Exam 4 2026 | Practice Questions, Answers & Detailed
Rationales | Advanced Pharmacology Exam Prep
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➢ NURS 615 Exam 4 practice questions
➢ Detailed answers
➢ Comprehensive rationales
➢ Pharmacology scenarios
➢ Prescribing case studies
, NURS 615 Exam 4 2026 | Advanced Pharmacology
Practice Questions, Answers & Detailed Rationales
| NP Exam Prep
1. Monitor Digoxin levels with:
A. Albuterol
B. Theophylline
C. Prednisone
D. Montelukast
Answer: A
Rationale: Albuterol and other beta-agonists can cause hypokalemia,
which increases the risk of digoxin toxicity. When beta-agonists stimulate
beta-2 receptors, they promote potassium uptake into cells, lowering
serum potassium. Low potassium levels increase the sensitivity of cardiac
muscle to digoxin, potentially causing toxicity even at therapeutic levels.
Patients taking both medications should have their potassium and digoxin
levels monitored.
2. Pheochromocytoma patients should avoid due to risk of HTN crisis:
A. Beta 2 Agonists
B. Anticholinergics
C. Inhaled corticosteroids
D. Mast cell stabilizers
,Answer: A
Rationale: Beta-2 agonists can stimulate catecholamine release, which can
precipitate a hypertensive crisis in patients with pheochromocytoma (a
catecholamine-secreting tumor). These medications increase sympathetic
nervous system activity, potentially causing massive release of
catecholamines from the tumor. Patients with known or suspected
pheochromocytoma should avoid beta-2 agonists and use alternative
medications for respiratory conditions.
3. Use with caution or avoid with African Americans:
A. Short-acting beta agonists
B. Long-acting beta agonists
C. Inhaled corticosteroids
D. Leukotriene receptor antagonists
Answer: B
Rationale: Long-acting beta agonists (LABAs) should be used with caution
or avoided in African American patients due to an increased risk of severe
asthma exacerbations and death. Studies have shown that African American
patients have a higher risk of fatal asthma events when using LABAs as
monotherapy. African American patients should always use LABAs in
combination with an inhaled corticosteroid (ICS) to reduce this risk.
, 4. Black Box for long acting beta agonists:
A. Increased risk of nephrotoxicity
B. Increased risk of death from asthma
C. Increased risk of cardiac arrhythmias
D. Increased risk of hepatotoxicity
Answer: B
Rationale: Long-acting beta agonists (LABAs) carry a black box warning for
an increased risk of asthma-related death. The warning is based on the
SMART study (Salmeterol Multicenter Asthma Research Trial), which found
an increased risk of asthma-related mortality when LABAs were used
without concomitant inhaled corticosteroids. LABAs should only be used as
add-on therapy for patients whose asthma is not controlled with ICS alone.
They should never be used as monotherapy for asthma.
5. Bronchodilator for patients on propranolol:
A. Albuterol
B. Ipratropium (Atrovent)
C. Theophylline
D. Salmeterol
Answer: B