UTA NURS 5334 Advanced Pharmacology for Nurse
Practitioners: Final Exam (Comprehensive) - Questions with
Correct Answers
100 questions
1. The parasympathetic nervous system primarily uses which neurotransmitter at effector
organs?
A. Acetylcholine
B. Norepinephrine
C. Dopamine
D. Serotonin
Correct Answer: A. Acetylcholine
Rationale: Muscarinic.
2. Glycopyrrolate is used to:
A. Increase salivation
B. Treat urinary retention
C. Treat glaucoma
D. Reduce secretions
Correct Answer: D. Reduce secretions
Rationale: Anticholinergic.
3. Hydralazine may cause:
A. Bradycardia
B. Hyperkalemia
C. Reflex tachycardia, fluid retention and drug-induced lupus
D. Cough
Correct Answer: C. Reflex tachycardia, fluid retention and drug-induced lupus
Rationale: Direct vasodilator.
4. Patients who develop ACE inhibitor cough can often switch to:
A. Another ACE inhibitor
B. Hydralazine only
C. No therapy
D. An ARB
Correct Answer: D. An ARB
Rationale: No bradykinin effect.
5. Statins work by inhibiting:
A. Cholesterol absorption
B. HMG-CoA reductase
C. PCSK9
D. Lipoprotein lipase
Correct Answer: B. HMG-CoA reductase
Rationale: Mechanism.
,6. Ranolazine is used for chronic angina and can:
A. Prolong the QT interval
B. Cause bradycardia mainly
C. Lower BP significantly
D. Cause hyperkalemia
Correct Answer: A. Prolong the QT interval
Rationale: Late sodium current.
7. Prasugrel is contraindicated in patients with:
A. Diabetes
B. A history of stroke or TIA
C. Hypertension
D. PAD
Correct Answer: B. A history of stroke or TIA
Rationale: Bleeding risk.
8. The reversal agent for apixaban or rivaroxaban is:
A. Andexanet alfa (or PCC)
B. Idarucizumab
C. Vitamin K
D. Protamine
Correct Answer: A. Andexanet alfa (or PCC)
Rationale: Reversal.
9. Metabolic monitoring for patients on atypical antipsychotics includes:
A. Only weight
B. Only ECG
C. Weight/BMI, waist circumference, BP, glucose/A1c and lipids
D. None
Correct Answer: C. Weight/BMI, waist circumference, BP, glucose/A1c and lipids
Rationale: ADA/APA.
10. Buprenorphine for opioid use disorder can now be prescribed by clinicians with a DEA
registration:
A. Without the former X-waiver (eliminated in 2023)
B. Only with an X-waiver
C. Never by NPs
D. Only in hospitals
Correct Answer: A. Without the former X-waiver (eliminated in 2023)
Rationale: MAT Act.
11. Insulin glargine is classified as:
A. Long-acting basal insulin
B. Rapid-acting bolus insulin
C. Intermediate-acting insulin
D. Short-acting regular insulin
Correct Answer: A. Long-acting basal insulin
Rationale: Relatively peakless ~24 hours.
, 12. Tirzepatide is a dual agonist of:
A. PPAR-alpha and PPAR-gamma
B. Insulin and amylin receptors
C. SGLT1 and SGLT2
D. GIP and GLP-1 receptors
Correct Answer: D. GIP and GLP-1 receptors
Rationale: Large A1C and weight reductions.
13. The major adverse effect of sulfonylureas is:
A. Lactic acidosis
B. Pancreatitis
C. Euglycemic ketoacidosis
D. Hypoglycemia
Correct Answer: D. Hypoglycemia
Rationale: Plus weight gain.
14. Sulfonylureas such as glipizide and glyburide work by:
A. Decreasing hepatic glucose output
B. Stimulating insulin secretion from pancreatic beta cells
C. Increasing urinary glucose excretion
D. Activating PPAR-gamma
Correct Answer: B. Stimulating insulin secretion from pancreatic beta cells
Rationale: Insulin secretagogues.
15. Unopened insulin should be stored:
A. In the freezer
B. In the refrigerator, not frozen
C. In a hot car
D. In direct sunlight
Correct Answer: B. In the refrigerator, not frozen
Rationale: In-use vials stable at room temperature about 28 days.
16. Metformin is contraindicated when eGFR is:
A. Below 90 mL/min/1.73 m2
B. Below 60 mL/min/1.73 m2
C. Below 30 mL/min/1.73 m2
D. Above 60 mL/min/1.73 m2
Correct Answer: C. Below 30 mL/min/1.73 m2
Rationale: Risk of lactic acidosis; do not start at eGFR 30-45.
17. Overbasalization is suspected when basal insulin exceeds about:
A. 0.05 units/kg/day
B. 0.5 units/kg/day with persistent hyperglycemia
C. 5 units daily
D. Any dose with normal fasting glucose
Correct Answer: B. 0.5 units/kg/day with persistent hyperglycemia
Rationale: Consider prandial insulin or GLP-1 RA.
