NR565 ADVANCED PHARMACOLOGY
FINAL EXAM PREP QUESTIONS AND
VERIFIED ANSWERS (2026/ 2027
UPDATE)- CHAMBERLAIN
1. A 65-year-old male with a history of heart failure with reduced ejection fraction (HFrEF)
and hypertension requires a new antihypertensive. Which of the following is the most
appropriate first-line choice?
A. Amlodipine
B. Hydrochlorothiazide
C. Doxazosin
D. Lisinopril
Answer: D
Conceptual Explanation: ACE inhibitors like Lisinopril are first-line for HFrEF due to their
ability to reduce afterload and prevent cardiac remodeling, whereas CCBs like Amlodipine
do not provide the same mortality benefit.
2. Which mechanism is responsible for the dry cough often associated with ACE inhibitor
therapy?
A. Inhibition of renin release
,B. Direct irritation of the bronchial mucosa
C. Accumulation of bradykinin in the lungs
D. Increased prostaglandin synthesis
Answer: C
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin, leading to
its accumulation in the respiratory tract, which triggers a dry, non-productive cough in
some patients.
3. A patient taking Warfarin for atrial fibrillation is prescribed Amiodarone for rhythm
control. What adjustment is usually necessary for the Warfarin dose?
A. Increase the Warfarin dose by 50%
B. Decrease the Warfarin dose by 30-50%
C. No change is needed
D. Discontinue Warfarin and switch to aspirin
Answer: B
Conceptual Explanation: Amiodarone inhibits the metabolism of Warfarin (via CYP2C9),
significantly increasing the INR. Therefore, the Warfarin dose should be reduced
preemptively.
, 4. Which laboratory value is the most critical to monitor before and during therapy with
Metformin?
A. Serum amylase
B. Glomerular filtration rate (GFR)
C. Liver transaminases
D. Complete blood count
Answer: B
Conceptual Explanation: Metformin is renally excreted and increases the risk of lactic
acidosis if renal function is impaired. It is contraindicated if GFR is below 30
mL/min/1.73m2.
5. A patient with Type 2 Diabetes and established Atherosclerotic Cardiovascular Disease
(ASCVD) requires intensification of therapy. Which class of medication is preferred?
A. Sulfonylureas
B. GLP-1 Receptor Agonists
C. DPP-4 Inhibitors
D. Thiazolidinediones
Answer: B
FINAL EXAM PREP QUESTIONS AND
VERIFIED ANSWERS (2026/ 2027
UPDATE)- CHAMBERLAIN
1. A 65-year-old male with a history of heart failure with reduced ejection fraction (HFrEF)
and hypertension requires a new antihypertensive. Which of the following is the most
appropriate first-line choice?
A. Amlodipine
B. Hydrochlorothiazide
C. Doxazosin
D. Lisinopril
Answer: D
Conceptual Explanation: ACE inhibitors like Lisinopril are first-line for HFrEF due to their
ability to reduce afterload and prevent cardiac remodeling, whereas CCBs like Amlodipine
do not provide the same mortality benefit.
2. Which mechanism is responsible for the dry cough often associated with ACE inhibitor
therapy?
A. Inhibition of renin release
,B. Direct irritation of the bronchial mucosa
C. Accumulation of bradykinin in the lungs
D. Increased prostaglandin synthesis
Answer: C
Conceptual Explanation: ACE inhibitors prevent the breakdown of bradykinin, leading to
its accumulation in the respiratory tract, which triggers a dry, non-productive cough in
some patients.
3. A patient taking Warfarin for atrial fibrillation is prescribed Amiodarone for rhythm
control. What adjustment is usually necessary for the Warfarin dose?
A. Increase the Warfarin dose by 50%
B. Decrease the Warfarin dose by 30-50%
C. No change is needed
D. Discontinue Warfarin and switch to aspirin
Answer: B
Conceptual Explanation: Amiodarone inhibits the metabolism of Warfarin (via CYP2C9),
significantly increasing the INR. Therefore, the Warfarin dose should be reduced
preemptively.
, 4. Which laboratory value is the most critical to monitor before and during therapy with
Metformin?
A. Serum amylase
B. Glomerular filtration rate (GFR)
C. Liver transaminases
D. Complete blood count
Answer: B
Conceptual Explanation: Metformin is renally excreted and increases the risk of lactic
acidosis if renal function is impaired. It is contraindicated if GFR is below 30
mL/min/1.73m2.
5. A patient with Type 2 Diabetes and established Atherosclerotic Cardiovascular Disease
(ASCVD) requires intensification of therapy. Which class of medication is preferred?
A. Sulfonylureas
B. GLP-1 Receptor Agonists
C. DPP-4 Inhibitors
D. Thiazolidinediones
Answer: B
