Page 1 of 70
NR 567 MIDTERM EXAM NEWEST 2025 ACTUAL
EXAM| NR567 ADVANCED PHARMACOLOGY FOR
THE AGACNP MIDTERM EXAM WITH 350 REAL
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (BRAND NEW!!)
What is the continuous rate of IV regular insulin in a DKA patient? –
ANSWER - 0.1 units/kg/hr
What is the initial bolus range in patients with IV regular insulin in
DKA? – ANSWER - 0.1-0.15 units/kg
Why might you not give bicarbonate to patients in DKA? – ANSWER -
bicarbonate promotes hypokalemia
What is a common cause of HHNS? – ANSWER - gram negative
pneumonia
What puts older adults at higher risk for HHNS? – ANSWER - diuretics
that lead to dehydration
Typically how much volume do DKA patients need in the first 12 hours
of treatment? – ANSWER - 8-10 L of fluid
pg. 1
,Page 2 of 70
Why does contrast media and metformin damage kidneys – ANSWER -
Contrast can cause AKI, leading to reduction of clearance of metformin
from body > increased risk of lactic acid
What is the recommendation for patient with normal kidney function
and getting contrast – ANSWER - metformin does not need to be
discontinued before or following IV contrast.
What is the recommendation for patients with CKD on metformin? –
ANSWER - Hold metformin at time of procedure and for 48 hours after
What are clinical indications for dobutamine? – ANSWER - Cardiogenic
shock, heart failure
How does isoproterenol treat AV block? – ANSWER - enhances impulse
conduction through AV node (B1, B2 receptors)
A patient taking isoproterenol develops a muscle tremor – ANSWER -
common side effect due to activation of B2 in muscles. dose dependent,
fades with time.
What is a side effect of phenelzine and epinephrine? – ANSWER - MAO
is an enzyme that inactivates epinephrine. MAOI's will prolong and
intensify epinephrine's effects
pg. 2
,Page 3 of 70
What medications should post MI patients take? – ANSWER - Beta
blocker, ACEI or ARB, statin, antiplatelet (asa or plavix) OR anticoag
(warfarin)
What should you do if the patient cant get to emergent PCI? – ANSWER
- use thrombolytics/fibrinolytics (alteplase, tenecteplase)
What are the benefits of reperfusion therapy? – ANSWER - less residual
stenosis, lower recurrence rates of ischemia, can be used when
fibrinolytics are contraindicated
What ACEI's decrease short term mortality in all patients and long term
mortality in patients with reduced LV? – ANSWER - captopril and
lisinopril
What is dosage of statin after STEMI? – ANSWER - high intensity
statin ASAP
Atorvastatin 40-80mg
Rosuvastatin 20mg
Your patient presents with essential hypertension, and in reviewing lab
results, you note that the circulating plasma renin and catecholamine
levels are high. You decide to lower blood pressure by reducing both
cardiac output and systemic vascular resistance (blocking both alpha-
and beta-adrenergic receptors) with a single pharmaceutical agent.
pg. 3
, Page 4 of 70
Which of the following is most likely to achieve this goal? – ANSWER -
Labetalol (Trandate)
A nonselective beta-blocker was initiated for your patient. Which of the
following diagnoses warrants initiating this pharmaceutical agent? –
ANSWER - Hyperthyroid crisis
You are managing a patient with a history of coronary artery disease and
transient ischemic attacks. Low-dose aspirin treatment is considered, but
the patient has a reported history of aspirin allergy. Which of the
following is the best alternative? – ANSWER - Clopidogrel (Plavix)
Which of the following adverse effects is likely when an angiotensin-
converting enzyme inhibitor (ACEI) is used with spironolactone
therapy? – ANSWER - Hyperkalemia
What is alteplase dosing for an acute MI? – ANSWER - For patients >
67kg, the total dose is 100mg : 15mg IV bolus followed by 50 mg over
30 minutes and then 35mg over 60 minutes
What is alteplase dosing for acute ischemic stroke? – ANSWER - 0.9
mg/kg (max 90mg) over 60 minutes with 10% of dose given as initial
bolus
What is the alteplase dosing for pulmonary embolism? – ANSWER -
100mg IV over 2 hours
pg. 4
NR 567 MIDTERM EXAM NEWEST 2025 ACTUAL
EXAM| NR567 ADVANCED PHARMACOLOGY FOR
THE AGACNP MIDTERM EXAM WITH 350 REAL
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (BRAND NEW!!)
