NURS 5334 ADVANCED
PHARMACOLOGY COMPREHENSIVE
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient with a history of heart failure is prescribed Digoxin. During a follow-up, the
patient reports seeing yellow-green halos around lights. Which of the following electrolyte
imbalances most significantly increases the risk of this toxicity?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: C
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity because
digoxin competes with potassium for binding at the Na+/K+ ATPase pump. Low potassium
levels allow more digoxin to bind, leading to toxicity.
2. Which pharmacological property describes the maximal effect a drug can produce,
regardless of the dose required to achieve it?
A. Potency
,B. Efficacy
C. Therapeutic Index
D. Bioavailability
Answer: B
Conceptual Explanation: Efficacy refers to the maximum response achievable from a
drug. Potency refers to the amount of drug needed to produce an effect of a given intensity.
3. A 65-year-old male with chronic kidney disease (CKD) requires an anticoagulant for atrial
fibrillation. Which of the following Direct Oral Anticoagulants (DOACs) requires the most
significant dose adjustment or is contraindicated in end-stage renal disease?
A. Rivaroxaban
B. Apixaban
C. Dabigatran
D. Edoxaban
Answer: C
Conceptual Explanation: Dabigatran is 80% renally excreted, making it highly sensitive to
changes in renal function compared to other DOACs.
4. A patient is prescribed Rifampin for tuberculosis. The nurse practitioner should warn the
patient that this drug is a potent inducer of which enzyme system?
A. MAO-B
, B. Cholinesterase
C. CYP450
D. Cyclooxygenase
Answer: C
Conceptual Explanation: Rifampin is a classic potent inducer of the Cytochrome P450
(CYP450) enzyme system, which can lead to decreased plasma concentrations of co-
administered drugs like oral contraceptives and warfarin.
5. Which of the following classes of antihypertensives is specifically contraindicated in a
pregnant woman due to the risk of teratogenicity, including renal dysgenesis?
A. ACE Inhibitors
B. Calcium Channel Blockers
C. Beta-blockers
D. Alpha-1 Antagonists
Answer: A
Conceptual Explanation: ACE inhibitors and ARBs are contraindicated in pregnancy
(Category D/X) because they interfere with fetal renal development and can cause
oligohydramnios.
PHARMACOLOGY COMPREHENSIVE
FINAL EXAM QUESTIONS AND
ANSWERS
1. A patient with a history of heart failure is prescribed Digoxin. During a follow-up, the
patient reports seeing yellow-green halos around lights. Which of the following electrolyte
imbalances most significantly increases the risk of this toxicity?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: C
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity because
digoxin competes with potassium for binding at the Na+/K+ ATPase pump. Low potassium
levels allow more digoxin to bind, leading to toxicity.
2. Which pharmacological property describes the maximal effect a drug can produce,
regardless of the dose required to achieve it?
A. Potency
,B. Efficacy
C. Therapeutic Index
D. Bioavailability
Answer: B
Conceptual Explanation: Efficacy refers to the maximum response achievable from a
drug. Potency refers to the amount of drug needed to produce an effect of a given intensity.
3. A 65-year-old male with chronic kidney disease (CKD) requires an anticoagulant for atrial
fibrillation. Which of the following Direct Oral Anticoagulants (DOACs) requires the most
significant dose adjustment or is contraindicated in end-stage renal disease?
A. Rivaroxaban
B. Apixaban
C. Dabigatran
D. Edoxaban
Answer: C
Conceptual Explanation: Dabigatran is 80% renally excreted, making it highly sensitive to
changes in renal function compared to other DOACs.
4. A patient is prescribed Rifampin for tuberculosis. The nurse practitioner should warn the
patient that this drug is a potent inducer of which enzyme system?
A. MAO-B
, B. Cholinesterase
C. CYP450
D. Cyclooxygenase
Answer: C
Conceptual Explanation: Rifampin is a classic potent inducer of the Cytochrome P450
(CYP450) enzyme system, which can lead to decreased plasma concentrations of co-
administered drugs like oral contraceptives and warfarin.
5. Which of the following classes of antihypertensives is specifically contraindicated in a
pregnant woman due to the risk of teratogenicity, including renal dysgenesis?
A. ACE Inhibitors
B. Calcium Channel Blockers
C. Beta-blockers
D. Alpha-1 Antagonists
Answer: A
Conceptual Explanation: ACE inhibitors and ARBs are contraindicated in pregnancy
(Category D/X) because they interfere with fetal renal development and can cause
oligohydramnios.
