NR566 ADVANCED PHARMACOLOGY
EXAM 3 - ENDOCRINE, GI, AND
HEMATOLOGY (LATEST 2026/ 2027
UPDATE) QUESTIONS AND 100%
CORRECT VERIFIED ANSWERS| GRADE
A+
1. A 55-year-old patient with Type 2 Diabetes has an eGFR of 28 mL/min/1.73 m². Which of
the following medications is absolutely contraindicated for this patient?
A. Glipizide
B. Pioglitazone
C. Sitagliptin
D. Metformin
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR less than
30 mL/min/1.73 m² due to the increased risk of lactic acidosis.
2. Which mechanism of action best describes how SGLT2 inhibitors like Empagliflozin lower
blood glucose?
A. Stimulating insulin secretion from pancreatic beta cells
,B. Slowing gastric emptying and suppressing glucagon
C. Increasing peripheral glucose uptake in muscle tissue
D. Inhibiting glucose reabsorption in the proximal renal tubule
Answer: D
Conceptual Explanation: SGLT2 inhibitors block the sodium-glucose cotransporter 2 in
the kidneys, leading to increased glucose excretion in the urine.
3. A patient with a history of Heart Failure (NYHA Class III) should avoid which class of
antidiabetic medications due to risk of fluid retention?
A. Sulfonylureas
B. DPP-4 Inhibitors
C. Thiazolidinediones (TZDs)
D. GLP-1 Receptor Agonists
Answer: C
Conceptual Explanation: TZDs like Pioglitazone cause fluid retention and can exacerbate
heart failure; they are contraindicated in NYHA Class III/IV heart failure.
4. What is the primary Black Box Warning associated with GLP-1 receptor agonists such as
Liraglutide?
A. Severe lactic acidosis
B. Risk of thyroid C-cell tumors
, C. Acute renal failure
D. Agranulocytosis
Answer: B
Conceptual Explanation: GLP-1 agonists carry a BBW regarding the risk of thyroid C-cell
tumors, based on rodent studies; they are contraindicated in patients with a history of
Medullary Thyroid Carcinoma.
5. When switching a patient from NPH insulin to Insulin Glargine, what dose adjustment is
typically recommended to avoid hypoglycemia?
A. Reduce the dose by 20%
B. Maintain the exact same unit-for-unit dose
C. Increase the dose by 20%
D. Double the dose
Answer: A
Conceptual Explanation: When switching from twice-daily NPH to once-daily Glargine,
the initial dose is often reduced by 20% to prevent hypoglycemia during the transition.
6. Which laboratory value must be monitored closely when a patient is taking
Propylthiouracil (PTU) for hyperthyroidism?
A. Serum Potassium
B. Hemoglobin A1c
EXAM 3 - ENDOCRINE, GI, AND
HEMATOLOGY (LATEST 2026/ 2027
UPDATE) QUESTIONS AND 100%
CORRECT VERIFIED ANSWERS| GRADE
A+
1. A 55-year-old patient with Type 2 Diabetes has an eGFR of 28 mL/min/1.73 m². Which of
the following medications is absolutely contraindicated for this patient?
A. Glipizide
B. Pioglitazone
C. Sitagliptin
D. Metformin
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR less than
30 mL/min/1.73 m² due to the increased risk of lactic acidosis.
2. Which mechanism of action best describes how SGLT2 inhibitors like Empagliflozin lower
blood glucose?
A. Stimulating insulin secretion from pancreatic beta cells
,B. Slowing gastric emptying and suppressing glucagon
C. Increasing peripheral glucose uptake in muscle tissue
D. Inhibiting glucose reabsorption in the proximal renal tubule
Answer: D
Conceptual Explanation: SGLT2 inhibitors block the sodium-glucose cotransporter 2 in
the kidneys, leading to increased glucose excretion in the urine.
3. A patient with a history of Heart Failure (NYHA Class III) should avoid which class of
antidiabetic medications due to risk of fluid retention?
A. Sulfonylureas
B. DPP-4 Inhibitors
C. Thiazolidinediones (TZDs)
D. GLP-1 Receptor Agonists
Answer: C
Conceptual Explanation: TZDs like Pioglitazone cause fluid retention and can exacerbate
heart failure; they are contraindicated in NYHA Class III/IV heart failure.
4. What is the primary Black Box Warning associated with GLP-1 receptor agonists such as
Liraglutide?
A. Severe lactic acidosis
B. Risk of thyroid C-cell tumors
, C. Acute renal failure
D. Agranulocytosis
Answer: B
Conceptual Explanation: GLP-1 agonists carry a BBW regarding the risk of thyroid C-cell
tumors, based on rodent studies; they are contraindicated in patients with a history of
Medullary Thyroid Carcinoma.
5. When switching a patient from NPH insulin to Insulin Glargine, what dose adjustment is
typically recommended to avoid hypoglycemia?
A. Reduce the dose by 20%
B. Maintain the exact same unit-for-unit dose
C. Increase the dose by 20%
D. Double the dose
Answer: A
Conceptual Explanation: When switching from twice-daily NPH to once-daily Glargine,
the initial dose is often reduced by 20% to prevent hypoglycemia during the transition.
6. Which laboratory value must be monitored closely when a patient is taking
Propylthiouracil (PTU) for hyperthyroidism?
A. Serum Potassium
B. Hemoglobin A1c