What is the continuous rate of IV regular insulin in a DKA patient? –
ANSWER - 0.1 units/kg/hr
What is the initial bolus range in patients with IV regular insulin in
DKA? – ANSWER - 0.1-0.15 units/kg
Why might you not give bicarbonate to patients in DKA? – ANSWER -
bicarbonate promotes hypokalemia
What is a common cause of HHNS? – ANSWER - gram negative
pneumonia
What puts older adults at higher risk for HHNS? – ANSWER - diuretics
that lead to dehydration
Typically how much volume do DKA patients need in the first 12 hours
of treatment? – ANSWER - 8-10 L of fluid
pg. 1
,Page 2 of 70
Why does contrast media and metformin damage kidneys – ANSWER -
Contrast can cause AKI, leading to reduction of clearance of metformin
from body > increased risk of lactic acid
What is the recommendation for patient with normal kidney function
and getting contrast – ANSWER - metformin does not need to be
discontinued before or following IV contrast.
What is the recommendation for patients with CKD on metformin? –
ANSWER - Hold metformin at time of procedure and for 48 hours after
What are clinical indications for dobutamine? – ANSWER - Cardiogenic
shock, heart failure
How does isoproterenol treat AV block? – ANSWER - enhances impulse
conduction through AV node (B1, B2 receptors)
A patient taking isoproterenol develops a muscle tremor – ANSWER -
common side effect due to activation of B2 in muscles. dose dependent,
fades with time.
What is a side effect of phenelzine and epinephrine? – ANSWER - MAO
is an enzyme that inactivates epinephrine. MAOI's will prolong and
intensify epinephrine's effects
pg. 2
,Page 3 of 70
What medications should post MI patients take? – ANSWER - Beta
blocker, ACEI or ARB, statin, antiplatelet (asa or plavix) OR anticoag
(warfarin)
What should you do if the patient cant get to emergent PCI? – ANSWER
- use thrombolytics/fibrinolytics (alteplase, tenecteplase)
What are the benefits of reperfusion therapy? – ANSWER - less residual
stenosis, lower recurrence rates of ischemia, can be used when
fibrinolytics are contraindicated
What ACEI's decrease short term mortality in all patients and long term
mortality in patients with reduced LV? – ANSWER - captopril and
lisinopril
What is dosage of statin after STEMI? – ANSWER - high intensity
statin ASAP
Atorvastatin 40-80mg
Rosuvastatin 20mg
Your patient presents with essential hypertension, and in reviewing lab
results, you note that the circulating plasma renin and catecholamine
levels are high. You decide to lower blood pressure by reducing both
cardiac output and systemic vascular resistance (blocking both alpha-
and beta-adrenergic receptors) with a single pharmaceutical agent.
pg. 3
, Page 4 of 70
Which of the following is most likely to achieve this goal? – ANSWER -
Labetalol (Trandate)
A nonselective beta-blocker was initiated for your patient. Which of the
following diagnoses warrants initiating this pharmaceutical agent? –
ANSWER - Hyperthyroid crisis
You are managing a patient with a history of coronary artery disease and
transient ischemic attacks. Low-dose aspirin treatment is considered, but
the patient has a reported history of aspirin allergy. Which of the
following is the best alternative? – ANSWER - Clopidogrel (Plavix)
Which of the following adverse effects is likely when an angiotensin-
converting enzyme inhibitor (ACEI) is used with spironolactone
therapy? – ANSWER - Hyperkalemia
What is alteplase dosing for an acute MI? – ANSWER - For patients >
67kg, the total dose is 100mg : 15mg IV bolus followed by 50 mg over
30 minutes and then 35mg over 60 minutes
What is alteplase dosing for acute ischemic stroke? – ANSWER - 0.9
mg/kg (max 90mg) over 60 minutes with 10% of dose given as initial
bolus
What is the alteplase dosing for pulmonary embolism? – ANSWER -
100mg IV over 2 hours
pg. 4
