NURS 6521 ADVANCED
PHARMACOLOGY COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS
1. A patient taking Warfarin is prescribed Rifampin for tuberculosis. Which adjustment should
the provider anticipate?
A. Discontinue Warfarin immediately
B. Decrease the Warfarin dose
C. Increase the Warfarin dose
D. Maintain current dose and check INR in one month
Answer: C
Conceptual Explanation: Rifampin is a potent CYP450 inducer, which increases the
metabolism of Warfarin, leading to subtherapeutic INR levels. Therefore, the Warfarin dose
typically needs to be increased.
2. Which parameter is most critical to monitor in a patient receiving Gentamicin?
A. Liver enzymes (AST/ALT)
B. Prothrombin Time (PT)
,C. Serum creatinine and trough levels
D. Hemoglobin A1c
Answer: C
Conceptual Explanation: Gentamicin is an aminoglycoside known for nephrotoxicity and
ototoxicity. Monitoring serum creatinine for renal function and trough levels to ensure
clearance is standard practice.
3. A patient with heart failure is prescribed Digoxin. Which electrolyte imbalance significantly
increases the risk of Digoxin toxicity?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypokalemia
Answer: D
Conceptual Explanation: Hypokalemia increases the risk of Digoxin toxicity because
Digoxin competes with potassium for binding sites on the Na+/K+ ATPase pump.
4. Metformin is contraindicated in patients with which of the following conditions?
A. Body Mass Index (BMI) over 35
B. History of gestational diabetes
C. Estimated Glomerular Filtration Rate (eGFR) less than 30 mL/min
, D. Total cholesterol over 200 mg/dL
Answer: C
Conceptual Explanation: Metformin is primarily excreted by the kidneys. Renal
impairment (eGFR < 30) increases the risk of lactic acidosis, a rare but life-threatening
complication.
5. Which side effect is a common reason for non-compliance with Selective Serotonin
Reuptake Inhibitors (SSRIs)?
A. Gingival hyperplasia
B. Sexual dysfunction
C. Urinary retention
D. Tendon rupture
Answer: B
Conceptual Explanation: Sexual dysfunction, including decreased libido and anorgasmia,
is a frequent and distressing side effect of SSRIs that often leads to treatment
discontinuation.
6. A patient is diagnosed with an ACE-inhibitor induced cough. What is the biochemical cause
of this side effect?
A. Decreased Nitric Oxide
B. Inhibition of Aldosterone
PHARMACOLOGY COMPREHENSIVE
EXAM QUESTIONS AND ANSWERS
1. A patient taking Warfarin is prescribed Rifampin for tuberculosis. Which adjustment should
the provider anticipate?
A. Discontinue Warfarin immediately
B. Decrease the Warfarin dose
C. Increase the Warfarin dose
D. Maintain current dose and check INR in one month
Answer: C
Conceptual Explanation: Rifampin is a potent CYP450 inducer, which increases the
metabolism of Warfarin, leading to subtherapeutic INR levels. Therefore, the Warfarin dose
typically needs to be increased.
2. Which parameter is most critical to monitor in a patient receiving Gentamicin?
A. Liver enzymes (AST/ALT)
B. Prothrombin Time (PT)
,C. Serum creatinine and trough levels
D. Hemoglobin A1c
Answer: C
Conceptual Explanation: Gentamicin is an aminoglycoside known for nephrotoxicity and
ototoxicity. Monitoring serum creatinine for renal function and trough levels to ensure
clearance is standard practice.
3. A patient with heart failure is prescribed Digoxin. Which electrolyte imbalance significantly
increases the risk of Digoxin toxicity?
A. Hyperkalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypokalemia
Answer: D
Conceptual Explanation: Hypokalemia increases the risk of Digoxin toxicity because
Digoxin competes with potassium for binding sites on the Na+/K+ ATPase pump.
4. Metformin is contraindicated in patients with which of the following conditions?
A. Body Mass Index (BMI) over 35
B. History of gestational diabetes
C. Estimated Glomerular Filtration Rate (eGFR) less than 30 mL/min
, D. Total cholesterol over 200 mg/dL
Answer: C
Conceptual Explanation: Metformin is primarily excreted by the kidneys. Renal
impairment (eGFR < 30) increases the risk of lactic acidosis, a rare but life-threatening
complication.
5. Which side effect is a common reason for non-compliance with Selective Serotonin
Reuptake Inhibitors (SSRIs)?
A. Gingival hyperplasia
B. Sexual dysfunction
C. Urinary retention
D. Tendon rupture
Answer: B
Conceptual Explanation: Sexual dysfunction, including decreased libido and anorgasmia,
is a frequent and distressing side effect of SSRIs that often leads to treatment
discontinuation.
6. A patient is diagnosed with an ACE-inhibitor induced cough. What is the biochemical cause
of this side effect?
A. Decreased Nitric Oxide
B. Inhibition of Aldosterone
