1
NSG 533 ADVANCED PHARM EXAM 2 LATEST 2026/2027 GUIDE WITH
COMPLETE SOLUTION/ADVANCED PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS(100% VERIFIED)
1.
A 58-year-old patient with type 2 diabetes has an A1C of 8.4% despite adherence
to metformin, dietary modification, and regular physical activity. The patient has
obesity and wants a medication that can improve glycemic control while also
promoting weight loss. Renal function is adequate. Which medication class would
be most appropriate to consider?
A. Sulfonylurea
B. Thiazolidinedione
C. GLP-1 receptor agonist
D. Alpha-glucosidase inhibitor
Answer: C
2.
A 64-year-old patient with type 2 diabetes is taking metformin and develops
severe vomiting and diarrhea with dehydration. Laboratory testing demonstrates
significant renal impairment during the acute illness. Which medication should be
temporarily withheld because of the increased risk of accumulation and lactic
acidosis?
A. Metformin
B. Sitagliptin
C. Glipizide
D. Pioglitazone
Answer: A
3.
,2
A 45-year-old patient with type 2 diabetes begins a medication that increases
urinary glucose excretion. Several weeks later, the patient reports genital itching
and dysuria. Which medication class is most likely responsible?
A. DPP-4 inhibitor
B. SGLT2 inhibitor
C. Sulfonylurea
D. Thiazolidinedione
Answer: B
4.
A patient with type 2 diabetes is prescribed a sulfonylurea. The patient has
irregular meal patterns because of a demanding work schedule. Which adverse
effect should be emphasized during medication counseling?
A. Severe hypernatremia
B. Hypoglycemia
C. Hypercalcemia
D. Pulmonary fibrosis
Answer: B
5.
A patient with type 2 diabetes is prescribed a GLP-1 receptor agonist and asks why
the medication may help with both glucose control and weight reduction. Which
pharmacologic effect best explains this benefit?
A. Increased hepatic glucose production
B. Delayed gastric emptying and enhanced glucose-dependent insulin secretion
C. Direct stimulation of glucagon release
D. Complete inhibition of renal glucose filtration
Answer: B
6.
,3
A patient taking a DPP-4 inhibitor develops persistent severe abdominal pain
radiating toward the back with nausea and vomiting. Which adverse effect should
be considered?
A. Acute pancreatitis
B. Acute hepatitis
C. Pulmonary embolism
D. Nephrolithiasis
Answer: A
7.
A patient with type 2 diabetes and established cardiovascular disease requires
additional glucose-lowering therapy. The clinician wants a medication class with
demonstrated cardiovascular benefit in appropriate patients. Which option should
be considered?
A. Meglitinide
B. SGLT2 inhibitor
C. Alpha-glucosidase inhibitor
D. Basal insulin only
Answer: B
8.
A patient with type 2 diabetes begins an SGLT2 inhibitor. The clinician explains
that the medication works primarily by:
A. Increasing renal glucose excretion
B. Increasing intestinal glucose absorption
C. Blocking insulin receptors
D. Suppressing pancreatic beta-cell function
Answer: A
9.
, 4
A 52-year-old patient with type 2 diabetes takes metformin and reports chronic
fatigue and numbness in the feet. Laboratory evaluation demonstrates macrocytic
anemia. Which nutritional deficiency should be considered with long-term
metformin therapy?
A. Vitamin C
B. Vitamin B12
C. Vitamin K
D. Vitamin E
Answer: B
10.
A patient with diabetes is prescribed insulin glargine. Which instruction is most
appropriate?
A. Use it only when the blood glucose exceeds 300 mg/dL
B. Mix it routinely with regular insulin in the same syringe
C. Administer it according to the prescribed basal schedule
D. Expect its effect to peak sharply several hours after administration
Answer: C
11.
A patient with type 2 diabetes has inadequate control on metformin and requires
an additional medication. The patient has a history of recurrent genital fungal
infections and prefers to avoid medications that increase urinary glucose
excretion. Which class may be less desirable?
A. SGLT2 inhibitors
B. DPP-4 inhibitors
C. GLP-1 receptor agonists
D. Biguanides
Answer: A
12.
