NR566 ADVANCED PHARMACOLOGY
MIDTERM EXAM PREP QUESTIONS
WITH 100% CORRECT ANSWERS
1. A patient taking an ACE inhibitor develops a dry, non-productive cough. What is the
primary biochemical mechanism responsible for this adverse effect?
A. Inhibition of renin release
B. Direct irritation of the bronchial mucosa
C. Accumulation of bradykinin in the lungs
D. Increase in prostaglandin E2 synthesis
Answer: C
Conceptual Explanation: ACE inhibitors block the enzyme that breaks down bradykinin.
The resulting accumulation of bradykinin in the lungs can trigger a persistent, dry cough in
some patients.
2. Which of the following classes of antihypertensive medications is generally contraindicated
in patients with a history of severe asthma?
A. Calcium Channel Blockers
B. Angiotensin II Receptor Blockers
C. Thiazide Diuretics
,D. Non-selective Beta-Blockers
Answer: D
Conceptual Explanation: Non-selective beta-blockers (like propranolol) block Beta-2
receptors in the lungs, which can cause bronchoconstriction and exacerbate asthma.
3. A patient is prescribed Atorvastatin (Lipitor) for hyperlipidemia. Which laboratory value
should the NP monitor most closely if the patient reports unexplained muscle pain?
A. Creatine Kinase (CK)
B. Serum Creatinine
C. Alkaline Phosphatase
D. Glycated Hemoglobin (A1C)
Answer: A
Conceptual Explanation: Statins can cause myopathy and rhabdomyolysis. Elevated
Creatine Kinase (CK) levels are an indicator of muscle injury.
4. What is the primary mechanism of action of Metformin in the management of Type 2
Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells
B. Increasing glucose excretion via the kidneys
C. Decreasing hepatic glucose production and improving insulin sensitivity
D. Slowing the absorption of carbohydrates in the GI tract
, Answer: C
Conceptual Explanation: Metformin reduces hepatic gluconeogenesis and increases
peripheral glucose uptake and utilization by improving insulin sensitivity.
5. When prescribing Amiodarone for cardiac arrhythmias, which organ system requires
baseline and periodic monitoring due to potential severe toxicity?
A. Renal system
B. Integumentary system
C. Pulmonary system
D. Musculoskeletal system
Answer: C
Conceptual Explanation: Amiodarone is associated with serious pulmonary toxicity
(interstitial pneumonitis or fibrosis), requiring baseline and regular chest X-rays and PFTs.
6. Which teaching point is most important for a patient newly prescribed alendronate
(Fosamax) for osteoporosis?
A. Take the medication with a glass of milk to increase absorption
B. Chew the tablet thoroughly to ensure rapid onset
C. Take the dose at bedtime to avoid dizziness
D. Remain upright for at least 30 minutes after taking the dose
Answer: D
MIDTERM EXAM PREP QUESTIONS
WITH 100% CORRECT ANSWERS
1. A patient taking an ACE inhibitor develops a dry, non-productive cough. What is the
primary biochemical mechanism responsible for this adverse effect?
A. Inhibition of renin release
B. Direct irritation of the bronchial mucosa
C. Accumulation of bradykinin in the lungs
D. Increase in prostaglandin E2 synthesis
Answer: C
Conceptual Explanation: ACE inhibitors block the enzyme that breaks down bradykinin.
The resulting accumulation of bradykinin in the lungs can trigger a persistent, dry cough in
some patients.
2. Which of the following classes of antihypertensive medications is generally contraindicated
in patients with a history of severe asthma?
A. Calcium Channel Blockers
B. Angiotensin II Receptor Blockers
C. Thiazide Diuretics
,D. Non-selective Beta-Blockers
Answer: D
Conceptual Explanation: Non-selective beta-blockers (like propranolol) block Beta-2
receptors in the lungs, which can cause bronchoconstriction and exacerbate asthma.
3. A patient is prescribed Atorvastatin (Lipitor) for hyperlipidemia. Which laboratory value
should the NP monitor most closely if the patient reports unexplained muscle pain?
A. Creatine Kinase (CK)
B. Serum Creatinine
C. Alkaline Phosphatase
D. Glycated Hemoglobin (A1C)
Answer: A
Conceptual Explanation: Statins can cause myopathy and rhabdomyolysis. Elevated
Creatine Kinase (CK) levels are an indicator of muscle injury.
4. What is the primary mechanism of action of Metformin in the management of Type 2
Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells
B. Increasing glucose excretion via the kidneys
C. Decreasing hepatic glucose production and improving insulin sensitivity
D. Slowing the absorption of carbohydrates in the GI tract
, Answer: C
Conceptual Explanation: Metformin reduces hepatic gluconeogenesis and increases
peripheral glucose uptake and utilization by improving insulin sensitivity.
5. When prescribing Amiodarone for cardiac arrhythmias, which organ system requires
baseline and periodic monitoring due to potential severe toxicity?
A. Renal system
B. Integumentary system
C. Pulmonary system
D. Musculoskeletal system
Answer: C
Conceptual Explanation: Amiodarone is associated with serious pulmonary toxicity
(interstitial pneumonitis or fibrosis), requiring baseline and regular chest X-rays and PFTs.
6. Which teaching point is most important for a patient newly prescribed alendronate
(Fosamax) for osteoporosis?
A. Take the medication with a glass of milk to increase absorption
B. Chew the tablet thoroughly to ensure rapid onset
C. Take the dose at bedtime to avoid dizziness
D. Remain upright for at least 30 minutes after taking the dose
Answer: D
