NURS 6521 ADVANCED
PHARMACOLOGY FINAL EXAM
COMPREHENSIVE QUESTIONS AND
ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. A patient with chronic kidney disease (CKD) is prescribed a drug that is primarily excreted
by the kidneys. If the clinician fails to adjust the dose, what is the most likely pharmacokinetic
consequence?
A. Decreased volume of distribution
B. Increased rate of hepatic metabolism
C. Increased half-life and potential toxicity
D. Decreased bioavailability
Answer: C
Conceptual Explanation: Renal impairment reduces the clearance of drugs primarily
excreted by the kidneys, leading to an increased half-life and a higher risk of accumulation
and toxicity.
2. Which mechanism best describes how Lisinopril, an ACE inhibitor, helps manage heart
failure and hypertension?
A. Directly blocking Calcium channels in vascular smooth muscle
,B. Inhibiting the conversion of Angiotensin I to Angiotensin II
C. Antagonizing Beta-1 receptors in the myocardium
D. Increasing sodium reabsorption in the distal tubule
Answer: B
Conceptual Explanation: ACE inhibitors block the Angiotensin-Converting Enzyme,
preventing the conversion of Angiotensin I to the potent vasoconstrictor Angiotensin II,
thereby reducing systemic vascular resistance.
3. A patient is prescribed Gentamicin for a severe gram-negative infection. What monitoring
is most critical to prevent permanent injury?
A. Periodic visual acuity tests
B. Serum peak and trough levels for ototoxicity and nephrotoxicity
C. Daily monitoring of blood glucose levels
D. Weekly international normalized ratio (INR) tests
Answer: B
Conceptual Explanation: Aminoglycosides like Gentamicin have a narrow therapeutic
index and are associated with significant ototoxicity and nephrotoxicity; monitoring
peak/trough levels is essential.
, 4. Which class of diabetic medication is contraindicated in a patient with a history of heart
failure (NYHA Class III/IV) due to the risk of fluid retention?
A. Biguanides (Metformin)
B. SGLT2 inhibitors (Empagliflozin)
C. Thiazolidinediones (Pioglitazone)
D. DPP-4 inhibitors (Sitagliptin)
Answer: C
Conceptual Explanation: Thiazolidinediones (TZDs) can cause fluid retention and edema,
which may exacerbate heart failure; they are generally contraindicated in symptomatic HF
patients.
5. A patient taking Digoxin complains of seeing yellow-green halos around lights and
experiencing nausea. Which electrolyte abnormality most increases the risk of this condition?
A. Hypokalemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hyperkalemia
Answer: A
PHARMACOLOGY FINAL EXAM
COMPREHENSIVE QUESTIONS AND
ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. A patient with chronic kidney disease (CKD) is prescribed a drug that is primarily excreted
by the kidneys. If the clinician fails to adjust the dose, what is the most likely pharmacokinetic
consequence?
A. Decreased volume of distribution
B. Increased rate of hepatic metabolism
C. Increased half-life and potential toxicity
D. Decreased bioavailability
Answer: C
Conceptual Explanation: Renal impairment reduces the clearance of drugs primarily
excreted by the kidneys, leading to an increased half-life and a higher risk of accumulation
and toxicity.
2. Which mechanism best describes how Lisinopril, an ACE inhibitor, helps manage heart
failure and hypertension?
A. Directly blocking Calcium channels in vascular smooth muscle
,B. Inhibiting the conversion of Angiotensin I to Angiotensin II
C. Antagonizing Beta-1 receptors in the myocardium
D. Increasing sodium reabsorption in the distal tubule
Answer: B
Conceptual Explanation: ACE inhibitors block the Angiotensin-Converting Enzyme,
preventing the conversion of Angiotensin I to the potent vasoconstrictor Angiotensin II,
thereby reducing systemic vascular resistance.
3. A patient is prescribed Gentamicin for a severe gram-negative infection. What monitoring
is most critical to prevent permanent injury?
A. Periodic visual acuity tests
B. Serum peak and trough levels for ototoxicity and nephrotoxicity
C. Daily monitoring of blood glucose levels
D. Weekly international normalized ratio (INR) tests
Answer: B
Conceptual Explanation: Aminoglycosides like Gentamicin have a narrow therapeutic
index and are associated with significant ototoxicity and nephrotoxicity; monitoring
peak/trough levels is essential.
, 4. Which class of diabetic medication is contraindicated in a patient with a history of heart
failure (NYHA Class III/IV) due to the risk of fluid retention?
A. Biguanides (Metformin)
B. SGLT2 inhibitors (Empagliflozin)
C. Thiazolidinediones (Pioglitazone)
D. DPP-4 inhibitors (Sitagliptin)
Answer: C
Conceptual Explanation: Thiazolidinediones (TZDs) can cause fluid retention and edema,
which may exacerbate heart failure; they are generally contraindicated in symptomatic HF
patients.
5. A patient taking Digoxin complains of seeing yellow-green halos around lights and
experiencing nausea. Which electrolyte abnormality most increases the risk of this condition?
A. Hypokalemia
B. Hypocalcemia
C. Hypomagnesemia
D. Hyperkalemia
Answer: A
