NURS 5663 ADVANCED
PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS
1. A patient with chronic kidney disease is prescribed a drug that is primarily excreted via the
kidneys. Which pharmacokinetic parameter is most significantly affected?
A. Absorption
B. Distribution
C. Elimination
D. Metabolism
Answer: C
Conceptual Explanation: Elimination refers to the removal of a drug from the body,
primarily through the kidneys. In chronic kidney disease, the glomerular filtration rate
decreases, leading to reduced drug clearance and potential toxicity.
2. Which mechanism best explains why ACE inhibitors, such as Lisinopril, can cause a
persistent dry cough?
A. Increased levels of angiotensin II
,B. Direct irritation of the bronchial mucosa
C. Accumulation of bradykinin in the lungs
D. Inhibition of surfactant production
Answer: C
Conceptual Explanation: ACE is responsible for the breakdown of bradykinin. Inhibiting
this enzyme leads to an accumulation of bradykinin, which promotes inflammation and
irritation in the respiratory tract, causing a cough.
3. When initiating Warfarin therapy, why is it common practice to overlap with Heparin for
the first few days?
A. Warfarin has a rapid onset but short half-life
B. Warfarin initially causes a pro-thrombotic state by depleting Protein C and S
C. Heparin increases the absorption of Warfarin
D. To prevent the development of HIT (Heparin-Induced Thrombocytopenia)
Answer: B
Conceptual Explanation: Warfarin inhibits Vitamin K-dependent clotting factors, but it
also inhibits natural anticoagulants Protein C and S. Because Protein C has a shorter half-
life than factors II, IX, and X, a transient hypercoagulable state occurs initially.
, 4. A patient is taking Spironolactone for heart failure. Which electrolyte abnormality should
the nurse practitioner monitor most closely?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypocalcemia
Answer: A
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic that acts as an
aldosterone antagonist. It prevents the excretion of potassium in the distal tubule,
increasing the risk of hyperkalemia.
5. Which of the following medications is considered the first-line therapy for Type 2 Diabetes
Mellitus, provided there are no contraindications?
A. Glipizide
B. Metformin
C. Sitagliptin
D. Pioglitazone
Answer: B
PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS
1. A patient with chronic kidney disease is prescribed a drug that is primarily excreted via the
kidneys. Which pharmacokinetic parameter is most significantly affected?
A. Absorption
B. Distribution
C. Elimination
D. Metabolism
Answer: C
Conceptual Explanation: Elimination refers to the removal of a drug from the body,
primarily through the kidneys. In chronic kidney disease, the glomerular filtration rate
decreases, leading to reduced drug clearance and potential toxicity.
2. Which mechanism best explains why ACE inhibitors, such as Lisinopril, can cause a
persistent dry cough?
A. Increased levels of angiotensin II
,B. Direct irritation of the bronchial mucosa
C. Accumulation of bradykinin in the lungs
D. Inhibition of surfactant production
Answer: C
Conceptual Explanation: ACE is responsible for the breakdown of bradykinin. Inhibiting
this enzyme leads to an accumulation of bradykinin, which promotes inflammation and
irritation in the respiratory tract, causing a cough.
3. When initiating Warfarin therapy, why is it common practice to overlap with Heparin for
the first few days?
A. Warfarin has a rapid onset but short half-life
B. Warfarin initially causes a pro-thrombotic state by depleting Protein C and S
C. Heparin increases the absorption of Warfarin
D. To prevent the development of HIT (Heparin-Induced Thrombocytopenia)
Answer: B
Conceptual Explanation: Warfarin inhibits Vitamin K-dependent clotting factors, but it
also inhibits natural anticoagulants Protein C and S. Because Protein C has a shorter half-
life than factors II, IX, and X, a transient hypercoagulable state occurs initially.
, 4. A patient is taking Spironolactone for heart failure. Which electrolyte abnormality should
the nurse practitioner monitor most closely?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypocalcemia
Answer: A
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic that acts as an
aldosterone antagonist. It prevents the excretion of potassium in the distal tubule,
increasing the risk of hyperkalemia.
5. Which of the following medications is considered the first-line therapy for Type 2 Diabetes
Mellitus, provided there are no contraindications?
A. Glipizide
B. Metformin
C. Sitagliptin
D. Pioglitazone
Answer: B
