NR 566 ADVANCED PHARMACOLOGY
PRACTICE EXAM QUESTIONS AND
VERIFIED ANSWERS | 100% CORRECT |
GRADE A+
1. A patient with hypertension and a history of angioedema from an ACE inhibitor is being
switched to an Angiotensin II Receptor Blocker (ARB). Which statement regarding this
transition is correct?
A. ARBs have a zero percent risk of causing angioedema in patients with a history of ACEI-
induced angioedema.
B. ARBs increase bradykinin levels just as significantly as ACE inhibitors do.
C. ARBs should be initiated at double the standard dose to compensate for receptor
sensitivity.
D. There is a small but potential risk of cross-reactivity, and the patient should be
monitored closely.
Answer: D
Conceptual Explanation: While ARBs do not directly inhibit the breakdown of bradykinin
like ACE inhibitors, cases of angioedema have been reported with ARBs, and patients with a
history of ACEI-induced angioedema are at a slightly higher risk for cross-reactivity.
,2. When prescribing Amiodarone, the nurse practitioner must monitor which of the following
organ systems due to potential long-term toxicity?
A. Renal, Musculoskeletal, and Integumentary
B. Gastrointestinal, Auditory, and Neurological
C. Thyroid, Pulmonary, and Hepatic
D. Pancreatic, Ocular, and Hematologic
Answer: C
Conceptual Explanation: Amiodarone is associated with high iodine content leading to
thyroid dysfunction, pulmonary fibrosis, and hepatotoxicity, requiring regular baseline and
follow-up monitoring of TSH, chest X-rays, and LFTs.
3. A patient is taking Warfarin and is recently diagnosed with a fungal infection requiring
Fluconazole. What is the expected drug-drug interaction?
A. Fluconazole induces CYP2C9, leading to a decrease in INR and increased clot risk.
B. Fluconazole inhibits CYP2C9, leading to an increase in INR and increased bleeding risk.
C. Fluconazole decreases the absorption of Warfarin in the small intestine.
D. There is no significant interaction between these two medications.
Answer: B
, Conceptual Explanation: Fluconazole is a potent inhibitor of the CYP2C9 enzyme, which is
responsible for metabolizing the more potent S-enantiomer of Warfarin, thus increasing
plasma levels and the risk of bleeding.
4. Metformin is contraindicated in patients with which of the following clinical parameters?
A. BMI greater than 35 kg/m2
B. Estimated Glomerular Filtration Rate (eGFR) less than 30 mL/min/1.73m2
C. HbA1c between 7.5% and 8.0%
D. History of gestational diabetes
Answer: B
Conceptual Explanation: Metformin carries a risk of lactic acidosis, particularly in
patients with significant renal impairment. It is contraindicated if eGFR is below 30
mL/min.
5. A patient currently taking Lithium for bipolar disorder presents with tremors, ataxia, and
confusion. Which concurrent medication is most likely contributing to Lithium toxicity?
A. Famotidine
B. Acetaminophen
C. Aspirin
D. Hydrochlorothiazide
Answer: D
PRACTICE EXAM QUESTIONS AND
VERIFIED ANSWERS | 100% CORRECT |
GRADE A+
1. A patient with hypertension and a history of angioedema from an ACE inhibitor is being
switched to an Angiotensin II Receptor Blocker (ARB). Which statement regarding this
transition is correct?
A. ARBs have a zero percent risk of causing angioedema in patients with a history of ACEI-
induced angioedema.
B. ARBs increase bradykinin levels just as significantly as ACE inhibitors do.
C. ARBs should be initiated at double the standard dose to compensate for receptor
sensitivity.
D. There is a small but potential risk of cross-reactivity, and the patient should be
monitored closely.
Answer: D
Conceptual Explanation: While ARBs do not directly inhibit the breakdown of bradykinin
like ACE inhibitors, cases of angioedema have been reported with ARBs, and patients with a
history of ACEI-induced angioedema are at a slightly higher risk for cross-reactivity.
,2. When prescribing Amiodarone, the nurse practitioner must monitor which of the following
organ systems due to potential long-term toxicity?
A. Renal, Musculoskeletal, and Integumentary
B. Gastrointestinal, Auditory, and Neurological
C. Thyroid, Pulmonary, and Hepatic
D. Pancreatic, Ocular, and Hematologic
Answer: C
Conceptual Explanation: Amiodarone is associated with high iodine content leading to
thyroid dysfunction, pulmonary fibrosis, and hepatotoxicity, requiring regular baseline and
follow-up monitoring of TSH, chest X-rays, and LFTs.
3. A patient is taking Warfarin and is recently diagnosed with a fungal infection requiring
Fluconazole. What is the expected drug-drug interaction?
A. Fluconazole induces CYP2C9, leading to a decrease in INR and increased clot risk.
B. Fluconazole inhibits CYP2C9, leading to an increase in INR and increased bleeding risk.
C. Fluconazole decreases the absorption of Warfarin in the small intestine.
D. There is no significant interaction between these two medications.
Answer: B
, Conceptual Explanation: Fluconazole is a potent inhibitor of the CYP2C9 enzyme, which is
responsible for metabolizing the more potent S-enantiomer of Warfarin, thus increasing
plasma levels and the risk of bleeding.
4. Metformin is contraindicated in patients with which of the following clinical parameters?
A. BMI greater than 35 kg/m2
B. Estimated Glomerular Filtration Rate (eGFR) less than 30 mL/min/1.73m2
C. HbA1c between 7.5% and 8.0%
D. History of gestational diabetes
Answer: B
Conceptual Explanation: Metformin carries a risk of lactic acidosis, particularly in
patients with significant renal impairment. It is contraindicated if eGFR is below 30
mL/min.
5. A patient currently taking Lithium for bipolar disorder presents with tremors, ataxia, and
confusion. Which concurrent medication is most likely contributing to Lithium toxicity?
A. Famotidine
B. Acetaminophen
C. Aspirin
D. Hydrochlorothiazide
Answer: D
