NR 565 Advanced
Pharmacology Care of the
Fundamentals Exam
1.
A 65-year-old male with hypertension and type 2 diabetes is prescribed lisinopril.
Which is the most important lab test to monitor after initiation?
A. Hemoglobin A1C
B. Serum creatinine and potassium
C. Liver function tests
D. CBC with differential
Answer: B. Serum creatinine and potassium
Rationale:
ACE inhibitors like lisinopril can cause hyperkalemia and decreased kidney function,
so monitoring potassium and creatinine is essential, especially in older adults or
those with diabetes.
2.
Which factor most affects the absorption of an orally administered drug?
A. Drug half-life
B. Gastric pH and motility
,C. Hepatic metabolism
D. Protein binding
Answer: B. Gastric pH and motility
Rationale:
Absorption depends on the drug's ability to cross the gastrointestinal tract, which is
influenced by pH and GI motility. Hepatic metabolism and protein binding occur after
absorption.
3.
A patient taking warfarin begins therapy with amiodarone. What should the clinician
do?
A. Increase warfarin dose by 50%
B. Monitor INR closely and reduce warfarin dose as needed
C. Stop amiodarone immediately
D. Add aspirin to prevent clot formation
Answer: B. Monitor INR closely and reduce warfarin dose as needed
Rationale:
Amiodarone inhibits warfarin metabolism, increasing INR and bleeding risk. Dose
adjustments and careful monitoring are required.
4.
Which statement best describes pharmacodynamics?
A. What the body does to the drug
B. The movement of a drug through absorption, distribution, metabolism, and
excretion
C. The effect of the drug on the body and target cells
,D. The rate at which the drug leaves the body
Answer: C. The effect of the drug on the body and target cells
Rationale:
Pharmacodynamics is about how the drug acts on the body, while pharmacokinetics
is about how the body processes the drug.
5.
Which is the first-line antibiotic for uncomplicated community-acquired pneumonia
in an otherwise healthy adult?
A. Amoxicillin
B. Levofloxacin
C. Azithromycin
D. Doxycycline
Answer: C. Azithromycin
Rationale:
Macrolides such as azithromycin are recommended first-line for uncomplicated
community-acquired pneumonia in healthy adults without comorbidities or recent
antibiotic use.
6.
A patient with asthma is prescribed a beta-2 agonist inhaler. Which side effect is
most common?
A. Bradycardia
B. Tachycardia and tremors
C. Hypoglycemia
D. Constipation
, Answer: B. Tachycardia and tremors
Rationale:
Beta-2 agonists (e.g., albuterol) can cause stimulation of beta receptors, leading to
tachycardia, tremors, and nervousness.
7.
A patient with renal impairment is prescribed gentamicin. The nurse practitioner
should:
A. Increase the dosage to achieve therapeutic effect
B. Give the usual dose and monitor for hypokalemia
C. Reduce the dose or extend the dosing interval
D. Switch to oral therapy
Answer: C. Reduce the dose or extend the dosing interval
Rationale:
Aminoglycosides are nephrotoxic and cleared through the kidneys, so dosing must
be adjusted in renal impairment.
8.
Which class of medications is contraindicated in pregnancy due to teratogenic
effects?
A. Beta blockers
B. ACE inhibitors
C. Insulin
D. Penicillin
Answer: B. ACE inhibitors
Pharmacology Care of the
Fundamentals Exam
1.
A 65-year-old male with hypertension and type 2 diabetes is prescribed lisinopril.
Which is the most important lab test to monitor after initiation?
A. Hemoglobin A1C
B. Serum creatinine and potassium
C. Liver function tests
D. CBC with differential
Answer: B. Serum creatinine and potassium
Rationale:
ACE inhibitors like lisinopril can cause hyperkalemia and decreased kidney function,
so monitoring potassium and creatinine is essential, especially in older adults or
those with diabetes.
2.
Which factor most affects the absorption of an orally administered drug?
A. Drug half-life
B. Gastric pH and motility
,C. Hepatic metabolism
D. Protein binding
Answer: B. Gastric pH and motility
Rationale:
Absorption depends on the drug's ability to cross the gastrointestinal tract, which is
influenced by pH and GI motility. Hepatic metabolism and protein binding occur after
absorption.
3.
A patient taking warfarin begins therapy with amiodarone. What should the clinician
do?
A. Increase warfarin dose by 50%
B. Monitor INR closely and reduce warfarin dose as needed
C. Stop amiodarone immediately
D. Add aspirin to prevent clot formation
Answer: B. Monitor INR closely and reduce warfarin dose as needed
Rationale:
Amiodarone inhibits warfarin metabolism, increasing INR and bleeding risk. Dose
adjustments and careful monitoring are required.
4.
Which statement best describes pharmacodynamics?
A. What the body does to the drug
B. The movement of a drug through absorption, distribution, metabolism, and
excretion
C. The effect of the drug on the body and target cells
,D. The rate at which the drug leaves the body
Answer: C. The effect of the drug on the body and target cells
Rationale:
Pharmacodynamics is about how the drug acts on the body, while pharmacokinetics
is about how the body processes the drug.
5.
Which is the first-line antibiotic for uncomplicated community-acquired pneumonia
in an otherwise healthy adult?
A. Amoxicillin
B. Levofloxacin
C. Azithromycin
D. Doxycycline
Answer: C. Azithromycin
Rationale:
Macrolides such as azithromycin are recommended first-line for uncomplicated
community-acquired pneumonia in healthy adults without comorbidities or recent
antibiotic use.
6.
A patient with asthma is prescribed a beta-2 agonist inhaler. Which side effect is
most common?
A. Bradycardia
B. Tachycardia and tremors
C. Hypoglycemia
D. Constipation
, Answer: B. Tachycardia and tremors
Rationale:
Beta-2 agonists (e.g., albuterol) can cause stimulation of beta receptors, leading to
tachycardia, tremors, and nervousness.
7.
A patient with renal impairment is prescribed gentamicin. The nurse practitioner
should:
A. Increase the dosage to achieve therapeutic effect
B. Give the usual dose and monitor for hypokalemia
C. Reduce the dose or extend the dosing interval
D. Switch to oral therapy
Answer: C. Reduce the dose or extend the dosing interval
Rationale:
Aminoglycosides are nephrotoxic and cleared through the kidneys, so dosing must
be adjusted in renal impairment.
8.
Which class of medications is contraindicated in pregnancy due to teratogenic
effects?
A. Beta blockers
B. ACE inhibitors
C. Insulin
D. Penicillin
Answer: B. ACE inhibitors
