NSG6005 ADVANCED PHARMACOLOGY
EXAMINATION 2026/2027 SOUTH
UNIVERSITY (CORRECT Q & A)
SATISFACTION GUARANTEED
1. A patient with chronic kidney disease is prescribed a drug with a narrow therapeutic index
that is primarily renally excreted. Which pharmacokinetic parameter should the nurse
practitioner most closely monitor to avoid toxicity?
A. Volume of distribution
B. Protein binding capacity
C. Hepatic metabolism rate
D. Glomerular filtration rate (GFR)
Answer: D
Conceptual Explanation: For drugs primarily excreted by the kidneys, GFR is the most
critical determinant of clearance and half-life. A decrease in GFR necessitates dosage
adjustments to prevent accumulation and toxicity.
2. A 68-year-old patient is taking Warfarin for atrial fibrillation. The patient is started on
Amiodarone for rhythm control. What is the expected interaction between these two
medications?
A. There is no significant interaction between these drugs.
,B. Amiodarone induces CYP3A4, decreasing Warfarin efficacy.
C. Warfarin reduces the absorption of Amiodarone.
D. Amiodarone inhibits CYP2C9, increasing Warfarin levels and INR.
Answer: D
Conceptual Explanation: Amiodarone is a potent inhibitor of CYP2C9, the primary
enzyme responsible for metabolizing S-warfarin. This leads to increased serum
concentrations of Warfarin and a significant rise in INR, increasing bleeding risk.
3. Which of the following describes the mechanism of action of Sacubitril in the management
of heart failure?
A. It inhibits the enzyme neprilysin, increasing levels of natriuretic peptides.
B. It acts as a selective Beta-1 blocker.
C. It directly blocks the Angiotensin II receptor.
D. It inhibits the HMG-CoA reductase enzyme.
Answer: A
Conceptual Explanation: Sacubitril is a neprilysin inhibitor. Neprilysin breaks down
natriuretic peptides; inhibiting it increases these peptides, leading to vasodilation,
natriuresis, and diuresis.
, 4. A patient is prescribed Metformin for Type 2 Diabetes. Which lab value would be a
contraindication for continuing this medication?
A. eGFR less than 30 mL/min/1.73m²
B. Serum Potassium of 5.2 mEq/L
C. Hemoglobin A1c of 8.5%
D. LDL cholesterol of 140 mg/dL
Answer: A
Conceptual Explanation: Metformin is contraindicated in patients with severe renal
impairment (eGFR < 30) due to the significantly increased risk of lactic acidosis.
5. When prescribing an ACE inhibitor to a patient, which electrolyte imbalance is most
commonly observed?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors block the conversion of Angiotensin I to
Angiotensin II, which leads to decreased aldosterone secretion. Since aldosterone promotes
potassium excretion, its reduction leads to potassium retention (hyperkalemia).
EXAMINATION 2026/2027 SOUTH
UNIVERSITY (CORRECT Q & A)
SATISFACTION GUARANTEED
1. A patient with chronic kidney disease is prescribed a drug with a narrow therapeutic index
that is primarily renally excreted. Which pharmacokinetic parameter should the nurse
practitioner most closely monitor to avoid toxicity?
A. Volume of distribution
B. Protein binding capacity
C. Hepatic metabolism rate
D. Glomerular filtration rate (GFR)
Answer: D
Conceptual Explanation: For drugs primarily excreted by the kidneys, GFR is the most
critical determinant of clearance and half-life. A decrease in GFR necessitates dosage
adjustments to prevent accumulation and toxicity.
2. A 68-year-old patient is taking Warfarin for atrial fibrillation. The patient is started on
Amiodarone for rhythm control. What is the expected interaction between these two
medications?
A. There is no significant interaction between these drugs.
,B. Amiodarone induces CYP3A4, decreasing Warfarin efficacy.
C. Warfarin reduces the absorption of Amiodarone.
D. Amiodarone inhibits CYP2C9, increasing Warfarin levels and INR.
Answer: D
Conceptual Explanation: Amiodarone is a potent inhibitor of CYP2C9, the primary
enzyme responsible for metabolizing S-warfarin. This leads to increased serum
concentrations of Warfarin and a significant rise in INR, increasing bleeding risk.
3. Which of the following describes the mechanism of action of Sacubitril in the management
of heart failure?
A. It inhibits the enzyme neprilysin, increasing levels of natriuretic peptides.
B. It acts as a selective Beta-1 blocker.
C. It directly blocks the Angiotensin II receptor.
D. It inhibits the HMG-CoA reductase enzyme.
Answer: A
Conceptual Explanation: Sacubitril is a neprilysin inhibitor. Neprilysin breaks down
natriuretic peptides; inhibiting it increases these peptides, leading to vasodilation,
natriuresis, and diuresis.
, 4. A patient is prescribed Metformin for Type 2 Diabetes. Which lab value would be a
contraindication for continuing this medication?
A. eGFR less than 30 mL/min/1.73m²
B. Serum Potassium of 5.2 mEq/L
C. Hemoglobin A1c of 8.5%
D. LDL cholesterol of 140 mg/dL
Answer: A
Conceptual Explanation: Metformin is contraindicated in patients with severe renal
impairment (eGFR < 30) due to the significantly increased risk of lactic acidosis.
5. When prescribing an ACE inhibitor to a patient, which electrolyte imbalance is most
commonly observed?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors block the conversion of Angiotensin I to
Angiotensin II, which leads to decreased aldosterone secretion. Since aldosterone promotes
potassium excretion, its reduction leads to potassium retention (hyperkalemia).
