NUR612/NUR612 Exam 2 V2 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient taking an ACE inhibitor develops a dry, persistent cough. What is the most likely
mechanism for this side effect?
A. Inhibition of renin release
B. Decreased prostaglandins
C. Accumulation of bradykinin
D. Increased angiotensin II levels
Answer: C
Rationale: ACE inhibitors block the enzyme that breaks down bradykinin, leading to its
accumulation in the respiratory tract. This accumulation irritates the lungs and causes a
characteristic dry cough in about 10-20% of patients. If the cough is intolerable, the
provider typically switches the patient to an Angiotensin II Receptor Blocker (ARB).
2. Which of the following beta-blockers is considered cardioselective and safer for a patient
with mild asthma?
A. Propranolol
B. Nadolol
C. Timolol
,D. Metoprolol
Answer: D
Rationale: Metoprolol is a selective beta-1 antagonist, meaning it primarily targets the
heart rather than the beta-2 receptors in the lungs. Non-selective beta-blockers like
propranolol can cause bronchoconstriction by blocking beta-2 receptors, which is
dangerous for asthmatic patients. However, even selective blockers should be used with
caution at high doses in patients with respiratory issues.
3. When initiating statin therapy, which laboratory test should be performed at baseline?
A. Serum amylase
B. Liver function tests (ALT/AST)
C. Creatinine clearance
D. Complete blood count
Answer: B
Rationale: Statins can occasionally cause hepatotoxicity, so obtaining baseline liver
enzymes is a standard safety protocol. Although routine monitoring is no longer strictly
required for all patients, it should be done if symptoms of liver injury appear. This baseline
measurement allows for a comparison if the patient develops signs of jaundice or
abdominal pain later.
, 4. A patient on Warfarin has an INR of 1.2. Which of the following is the most appropriate
action?
A. Hold the next dose
B. Administer Vitamin K
C. Administer Protamine Sulfate
D. Increase the daily dose
Answer: D
Rationale: For most indications, the therapeutic INR range for a patient on Warfarin is
between 2.0 and 3.0. An INR of 1.2 is sub-therapeutic, meaning the blood is too ‘thick’ and
the risk of clotting is high. The clinician should increase the dose and recheck the INR in a
few days to ensure it reaches the target range.
5. Which medication is the first-line treatment for Type 2 Diabetes unless contraindicated?
A. Metformin
B. Pioglitazone
C. Glyburide
D. Sitagliptin
Answer: A
Rationale: Metformin is the preferred initial pharmacologic agent for the treatment of type
2 diabetes mellitus due to its efficacy and safety profile. It works primarily by decreasing
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient taking an ACE inhibitor develops a dry, persistent cough. What is the most likely
mechanism for this side effect?
A. Inhibition of renin release
B. Decreased prostaglandins
C. Accumulation of bradykinin
D. Increased angiotensin II levels
Answer: C
Rationale: ACE inhibitors block the enzyme that breaks down bradykinin, leading to its
accumulation in the respiratory tract. This accumulation irritates the lungs and causes a
characteristic dry cough in about 10-20% of patients. If the cough is intolerable, the
provider typically switches the patient to an Angiotensin II Receptor Blocker (ARB).
2. Which of the following beta-blockers is considered cardioselective and safer for a patient
with mild asthma?
A. Propranolol
B. Nadolol
C. Timolol
,D. Metoprolol
Answer: D
Rationale: Metoprolol is a selective beta-1 antagonist, meaning it primarily targets the
heart rather than the beta-2 receptors in the lungs. Non-selective beta-blockers like
propranolol can cause bronchoconstriction by blocking beta-2 receptors, which is
dangerous for asthmatic patients. However, even selective blockers should be used with
caution at high doses in patients with respiratory issues.
3. When initiating statin therapy, which laboratory test should be performed at baseline?
A. Serum amylase
B. Liver function tests (ALT/AST)
C. Creatinine clearance
D. Complete blood count
Answer: B
Rationale: Statins can occasionally cause hepatotoxicity, so obtaining baseline liver
enzymes is a standard safety protocol. Although routine monitoring is no longer strictly
required for all patients, it should be done if symptoms of liver injury appear. This baseline
measurement allows for a comparison if the patient develops signs of jaundice or
abdominal pain later.
, 4. A patient on Warfarin has an INR of 1.2. Which of the following is the most appropriate
action?
A. Hold the next dose
B. Administer Vitamin K
C. Administer Protamine Sulfate
D. Increase the daily dose
Answer: D
Rationale: For most indications, the therapeutic INR range for a patient on Warfarin is
between 2.0 and 3.0. An INR of 1.2 is sub-therapeutic, meaning the blood is too ‘thick’ and
the risk of clotting is high. The clinician should increase the dose and recheck the INR in a
few days to ensure it reaches the target range.
5. Which medication is the first-line treatment for Type 2 Diabetes unless contraindicated?
A. Metformin
B. Pioglitazone
C. Glyburide
D. Sitagliptin
Answer: A
Rationale: Metformin is the preferred initial pharmacologic agent for the treatment of type
2 diabetes mellitus due to its efficacy and safety profile. It works primarily by decreasing
