NURS 5334 ADVANCED
PHARMACOLOGY FINAL EXAM V2
QUESTIONS AND ANSWERS
1. A patient with a history of atrial fibrillation is being started on Warfarin (Coumadin). Which
of the following statements regarding the mechanism of action is correct?
A. It inhibits the conversion of fibrinogen to fibrin directly.
B. It binds to antithrombin III to accelerate the inactivation of Factor Xa.
C. It inhibits the vitamin K-dependent synthesis of clotting factors II, VII, IX, and X.
D. It prevents platelet aggregation by inhibiting cyclooxygenase-1.
Answer: C
Conceptual Explanation: Warfarin works by inhibiting the enzyme vitamin K epoxide
reductase, which is necessary for the synthesis of vitamin K-dependent clotting factors II,
VII, IX, and X, as well as proteins C and S.
2. When prescribing an ACE inhibitor such as Lisinopril, which electrolyte abnormality must
the clinician monitor for?
A. Hyponatremia
,B. Hyperkalemia
C. Hypocalcemia
D. Hypomagnesemia
Answer: B
Conceptual Explanation: ACE inhibitors decrease aldosterone secretion, which leads to
potassium retention. Therefore, hyperkalemia is a significant risk, especially in patients
with renal impairment or those taking potassium supplements.
3. A 65-year-old male with a history of COPD and hypertension requires a beta-blocker.
Which of the following would be the most appropriate choice to minimize respiratory
complications?
A. Metoprolol Succinate
B. Nadolol
C. Propranolol
D. Carvedilol
Answer: A
Conceptual Explanation: Metoprolol is a cardioselective beta-1 blocker. Cardioselective
agents are preferred in patients with reactive airway diseases like COPD or asthma because
they have less effect on beta-2 receptors in the lungs compared to non-selective agents like
Propranolol.
, 4. A patient taking Atorvastatin (Lipitor) reports new-onset muscle pain and weakness. What
is the most appropriate next step for the APRN?
A. Reassure the patient that this is a common, self-limiting side effect.
B. Increase the dose to achieve faster cholesterol lowering.
C. Order a Creatine Kinase (CK) level and assess for rhabdomyolysis.
D. Switch the patient to Simvastatin immediately.
Answer: C
Conceptual Explanation: Statin-associated muscle symptoms (SAMS) range from mild
myalgia to life-threatening rhabdomyolysis. A CK level is necessary to assess the severity of
muscle injury.
5. Which Black Box Warning is associated with the use of Fluoroquinolones, such as
Ciprofloxacin?
A. Risk of severe hepatic failure.
B. Increased risk of tendonitis and tendon rupture.
C. Potential for Stevens-Johnson Syndrome.
D. Risk of profound neutropenia.
Answer: B
PHARMACOLOGY FINAL EXAM V2
QUESTIONS AND ANSWERS
1. A patient with a history of atrial fibrillation is being started on Warfarin (Coumadin). Which
of the following statements regarding the mechanism of action is correct?
A. It inhibits the conversion of fibrinogen to fibrin directly.
B. It binds to antithrombin III to accelerate the inactivation of Factor Xa.
C. It inhibits the vitamin K-dependent synthesis of clotting factors II, VII, IX, and X.
D. It prevents platelet aggregation by inhibiting cyclooxygenase-1.
Answer: C
Conceptual Explanation: Warfarin works by inhibiting the enzyme vitamin K epoxide
reductase, which is necessary for the synthesis of vitamin K-dependent clotting factors II,
VII, IX, and X, as well as proteins C and S.
2. When prescribing an ACE inhibitor such as Lisinopril, which electrolyte abnormality must
the clinician monitor for?
A. Hyponatremia
,B. Hyperkalemia
C. Hypocalcemia
D. Hypomagnesemia
Answer: B
Conceptual Explanation: ACE inhibitors decrease aldosterone secretion, which leads to
potassium retention. Therefore, hyperkalemia is a significant risk, especially in patients
with renal impairment or those taking potassium supplements.
3. A 65-year-old male with a history of COPD and hypertension requires a beta-blocker.
Which of the following would be the most appropriate choice to minimize respiratory
complications?
A. Metoprolol Succinate
B. Nadolol
C. Propranolol
D. Carvedilol
Answer: A
Conceptual Explanation: Metoprolol is a cardioselective beta-1 blocker. Cardioselective
agents are preferred in patients with reactive airway diseases like COPD or asthma because
they have less effect on beta-2 receptors in the lungs compared to non-selective agents like
Propranolol.
, 4. A patient taking Atorvastatin (Lipitor) reports new-onset muscle pain and weakness. What
is the most appropriate next step for the APRN?
A. Reassure the patient that this is a common, self-limiting side effect.
B. Increase the dose to achieve faster cholesterol lowering.
C. Order a Creatine Kinase (CK) level and assess for rhabdomyolysis.
D. Switch the patient to Simvastatin immediately.
Answer: C
Conceptual Explanation: Statin-associated muscle symptoms (SAMS) range from mild
myalgia to life-threatening rhabdomyolysis. A CK level is necessary to assess the severity of
muscle injury.
5. Which Black Box Warning is associated with the use of Fluoroquinolones, such as
Ciprofloxacin?
A. Risk of severe hepatic failure.
B. Increased risk of tendonitis and tendon rupture.
C. Potential for Stevens-Johnson Syndrome.
D. Risk of profound neutropenia.
Answer: B
