NSG 533 Advanced Pharmacology Exam (2026) Exam
Questions & Answers | Latest Already Graded A+
,EP is a 38-year-old female patient that comes in forExenatide - Exenatide (Bydureon) once weekly has been able to demonstrate diabetes
education and management. She was diagnosedweight loss and decrease A1C% by 0.7% to 1.2% in clinical trials; however it is 12 years ago and
states lately she is not able to controlcontraindicated for EP due to the self-reported history of thyroid cancer.
her diet although she continues a 1600 calorie diet withDapagliflozin - Dapagliflozin (Farxiga) is contraindicated in this patient due to
appropriate daily carbohydrate intake (per dietitianhyperkalemia which could be made worse by this drug. The package insert does prescription) and
walks 40 minutes every day of thenot indicate a specific potassium concentration cut off to no longer use this week. She states compliance with
all medications. Shemedication; however, there are better choices in this patient.
denies any history of hypoglycemia despite being able toSitagliptin - Sitagliptin (Januvia) is able to obtain an A1C goal of less than 7% identify
signs and symptoms and describe appropriatebased on clinical trials and currently the patient does not have any cautionary treatment
strategies.objective measures to not use this medication. DPP-IV inhibitors are weight
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomyneutral. DPP-IV inhibitors can be used in patients taking sulfonylureas; however, it due to
thyroid cancermay be recommended to reduce or stop the sulfonylurea dose.
FmHx: NoncontributoryAcarbose - Acarbose (Precose) is not recommended for initial management and
SHx: (−) Smoking, alcohol use, past marijuana use while inis associated with significant GI side effects. More information would be needed
high schoolregarding fasting and post-prandial numbers. In addition, adding acarbose would
Medications: Metformin 850 mg tid, glipizide 20 mg bid,only lower A1c by 0.8% at best and therefore would not achieve the desired A1C lisinopril
20 mg daily, sertraline 100 mg daily, multivitamingoal of <7% daily
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl 106 mEq/L,
BUN
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JR is a 68-year-old African American man with a newMetformin is the drug of choice recommended for most patients with diabetes in diagnosis of T2DM.
He was classified as havingaddition to lifestyle modifications assuming no contraindications or intolerabilities prediabetes (at risk for developing
diabetes) 5 yearsare present upon evaluation. Metformin has also shown to provide positive weight before the diagnosis and has a strong family history
ofneutral/loss effects in obese patients. It is crucial to know the renal status of type 2 diabetes. JR's blood pressure was 150/92 mm Hg.patients
commencing metformin therapy to limit the risk of lactic acidosis (JR is His laboratory results revealed an A1C of 8.1%, normalwithout contraindication).
cholesterol panel, and normal renal/hepatic functionSince his entry A1C is >7.5%, dual therapy is indicated. There are several potential were noted
with today's laboratory test results.choices. The second step can be a dipeptidyl peptidase-4 inhibitor, it can be a
Past medical history: Hypertension (diagnosed 4 y ago)glucagon- like peptide-1 (GLP-1) receptor agonist, it can be a TZD, it can be a Hyperlipidemia
(diagnosed 2 y ago) Pancreatitissulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal insulin.
(idiopathic) (acute hospitalization 3 y ago)Anything next can be tried depending on what suits the circumstance
Family history: Type 2 diabetesDPP4 inhibitors are weight neutral bet relatively benign side effect profile.
Medication: HCTZ 25 mg daily, simvastatin 10 mg dailySitagliptin has been associated with case reports of pancreatitis, so this specific
Allergies: SMZ/TMPagent should be avoided. $$$
Vitals: BP: 150/92 mm Hg P: 78 beats/min RR: 12 rpm WaistGLP-1 analog and has data to support an A1C reduction necessary to gain
Circumference: 46 in Weight: 267 lb Height: 5 ′ 6 ″ BMI:glycemic control and may assist with weight loss goals for this patient. New
43.1 kg/m 2information suggests these agents may provide benefits in those with ASCVD. JR
has a past history of
pancreatitis and GLP-
1 analogs are not
recommended due to
this contraindication
Despite improvements in the past six weeks due toTZDs have data to support an A1C reduction necessary to gain glycemic control, lifestyle changes and
exercise, drug therapy is to bebut are associated with weight gain, negative effects on lipids and increased risk
started for JR's diabetof fracture. Until recently, TZDs have also been linked to increased CV events and
use has fallen out of
favor
Sulfonylureas provide
excellent A1C
lowering, but are also associated with weight gain. They also have the potential to cause
hypoglycemia, so patient education is crucial. Because of his allergies to "sulfa", use would be
contr
A patient with type 1 diabetes reports taking propranololA patient with Type 1 DM is insulin dependent for glucose control and at high risk for
hypertension. What concern does this informationfor hypoglycemic episodes. Propanolol causes prolonged hypoglycemic present for the
provider?episodes. Needs to switch to ACE or ARB.
A provider teaches a patient who has been diagnosedD. Calcium may reduce levothyroxine absorption. Further education is needed if with
hypothyroidism about a new prescription forthe patient feels she can take half of a prescribed medication.
levothyroxine. Which statement by the patient indicates a need
for further teaching?
a. "I should not take heartburn medication
withoutconsulting my provider first."
b. "I should report insomnia, tremors, and an
increasedheart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4
hoursafter the levothyroxine."
d. "If I take calcium supplements, I may need to
decreasemy dose of levothyroxine."
