NURS 6521 ADVANCED
PHARMACOTHERAPEUTICS EXAM 3
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A patient with Type 1 Diabetes is prescribed insulin glargine (Lantus). Which characteristic
of this medication should the nurse practitioner emphasize during patient education?
A. It provides a basal rate of insulin with no peak and a duration of 24 hours.
B. It has a peak effect occurring 4 to 12 hours after injection.
C. It should be mixed with rapid-acting insulin in the same syringe to minimize injections.
D. It is administered intravenously during episodes of diabetic ketoacidosis.
Answer: A
Conceptual Explanation: Insulin glargine is a long-acting basal insulin that lacks a distinct
peak and maintains a steady blood level for approximately 24 hours. It must not be mixed
with other insulins because the acidic pH can cause precipitation.
2. When prescribing levothyroxine for a 72-year-old patient with new-onset hypothyroidism,
what is the most appropriate starting dose strategy?
A. Start at the full replacement dose of 1.6 mcg/kg/day.
B. Start with a loading dose of 200 mcg followed by 50 mcg daily.
,C. Start at 25 mcg/day and titrate slowly based on TSH levels.
D. Combine levothyroxine with liothyronine for faster symptom relief.
Answer: C
Conceptual Explanation: In elderly patients, especially those with potential underlying
cardiovascular disease, levothyroxine should be started at a low dose (e.g., 25 mcg) to
avoid sudden increases in cardiac demand that could precipitate angina or arrhythmias.
3. A patient taking long-term Omeprazole (Prilosec) for GERD is at an increased risk for which
of the following electrolyte imbalances and complications?
A. Hypomagnesemia and increased risk of hip fractures.
B. Hyperkalemia and renal calculi.
C. Hypernatremia and fluid retention.
D. Hypocalcemia and metabolic alkalosis.
Answer: A
Conceptual Explanation: Long-term proton pump inhibitor (PPI) use is associated with
hypomagnesemia due to impaired intestinal absorption and an increased risk of
osteoporosis-related fractures due to decreased calcium absorption.
, 4. A patient is initiated on Warfarin (Coumadin) therapy for atrial fibrillation. The nurse
practitioner knows that which of the following genetic variations may require a significantly
lower starting dose?
A. CYP2D6 polymorphism.
B. CYP3A4 induction.
C. ABCB1 efflux transporter deficiency.
D. CYP2C9 and VKORC1 variants.
Answer: D
Conceptual Explanation: Polymorphisms in the CYP2C9 enzyme (responsible for
metabolism) and the VKORC1 gene (the target enzyme for warfarin) can lead to increased
sensitivity and higher risk of bleeding, necessitating lower doses.
5. Which of the following is an absolute contraindication for the use of combined oral
contraceptives (COCs)?
A. A 25-year-old female with a history of tension headaches.
B. A 36-year-old female who smokes 1 pack of cigarettes per day.
C. A 30-year-old female with well-controlled Type 2 Diabetes without vascular disease.
D. A 22-year-old female with a family history of breast cancer.
Answer: B
PHARMACOTHERAPEUTICS EXAM 3
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A patient with Type 1 Diabetes is prescribed insulin glargine (Lantus). Which characteristic
of this medication should the nurse practitioner emphasize during patient education?
A. It provides a basal rate of insulin with no peak and a duration of 24 hours.
B. It has a peak effect occurring 4 to 12 hours after injection.
C. It should be mixed with rapid-acting insulin in the same syringe to minimize injections.
D. It is administered intravenously during episodes of diabetic ketoacidosis.
Answer: A
Conceptual Explanation: Insulin glargine is a long-acting basal insulin that lacks a distinct
peak and maintains a steady blood level for approximately 24 hours. It must not be mixed
with other insulins because the acidic pH can cause precipitation.
2. When prescribing levothyroxine for a 72-year-old patient with new-onset hypothyroidism,
what is the most appropriate starting dose strategy?
A. Start at the full replacement dose of 1.6 mcg/kg/day.
B. Start with a loading dose of 200 mcg followed by 50 mcg daily.
,C. Start at 25 mcg/day and titrate slowly based on TSH levels.
D. Combine levothyroxine with liothyronine for faster symptom relief.
Answer: C
Conceptual Explanation: In elderly patients, especially those with potential underlying
cardiovascular disease, levothyroxine should be started at a low dose (e.g., 25 mcg) to
avoid sudden increases in cardiac demand that could precipitate angina or arrhythmias.
3. A patient taking long-term Omeprazole (Prilosec) for GERD is at an increased risk for which
of the following electrolyte imbalances and complications?
A. Hypomagnesemia and increased risk of hip fractures.
B. Hyperkalemia and renal calculi.
C. Hypernatremia and fluid retention.
D. Hypocalcemia and metabolic alkalosis.
Answer: A
Conceptual Explanation: Long-term proton pump inhibitor (PPI) use is associated with
hypomagnesemia due to impaired intestinal absorption and an increased risk of
osteoporosis-related fractures due to decreased calcium absorption.
, 4. A patient is initiated on Warfarin (Coumadin) therapy for atrial fibrillation. The nurse
practitioner knows that which of the following genetic variations may require a significantly
lower starting dose?
A. CYP2D6 polymorphism.
B. CYP3A4 induction.
C. ABCB1 efflux transporter deficiency.
D. CYP2C9 and VKORC1 variants.
Answer: D
Conceptual Explanation: Polymorphisms in the CYP2C9 enzyme (responsible for
metabolism) and the VKORC1 gene (the target enzyme for warfarin) can lead to increased
sensitivity and higher risk of bleeding, necessitating lower doses.
5. Which of the following is an absolute contraindication for the use of combined oral
contraceptives (COCs)?
A. A 25-year-old female with a history of tension headaches.
B. A 36-year-old female who smokes 1 pack of cigarettes per day.
C. A 30-year-old female with well-controlled Type 2 Diabetes without vascular disease.
D. A 22-year-old female with a family history of breast cancer.
Answer: B