Practitioners: Final Exam (Comprehensive) - Questions with
Correct Answers
100 questions
1. The parasympathetic nervous system primarily uses which neurotransmitter at effector
organs?
A. Acetylcholine
B. Norepinephrine
C. Dopamine
D. Serotonin
Correct Answer: A. Acetylcholine
Rationale: Muscarinic.
2. Glycopyrrolate is used to:
A. Increase salivation
B. Treat urinary retention
C. Treat glaucoma
D. Reduce secretions
Correct Answer: D. Reduce secretions
Rationale: Anticholinergic.
3. Hydralazine may cause:
A. Bradycardia
B. Hyperkalemia
C. Reflex tachycardia, fluid retention and drug-induced lupus
D. Cough
Correct Answer: C. Reflex tachycardia, fluid retention and drug-induced lupus
Rationale: Direct vasodilator.
4. Patients who develop ACE inhibitor cough can often switch to:
A. Another ACE inhibitor
B. Hydralazine only
C. No therapy
D. An ARB
Correct Answer: D. An ARB
Rationale: No bradykinin effect.
5. Statins work by inhibiting:
A. Cholesterol absorption
B. HMG-CoA reductase
C. PCSK9
D. Lipoprotein lipase
Correct Answer: B. HMG-CoA reductase
Rationale: Mechanism.
,6. Ranolazine is used for chronic angina and can:
A. Prolong the QT interval
B. Cause bradycardia mainly
C. Lower BP significantly
D. Cause hyperkalemia
Correct Answer: A. Prolong the QT interval
Rationale: Late sodium current.
7. Prasugrel is contraindicated in patients with:
A. Diabetes
B. A history of stroke or TIA
C. Hypertension
D. PAD
Correct Answer: B. A history of stroke or TIA
Rationale: Bleeding risk.
8. The reversal agent for apixaban or rivaroxaban is:
A. Andexanet alfa (or PCC)
B. Idarucizumab
C. Vitamin K
D. Protamine
Correct Answer: A. Andexanet alfa (or PCC)
Rationale: Reversal.
9. Metabolic monitoring for patients on atypical antipsychotics includes:
A. Only weight
B. Only ECG
C. Weight/BMI, waist circumference, BP, glucose/A1c and lipids
D. None
Correct Answer: C. Weight/BMI, waist circumference, BP, glucose/A1c and lipids
Rationale: ADA/APA.
10. Buprenorphine for opioid use disorder can now be prescribed by clinicians with a DEA
registration:
A. Without the former X-waiver (eliminated in 2023)
B. Only with an X-waiver
C. Never by NPs
D. Only in hospitals
Correct Answer: A. Without the former X-waiver (eliminated in 2023)
Rationale: MAT Act.
11. Insulin glargine is classified as:
A. Long-acting basal insulin
B. Rapid-acting bolus insulin
C. Intermediate-acting insulin
D. Short-acting regular insulin
Correct Answer: A. Long-acting basal insulin
Rationale: Relatively peakless ~24 hours.
, 12. Tirzepatide is a dual agonist of:
A. PPAR-alpha and PPAR-gamma
B. Insulin and amylin receptors
C. SGLT1 and SGLT2
D. GIP and GLP-1 receptors
Correct Answer: D. GIP and GLP-1 receptors
Rationale: Large A1C and weight reductions.
13. The major adverse effect of sulfonylureas is:
A. Lactic acidosis
B. Pancreatitis
C. Euglycemic ketoacidosis
D. Hypoglycemia
Correct Answer: D. Hypoglycemia
Rationale: Plus weight gain.
14. Sulfonylureas such as glipizide and glyburide work by:
A. Decreasing hepatic glucose output
B. Stimulating insulin secretion from pancreatic beta cells
C. Increasing urinary glucose excretion
D. Activating PPAR-gamma
Correct Answer: B. Stimulating insulin secretion from pancreatic beta cells
Rationale: Insulin secretagogues.
15. Unopened insulin should be stored:
A. In the freezer
B. In the refrigerator, not frozen
C. In a hot car
D. In direct sunlight
Correct Answer: B. In the refrigerator, not frozen
Rationale: In-use vials stable at room temperature about 28 days.
16. Metformin is contraindicated when eGFR is:
A. Below 90 mL/min/1.73 m2
B. Below 60 mL/min/1.73 m2
C. Below 30 mL/min/1.73 m2
D. Above 60 mL/min/1.73 m2
Correct Answer: C. Below 30 mL/min/1.73 m2
Rationale: Risk of lactic acidosis; do not start at eGFR 30-45.
17. Overbasalization is suspected when basal insulin exceeds about:
A. 0.05 units/kg/day
B. 0.5 units/kg/day with persistent hyperglycemia
C. 5 units daily
D. Any dose with normal fasting glucose
Correct Answer: B. 0.5 units/kg/day with persistent hyperglycemia
Rationale: Consider prandial insulin or GLP-1 RA.