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Questions & Answers | Latest Already Graded A+
,EP is a 38-year-old female patient that comes in forExenatide - Exenatide (Bydureon) once weekly has been able to demonstrate diabetes
education and management. She was diagnosedweight loss and decrease A1C% by 0.7% to 1.2% in clinical trials; however it is 12 years ago and
states lately she is not able to controlcontraindicated for EP due to the self-reported history of thyroid cancer.
her diet although she continues a 1600 calorie diet withDapagliflozin - Dapagliflozin (Farxiga) is contraindicated in this patient due to
appropriate daily carbohydrate intake (per dietitianhyperkalemia which could be made worse by this drug. The package insert does prescription) and
walks 40 minutes every day of thenot indicate a specific potassium concentration cut off to no longer use this week. She states compliance with
all medications. Shemedication; however, there are better choices in this patient.
denies any history of hypoglycemia despite being able toSitagliptin - Sitagliptin (Januvia) is able to obtain an A1C goal of less than 7% identify
signs and symptoms and describe appropriatebased on clinical trials and currently the patient does not have any cautionary treatment
strategies.objective measures to not use this medication. DPP-IV inhibitors are weight
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomyneutral. DPP-IV inhibitors can be used in patients taking sulfonylureas; however, it due to
thyroid cancermay be recommended to reduce or stop the sulfonylurea dose.
FmHx: NoncontributoryAcarbose - Acarbose (Precose) is not recommended for initial management and
SHx: (−) Smoking, alcohol use, past marijuana use while inis associated with significant GI side effects. More information would be needed
high schoolregarding fasting and post-prandial numbers. In addition, adding acarbose would
Medications: Metformin 850 mg tid, glipizide 20 mg bid,only lower A1c by 0.8% at best and therefore would not achieve the desired A1C lisinopril
20 mg daily, sertraline 100 mg daily, multivitamingoal of <7% daily
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl 106 mEq/L,
BUN
Downloaded by: ruthaddison | Want to earn $1.236 Distribution of
this document is illegal extra per year?
, Stuvia.com - The Marketplace to Buy and Sell your Study Material
JR is a 68-year-old African American man with a newMetformin is the drug of choice recommended for most patients with diabetes in diagnosis of T2DM.
He was classified as havingaddition to lifestyle modifications assuming no contraindications or intolerabilities prediabetes (at risk for developing
diabetes) 5 yearsare present upon evaluation. Metformin has also shown to provide positive weight before the diagnosis and has a strong family history
ofneutral/loss effects in obese patients. It is crucial to know the renal status of type 2 diabetes. JR's blood pressure was 150/92 mm Hg.patients
commencing metformin therapy to limit the risk of lactic acidosis (JR is His laboratory results revealed an A1C of 8.1%, normalwithout contraindication).
cholesterol panel, and normal renal/hepatic functionSince his entry A1C is >7.5%, dual therapy is indicated. There are several potential were noted
with today's laboratory test results.choices. The second step can be a dipeptidyl peptidase-4 inhibitor, it can be a
Past medical history: Hypertension (diagnosed 4 y ago)glucagon- like peptide-1 (GLP-1) receptor agonist, it can be a TZD, it can be a Hyperlipidemia
(diagnosed 2 y ago) Pancreatitissulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal insulin.
(idiopathic) (acute hospitalization 3 y ago)Anything next can be tried depending on what suits the circumstance
Family history: Type 2 diabetesDPP4 inhibitors are weight neutral bet relatively benign side effect profile.
Medication: HCTZ 25 mg daily, simvastatin 10 mg dailySitagliptin has been associated with case reports of pancreatitis, so this specific
Allergies: SMZ/TMPagent should be avoided. $$$
Vitals: BP: 150/92 mm Hg P: 78 beats/min RR: 12 rpm WaistGLP-1 analog and has data to support an A1C reduction necessary to gain
Circumference: 46 in Weight: 267 lb Height: 5 ′ 6 ″ BMI:glycemic control and may assist with weight loss goals for this patient. New
43.1 kg/m 2information suggests these agents may provide benefits in those with ASCVD. JR
has a past history of
pancreatitis and GLP-
1 analogs are not
recommended due to
this contraindication
Despite improvements in the past six weeks due toTZDs have data to support an A1C reduction necessary to gain glycemic control, lifestyle changes and
exercise, drug therapy is to bebut are associated with weight gain, negative effects on lipids and increased risk
started for JR's diabetof fracture. Until recently, TZDs have also been linked to increased CV events and
use has fallen out of
favor
Sulfonylureas provide
excellent A1C
lowering, but are also associated with weight gain. They also have the potential to cause
hypoglycemia, so patient education is crucial. Because of his allergies to "sulfa", use would be
contr
A patient with type 1 diabetes reports taking propranololA patient with Type 1 DM is insulin dependent for glucose control and at high risk for
hypertension. What concern does this informationfor hypoglycemic episodes. Propanolol causes prolonged hypoglycemic present for the
provider?episodes. Needs to switch to ACE or ARB.
A provider teaches a patient who has been diagnosedD. Calcium may reduce levothyroxine absorption. Further education is needed if with
hypothyroidism about a new prescription forthe patient feels she can take half of a prescribed medication.
levothyroxine. Which statement by the patient indicates a need
for further teaching?
a. "I should not take heartburn medication
withoutconsulting my provider first."
b. "I should report insomnia, tremors, and an
increasedheart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4
hoursafter the levothyroxine."
d. "If I take calcium supplements, I may need to
decreasemy dose of levothyroxine."
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