NR 565 ADVANCED PHARMACOLOGY FINAL
EXAM ACTUAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS WITH
RATIONALES 100% GUARANTEED PASS!!
CHAMBERLAIN UNIVERSITY LATEST
VERSION
Question 1
A 57-year-old man with newly diagnosed type 2 diabetes has an A1C of 8.4%. His
estimated glomerular filtration rate (eGFR) is 72 mL/min/1.73 m². He has no
history of heart failure or chronic kidney disease. Which medication is the most
appropriate initial pharmacologic therapy?
A. Glipizide
B. Metformin
C. Insulin glargine
D. Pioglitazone
Answer: B. Metformin
Rationale: Metformin is the preferred first-line medication for most patients with
type 2 diabetes because it decreases hepatic glucose production and improves
insulin sensitivity without causing weight gain or significant hypoglycemia. Renal
function is adequate for safe initiation.
Question 2
A patient with type 1 diabetes is prescribed insulin lispro before meals and insulin
glargine once nightly. Which statement demonstrates correct understanding of the
medication regimen?
,A. “I will inject lispro immediately after finishing my meal.”
B. “I should mix glargine and lispro in the same syringe.”
C. “I should take lispro within 15 minutes of eating.”
D. “Glargine replaces the need for mealtime insulin.”
Answer: C. “I should take lispro within 15 minutes of eating.”
Rationale: Lispro is a rapid-acting insulin with rapid onset and should be
administered within 15 minutes before or immediately after beginning a meal.
Glargine provides basal insulin coverage and should never be mixed with other
insulins.
Question 3
A 64-year-old woman with type 2 diabetes and New York Heart Association Class
III heart failure requires improved glycemic control. Which medication should be
avoided?
A. Empagliflozin
B. Sitagliptin
C. Pioglitazone
D. Metformin
Answer: C. Pioglitazone
Rationale: Pioglitazone can cause fluid retention and worsen heart failure. It is
contraindicated in patients with NYHA Class III or IV heart failure.
Question 4
A patient taking empagliflozin calls the clinic reporting burning with urination and
increased urinary frequency. What is the most likely explanation?
A. Expected therapeutic effect
B. Diabetic ketoacidosis
C. Genitourinary infection associated with therapy
D. Acute kidney injury
,Answer: C. Genitourinary infection associated with therapy
Rationale: SGLT2 inhibitors increase urinary glucose excretion, creating an
environment that promotes urinary tract and genital fungal infections.
Question 5
A nurse practitioner prescribes semaglutide for a patient with obesity and type 2
diabetes. Which mechanism best explains its therapeutic benefit?
A. Increases renal glucose excretion
B. Stimulates hepatic glycogen breakdown
C. Enhances glucose-dependent insulin secretion and slows gastric emptying
D. Blocks intestinal carbohydrate absorption
Answer: C. Enhances glucose-dependent insulin secretion and slows gastric
emptying
Rationale: GLP-1 receptor agonists increase glucose-dependent insulin release,
suppress glucagon secretion, delay gastric emptying, and promote satiety.
Question 6
A 49-year-old woman is beginning levothyroxine therapy for primary
hypothyroidism. Which instruction is most appropriate?
A. Take with breakfast and calcium supplements.
B. Take at bedtime with a snack.
C. Take on an empty stomach and separate calcium or iron by at least four hours.
D. Stop the medication when symptoms improve.
Answer: C. Take on an empty stomach and separate calcium or iron by at
least four hours.
Rationale: Calcium, iron, antacids, and food decrease levothyroxine absorption.
The medication should be taken consistently on an empty stomach.
, Question 7
A patient receiving levothyroxine asks when laboratory monitoring should occur
after initiating therapy. What is the best response?
A. One week
B. Two weeks
C. Six to eight weeks
D. Six months
Answer: C. Six to eight weeks
Rationale: TSH requires approximately 6–8 weeks to reach a new steady state
following dosage adjustments.
Question 8
A 42-year-old patient with hypertension is started on lisinopril. Which laboratory
abnormality is most important to monitor after initiation?
A. Decreased serum sodium
B. Increased serum potassium
C. Decreased serum calcium
D. Increased serum chloride
Answer: B. Increased serum potassium
Rationale: ACE inhibitors decrease aldosterone secretion, which can reduce renal
potassium excretion and cause hyperkalemia. Serum creatinine and potassium
should be monitored after initiation and dose changes.
