TEST BANK
NSG 533 Advanced Pharmacology Test 1
|Actual Exam Questions with Correct Detailed
Answers & Rationales | A+ Graded
QUESTION
A nurse is providing education to a 38-year-old female patient with a 12-year
history of type 2 diabetes mellitus who reports difficulty achieving glycemic
control despite dietary compliance, daily physical activity, and adherence to
current medications. Her BMI is 31 kg/m², and her serum potassium level is 5.4
mEq/L. She also has a history of thyroid cancer requiring thyroidectomy. Which of
,the following antidiabetic medications is most appropriate to add to her current
regimen?
Correct Answer: Sitagliptin (Januvia)
Rationale: Sitagliptin is effective in lowering A1C and is weight neutral. It does not
worsen hyperkalemia and is not contraindicated in patients with a history of
thyroid cancer. It is safe to use alongside sulfonylureas like glipizide, though dose
adjustments may be needed.
QUESTION
A 68-year-old male with newly diagnosed type 2 diabetes mellitus has a BMI of
43.1 kg/m², history of pancreatitis, and normal renal function. Which of the
following medications is the most appropriate initial treatment for glycemic
control?
Correct Answer: Metformin
Rationale: Metformin is the first-line treatment for type 2 diabetes in the absence
of contraindications. It is weight-neutral or promotes weight loss and does not
increase risk for pancreatitis, unlike GLP-1 receptor agonists.
QUESTION
A nurse is reviewing medications for a patient with type 2 diabetes and a history
of acute pancreatitis. Which antidiabetic medication should the nurse question?
Correct Answer: Sitagliptin
Rationale: Sitagliptin is a DPP-4 inhibitor associated with rare cases of pancreatitis
and should be avoided in patients with a history of this condition.
QUESTION
A nurse is educating a patient recently diagnosed with hypothyroidism who has
been prescribed levothyroxine. Which patient statement indicates a need for
further teaching?
,A. "I should not take heartburn medication without consulting my provider first."
B. "I should report insomnia, tremors, and an increased heart rate to my provider."
C. "If I take a multivitamin with iron, I should take it 4 hours after the
levothyroxine."
D. "If I take calcium supplements, I may need to decrease my dose of
levothyroxine."
Correct Answer: D. "If I take calcium supplements, I may need to decrease my
dose of levothyroxine."
Rationale: Calcium interferes with absorption of levothyroxine; the issue is not
dose reduction, but separation in timing.
QUESTION
A patient with type 1 diabetes is prescribed propranolol for hypertension. What is
the nurse's primary concern regarding this combination?
Correct Answer: Propranolol can mask signs of hypoglycemia and prolong
hypoglycemic episodes.
Rationale: Beta-blockers like propranolol can mask adrenergic symptoms of
hypoglycemia (e.g., tremors, tachycardia), and in type 1 diabetes this may delay
treatment of low blood sugar, increasing risk of severe hypoglycemia.
QUESTION
A patient with a history of multiple gastric ulcers develops sudden GI distress after
consuming alcohol and taking an OTC antacid. Minutes later, he experiences
belching, bloating, and nausea. He presents with bleeding ulcers. Which antacid
likely contributed to this event?
Correct Answer: Alka-Seltzer
Rationale: Alka-Seltzer contains sodium bicarbonate and aspirin, which can
release CO₂ in the stomach, increasing pressure and potentially worsening ulcer
damage.
, QUESTION
A patient self-administers an OTC medication for diarrhea. Which of the following
agents is chemically related to opioids but acts only peripherally on the GI tract?
Correct Answer: Loperamide
Rationale: Loperamide is structurally related to opioids but does not cross the
blood-brain barrier, thus reducing GI motility without central effects.
QUESTION
A patient stabilized on theophylline, warfarin, and phenytoin presents with
toxicity signs. Which OTC medication most likely caused elevated plasma levels of
these drugs?
Correct Answer: Cimetidine
Rationale: Cimetidine is a known CYP450 inhibitor that can elevate levels of many
medications, including theophylline, warfarin, and phenytoin.
QUESTION
A patient with newly diagnosed GERD asks about lifestyle changes to manage
symptoms. Which of the following recommendations should the nurse include?
Correct Answer: Lose weight, elevate the head of bed, avoid alcohol and
trigger foods.
Rationale: Lifestyle modifications are first-line treatment for GERD and include
weight loss, avoiding alcohol, spicy/fatty foods, and elevating the head of the bed.
QUESTION
Which medications or foods are known to worsen symptoms of GERD?
Correct Answer: Anticholinergics, chocolate, caffeine, fatty foods
Rationale: Certain medications and foods lower lower esophageal sphincter tone
or increase gastric acid production, exacerbating GERD symptoms.
