NR 508 Advanced Pharmacology Midterm Exam
2025
Which of the following has been shown to prolong life in patients with
chronic congestive heart failure despite having a negative inotropic effect
on cardiac contractility?
Answer: Beta-blockers (e.g., carvedilol, metoprolol).
RATIONALE: Beta-blockers improve survival in heart failure by reducing sympathetic
overactivity, even though they initially decrease cardiac contractility (negative inotropic
effect).
Which of the following statements gives the best explanation for the use of
beta-blockers in congestive heart failure?
Answer: Beta-blockers reduce sympathetic overactivity and improve long-term
survival.
RATIONALE: Beta-blockers counteract the harmful effects of chronic sympathetic
activation in heart failure, improving outcomes.
What is the molecular mechanism of action of digoxin (Lanoxin, Cardoxin)
used in the management of congestive heart failure?
Answer: Inhibition of Na+/K+ ATPase, leading to increased intracellular calcium and
enhanced cardiac contractility.
RATIONALE: Digoxin increases intracellular calcium by inhibiting the Na+/K+ pump,
which improves myocardial contraction.
Which of the following is an aldosterone antagonist and is useful in the
management of hypertensive patients with hypokalemia?
Answer: Spironolactone.
RATIONALE: Spironolactone blocks aldosterone receptors, reducing sodium retention
and potassium loss, making it useful in hypertension with hypokalemia.
Which agent is the most appropriate choice as a diuretic in patients with
hypertension, heart failure, and renal failure?
Answer: Loop diuretics (e.g., furosemide).
RATIONALE: Loop diuretics are effective in patients with renal impairment and are
commonly used in heart failure and hypertension.
, Which is the atypical antidepressant known to block the reuptake of
dopamine and norepinephrine (NDRI) and is used to treat depression and
nicotine addiction?
Answer: Bupropion.
RATIONALE: Bupropion is an NDRI used for depression and as an aid for smoking
cessation.
Which drug increases GABA activity and chloride conductance in neuronal
cells, thus inhibiting action potentials, and is used to treat anxiety,
convulsions, and could cause marked sedation?
Answer: Benzodiazepines (e.g., diazepam).
RATIONALE: Benzodiazepines enhance GABA activity, leading to sedation, anxiolysis,
and anticonvulsant effects.
Which agent is a carbonic anhydrase inhibitor that works at the proximal
convoluted tubule and is used in the treatment of ocular hypertension?
Answer: Acetazolamide.
RATIONALE: Acetazolamide inhibits carbonic anhydrase, reducing aqueous humor
production and lowering intraocular pressure.
Which drugs bind to 30S ribosome units and are used in the treatment of
Propionibacterium (acne), Mycoplasma, Chlamydia, and Helicobacter
infections?
Answer: Tetracyclines (e.g., doxycycline).
RATIONALE: Tetracyclines inhibit protein synthesis by binding to the 30S ribosomal
subunit.
The primary care NP sees a patient several months after a myocardial
infarction. The patient has been on furosemide to treat heart failure. The
NP notes edema of the hands, feet, and ankles. The NP should add which
drug?
Answer: Spironolactone.
RATIONALE: Spironolactone is added to loop diuretics in heart failure to reduce fluid
retention and improve outcomes.
MK is a 64-year-old male taking lisinopril for HTN. One month after
starting the drug, he is noted to have a decline in renal function. Which is
2025
Which of the following has been shown to prolong life in patients with
chronic congestive heart failure despite having a negative inotropic effect
on cardiac contractility?
Answer: Beta-blockers (e.g., carvedilol, metoprolol).
RATIONALE: Beta-blockers improve survival in heart failure by reducing sympathetic
overactivity, even though they initially decrease cardiac contractility (negative inotropic
effect).
Which of the following statements gives the best explanation for the use of
beta-blockers in congestive heart failure?
Answer: Beta-blockers reduce sympathetic overactivity and improve long-term
survival.
RATIONALE: Beta-blockers counteract the harmful effects of chronic sympathetic
activation in heart failure, improving outcomes.
What is the molecular mechanism of action of digoxin (Lanoxin, Cardoxin)
used in the management of congestive heart failure?
Answer: Inhibition of Na+/K+ ATPase, leading to increased intracellular calcium and
enhanced cardiac contractility.
RATIONALE: Digoxin increases intracellular calcium by inhibiting the Na+/K+ pump,
which improves myocardial contraction.
Which of the following is an aldosterone antagonist and is useful in the
management of hypertensive patients with hypokalemia?
Answer: Spironolactone.
RATIONALE: Spironolactone blocks aldosterone receptors, reducing sodium retention
and potassium loss, making it useful in hypertension with hypokalemia.
Which agent is the most appropriate choice as a diuretic in patients with
hypertension, heart failure, and renal failure?
Answer: Loop diuretics (e.g., furosemide).
RATIONALE: Loop diuretics are effective in patients with renal impairment and are
commonly used in heart failure and hypertension.
, Which is the atypical antidepressant known to block the reuptake of
dopamine and norepinephrine (NDRI) and is used to treat depression and
nicotine addiction?
Answer: Bupropion.
RATIONALE: Bupropion is an NDRI used for depression and as an aid for smoking
cessation.
Which drug increases GABA activity and chloride conductance in neuronal
cells, thus inhibiting action potentials, and is used to treat anxiety,
convulsions, and could cause marked sedation?
Answer: Benzodiazepines (e.g., diazepam).
RATIONALE: Benzodiazepines enhance GABA activity, leading to sedation, anxiolysis,
and anticonvulsant effects.
Which agent is a carbonic anhydrase inhibitor that works at the proximal
convoluted tubule and is used in the treatment of ocular hypertension?
Answer: Acetazolamide.
RATIONALE: Acetazolamide inhibits carbonic anhydrase, reducing aqueous humor
production and lowering intraocular pressure.
Which drugs bind to 30S ribosome units and are used in the treatment of
Propionibacterium (acne), Mycoplasma, Chlamydia, and Helicobacter
infections?
Answer: Tetracyclines (e.g., doxycycline).
RATIONALE: Tetracyclines inhibit protein synthesis by binding to the 30S ribosomal
subunit.
The primary care NP sees a patient several months after a myocardial
infarction. The patient has been on furosemide to treat heart failure. The
NP notes edema of the hands, feet, and ankles. The NP should add which
drug?
Answer: Spironolactone.
RATIONALE: Spironolactone is added to loop diuretics in heart failure to reduce fluid
retention and improve outcomes.
MK is a 64-year-old male taking lisinopril for HTN. One month after
starting the drug, he is noted to have a decline in renal function. Which is