EXAM ACTUAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS WITH
RATIONALES 100% GUARANTEED PASS!!
CHAMBERLAIN UNIVERSITY LATEST
VERSION
Question 1
A 57-year-old man with newly diagnosed type 2 diabetes has an A1C of 8.4%. His
estimated glomerular filtration rate (eGFR) is 72 mL/min/1.73 m². He has no
history of heart failure or chronic kidney disease. Which medication is the most
appropriate initial pharmacologic therapy?
A. Glipizide
B. Metformin
C. Insulin glargine
D. Pioglitazone
Answer: B. Metformin
Rationale: Metformin is the preferred first-line medication for most patients with
type 2 diabetes because it decreases hepatic glucose production and improves
insulin sensitivity without causing weight gain or significant hypoglycemia. Renal
function is adequate for safe initiation.
Question 2
A patient with type 1 diabetes is prescribed insulin lispro before meals and insulin
glargine once nightly. Which statement demonstrates correct understanding of the
medication regimen?
,A. “I will inject lispro immediately after finishing my meal.”
B. “I should mix glargine and lispro in the same syringe.”
C. “I should take lispro within 15 minutes of eating.”
D. “Glargine replaces the need for mealtime insulin.”
Answer: C. “I should take lispro within 15 minutes of eating.”
Rationale: Lispro is a rapid-acting insulin with rapid onset and should be
administered within 15 minutes before or immediately after beginning a meal.
Glargine provides basal insulin coverage and should never be mixed with other
insulins.
Question 3
A 64-year-old woman with type 2 diabetes and New York Heart Association Class
III heart failure requires improved glycemic control. Which medication should be
avoided?
A. Empagliflozin
B. Sitagliptin
C. Pioglitazone
D. Metformin
Answer: C. Pioglitazone
Rationale: Pioglitazone can cause fluid retention and worsen heart failure. It is
contraindicated in patients with NYHA Class III or IV heart failure.
Question 4
A patient taking empagliflozin calls the clinic reporting burning with urination and
increased urinary frequency. What is the most likely explanation?
A. Expected therapeutic effect
B. Diabetic ketoacidosis
C. Genitourinary infection associated with therapy
D. Acute kidney injury
,Answer: C. Genitourinary infection associated with therapy
Rationale: SGLT2 inhibitors increase urinary glucose excretion, creating an
environment that promotes urinary tract and genital fungal infections.
Question 5
A nurse practitioner prescribes semaglutide for a patient with obesity and type 2
diabetes. Which mechanism best explains its therapeutic benefit?
A. Increases renal glucose excretion
B. Stimulates hepatic glycogen breakdown
C. Enhances glucose-dependent insulin secretion and slows gastric emptying
D. Blocks intestinal carbohydrate absorption
Answer: C. Enhances glucose-dependent insulin secretion and slows gastric
emptying
Rationale: GLP-1 receptor agonists increase glucose-dependent insulin release,
suppress glucagon secretion, delay gastric emptying, and promote satiety.
Question 6
A 49-year-old woman is beginning levothyroxine therapy for primary
hypothyroidism. Which instruction is most appropriate?
A. Take with breakfast and calcium supplements.
B. Take at bedtime with a snack.
C. Take on an empty stomach and separate calcium or iron by at least four hours.
D. Stop the medication when symptoms improve.
Answer: C. Take on an empty stomach and separate calcium or iron by at
least four hours.
Rationale: Calcium, iron, antacids, and food decrease levothyroxine absorption.
The medication should be taken consistently on an empty stomach.
, Question 7
A patient receiving levothyroxine asks when laboratory monitoring should occur
after initiating therapy. What is the best response?
A. One week
B. Two weeks
C. Six to eight weeks
D. Six months
Answer: C. Six to eight weeks
Rationale: TSH requires approximately 6–8 weeks to reach a new steady state
following dosage adjustments.
Question 8
A 42-year-old patient with hypertension is started on lisinopril. Which laboratory
abnormality is most important to monitor after initiation?
A. Decreased serum sodium
B. Increased serum potassium
C. Decreased serum calcium
D. Increased serum chloride
Answer: B. Increased serum potassium
Rationale: ACE inhibitors decrease aldosterone secretion, which can reduce renal
potassium excretion and cause hyperkalemia. Serum creatinine and potassium
should be monitored after initiation and dose changes.
