NR565 EXAM 2: CARDIOVASCULAR,
RESPIRATORY, AND ENDOCRINE
PHARMACOLOGY QUESTIONS AND
VERIFIED ANSWERS (2026/ 2027
UPDATE)- CHAMBERLAIN
1. Which mechanism best explains the development of a dry, hacking cough in patients taking
ACE inhibitors?
A. Inhibition of Angiotensin II production
B. Activation of the sympathetic nervous system
C. Increased levels of aldosterone
D. Accumulation of bradykinin in the upper airways
Answer: D
Conceptual Explanation: ACE inhibitors block the enzyme that breaks down bradykinin,
leading to its accumulation in the lungs, which triggers the cough reflex.
2. A patient with a history of heart failure (HFrEF) is currently taking an ACE inhibitor and a
beta-blocker. Which medication should be added to reduce mortality based on current
guidelines?
A. Furosemide
,B. Spironolactone
C. Digoxin
D. Amlodipine
Answer: B
Conceptual Explanation: Mineralocorticoid receptor antagonists (MRAs) like
spironolactone have been shown to reduce mortality and hospitalizations in patients with
HFrEF.
3. What is the primary contraindication for the use of Metformin in a diabetic patient?
A. BMI > 30
B. History of hypertension
C. Estimated Glomerular Filtration Rate (eGFR) < 30 mL/min/1.73m²
D. Age over 65
Answer: C
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR below 30
due to the significantly increased risk of lactic acidosis.
4. Which statin is considered high-intensity and capable of lowering LDL-C by 50% or more?
A. Simvastatin 20mg
B. Pravastatin 40mg
, C. Lovastatin 20mg
D. Atorvastatin 40mg
Answer: D
Conceptual Explanation: Atorvastatin (40-80 mg) and Rosuvastatin (20-40 mg) are
categorized as high-intensity statins.
5. In the treatment of COPD, what is the primary purpose of LAMA (Long-Acting Muscarinic
Antagonists)?
A. To provide long-term bronchodilation by blocking acetylcholine
B. To reduce systemic inflammation
C. To provide rapid rescue from acute bronchospasm
D. To thin mucus secretions
Answer: A
Conceptual Explanation: LAMAs block muscarinic receptors on airway smooth muscle,
leading to sustained bronchodilation in COPD management.
6. Which laboratory parameter must be closely monitored when initiating an ACE inhibitor or
ARB?
A. Serum Calcium
B. ALT/AST
C. Hemoglobin A1c
RESPIRATORY, AND ENDOCRINE
PHARMACOLOGY QUESTIONS AND
VERIFIED ANSWERS (2026/ 2027
UPDATE)- CHAMBERLAIN
1. Which mechanism best explains the development of a dry, hacking cough in patients taking
ACE inhibitors?
A. Inhibition of Angiotensin II production
B. Activation of the sympathetic nervous system
C. Increased levels of aldosterone
D. Accumulation of bradykinin in the upper airways
Answer: D
Conceptual Explanation: ACE inhibitors block the enzyme that breaks down bradykinin,
leading to its accumulation in the lungs, which triggers the cough reflex.
2. A patient with a history of heart failure (HFrEF) is currently taking an ACE inhibitor and a
beta-blocker. Which medication should be added to reduce mortality based on current
guidelines?
A. Furosemide
,B. Spironolactone
C. Digoxin
D. Amlodipine
Answer: B
Conceptual Explanation: Mineralocorticoid receptor antagonists (MRAs) like
spironolactone have been shown to reduce mortality and hospitalizations in patients with
HFrEF.
3. What is the primary contraindication for the use of Metformin in a diabetic patient?
A. BMI > 30
B. History of hypertension
C. Estimated Glomerular Filtration Rate (eGFR) < 30 mL/min/1.73m²
D. Age over 65
Answer: C
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR below 30
due to the significantly increased risk of lactic acidosis.
4. Which statin is considered high-intensity and capable of lowering LDL-C by 50% or more?
A. Simvastatin 20mg
B. Pravastatin 40mg
, C. Lovastatin 20mg
D. Atorvastatin 40mg
Answer: D
Conceptual Explanation: Atorvastatin (40-80 mg) and Rosuvastatin (20-40 mg) are
categorized as high-intensity statins.
5. In the treatment of COPD, what is the primary purpose of LAMA (Long-Acting Muscarinic
Antagonists)?
A. To provide long-term bronchodilation by blocking acetylcholine
B. To reduce systemic inflammation
C. To provide rapid rescue from acute bronchospasm
D. To thin mucus secretions
Answer: A
Conceptual Explanation: LAMAs block muscarinic receptors on airway smooth muscle,
leading to sustained bronchodilation in COPD management.
6. Which laboratory parameter must be closely monitored when initiating an ACE inhibitor or
ARB?
A. Serum Calcium
B. ALT/AST
C. Hemoglobin A1c