NSG 533 ADVANCED PHARM EXAM 2 LATEST 2026/2027 GUIDE WITH
COMPLETE SOLUTION/ADVANCED PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS(100% VERIFIED)
1.
A 58-year-old patient with type 2 diabetes has an A1C of 8.4% despite adherence
to metformin, dietary modification, and regular physical activity. The patient has
obesity and wants a medication that can improve glycemic control while also
promoting weight loss. Renal function is adequate. Which medication class would
be most appropriate to consider?
A. Sulfonylurea
B. Thiazolidinedione
C. GLP-1 receptor agonist
D. Alpha-glucosidase inhibitor
Answer: C
2.
A 64-year-old patient with type 2 diabetes is taking metformin and develops
severe vomiting and diarrhea with dehydration. Laboratory testing demonstrates
significant renal impairment during the acute illness. Which medication should be
temporarily withheld because of the increased risk of accumulation and lactic
acidosis?
A. Metformin
B. Sitagliptin
C. Glipizide
D. Pioglitazone
Answer: A
3.
,2
A 45-year-old patient with type 2 diabetes begins a medication that increases
urinary glucose excretion. Several weeks later, the patient reports genital itching
and dysuria. Which medication class is most likely responsible?
A. DPP-4 inhibitor
B. SGLT2 inhibitor
C. Sulfonylurea
D. Thiazolidinedione
Answer: B
4.
A patient with type 2 diabetes is prescribed a sulfonylurea. The patient has
irregular meal patterns because of a demanding work schedule. Which adverse
effect should be emphasized during medication counseling?
A. Severe hypernatremia
B. Hypoglycemia
C. Hypercalcemia
D. Pulmonary fibrosis
Answer: B
5.
A patient with type 2 diabetes is prescribed a GLP-1 receptor agonist and asks why
the medication may help with both glucose control and weight reduction. Which
pharmacologic effect best explains this benefit?
A. Increased hepatic glucose production
B. Delayed gastric emptying and enhanced glucose-dependent insulin secretion
C. Direct stimulation of glucagon release
D. Complete inhibition of renal glucose filtration
Answer: B
6.
,3
A patient taking a DPP-4 inhibitor develops persistent severe abdominal pain
radiating toward the back with nausea and vomiting. Which adverse effect should
be considered?
A. Acute pancreatitis
B. Acute hepatitis
C. Pulmonary embolism
D. Nephrolithiasis
Answer: A
7.
A patient with type 2 diabetes and established cardiovascular disease requires
additional glucose-lowering therapy. The clinician wants a medication class with
demonstrated cardiovascular benefit in appropriate patients. Which option should
be considered?
A. Meglitinide
B. SGLT2 inhibitor
C. Alpha-glucosidase inhibitor
D. Basal insulin only
Answer: B
8.
A patient with type 2 diabetes begins an SGLT2 inhibitor. The clinician explains
that the medication works primarily by:
A. Increasing renal glucose excretion
B. Increasing intestinal glucose absorption
C. Blocking insulin receptors
D. Suppressing pancreatic beta-cell function
Answer: A
9.
, 4
A 52-year-old patient with type 2 diabetes takes metformin and reports chronic
fatigue and numbness in the feet. Laboratory evaluation demonstrates macrocytic
anemia. Which nutritional deficiency should be considered with long-term
metformin therapy?
A. Vitamin C
B. Vitamin B12
C. Vitamin K
D. Vitamin E
Answer: B
10.
A patient with diabetes is prescribed insulin glargine. Which instruction is most
appropriate?
A. Use it only when the blood glucose exceeds 300 mg/dL
B. Mix it routinely with regular insulin in the same syringe
C. Administer it according to the prescribed basal schedule
D. Expect its effect to peak sharply several hours after administration
Answer: C
11.
A patient with type 2 diabetes has inadequate control on metformin and requires
an additional medication. The patient has a history of recurrent genital fungal
infections and prefers to avoid medications that increase urinary glucose
excretion. Which class may be less desirable?
A. SGLT2 inhibitors
B. DPP-4 inhibitors
C. GLP-1 receptor agonists
D. Biguanides
Answer: A
12.
