NURS 6521 ADVANCED
PHARMACOLOGY EXAM QUESTIONS
AND ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. A patient with a history of chronic kidney disease (CKD) is prescribed a drug that is
primarily excreted by the kidneys. Which pharmacokinetic parameter should the nurse
practitioner most closely monitor to avoid toxicity?
A. Creatinine clearance
B. Drug absorption rate
C. Protein binding capacity
D. Volume of distribution
Answer: A
Conceptual Explanation: Creatinine clearance is the best indicator of renal function and
determines how efficiently the kidneys can excrete drugs, preventing accumulation and
toxicity.
2. When initiating Levothyroxine therapy for a 75-year-old patient with hypothyroidism,
which of the following is the most appropriate starting dose strategy?
A. Standard adult dose of 100 mcg daily
,B. Low dose (e.g., 25 mcg) to avoid cardiac strain
C. High dose to rapidly resolve symptoms
D. Twice the standard dose because of decreased metabolism
Answer: B
Conceptual Explanation: In geriatric patients, levothyroxine should be started at a low
dose (‘start low, go slow’) because thyroid hormones increase cardiac workload and can
precipitate myocardial ischemia or arrhythmias.
3. A patient taking Digoxin for heart failure reports blurred vision and seeing yellow-green
halos. What is the priority nursing action?
A. Assess the apical pulse and request a serum digoxin level
B. Advise the patient to take the next dose with food
C. Inform the patient this is a common, non-serious side effect
D. Increase the patient’s potassium intake immediately
Answer: A
Conceptual Explanation: Visual disturbances like yellow-green halos are classic signs of
digoxin toxicity. Assessing the pulse and checking serum levels is the clinical priority.
4. Which mechanism best describes the action of Metformin in managing Type 2 Diabetes
Mellitus?
A. Stimulating the pancreas to secrete more insulin
, B. Decreasing hepatic glucose production and increasing insulin sensitivity
C. Increasing glucose reabsorption in the kidneys
D. Delaying the absorption of carbohydrates in the small intestine
Answer: B
Conceptual Explanation: Metformin works by inhibiting gluconeogenesis in the liver and
improving peripheral insulin sensitivity, rather than stimulating insulin secretion.
5. A patient is prescribed Warfarin (Coumadin) for atrial fibrillation. Which lab value is
essential for monitoring the therapeutic effect of this medication?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT) and International Normalized Ratio (INR)
C. Serum potassium levels
D. Complete blood count (CBC)
Answer: B
Conceptual Explanation: PT/INR is the standard monitoring tool for Warfarin to ensure
the dosage is within the therapeutic range (usually 2.0 to 3.0).
6. A pregnant woman in her third trimester requires treatment for a bacterial infection.
Which of the following antibiotics is generally considered contraindicated due to the risk of
teeth discoloration in the fetus?
A. Tetracycline
PHARMACOLOGY EXAM QUESTIONS
AND ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. A patient with a history of chronic kidney disease (CKD) is prescribed a drug that is
primarily excreted by the kidneys. Which pharmacokinetic parameter should the nurse
practitioner most closely monitor to avoid toxicity?
A. Creatinine clearance
B. Drug absorption rate
C. Protein binding capacity
D. Volume of distribution
Answer: A
Conceptual Explanation: Creatinine clearance is the best indicator of renal function and
determines how efficiently the kidneys can excrete drugs, preventing accumulation and
toxicity.
2. When initiating Levothyroxine therapy for a 75-year-old patient with hypothyroidism,
which of the following is the most appropriate starting dose strategy?
A. Standard adult dose of 100 mcg daily
,B. Low dose (e.g., 25 mcg) to avoid cardiac strain
C. High dose to rapidly resolve symptoms
D. Twice the standard dose because of decreased metabolism
Answer: B
Conceptual Explanation: In geriatric patients, levothyroxine should be started at a low
dose (‘start low, go slow’) because thyroid hormones increase cardiac workload and can
precipitate myocardial ischemia or arrhythmias.
3. A patient taking Digoxin for heart failure reports blurred vision and seeing yellow-green
halos. What is the priority nursing action?
A. Assess the apical pulse and request a serum digoxin level
B. Advise the patient to take the next dose with food
C. Inform the patient this is a common, non-serious side effect
D. Increase the patient’s potassium intake immediately
Answer: A
Conceptual Explanation: Visual disturbances like yellow-green halos are classic signs of
digoxin toxicity. Assessing the pulse and checking serum levels is the clinical priority.
4. Which mechanism best describes the action of Metformin in managing Type 2 Diabetes
Mellitus?
A. Stimulating the pancreas to secrete more insulin
, B. Decreasing hepatic glucose production and increasing insulin sensitivity
C. Increasing glucose reabsorption in the kidneys
D. Delaying the absorption of carbohydrates in the small intestine
Answer: B
Conceptual Explanation: Metformin works by inhibiting gluconeogenesis in the liver and
improving peripheral insulin sensitivity, rather than stimulating insulin secretion.
5. A patient is prescribed Warfarin (Coumadin) for atrial fibrillation. Which lab value is
essential for monitoring the therapeutic effect of this medication?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT) and International Normalized Ratio (INR)
C. Serum potassium levels
D. Complete blood count (CBC)
Answer: B
Conceptual Explanation: PT/INR is the standard monitoring tool for Warfarin to ensure
the dosage is within the therapeutic range (usually 2.0 to 3.0).
6. A pregnant woman in her third trimester requires treatment for a bacterial infection.
Which of the following antibiotics is generally considered contraindicated due to the risk of
teeth discoloration in the fetus?
A. Tetracycline
