NURS 6521 EXAM 4: ADVANCED
PHARMACOLOGY QUESTIONS AND
ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027: WALDEN
UNIVERSITY
1. A 55-year-old female patient with an intact uterus is seeking hormone replacement
therapy (HRT) for severe vasomotor symptoms. Which of the following describes the most
appropriate pharmacological approach?
A. Estrogen-only therapy to minimize metabolic side effects
B. High-dose testosterone to improve libido and energy levels
C. Progestin-only therapy to avoid the risk of deep vein thrombosis
D. Combined estrogen and progestin therapy to reduce the risk of endometrial cancer
Answer: D
Conceptual Explanation: In women with an intact uterus, estrogen-only therapy increases
the risk of endometrial hyperplasia and cancer. Progestin is added to oppose the effects of
estrogen on the endometrium.
2. Which of the following laboratory values is the most critical to monitor before and during
treatment with Metformin (Glucophage)?
A. Estimated Glomerular Filtration Rate (eGFR)
,B. Serum amylase
C. Alanine aminotransferase (ALT)
D. Thyroid Stimulating Hormone (TSH)
Answer: A
Conceptual Explanation: Metformin is renally excreted and is associated with a risk of
lactic acidosis. It is contraindicated in patients with an eGFR below 30 mL/min/1.73m².
3. A patient is prescribed Levothyroxine (Synthroid) for primary hypothyroidism. What
instruction should the nurse practitioner provide regarding the administration of this
medication?
A. Take the medication with a full meal to enhance absorption.
B. Take the medication in the morning on an empty stomach, 30 to 60 minutes before
breakfast.
C. Take the medication at bedtime with a glass of milk.
D. Take the medication concurrently with calcium supplements to prevent osteoporosis.
Answer: B
Conceptual Explanation: Levothyroxine absorption is decreased by food, calcium, and
iron. It should be taken on an empty stomach in the morning for optimal and consistent
absorption.
, 4. A 62-year-old male is requesting a prescription for Sildenafil (Viagra). Which medication in
his current profile would be an absolute contraindication for this drug?
A. Lisinopril
B. Metoprolol
C. Atorvastatin
D. Isosorbide mononitrate
Answer: D
Conceptual Explanation: Sildenafil causes vasodilation. When combined with nitrates like
isosorbide mononitrate or nitroglycerin, it can cause life-threatening hypotension.
5. Which statement regarding the ‘mini-pill’ (progestin-only contraceptive) is correct?
A. It is more effective than combined oral contraceptives.
B. It must be taken at the same time every day to maintain efficacy.
C. It works primarily by inhibiting ovulation in 100% of cycles.
D. It is contraindicated in breastfeeding mothers.
Answer: B
Conceptual Explanation: Progestin-only pills have a narrow therapeutic window; taking a
dose more than 3 hours late can significantly reduce efficacy by thinning the cervical mucus
barrier.
PHARMACOLOGY QUESTIONS AND
ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027: WALDEN
UNIVERSITY
1. A 55-year-old female patient with an intact uterus is seeking hormone replacement
therapy (HRT) for severe vasomotor symptoms. Which of the following describes the most
appropriate pharmacological approach?
A. Estrogen-only therapy to minimize metabolic side effects
B. High-dose testosterone to improve libido and energy levels
C. Progestin-only therapy to avoid the risk of deep vein thrombosis
D. Combined estrogen and progestin therapy to reduce the risk of endometrial cancer
Answer: D
Conceptual Explanation: In women with an intact uterus, estrogen-only therapy increases
the risk of endometrial hyperplasia and cancer. Progestin is added to oppose the effects of
estrogen on the endometrium.
2. Which of the following laboratory values is the most critical to monitor before and during
treatment with Metformin (Glucophage)?
A. Estimated Glomerular Filtration Rate (eGFR)
,B. Serum amylase
C. Alanine aminotransferase (ALT)
D. Thyroid Stimulating Hormone (TSH)
Answer: A
Conceptual Explanation: Metformin is renally excreted and is associated with a risk of
lactic acidosis. It is contraindicated in patients with an eGFR below 30 mL/min/1.73m².
3. A patient is prescribed Levothyroxine (Synthroid) for primary hypothyroidism. What
instruction should the nurse practitioner provide regarding the administration of this
medication?
A. Take the medication with a full meal to enhance absorption.
B. Take the medication in the morning on an empty stomach, 30 to 60 minutes before
breakfast.
C. Take the medication at bedtime with a glass of milk.
D. Take the medication concurrently with calcium supplements to prevent osteoporosis.
Answer: B
Conceptual Explanation: Levothyroxine absorption is decreased by food, calcium, and
iron. It should be taken on an empty stomach in the morning for optimal and consistent
absorption.
, 4. A 62-year-old male is requesting a prescription for Sildenafil (Viagra). Which medication in
his current profile would be an absolute contraindication for this drug?
A. Lisinopril
B. Metoprolol
C. Atorvastatin
D. Isosorbide mononitrate
Answer: D
Conceptual Explanation: Sildenafil causes vasodilation. When combined with nitrates like
isosorbide mononitrate or nitroglycerin, it can cause life-threatening hypotension.
5. Which statement regarding the ‘mini-pill’ (progestin-only contraceptive) is correct?
A. It is more effective than combined oral contraceptives.
B. It must be taken at the same time every day to maintain efficacy.
C. It works primarily by inhibiting ovulation in 100% of cycles.
D. It is contraindicated in breastfeeding mothers.
Answer: B
Conceptual Explanation: Progestin-only pills have a narrow therapeutic window; taking a
dose more than 3 hours late can significantly reduce efficacy by thinning the cervical mucus
barrier.
