1
REGIS NU641 ADVANCED PHARMACOLOGY EXAM 1 2026–2027 | 200
VERIFIED QUESTIONS & ANSWERS | FNP PHARMACOLOGY PREP
1. A patient with hypertension and diabetes is started on lisinopril.
What is the main therapeutic advantage of using an ACE inhibitor in this patient?
A. Reduction of heart rate
B. Renal protection by decreasing intraglomerular pressure
C. Increase in insulin secretion
D. Prevention of hypoglycemia
Answer: B. Renal protection by decreasing intraglomerular pressure
Rationale: ACE inhibitors lower glomerular filtration pressure, slowing diabetic
nephropathy progression.
2. A 65-year-old male with a history of heart failure is prescribed spironolactone.
Which electrolyte imbalance is most likely to occur?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic; it increases serum
potassium levels.
3. A patient reports a persistent dry cough after starting captopril.
Which alternative medication provides a similar benefit without this side effect?
A. Losartan
B. Amlodipine
C. Furosemide
, 2
D. Clonidine
Answer: A. Losartan
Rationale: ARBs like losartan block angiotensin II without increasing bradykinin,
preventing the cough seen with ACE inhibitors.
4. A 45-year-old woman with asthma is prescribed propranolol.
Which adverse reaction is the greatest concern?
A. Bradycardia
B. Bronchospasm
C. Hypertension
D. Insomnia
Answer: B. Bronchospasm
Rationale: Nonselective beta blockers like propranolol block β2 receptors, causing
bronchoconstriction in asthmatic patients.
5. A patient taking furosemide complains of muscle cramps and weakness.
What lab abnormality should the provider suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics promote potassium excretion, leading to muscle
weakness and arrhythmia risk.
6. A patient on warfarin therapy presents with an INR of 6.0 and no bleeding.
What is the appropriate next step?
A. Stop warfarin and recheck INR in 2 days
B. Give vitamin K immediately
C. Continue same dose
D. Administer heparin
Answer: A. Stop warfarin and recheck INR in 2 days
, 3
Rationale: Holding the dose allows INR to return to therapeutic range; vitamin K
is reserved for INR >10 or active bleeding.
7. A patient on amiodarone for atrial fibrillation complains of shortness of breath
and cough.
Which adverse effect should be suspected?
A. Pulmonary fibrosis
B. Hypoglycemia
C. Pulmonary embolism
D. Bronchospasm
Answer: A. Pulmonary fibrosis
Rationale: Amiodarone can cause interstitial lung disease; baseline and follow-up
chest imaging are recommended.
8. A patient taking metformin for type 2 diabetes develops lactic acidosis.
Which condition most likely contributed to this complication?
A. Chronic kidney disease
B. Hyperthyroidism
C. Asthma
D. Hypertension
Answer: A. Chronic kidney disease
Rationale: Metformin is contraindicated in renal impairment due to risk of lactic
acid accumulation.
9. A patient on digoxin reports nausea, blurred vision, and seeing yellow halos.
What electrolyte imbalance can worsen this toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
, 4
Rationale: Low potassium enhances digoxin binding to Na⁺/K⁺ ATPase,
increasing toxicity risk.
10. A patient prescribed atorvastatin complains of muscle pain and weakness.
Which lab test should be ordered?
A. Creatine kinase (CK)
B. Liver enzymes
C. CBC
D. Blood glucose
Answer: A. Creatine kinase (CK)
Rationale: Elevated CK indicates myopathy or rhabdomyolysis, a serious adverse
effect of statins.
11. A patient on hydrochlorothiazide has a serum sodium level of 128 mEq/L.
What action should the provider take?
A. Hold the medication and reassess sodium
B. Double the dose
C. Add furosemide
D. Encourage fluid restriction
Answer: A. Hold the medication and reassess sodium
Rationale: Thiazide diuretics can cause hyponatremia; discontinuation may be
necessary.
12. A woman taking oral contraceptives begins rifampin therapy for tuberculosis.
What teaching is essential?
A. Use an alternative form of birth control
B. Continue as prescribed; no interaction occurs
C. Increase contraceptive dose
D. Skip rifampin doses during menses
Answer: A. Use an alternative form of birth control
Rationale: Rifampin induces hepatic enzymes that reduce contraceptive
effectiveness.
