NR 565 ADVANCED PHARMACOLOGY
FINAL EXAM PREP QUESTIONS AND
ANSWERS
1. When transitioning a patient from an ACE inhibitor to an Angiotensin Receptor-Neprilysin
Inhibitor (ARNI) such as sacubitril/valsartan, what is the mandatory washout period?
A. 12 hours
B. 24 hours
C. 36 hours
D. 48 hours
Answer: C
Conceptual Explanation: A 36-hour washout period is required when switching from an
ACE inhibitor to an ARNI to minimize the risk of angioedema, as both medications inhibit
the breakdown of bradykinin.
2. A patient with a GFR of 28 mL/min/1.73m² is currently taking Metformin. According to
standard guidelines, what is the most appropriate action?
A. Continue the current dose but monitor renal function monthly.
,B. Reduce the dose by 50%.
C. Discontinue Metformin immediately.
D. Switch to a sulfonylurea without dose adjustment.
Answer: C
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR below 30
mL/min/1.73m² due to the increased risk of lactic acidosis.
3. Which of the following GLP-1 receptor agonists has demonstrated a reduction in major
adverse cardiovascular events (MACE) in patients with Type 2 Diabetes?
A. Exenatide (immediate release)
B. Liraglutide
C. Lixisenatide
D. Albiglutide
Answer: B
Conceptual Explanation: Liraglutide (Victoza) has been shown in the LEADER trial to
significantly reduce the risk of MACE in patients with T2DM and high cardiovascular risk.
4. What is the primary mechanism of action of SGLT2 inhibitors like empagliflozin?
A. Increasing insulin sensitivity in peripheral tissues.
B. Decreasing hepatic glucose production.
, C. Inhibiting glucose reabsorption in the proximal convoluted tubule.
D. Stimulating insulin secretion from pancreatic beta cells.
Answer: C
Conceptual Explanation: SGLT2 inhibitors lower blood glucose by preventing the kidneys
from reabsorbing glucose back into the blood, leading to glucosuria.
5. A patient taking Amiodarone requires monitoring for which of the following potential
toxicities?
A. Ototoxicity and renal failure
B. Pulmonary fibrosis and thyroid dysfunction
C. Gingival hyperplasia and hirsutism
D. Lactic acidosis and vitamin B12 deficiency
Answer: B
Conceptual Explanation: Amiodarone is associated with serious adverse effects including
pulmonary toxicity (fibrosis) and thyroid dysfunction (both hypo- and hyperthyroidism)
due to its high iodine content.
6. Which antidepressant is most likely to cause a hypertensive crisis if consumed with
tyramine-rich foods?
A. Sertraline
B. Phenelzine
FINAL EXAM PREP QUESTIONS AND
ANSWERS
1. When transitioning a patient from an ACE inhibitor to an Angiotensin Receptor-Neprilysin
Inhibitor (ARNI) such as sacubitril/valsartan, what is the mandatory washout period?
A. 12 hours
B. 24 hours
C. 36 hours
D. 48 hours
Answer: C
Conceptual Explanation: A 36-hour washout period is required when switching from an
ACE inhibitor to an ARNI to minimize the risk of angioedema, as both medications inhibit
the breakdown of bradykinin.
2. A patient with a GFR of 28 mL/min/1.73m² is currently taking Metformin. According to
standard guidelines, what is the most appropriate action?
A. Continue the current dose but monitor renal function monthly.
,B. Reduce the dose by 50%.
C. Discontinue Metformin immediately.
D. Switch to a sulfonylurea without dose adjustment.
Answer: C
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR below 30
mL/min/1.73m² due to the increased risk of lactic acidosis.
3. Which of the following GLP-1 receptor agonists has demonstrated a reduction in major
adverse cardiovascular events (MACE) in patients with Type 2 Diabetes?
A. Exenatide (immediate release)
B. Liraglutide
C. Lixisenatide
D. Albiglutide
Answer: B
Conceptual Explanation: Liraglutide (Victoza) has been shown in the LEADER trial to
significantly reduce the risk of MACE in patients with T2DM and high cardiovascular risk.
4. What is the primary mechanism of action of SGLT2 inhibitors like empagliflozin?
A. Increasing insulin sensitivity in peripheral tissues.
B. Decreasing hepatic glucose production.
, C. Inhibiting glucose reabsorption in the proximal convoluted tubule.
D. Stimulating insulin secretion from pancreatic beta cells.
Answer: C
Conceptual Explanation: SGLT2 inhibitors lower blood glucose by preventing the kidneys
from reabsorbing glucose back into the blood, leading to glucosuria.
5. A patient taking Amiodarone requires monitoring for which of the following potential
toxicities?
A. Ototoxicity and renal failure
B. Pulmonary fibrosis and thyroid dysfunction
C. Gingival hyperplasia and hirsutism
D. Lactic acidosis and vitamin B12 deficiency
Answer: B
Conceptual Explanation: Amiodarone is associated with serious adverse effects including
pulmonary toxicity (fibrosis) and thyroid dysfunction (both hypo- and hyperthyroidism)
due to its high iodine content.
6. Which antidepressant is most likely to cause a hypertensive crisis if consumed with
tyramine-rich foods?
A. Sertraline
B. Phenelzine
