NURS 5334 – Advanced Pharmacology Final Exam
(2025–2026) | Full 100-Question Study Guide with
Answers & Rationales
Overview:
This study guide is a comprehensive, up-to-date resource for students preparing for the NURS 5334
Advanced Pharmacology final exam (2025–2026). It includes 100 multiple-choice questions covering
core pharmacologic principles, cardiovascular, endocrine, renal, and neuropharmacology, as well as drugs
commonly used in chronic conditions such as hypertension, heart failure, angina, and arrhythmias.
Each question is paired with:
Correct answer: verified against the latest evidence and pharmacology guidelines.
Rationale: a detailed explanation to enhance understanding and promote critical thinking.
The guide emphasizes clinical relevance, linking pharmacologic actions to patient outcomes, safety
monitoring, and common adverse effects. This ensures that students not only memorize drug mechanisms
but also apply knowledge to patient care.
1. Which of the following adverse effects are less likely in a beta-1 selective
blocker?
A. Reflex orthostatic changes
B. Dysrhythmias
C. Decreased triglycerides and cholesterol
D. Impair recovery from hypoglycemic episode
Rationale: Beta-1 selective blockers primarily affect the heart and have minimal
effect on pancreatic beta-2 receptors, so they are less likely to interfere with
hypoglycemia recovery.
2. While taking an angiotensin II receptor blocker (ARB), patients need to
avoid certain OTC drugs without consulting the provider because:
A. Tylenol related to hepatic enzyme competition
B. Cimetidine is metabolized by the CYP 3A4 isoenzymes
,C. NSAIDs reduce prostaglandin levels
D. Loratadine can cause ARB toxicity
Rationale: Cimetidine can affect ARB metabolism via CYP3A4, and NSAIDs
reduce prostaglandins, which may reduce the antihypertensive effect of ARBs.
3. Furosemide is added to a treatment regimen for heart failure that includes
digoxin. Monitoring for this combination includes:
A. Hemoglobin
B. Serum potassium
C. Blood urea nitrogen
D. Serum glucose
Rationale: Loop diuretics like furosemide can cause hypokalemia, which increases
the risk of digoxin toxicity. Monitoring potassium is essential.
4. Your patient has migraines and uses albuterol for asthma. Why is
propranolol inappropriate for migraine prophylaxis?
A. It may induce cerebral hypotension, worsening headaches
B. It may induce bronchoconstriction, causing an asthma attack
C. It is not inappropriate; safe to use
D. It may increase blood pressure, worsening headaches
Rationale: Non-selective beta-blockers like propranolol block beta-2 receptors in
the lungs, risking bronchospasm in asthmatic patients.
5. ACE inhibitors treat hypertension because they (select all that apply):
A. Reduce sodium and water retention
B. Decrease cardiac oxygen demand
C. Decrease vasoconstriction
D. Increase vasodilation
Rationale: ACE inhibitors reduce sodium/water retention, decrease angiotensin II–
mediated vasoconstriction, and promote vasodilation.
, 6. Thiazide diuretics treat hypertension because they:
A. Decrease the production of aldosterone
B. Deplete body sodium and reduce fluid volume
C. Increase renin secretion
D. Decrease blood viscosity
Rationale: Thiazides reduce plasma volume by promoting sodium and water
excretion, lowering blood pressure.
7. Adherence to beta-blocker therapy may be affected by the medication’s:
A. Short half-lives requiring twice daily dosing
B. Tendency to elevate lipid levels
C. Tendency to cause hunger
Rationale: Short half-lives require frequent dosing, which can reduce adherence.
Some beta-blockers can also increase lipid levels, affecting long-term compliance.
8. Which beta-blocker property is most important for patients with asthma?
A. Non-selective beta-blocker
B. Beta-1 selective blocker
C. Alpha-1 blockade
D. Vasodilating beta-blocker
Rationale: Beta-1 selective blockers primarily affect the heart and spare
pulmonary beta-2 receptors, reducing risk of bronchospasm in asthmatic patients.
