NUR 5461 ADVANCED
PHARMACOLOGY EXAM QUESTIONS
AND CORRECT ANSWERS 2026/2027
1. A patient with chronic kidney disease (Stage 4) is prescribed a new medication that is
primarily excreted renally. Which pharmacokinetic adjustment is most appropriate?
A. Increase the loading dose significantly
B. Decrease the dosing frequency
C. Reduce the maintenance dose or extend the interval
D. Switch to a medication with a shorter half-life
Answer: C
Conceptual Explanation: In patients with renal impairment, medications excreted by the
kidneys require a reduction in dose or an extension of the dosing interval to prevent
accumulation and toxicity.
2. Which of the following represents a significant contraindication for the use of ACE
inhibitors in a hypertensive patient?
A. History of angioedema
B. Hypokalemia
C. Essential tremor
,D. Peripheral edema
Answer: A
Conceptual Explanation: ACE inhibitors are strictly contraindicated in patients with a
history of angioedema, as they can cause life-threatening airway obstruction.
3. When prescribing Lithium for bipolar disorder, which laboratory value must be monitored
closely to prevent toxicity due to competitive reabsorption?
A. Serum Calcium
B. Blood Urea Nitrogen
C. Serum Sodium
D. Liver Transaminases
Answer: C
Conceptual Explanation: Lithium is handled by the kidneys similarly to sodium. Low
sodium levels lead to increased lithium reabsorption, increasing the risk of toxicity.
4. A patient is taking Warfarin and is started on Amiodarone. What is the expected drug-drug
interaction effect?
A. Decreased INR due to CYP3A4 induction
B. No significant interaction
C. Decreased risk of bleeding
D. Increased INR due to inhibition of CYP2C9
, Answer: D
Conceptual Explanation: Amiodarone inhibits CYP2C9, the primary enzyme responsible
for metabolizing S-warfarin, leading to increased warfarin levels and elevated INR.
5. Which mechanism best describes the action of GLP-1 receptor agonists in the treatment of
Type 2 Diabetes?
A. Inhibiting glucose reabsorption in the proximal tubule
B. Decreasing hepatic glucose production via AMPK activation
C. Increasing insulin secretion and slowing gastric emptying
D. Stimulating PPAR-gamma receptors in adipose tissue
Answer: C
Conceptual Explanation: GLP-1 agonists mimic incretin hormones, stimulating glucose-
dependent insulin secretion, suppressing glucagon, and slowing gastric emptying.
6. What is the black box warning associated with all SSRIs and SNRIs regarding the pediatric
and young adult population?
A. Increased risk of cardiac arrhythmias
B. Increased risk of suicidal ideation and behavior
C. Risk of hepatotoxicity
D. Potential for permanent growth stunting
Answer: B
PHARMACOLOGY EXAM QUESTIONS
AND CORRECT ANSWERS 2026/2027
1. A patient with chronic kidney disease (Stage 4) is prescribed a new medication that is
primarily excreted renally. Which pharmacokinetic adjustment is most appropriate?
A. Increase the loading dose significantly
B. Decrease the dosing frequency
C. Reduce the maintenance dose or extend the interval
D. Switch to a medication with a shorter half-life
Answer: C
Conceptual Explanation: In patients with renal impairment, medications excreted by the
kidneys require a reduction in dose or an extension of the dosing interval to prevent
accumulation and toxicity.
2. Which of the following represents a significant contraindication for the use of ACE
inhibitors in a hypertensive patient?
A. History of angioedema
B. Hypokalemia
C. Essential tremor
,D. Peripheral edema
Answer: A
Conceptual Explanation: ACE inhibitors are strictly contraindicated in patients with a
history of angioedema, as they can cause life-threatening airway obstruction.
3. When prescribing Lithium for bipolar disorder, which laboratory value must be monitored
closely to prevent toxicity due to competitive reabsorption?
A. Serum Calcium
B. Blood Urea Nitrogen
C. Serum Sodium
D. Liver Transaminases
Answer: C
Conceptual Explanation: Lithium is handled by the kidneys similarly to sodium. Low
sodium levels lead to increased lithium reabsorption, increasing the risk of toxicity.
4. A patient is taking Warfarin and is started on Amiodarone. What is the expected drug-drug
interaction effect?
A. Decreased INR due to CYP3A4 induction
B. No significant interaction
C. Decreased risk of bleeding
D. Increased INR due to inhibition of CYP2C9
, Answer: D
Conceptual Explanation: Amiodarone inhibits CYP2C9, the primary enzyme responsible
for metabolizing S-warfarin, leading to increased warfarin levels and elevated INR.
5. Which mechanism best describes the action of GLP-1 receptor agonists in the treatment of
Type 2 Diabetes?
A. Inhibiting glucose reabsorption in the proximal tubule
B. Decreasing hepatic glucose production via AMPK activation
C. Increasing insulin secretion and slowing gastric emptying
D. Stimulating PPAR-gamma receptors in adipose tissue
Answer: C
Conceptual Explanation: GLP-1 agonists mimic incretin hormones, stimulating glucose-
dependent insulin secretion, suppressing glucagon, and slowing gastric emptying.
6. What is the black box warning associated with all SSRIs and SNRIs regarding the pediatric
and young adult population?
A. Increased risk of cardiac arrhythmias
B. Increased risk of suicidal ideation and behavior
C. Risk of hepatotoxicity
D. Potential for permanent growth stunting
Answer: B
