NR565 ADVANCED PHARMACOLOGY
COMPREHENSIVE EXAM STUDY GUIDE
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+|CHAMBERLAIN COLLEGE
1. A patient with a history of heart failure is prescribed a loop diuretic. Which of the following
electrolyte abnormalities is most likely to occur and requires close monitoring?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C
Conceptual Explanation: Loop diuretics, such as furosemide, inhibit the sodium-
potassium-chloride cotransporter in the thick ascending limb of the loop of Henle, leading
to increased excretion of potassium and potential hypokalemia.
2. Which pharmacokinetic process is primarily affected by a patient’s genetic polymorphism
of the CYP2C19 enzyme when taking clopidogrel?
A. Absorption
B. Metabolism
,C. Distribution
D. Excretion
Answer: B
Conceptual Explanation: Clopidogrel is a prodrug that requires activation by the CYP2C19
enzyme; polymorphisms can lead to poor metabolism and reduced antiplatelet efficacy.
3. According to the Beers Criteria, which class of medications should generally be avoided in
elderly patients due to the high risk of orthostatic hypotension and CNS effects?
A. Tricyclic Antidepressants
B. Selective Serotonin Reuptake Inhibitors
C. ACE Inhibitors
D. HMG-CoA Reductase Inhibitors
Answer: A
Conceptual Explanation: Tricyclic antidepressants (TCAs) have significant anticholinergic
and alpha-adrenergic blocking properties, increasing the risk of falls and confusion in the
elderly.
4. When initiating levothyroxine therapy for a 75-year-old patient with a history of coronary
artery disease, what is the most appropriate starting dose strategy?
A. Full replacement dose based on weight
B. High loading dose followed by maintenance
, C. Start low (12.5-25 mcg) and titrate slowly
D. Standard adult dose of 75 mcg daily
Answer: C
Conceptual Explanation: In elderly patients with cardiac disease, levothyroxine must be
started at a low dose to prevent exacerbation of angina or arrhythmias caused by increased
myocardial oxygen demand.
5. A patient taking Amiodarone for atrial fibrillation requires monitoring for which serious
potential adverse effect?
A. Pancreatitis
B. Ototoxicity
C. Gingival hyperplasia
D. Pulmonary toxicity
Answer: D
Conceptual Explanation: Amiodarone is associated with pulmonary fibrosis and
interstitial pneumonitis, necessitating baseline and periodic chest X-rays and pulmonary
function tests.
6. What is the primary mechanism of action of SGLT2 inhibitors in the management of Type 2
Diabetes?
A. Increasing insulin secretion from the pancreas
COMPREHENSIVE EXAM STUDY GUIDE
QUESTIONS AND VERIFIED ANSWERS
|GRADE A+|CHAMBERLAIN COLLEGE
1. A patient with a history of heart failure is prescribed a loop diuretic. Which of the following
electrolyte abnormalities is most likely to occur and requires close monitoring?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypercalcemia
Answer: C
Conceptual Explanation: Loop diuretics, such as furosemide, inhibit the sodium-
potassium-chloride cotransporter in the thick ascending limb of the loop of Henle, leading
to increased excretion of potassium and potential hypokalemia.
2. Which pharmacokinetic process is primarily affected by a patient’s genetic polymorphism
of the CYP2C19 enzyme when taking clopidogrel?
A. Absorption
B. Metabolism
,C. Distribution
D. Excretion
Answer: B
Conceptual Explanation: Clopidogrel is a prodrug that requires activation by the CYP2C19
enzyme; polymorphisms can lead to poor metabolism and reduced antiplatelet efficacy.
3. According to the Beers Criteria, which class of medications should generally be avoided in
elderly patients due to the high risk of orthostatic hypotension and CNS effects?
A. Tricyclic Antidepressants
B. Selective Serotonin Reuptake Inhibitors
C. ACE Inhibitors
D. HMG-CoA Reductase Inhibitors
Answer: A
Conceptual Explanation: Tricyclic antidepressants (TCAs) have significant anticholinergic
and alpha-adrenergic blocking properties, increasing the risk of falls and confusion in the
elderly.
4. When initiating levothyroxine therapy for a 75-year-old patient with a history of coronary
artery disease, what is the most appropriate starting dose strategy?
A. Full replacement dose based on weight
B. High loading dose followed by maintenance
, C. Start low (12.5-25 mcg) and titrate slowly
D. Standard adult dose of 75 mcg daily
Answer: C
Conceptual Explanation: In elderly patients with cardiac disease, levothyroxine must be
started at a low dose to prevent exacerbation of angina or arrhythmias caused by increased
myocardial oxygen demand.
5. A patient taking Amiodarone for atrial fibrillation requires monitoring for which serious
potential adverse effect?
A. Pancreatitis
B. Ototoxicity
C. Gingival hyperplasia
D. Pulmonary toxicity
Answer: D
Conceptual Explanation: Amiodarone is associated with pulmonary fibrosis and
interstitial pneumonitis, necessitating baseline and periodic chest X-rays and pulmonary
function tests.
6. What is the primary mechanism of action of SGLT2 inhibitors in the management of Type 2
Diabetes?
A. Increasing insulin secretion from the pancreas
