Answer Key – NURS 6630 (40 Answers 2B)
1. B – Metoprolol
Causative mechanism: Selective β1-blocker; avoids bronchospasm in asthma.
2. A – Ibuprofen
Causative mechanism: NSAID; inhibits prostaglandin synthesis → nephrotoxicity in
CKD.
3. A – Phenytoin
Causative mechanism: Alters gingival fibroblast proliferation → gingival hyperplasia.
4. B – ACE inhibitor/ARB
Mechanism: Inhibits renin-angiotensin system → BP reduction and nephroprotection in
diabetes.
5. B – Children under 18
Causative agent: Fluoroquinolones → cartilage damage (arthropathy).
6. B – Warfarin
Mechanism: Vitamin K antagonist → requires INR monitoring to prevent bleeding.
7. B – PTU
Mechanism: Thyroid peroxidase inhibition → reduces thyroid hormone; safer in 1st
trimester.
8. B – Tendon rupture
Causative agent: Fluoroquinolones → collagen degradation in tendons.
9. B – Atorvastatin 40–80 mg
Mechanism: HMG-CoA reductase inhibition → lowers LDL, reduces CV risk.
10. C – Corticosteroids
Mechanism: Anti-inflammatory → safe in gout while on warfarin.
11. C – Glargine
Mechanism: Long-acting insulin → steady basal glucose control.
12. A – Biguanides
Mechanism: Metformin inhibits gluconeogenesis → risk of lactic acidosis in renal
impairment.
13. D – All of the above
Mechanism: NSAIDs inhibit prostaglandins → worsen hypertension, asthma, renal
function.
14. A – Acetaminophen
Mechanism: Hepatotoxic metabolite NAPQI accumulation → monitor LFTs.
15. C – Fentanyl
Mechanism: Opioid metabolism primarily hepatic → safe in CKD.
16. B – Duloxetine
Mechanism: SNRI; inhibits serotonin and norepinephrine reuptake → analgesic effect in
neuropathic pain.
17. A – Hyperkalemia
Mechanism: ARBs inhibit aldosterone → potassium retention.
1. B – Metoprolol
Causative mechanism: Selective β1-blocker; avoids bronchospasm in asthma.
2. A – Ibuprofen
Causative mechanism: NSAID; inhibits prostaglandin synthesis → nephrotoxicity in
CKD.
3. A – Phenytoin
Causative mechanism: Alters gingival fibroblast proliferation → gingival hyperplasia.
4. B – ACE inhibitor/ARB
Mechanism: Inhibits renin-angiotensin system → BP reduction and nephroprotection in
diabetes.
5. B – Children under 18
Causative agent: Fluoroquinolones → cartilage damage (arthropathy).
6. B – Warfarin
Mechanism: Vitamin K antagonist → requires INR monitoring to prevent bleeding.
7. B – PTU
Mechanism: Thyroid peroxidase inhibition → reduces thyroid hormone; safer in 1st
trimester.
8. B – Tendon rupture
Causative agent: Fluoroquinolones → collagen degradation in tendons.
9. B – Atorvastatin 40–80 mg
Mechanism: HMG-CoA reductase inhibition → lowers LDL, reduces CV risk.
10. C – Corticosteroids
Mechanism: Anti-inflammatory → safe in gout while on warfarin.
11. C – Glargine
Mechanism: Long-acting insulin → steady basal glucose control.
12. A – Biguanides
Mechanism: Metformin inhibits gluconeogenesis → risk of lactic acidosis in renal
impairment.
13. D – All of the above
Mechanism: NSAIDs inhibit prostaglandins → worsen hypertension, asthma, renal
function.
14. A – Acetaminophen
Mechanism: Hepatotoxic metabolite NAPQI accumulation → monitor LFTs.
15. C – Fentanyl
Mechanism: Opioid metabolism primarily hepatic → safe in CKD.
16. B – Duloxetine
Mechanism: SNRI; inhibits serotonin and norepinephrine reuptake → analgesic effect in
neuropathic pain.
17. A – Hyperkalemia
Mechanism: ARBs inhibit aldosterone → potassium retention.
