Wilkes NSG 533 Exam 1 Advanced Pharmacology 2026/2027 | Practice Questions, Correct Answers & Detailed Rationales | Wilkes University Exam Prep PDF

Wilkes NSG 533 Exam 1 Advanced
Pharmacology 2026/2027 | Practice
Questions, Correct Answers & Detailed
Rationales | Wilkes University Exam Prep
PDF
WILKES NSG 533 EXAM 1: ADVANCED PHARMACOLOGY 2026/2027

Practice Questions, Correct Answers & Detailed Rationales



DOCUMENT OVERVIEW

• This comprehensive 200-question practice exam covers advanced pharmacology
principles, mechanisms of action, clinical applications, drug interactions, and
adverse effects relevant to nursing practice at the graduate level

• Study this material by reviewing each question thoroughly, attempting answers
before checking the correct response, and using detailed rationales to understand
pharmacological concepts and their clinical implications




QUESTION 1

A 58-year-old patient with hypertension is prescribed lisinopril, an ACE
inhibitor. Which of the following best describes the mechanism of action of
ACE inhibitors?

A) Blocking alpha-1 adrenergic receptors in vascular smooth muscle

B) Inhibiting angiotensin-converting enzyme, preventing conversion of angiotensin I
to angiotensin II

C) Blocking calcium channels in the heart and blood vessels

D) Inhibiting the sympathetic nervous system at the central level

E) Direct relaxation of vascular smooth muscle through nitric oxide release

,CORRECT ANSWER: B) Inhibiting angiotensin-converting enzyme, preventing
conversion of angiotensin I to angiotensin II

RATIONALE: ACE inhibitors work by blocking the enzyme responsible for
converting angiotensin I to angiotensin II, a potent vasoconstrictor. This mechanism
reduces peripheral vascular resistance and decreases blood pressure. Option A
describes alpha blockers, option C describes calcium channel blockers, option D
describes centrally acting agents, and option E describes nitrates. ACE inhibitors
specifically target the renin-angiotensin-aldosterone system at the ACE enzyme
level.



QUESTION 2

A patient is taking metformin for type 2 diabetes. Which adverse effect is
most commonly associated with metformin use, particularly in older adults?

A) Hyperglycemia and polycythemia

B) Lactic acidosis, especially when renal function is impaired

C) Severe hypoglycemia requiring glucagon administration

D) Acute pancreatitis and elevated pancreatic enzymes

E) Thyroid dysfunction and hypothyroidism

CORRECT ANSWER: B) Lactic acidosis, especially when renal function is
impaired

RATIONALE: Metformin can accumulate in patients with renal impairment,
increasing the risk of lactic acidosis, a serious and potentially fatal adverse effect.
This is particularly concerning in older adults who may have age-related declining
renal function. Metformin is contraindicated in patients with creatinine clearance
less than 30 mL/min. Hypoglycemia is rare with metformin alone, and the other
options are not characteristic adverse effects of this medication.



QUESTION 3

,Which of the following warfarin interactions would most likely increase the
anticoagulant effect and bleeding risk?

A) Concurrent use with rifampin

B) Concurrent use with phenytoin

C) Concurrent use with aspirin and NSAIDs

D) Concurrent use with barbiturates

E) Concurrent use with oral contraceptives

CORRECT ANSWER: C) Concurrent use with aspirin and NSAIDs

RATIONALE: Aspirin and NSAIDs inhibit platelet function and can displace warfarin
from protein binding, significantly increasing warfarin levels and anticoagulant
effect. This combination substantially increases bleeding risk. Options A, B, and D
are enzyme inducers that decrease warfarin effect. Option E may actually decrease
warfarin effect due to estrogen's effects on clotting factors. The combination of
warfarin with antiplatelet or antiinflammatory drugs requires careful monitoring.



QUESTION 4

A 72-year-old patient with atrial fibrillation takes digoxin. What is the primary
mechanism by which digoxin increases cardiac contractility?

A) Blocking beta-1 adrenergic receptors

B) Inhibiting Na+/K+ ATPase pump, which increases intracellular calcium

C) Opening calcium channels in the sinoatrial node

D) Increasing sympathetic nervous system activity

E) Dilating coronary blood vessels

CORRECT ANSWER: B) Inhibiting Na+/K+ ATPase pump, which increases
intracellular calcium

RATIONALE: Digoxin is a cardiac glycoside that inhibits the sodium-potassium
ATPase pump. This inhibition leads to increased intracellular sodium, which

, reduces the activity of the Na+/Ca2+ exchanger, thereby increasing intracellular
calcium stores. Increased intracellular calcium results in stronger myocardial
contractions and positive inotropic effects. This mechanism also slows conduction
through the AV node, making digoxin useful for rate control in atrial fibrillation.



QUESTION 5

A patient presents with acute asthma exacerbation. Which medication
provides the most rapid bronchodilation?

A) Montelukast (Singulair), a leukotriene antagonist

B) Fluticasone (Flovent), an inhaled corticosteroid

C) Albuterol (Ventolin), a short-acting beta-2 agonist

D) Theophylline, a methylxanthine

E) Tiotropium (Spiriva), a long-acting anticholinergic

CORRECT ANSWER: C) Albuterol (Ventolin), a short-acting beta-2 agonist

RATIONALE: Short-acting beta-2 agonists (SABAs) like albuterol work within
minutes to relax bronchial smooth muscle by stimulating beta-2 adrenergic
receptors, causing rapid bronchodilation. This makes them ideal for acute
exacerbations. Corticosteroids work more slowly (hours to days), leukotriene
antagonists take longer, long-acting agents are not appropriate for acute relief, and
theophylline has a slower onset. SABAs are the first-line treatment for acute
bronchospasm.



QUESTION 6

A patient on chronic opioid therapy for cancer pain develops constipation.
Which medication is most appropriate for opioid-induced constipation?

A) Atropine, an anticholinergic agent

B) Methylnaltrexone (Relistor), a peripherally acting mu-receptor antagonist