9. A patient taking digoxin and furosemide should be monitored for:
A. Hypernatremia
B. Hyperglycemia
C. Hypokalemia
D. Hypocalcemia
(2025–2026) | Full 100-Question Study Guide with
Answers & Rationales
Overview:
This study guide is a comprehensive, up-to-date resource for students preparing for the NURS 5334
Advanced Pharmacology final exam (2025–2026). It includes 100 multiple-choice questions covering
core pharmacologic principles, cardiovascular, endocrine, renal, and neuropharmacology, as well as drugs
commonly used in chronic conditions such as hypertension, heart failure, angina, and arrhythmias.
Each question is paired with:
Correct answer: verified against the latest evidence and pharmacology guidelines.
Rationale: a detailed explanation to enhance understanding and promote critical thinking.
The guide emphasizes clinical relevance, linking pharmacologic actions to patient outcomes, safety
monitoring, and common adverse effects. This ensures that students not only memorize drug mechanisms
but also apply knowledge to patient care.
1. Which of the following adverse effects are less likely in a beta-1 selective
blocker?
A. Reflex orthostatic changes
B. Dysrhythmias
C. Decreased triglycerides and cholesterol
D. Impair recovery from hypoglycemic episode
Rationale: Beta-1 selective blockers primarily affect the heart and have minimal
effect on pancreatic beta-2 receptors, so they are less likely to interfere with
hypoglycemia recovery.
2. While taking an angiotensin II receptor blocker (ARB), patients need to
avoid certain OTC drugs without consulting the provider because:
A. Tylenol related to hepatic enzyme competition
B. Cimetidine is metabolized by the CYP 3A4 isoenzymes
,C. NSAIDs reduce prostaglandin levels
D. Loratadine can cause ARB toxicity
Rationale: Cimetidine can affect ARB metabolism via CYP3A4, and NSAIDs
reduce prostaglandins, which may reduce the antihypertensive effect of ARBs.
3. Furosemide is added to a treatment regimen for heart failure that includes
digoxin. Monitoring for this combination includes:
A. Hemoglobin
B. Serum potassium
C. Blood urea nitrogen
D. Serum glucose
Rationale: Loop diuretics like furosemide can cause hypokalemia, which increases
the risk of digoxin toxicity. Monitoring potassium is essential.
4. Your patient has migraines and uses albuterol for asthma. Why is
propranolol inappropriate for migraine prophylaxis?
A. It may induce cerebral hypotension, worsening headaches
B. It may induce bronchoconstriction, causing an asthma attack
C. It is not inappropriate; safe to use
D. It may increase blood pressure, worsening headaches
Rationale: Non-selective beta-blockers like propranolol block beta-2 receptors in
the lungs, risking bronchospasm in asthmatic patients.
5. ACE inhibitors treat hypertension because they (select all that apply):
A. Reduce sodium and water retention
B. Decrease cardiac oxygen demand
C. Decrease vasoconstriction
D. Increase vasodilation
Rationale: ACE inhibitors reduce sodium/water retention, decrease angiotensin II–
mediated vasoconstriction, and promote vasodilation.
, 6. Thiazide diuretics treat hypertension because they:
A. Decrease the production of aldosterone
B. Deplete body sodium and reduce fluid volume
C. Increase renin secretion
D. Decrease blood viscosity
Rationale: Thiazides reduce plasma volume by promoting sodium and water
excretion, lowering blood pressure.
7. Adherence to beta-blocker therapy may be affected by the medication’s:
A. Short half-lives requiring twice daily dosing
B. Tendency to elevate lipid levels
C. Tendency to cause hunger
Rationale: Short half-lives require frequent dosing, which can reduce adherence.
Some beta-blockers can also increase lipid levels, affecting long-term compliance.
8. Which beta-blocker property is most important for patients with asthma?
A. Non-selective beta-blocker
B. Beta-1 selective blocker
C. Alpha-1 blockade
D. Vasodilating beta-blocker
Rationale: Beta-1 selective blockers primarily affect the heart and spare
pulmonary beta-2 receptors, reducing risk of bronchospasm in asthmatic patients.
9. A patient taking digoxin and furosemide should be monitored for:
A. Hypernatremia
B. Hyperglycemia
C. Hypokalemia
D. Hypocalcemia
