NR566 ADVANCED PHARMACOLOGY
MIDTERM EXAM QUESTIONS WITH
100% CORRECT ANSWERS
1. Which of the following describes the primary mechanism of action of Angiotensin-
Converting Enzyme (ACE) inhibitors?
A. Directly blocks the AT1 receptors on the vascular smooth muscle.
B. Stimulates the release of bradykinin to induce vasodilation.
C. Promotes the excretion of sodium by blocking aldosterone production directly.
D. Inhibits the conversion of Angiotensin I to Angiotensin II.
Answer: D
Conceptual Explanation: ACE inhibitors work by inhibiting the enzyme that converts
Angiotensin I to Angiotensin II, which is a potent vasoconstrictor.
2. A patient taking Lisinopril develops a dry, hacking cough. Which substance is responsible
for this side effect?
A. Bradykinin
B. Aldosterone
C. Renin
D. Angiotensinogen
,Answer: A
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin. The
accumulation of bradykinin in the lungs is what leads to the dry cough.
3. Which Beta-blocker is considered cardio-selective and preferred for patients with
underlying respiratory conditions like asthma?
A. Propranolol
B. Nadolol
C. Metoprolol Succinate
D. Sotalol
Answer: C
Conceptual Explanation: Metoprolol is a selective Beta-1 blocker, meaning it primarily
affects the heart and is less likely to cause bronchoconstriction compared to non-selective
blockers like Propranolol.
4. A patient with Heart Failure with Reduced Ejection Fraction (HFrEF) is prescribed
Spironolactone. Which electrolyte abnormality must the provider monitor closely?
A. Hypocalcemia
B. Hyponatremia
C. Hyperkalemia
D. Hypomagnesemia
, Answer: C
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic (aldosterone
antagonist) and can lead to dangerous elevations in serum potassium.
5. When initiating Statin therapy, which of the following baseline laboratory tests is required
according to current guidelines?
A. Creatine kinase (CK) for all patients
B. Alanine aminotransferase (ALT)
C. Brain Natriuretic Peptide (BNP)
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Conceptual Explanation: Baseline ALT is recommended before starting a statin to
monitor for potential hepatotoxicity, though routine monitoring is no longer required
unless symptoms occur.
6. Which medication class is the first-line treatment for a patient newly diagnosed with Type
2 Diabetes Mellitus, assuming no contraindications?
A. Sulfonylureas
B. Biguanides (Metformin)
C. DPP-4 Inhibitors
D. SGLT2 Inhibitors
MIDTERM EXAM QUESTIONS WITH
100% CORRECT ANSWERS
1. Which of the following describes the primary mechanism of action of Angiotensin-
Converting Enzyme (ACE) inhibitors?
A. Directly blocks the AT1 receptors on the vascular smooth muscle.
B. Stimulates the release of bradykinin to induce vasodilation.
C. Promotes the excretion of sodium by blocking aldosterone production directly.
D. Inhibits the conversion of Angiotensin I to Angiotensin II.
Answer: D
Conceptual Explanation: ACE inhibitors work by inhibiting the enzyme that converts
Angiotensin I to Angiotensin II, which is a potent vasoconstrictor.
2. A patient taking Lisinopril develops a dry, hacking cough. Which substance is responsible
for this side effect?
A. Bradykinin
B. Aldosterone
C. Renin
D. Angiotensinogen
,Answer: A
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin. The
accumulation of bradykinin in the lungs is what leads to the dry cough.
3. Which Beta-blocker is considered cardio-selective and preferred for patients with
underlying respiratory conditions like asthma?
A. Propranolol
B. Nadolol
C. Metoprolol Succinate
D. Sotalol
Answer: C
Conceptual Explanation: Metoprolol is a selective Beta-1 blocker, meaning it primarily
affects the heart and is less likely to cause bronchoconstriction compared to non-selective
blockers like Propranolol.
4. A patient with Heart Failure with Reduced Ejection Fraction (HFrEF) is prescribed
Spironolactone. Which electrolyte abnormality must the provider monitor closely?
A. Hypocalcemia
B. Hyponatremia
C. Hyperkalemia
D. Hypomagnesemia
, Answer: C
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic (aldosterone
antagonist) and can lead to dangerous elevations in serum potassium.
5. When initiating Statin therapy, which of the following baseline laboratory tests is required
according to current guidelines?
A. Creatine kinase (CK) for all patients
B. Alanine aminotransferase (ALT)
C. Brain Natriuretic Peptide (BNP)
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Conceptual Explanation: Baseline ALT is recommended before starting a statin to
monitor for potential hepatotoxicity, though routine monitoring is no longer required
unless symptoms occur.
6. Which medication class is the first-line treatment for a patient newly diagnosed with Type
2 Diabetes Mellitus, assuming no contraindications?
A. Sulfonylureas
B. Biguanides (Metformin)
C. DPP-4 Inhibitors
D. SGLT2 Inhibitors