REGIS NU641 ADVANCED PHARMACOLOGY EXAM 1 2026–2027 | 200
VERIFIED QUESTIONS & ANSWERS | FNP PHARMACOLOGY PREP
1. A patient with hypertension and diabetes is started on lisinopril.
What is the main therapeutic advantage of using an ACE inhibitor in this patient?
A. Reduction of heart rate
B. Renal protection by decreasing intraglomerular pressure
C. Increase in insulin secretion
D. Prevention of hypoglycemia
Answer: B. Renal protection by decreasing intraglomerular pressure
Rationale: ACE inhibitors lower glomerular filtration pressure, slowing diabetic
nephropathy progression.
2. A 65-year-old male with a history of heart failure is prescribed spironolactone.
Which electrolyte imbalance is most likely to occur?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic; it increases serum
potassium levels.
3. A patient reports a persistent dry cough after starting captopril.
Which alternative medication provides a similar benefit without this side effect?
A. Losartan
B. Amlodipine
C. Furosemide
, 2
D. Clonidine
Answer: A. Losartan
Rationale: ARBs like losartan block angiotensin II without increasing bradykinin,
preventing the cough seen with ACE inhibitors.
4. A 45-year-old woman with asthma is prescribed propranolol.
Which adverse reaction is the greatest concern?
A. Bradycardia
B. Bronchospasm
C. Hypertension
D. Insomnia
Answer: B. Bronchospasm
Rationale: Nonselective beta blockers like propranolol block β2 receptors, causing
bronchoconstriction in asthmatic patients.
5. A patient taking furosemide complains of muscle cramps and weakness.
What lab abnormality should the provider suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics promote potassium excretion, leading to muscle
weakness and arrhythmia risk.
6. A patient on warfarin therapy presents with an INR of 6.0 and no bleeding.
What is the appropriate next step?
A. Stop warfarin and recheck INR in 2 days
B. Give vitamin K immediately
C. Continue same dose
D. Administer heparin
Answer: A. Stop warfarin and recheck INR in 2 days
, 3
Rationale: Holding the dose allows INR to return to therapeutic range; vitamin K
is reserved for INR >10 or active bleeding.
7. A patient on amiodarone for atrial fibrillation complains of shortness of breath
and cough.
Which adverse effect should be suspected?
A. Pulmonary fibrosis
B. Hypoglycemia
C. Pulmonary embolism
D. Bronchospasm
Answer: A. Pulmonary fibrosis
Rationale: Amiodarone can cause interstitial lung disease; baseline and follow-up
chest imaging are recommended.
8. A patient taking metformin for type 2 diabetes develops lactic acidosis.
Which condition most likely contributed to this complication?
A. Chronic kidney disease
B. Hyperthyroidism
C. Asthma
D. Hypertension
Answer: A. Chronic kidney disease
Rationale: Metformin is contraindicated in renal impairment due to risk of lactic
acid accumulation.
9. A patient on digoxin reports nausea, blurred vision, and seeing yellow halos.
What electrolyte imbalance can worsen this toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
, 4
Rationale: Low potassium enhances digoxin binding to Na⁺/K⁺ ATPase,
increasing toxicity risk.
10. A patient prescribed atorvastatin complains of muscle pain and weakness.
Which lab test should be ordered?
A. Creatine kinase (CK)
B. Liver enzymes
C. CBC
D. Blood glucose
Answer: A. Creatine kinase (CK)
Rationale: Elevated CK indicates myopathy or rhabdomyolysis, a serious adverse
effect of statins.
11. A patient on hydrochlorothiazide has a serum sodium level of 128 mEq/L.
What action should the provider take?
A. Hold the medication and reassess sodium
B. Double the dose
C. Add furosemide
D. Encourage fluid restriction
Answer: A. Hold the medication and reassess sodium
Rationale: Thiazide diuretics can cause hyponatremia; discontinuation may be
necessary.
12. A woman taking oral contraceptives begins rifampin therapy for tuberculosis.
What teaching is essential?
A. Use an alternative form of birth control
B. Continue as prescribed; no interaction occurs
C. Increase contraceptive dose
D. Skip rifampin doses during menses
Answer: A. Use an alternative form of birth control
Rationale: Rifampin induces hepatic enzymes that reduce contraceptive
effectiveness.
