a persistent, dry cough?
A. Direct irritation of the bronchial mucosa
B. Accumulation of bradykinin in the lungs
C. Inhibition of prostaglandin synthesis
D. Localized pulmonary edema
Answer: B
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin and
substance P, leading to their accumulation in the respiratory tract, which triggers the cough
reflex in susceptible individuals.
3. Which electrolyte abnormality significantly increases the risk of digoxin toxicity?
A. Hypokalemia
B. Hypocalcemia
C. Hyperkalemia
D. Hypernatremia
Answer: A
Conceptual Explanation: Digoxin competes with potassium for binding sites on the
Na+/K+ ATPase pump. Low potassium levels allow more digoxin to bind, increasing the
risk of toxicity.
, 4. A patient with a history of heart failure is prescribed Spironolactone. The provider must
monitor for which of the following side effects?
A. Hypokalemia
B. Hyperkalemia
C. Hyperglycemia
D. Ototoxicity
Answer: B
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic (aldosterone
antagonist) that inhibits potassium excretion, making hyperkalemia a primary concern.
5. Warfarin’s anticoagulant effect is monitored using which laboratory value?
A. aPTT (Activated Partial Thromboplastin Time)
B. Bleeding time
C. INR (International Normalized Ratio)
D. Platelet count
Answer: C
Conceptual Explanation: The INR is the standard measurement used to monitor the
effectiveness and safety of Warfarin therapy.
PHARMACOLOGY FINAL
EXAMINATION V2 QUESTIONS AND
ANSWERS
1. Which of the following physiological changes in geriatric patients most significantly impacts
the distribution of highly lipophilic drugs?
A. Decreased total body water
B. Reduced serum albumin levels
C. Increased percentage of body fat
D. Increased gastric pH
Answer: C
Conceptual Explanation: As patients age, the percentage of body fat increases, which
increases the volume of distribution for lipophilic drugs, potentially leading to a longer
half-life and prolonged effect.
,2. A patient is prescribed an ACE inhibitor for hypertension. What is the primary mechanism
by which these drugs can cause a persistent, dry cough?
A. Direct irritation of the bronchial mucosa
B. Accumulation of bradykinin in the lungs
C. Inhibition of prostaglandin synthesis
D. Localized pulmonary edema
Answer: B
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin and
substance P, leading to their accumulation in the respiratory tract, which triggers the cough
reflex in susceptible individuals.
3. Which electrolyte abnormality significantly increases the risk of digoxin toxicity?
A. Hypokalemia
B. Hypocalcemia
C. Hyperkalemia
D. Hypernatremia
Answer: A
Conceptual Explanation: Digoxin competes with potassium for binding sites on the
Na+/K+ ATPase pump. Low potassium levels allow more digoxin to bind, increasing the
risk of toxicity.
, 4. A patient with a history of heart failure is prescribed Spironolactone. The provider must
monitor for which of the following side effects?
A. Hypokalemia
B. Hyperkalemia
C. Hyperglycemia
D. Ototoxicity
Answer: B
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic (aldosterone
antagonist) that inhibits potassium excretion, making hyperkalemia a primary concern.
5. Warfarin’s anticoagulant effect is monitored using which laboratory value?
A. aPTT (Activated Partial Thromboplastin Time)
B. Bleeding time
C. INR (International Normalized Ratio)
D. Platelet count
Answer: C
Conceptual Explanation: The INR is the standard measurement used to monitor the
effectiveness and safety of Warfarin therapy.