NSG 533 Advanced Pharmacology Test 1
|Actual Exam Questions with Correct Detailed
Answers & Rationales | A+ Graded
QUESTION
A nurse is providing education to a 38-year-old female patient with a 12-year
history of type 2 diabetes mellitus who reports difficulty achieving glycemic
control despite dietary compliance, daily physical activity, and adherence to
current medications. Her BMI is 31 kg/m², and her serum potassium level is 5.4
mEq/L. She also has a history of thyroid cancer requiring thyroidectomy. Which of
,the following antidiabetic medications is most appropriate to add to her current
regimen?
Correct Answer: Sitagliptin (Januvia)
Rationale: Sitagliptin is effective in lowering A1C and is weight neutral. It does not
worsen hyperkalemia and is not contraindicated in patients with a history of
thyroid cancer. It is safe to use alongside sulfonylureas like glipizide, though dose
adjustments may be needed.
QUESTION
A 68-year-old male with newly diagnosed type 2 diabetes mellitus has a BMI of
43.1 kg/m², history of pancreatitis, and normal renal function. Which of the
following medications is the most appropriate initial treatment for glycemic
control?
Correct Answer: Metformin
Rationale: Metformin is the first-line treatment for type 2 diabetes in the absence
of contraindications. It is weight-neutral or promotes weight loss and does not
increase risk for pancreatitis, unlike GLP-1 receptor agonists.
QUESTION
A nurse is reviewing medications for a patient with type 2 diabetes and a history
of acute pancreatitis. Which antidiabetic medication should the nurse question?
Correct Answer: Sitagliptin
Rationale: Sitagliptin is a DPP-4 inhibitor associated with rare cases of pancreatitis
and should be avoided in patients with a history of this condition.
QUESTION
A nurse is educating a patient recently diagnosed with hypothyroidism who has
been prescribed levothyroxine. Which patient statement indicates a need for
further teaching?
,A. "I should not take heartburn medication without consulting my provider first."
B. "I should report insomnia, tremors, and an increased heart rate to my provider."
C. "If I take a multivitamin with iron, I should take it 4 hours after the
levothyroxine."
D. "If I take calcium supplements, I may need to decrease my dose of
levothyroxine."
Correct Answer: D. "If I take calcium supplements, I may need to decrease my
dose of levothyroxine."
Rationale: Calcium interferes with absorption of levothyroxine; the issue is not
dose reduction, but separation in timing.
QUESTION
A patient with type 1 diabetes is prescribed propranolol for hypertension. What is
the nurse's primary concern regarding this combination?
Correct Answer: Propranolol can mask signs of hypoglycemia and prolong
hypoglycemic episodes.
Rationale: Beta-blockers like propranolol can mask adrenergic symptoms of
hypoglycemia (e.g., tremors, tachycardia), and in type 1 diabetes this may delay
treatment of low blood sugar, increasing risk of severe hypoglycemia.
QUESTION
A patient with a history of multiple gastric ulcers develops sudden GI distress after
consuming alcohol and taking an OTC antacid. Minutes later, he experiences
belching, bloating, and nausea. He presents with bleeding ulcers. Which antacid
likely contributed to this event?
Correct Answer: Alka-Seltzer
Rationale: Alka-Seltzer contains sodium bicarbonate and aspirin, which can
release CO₂ in the stomach, increasing pressure and potentially worsening ulcer
damage.
, QUESTION
A patient self-administers an OTC medication for diarrhea. Which of the following
agents is chemically related to opioids but acts only peripherally on the GI tract?
Correct Answer: Loperamide
Rationale: Loperamide is structurally related to opioids but does not cross the
blood-brain barrier, thus reducing GI motility without central effects.
QUESTION
A patient stabilized on theophylline, warfarin, and phenytoin presents with
toxicity signs. Which OTC medication most likely caused elevated plasma levels of
these drugs?
Correct Answer: Cimetidine
Rationale: Cimetidine is a known CYP450 inhibitor that can elevate levels of many
medications, including theophylline, warfarin, and phenytoin.
QUESTION
A patient with newly diagnosed GERD asks about lifestyle changes to manage
symptoms. Which of the following recommendations should the nurse include?
Correct Answer: Lose weight, elevate the head of bed, avoid alcohol and
trigger foods.
Rationale: Lifestyle modifications are first-line treatment for GERD and include
weight loss, avoiding alcohol, spicy/fatty foods, and elevating the head of the bed.
QUESTION
Which medications or foods are known to worsen symptoms of GERD?
Correct Answer: Anticholinergics, chocolate, caffeine, fatty foods
Rationale: Certain medications and foods lower lower esophageal sphincter tone
or increase gastric acid production, exacerbating GERD symptoms.
