NR 566 FINAL EXAM PREP – ADVANCED PHARMACOLOGY – (2026) ACTUAL QUESTIONS AND ANSWERS
ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | (CHAMBERLAIN)|
GRADED A+
Question 1
An APRN is managing a 68-year-old patient with heart failure with reduced ejection fraction (HFrEF). The patient
is currently on an ACE inhibitor and a beta-blocker. Which of the following additional medications is most likely
to improve survival in this patient?
A. Hydralazine plus isosorbide dinitrate
B. Digoxin
C. Spironolactone
D. Ivabradine
🟢 Correct Answer: C. Spironolactone
🔴 RATIONALE: Spironolactone, an aldosterone antagonist, has been shown to reduce mortality in patients with
HFrEF (NYHA class III-IV) when added to standard therapy. Hydralazine/isosorbide dinitrate is indicated in
African American patients. Digoxin improves symptoms but not survival. Ivabradine reduces hospitalization but
is not a mortality benefit medication.
,Question 2
A patient is started on apixaban for non-valvular atrial fibrillation. Which of the following is the most
appropriate monitoring parameter for this medication?
A. INR
B. aPTT
C. Serum creatinine
D. Platelet count
🟢 Correct Answer: C. Serum creatinine
🔴 RATIONALE: Apixaban is a direct factor Xa inhibitor that does not require routine INR or aPTT monitoring.
However, renal function should be monitored because apixaban is partially renally excreted and dosing
adjustments are needed for severe renal impairment. Platelet count is not routinely monitored.
Question 3
A patient with type 2 diabetes is prescribed dulaglutide. Which of the following is a common side effect of GLP-
1 receptor agonists?
A. Hypoglycemia
B. Weight gain
C. Gastrointestinal upset (nausea, vomiting)
D. Hyperkalemia
,🟢 Correct Answer: C. Gastrointestinal upset (nausea, vomiting)
🔴 RATIONALE: GLP-1 receptor agonists commonly cause nausea, vomiting, and diarrhea, especially upon
initiation and dose titration. Hypoglycemia is uncommon unless combined with sulfonylureas or insulin. They
typically cause weight loss, not gain. Hyperkalemia is not associated.
Question 4
A patient with hypertension and benign prostatic hyperplasia is prescribed doxazosin. Which of the following is
a key side effect that should be discussed with the patient?
A. Orthostatic hypotension
B. Hyperkalemia
C. Cough
D. Peripheral edema
🟢 Correct Answer: A. Orthostatic hypotension
🔴 RATIONALE: Doxazosin is an alpha-1 blocker that causes vasodilation and can lead to orthostatic
hypotension. Patients should be advised to rise slowly from sitting or lying positions. Cough is associated with
ACE inhibitors, peripheral edema with calcium channel blockers, and hyperkalemia with ACE inhibitors/ARBs.
Question 5
, A patient with gout is started on allopurinol. Which of the following is a key patient education point?
A. Take the medication during an acute gout attack for immediate pain relief
B. Increase fluid intake to prevent renal stones
C. The medication can be stopped once uric acid levels normalize
D. It is safe to take with high-dose aspirin
🟢 Correct Answer: B. Increase fluid intake to prevent renal stones
🔴 RATIONALE: Allopurinol can increase the risk of uric acid renal stones. Patients should maintain adequate
hydration. It is not used for acute attacks (colchicine or NSAIDs are used for acute flares); it is a chronic therapy.
It should not be stopped abruptly. High-dose aspirin can interfere with uric acid excretion.
Question 6
A patient is prescribed lithium for bipolar disorder. Which of the following medications can significantly increase
lithium levels and risk of toxicity?
A. Acetaminophen
B. Lisinopril
C. Omeprazole
D. Atorvastatin
🟢 Correct Answer: B. Lisinopril
ALREADY GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | (CHAMBERLAIN)|
GRADED A+
Question 1
An APRN is managing a 68-year-old patient with heart failure with reduced ejection fraction (HFrEF). The patient
is currently on an ACE inhibitor and a beta-blocker. Which of the following additional medications is most likely
to improve survival in this patient?
A. Hydralazine plus isosorbide dinitrate
B. Digoxin
C. Spironolactone
D. Ivabradine
🟢 Correct Answer: C. Spironolactone
🔴 RATIONALE: Spironolactone, an aldosterone antagonist, has been shown to reduce mortality in patients with
HFrEF (NYHA class III-IV) when added to standard therapy. Hydralazine/isosorbide dinitrate is indicated in
African American patients. Digoxin improves symptoms but not survival. Ivabradine reduces hospitalization but
is not a mortality benefit medication.
,Question 2
A patient is started on apixaban for non-valvular atrial fibrillation. Which of the following is the most
appropriate monitoring parameter for this medication?
A. INR
B. aPTT
C. Serum creatinine
D. Platelet count
🟢 Correct Answer: C. Serum creatinine
🔴 RATIONALE: Apixaban is a direct factor Xa inhibitor that does not require routine INR or aPTT monitoring.
However, renal function should be monitored because apixaban is partially renally excreted and dosing
adjustments are needed for severe renal impairment. Platelet count is not routinely monitored.
Question 3
A patient with type 2 diabetes is prescribed dulaglutide. Which of the following is a common side effect of GLP-
1 receptor agonists?
A. Hypoglycemia
B. Weight gain
C. Gastrointestinal upset (nausea, vomiting)
D. Hyperkalemia
,🟢 Correct Answer: C. Gastrointestinal upset (nausea, vomiting)
🔴 RATIONALE: GLP-1 receptor agonists commonly cause nausea, vomiting, and diarrhea, especially upon
initiation and dose titration. Hypoglycemia is uncommon unless combined with sulfonylureas or insulin. They
typically cause weight loss, not gain. Hyperkalemia is not associated.
Question 4
A patient with hypertension and benign prostatic hyperplasia is prescribed doxazosin. Which of the following is
a key side effect that should be discussed with the patient?
A. Orthostatic hypotension
B. Hyperkalemia
C. Cough
D. Peripheral edema
🟢 Correct Answer: A. Orthostatic hypotension
🔴 RATIONALE: Doxazosin is an alpha-1 blocker that causes vasodilation and can lead to orthostatic
hypotension. Patients should be advised to rise slowly from sitting or lying positions. Cough is associated with
ACE inhibitors, peripheral edema with calcium channel blockers, and hyperkalemia with ACE inhibitors/ARBs.
Question 5
, A patient with gout is started on allopurinol. Which of the following is a key patient education point?
A. Take the medication during an acute gout attack for immediate pain relief
B. Increase fluid intake to prevent renal stones
C. The medication can be stopped once uric acid levels normalize
D. It is safe to take with high-dose aspirin
🟢 Correct Answer: B. Increase fluid intake to prevent renal stones
🔴 RATIONALE: Allopurinol can increase the risk of uric acid renal stones. Patients should maintain adequate
hydration. It is not used for acute attacks (colchicine or NSAIDs are used for acute flares); it is a chronic therapy.
It should not be stopped abruptly. High-dose aspirin can interfere with uric acid excretion.
Question 6
A patient is prescribed lithium for bipolar disorder. Which of the following medications can significantly increase
lithium levels and risk of toxicity?
A. Acetaminophen
B. Lisinopril
C. Omeprazole
D. Atorvastatin
🟢 Correct Answer: B. Lisinopril
