NR 565 ADVANCED PHARMACOLOGY
FINAL EXAM REVIEW QUESTIONS AND
ANSWERS
1. A patient with Type 2 Diabetes has a current eGFR of 28 mL/min/1.73m². Which action
regarding their Metformin therapy is most appropriate?
A. Continue the current dose but monitor renal function monthly.
B. Reduce the dose by 50% immediately.
C. Switch to a Sulfonylurea at a maximum dose.
D. Discontinue Metformin due to the risk of lactic acidosis.
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR below 30
mL/min/1.73m² due to the significantly increased risk of lactic acidosis.
2. When initiating Levothyroxine for a 75-year-old patient with a history of coronary artery
disease, what is the recommended starting dose?
A. 1.6 mcg/kg/day
B. 100 mcg/day
,C. 50 to 75 mcg/day
D. 12.5 to 25 mcg/day
Answer: D
Conceptual Explanation: In elderly patients or those with cardiovascular disease,
Levothyroxine should be started at a low dose (12.5-25 mcg) to avoid overstressing the
heart.
3. A patient is prescribed Exenatide (Byetta). Which side effect requires immediate medical
attention and discontinuation of the drug?
A. Mild nausea after injection
B. Occasional constipation
C. A localized skin reaction at the injection site
D. Severe, persistent abdominal pain radiating to the back
Answer: D
Conceptual Explanation: Severe abdominal pain radiating to the back is a hallmark
symptom of pancreatitis, a serious potential adverse effect of GLP-1 agonists like Exenatide.
4. Which medication is considered the first-line treatment for a pregnant patient in her first
trimester diagnosed with hyperthyroidism?
A. Propylthiouracil (PTU)
B. Radioactive Iodine
, C. Methimazole
D. Amiodarone
Answer: A
Conceptual Explanation: PTU is preferred in the first trimester of pregnancy because
Methimazole is associated with birth defects (aplasia cutis). Methimazole may be used in
the second and third trimesters.
5. A patient taking Sildenafil (Viagra) for erectile dysfunction is rushed to the ER with chest
pain. Which medication is strictly contraindicated for this patient?
A. Aspirin
B. Metoprolol
C. Nitroglycerin
D. Morphine
Answer: C
Conceptual Explanation: Nitrates are contraindicated with PDE5 inhibitors like Sildenafil
as the combination can cause life-threatening hypotension.
6. Which mechanism best describes the action of Sulfonylureas?
A. Increasing insulin sensitivity in the liver
B. Stimulating insulin secretion from pancreatic beta cells
C. Slowing gastric emptying
FINAL EXAM REVIEW QUESTIONS AND
ANSWERS
1. A patient with Type 2 Diabetes has a current eGFR of 28 mL/min/1.73m². Which action
regarding their Metformin therapy is most appropriate?
A. Continue the current dose but monitor renal function monthly.
B. Reduce the dose by 50% immediately.
C. Switch to a Sulfonylurea at a maximum dose.
D. Discontinue Metformin due to the risk of lactic acidosis.
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR below 30
mL/min/1.73m² due to the significantly increased risk of lactic acidosis.
2. When initiating Levothyroxine for a 75-year-old patient with a history of coronary artery
disease, what is the recommended starting dose?
A. 1.6 mcg/kg/day
B. 100 mcg/day
,C. 50 to 75 mcg/day
D. 12.5 to 25 mcg/day
Answer: D
Conceptual Explanation: In elderly patients or those with cardiovascular disease,
Levothyroxine should be started at a low dose (12.5-25 mcg) to avoid overstressing the
heart.
3. A patient is prescribed Exenatide (Byetta). Which side effect requires immediate medical
attention and discontinuation of the drug?
A. Mild nausea after injection
B. Occasional constipation
C. A localized skin reaction at the injection site
D. Severe, persistent abdominal pain radiating to the back
Answer: D
Conceptual Explanation: Severe abdominal pain radiating to the back is a hallmark
symptom of pancreatitis, a serious potential adverse effect of GLP-1 agonists like Exenatide.
4. Which medication is considered the first-line treatment for a pregnant patient in her first
trimester diagnosed with hyperthyroidism?
A. Propylthiouracil (PTU)
B. Radioactive Iodine
, C. Methimazole
D. Amiodarone
Answer: A
Conceptual Explanation: PTU is preferred in the first trimester of pregnancy because
Methimazole is associated with birth defects (aplasia cutis). Methimazole may be used in
the second and third trimesters.
5. A patient taking Sildenafil (Viagra) for erectile dysfunction is rushed to the ER with chest
pain. Which medication is strictly contraindicated for this patient?
A. Aspirin
B. Metoprolol
C. Nitroglycerin
D. Morphine
Answer: C
Conceptual Explanation: Nitrates are contraindicated with PDE5 inhibitors like Sildenafil
as the combination can cause life-threatening hypotension.
6. Which mechanism best describes the action of Sulfonylureas?
A. Increasing insulin sensitivity in the liver
B. Stimulating insulin secretion from pancreatic beta cells
C. Slowing gastric emptying
