NURS 6521N WEEK 8 EXAM -
ADVANCED PHARMACOLOGY
QUESTIONS WITH COMPLETE AND
VERIFIED SOLUTIONS: WALDEN
UNIVERSITY
1. A 55-year-old patient with Type 2 Diabetes is started on Metformin. Which of the following
is the most significant Black Box Warning associated with this medication?
A. Lactic Acidosis
B. Acute Pancreatitis
C. Congestive Heart Failure
D. Medullary Thyroid Carcinoma
Answer: A
Conceptual Explanation: Metformin carries a Black Box Warning for lactic acidosis, a rare
but potentially fatal metabolic complication, especially in patients with renal impairment.
2. Which mechanism of action best describes SGLT2 inhibitors like Canagliflozin?
A. Increasing insulin sensitivity in muscle tissue
B. Reducing glucose absorption in the small intestine
C. Promoting urinary glucose excretion by inhibiting reabsorption in the proximal tubule
,D. Stimulating pancreatic beta cells to release more insulin
Answer: C
Conceptual Explanation: SGLT2 inhibitors block the Sodium-Glucose Cotransporter 2 in
the kidneys, leading to increased glucosuria and lower blood glucose levels.
3. A patient is prescribed Levothyroxine for hypothyroidism. The nurse should instruct the
patient to take this medication:
A. With a high-fiber breakfast to improve digestion
B. At bedtime with a glass of warm milk
C. Immediately after the largest meal of the day
D. On an empty stomach, at least 30-60 minutes before breakfast
Answer: D
Conceptual Explanation: Levothyroxine absorption is decreased by food, calcium, and
iron; it must be taken on an empty stomach to ensure consistent therapeutic levels.
4. Which of the following is a primary contraindication for the use of Pioglitazone?
A. Chronic Obstructive Pulmonary Disease
B. History of Peptic Ulcer Disease
C. NYHA Class III or IV Heart Failure
D. Hypothyroidism
, Answer: C
Conceptual Explanation: Thiazolidinediones like Pioglitazone cause fluid retention, which
can exacerbate or precipitate congestive heart failure.
5. A patient with hyperthyroidism is pregnant (first trimester). Which medication is preferred
for treatment?
A. Propylthiouracil (PTU)
B. Radioactive Iodine
C. Methimazole
D. Levothyroxine
Answer: A
Conceptual Explanation: PTU is preferred in the first trimester of pregnancy due to a
lower risk of teratogenic effects compared to Methimazole.
6. What is the mechanism of action of DPP-4 inhibitors like Sitagliptin?
A. They act as direct GLP-1 receptor agonists
B. They slow the inactivation of incretin hormones, increasing insulin release
C. They inhibit the alpha-glucosidase enzyme in the gut
D. They increase peripheral glucose uptake via GLUT-4 transporters
Answer: B
ADVANCED PHARMACOLOGY
QUESTIONS WITH COMPLETE AND
VERIFIED SOLUTIONS: WALDEN
UNIVERSITY
1. A 55-year-old patient with Type 2 Diabetes is started on Metformin. Which of the following
is the most significant Black Box Warning associated with this medication?
A. Lactic Acidosis
B. Acute Pancreatitis
C. Congestive Heart Failure
D. Medullary Thyroid Carcinoma
Answer: A
Conceptual Explanation: Metformin carries a Black Box Warning for lactic acidosis, a rare
but potentially fatal metabolic complication, especially in patients with renal impairment.
2. Which mechanism of action best describes SGLT2 inhibitors like Canagliflozin?
A. Increasing insulin sensitivity in muscle tissue
B. Reducing glucose absorption in the small intestine
C. Promoting urinary glucose excretion by inhibiting reabsorption in the proximal tubule
,D. Stimulating pancreatic beta cells to release more insulin
Answer: C
Conceptual Explanation: SGLT2 inhibitors block the Sodium-Glucose Cotransporter 2 in
the kidneys, leading to increased glucosuria and lower blood glucose levels.
3. A patient is prescribed Levothyroxine for hypothyroidism. The nurse should instruct the
patient to take this medication:
A. With a high-fiber breakfast to improve digestion
B. At bedtime with a glass of warm milk
C. Immediately after the largest meal of the day
D. On an empty stomach, at least 30-60 minutes before breakfast
Answer: D
Conceptual Explanation: Levothyroxine absorption is decreased by food, calcium, and
iron; it must be taken on an empty stomach to ensure consistent therapeutic levels.
4. Which of the following is a primary contraindication for the use of Pioglitazone?
A. Chronic Obstructive Pulmonary Disease
B. History of Peptic Ulcer Disease
C. NYHA Class III or IV Heart Failure
D. Hypothyroidism
, Answer: C
Conceptual Explanation: Thiazolidinediones like Pioglitazone cause fluid retention, which
can exacerbate or precipitate congestive heart failure.
5. A patient with hyperthyroidism is pregnant (first trimester). Which medication is preferred
for treatment?
A. Propylthiouracil (PTU)
B. Radioactive Iodine
C. Methimazole
D. Levothyroxine
Answer: A
Conceptual Explanation: PTU is preferred in the first trimester of pregnancy due to a
lower risk of teratogenic effects compared to Methimazole.
6. What is the mechanism of action of DPP-4 inhibitors like Sitagliptin?
A. They act as direct GLP-1 receptor agonists
B. They slow the inactivation of incretin hormones, increasing insulin release
C. They inhibit the alpha-glucosidase enzyme in the gut
D. They increase peripheral glucose uptake via GLUT-4 transporters
Answer: B
