NURS 5334 ADVANCED PHARMACOLOGY EXAM 2
COMPLETE PRACTICE EXAM | ORIGINAL QUESTIONS &
DETAILED ANSWERS | 2026/2027 EDITION
Examiner/Administrator: The University of Texas at Arlington (Course-Based Graduate
Nursing Assessment)
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
2026/2027 EDITION
COMPLETE ADVANCED PHARMACOLOGY PRACTICE EXAM
30 Original Multiple-Choice Questions (Part 1)
Passing Score: 80%
Testing Time: 75 Minutes
Blueprint Topics
Cardiovascular Pharmacology
Antihypertensive Agents
Heart Failure Medications
Antiarrhythmics
Anticoagulants & Antiplatelets
Lipid-Lowering Therapy
Diabetes Pharmacology
Endocrine Pharmacology
Pharmacokinetics & Drug Interactions
Advanced Clinical Therapeutics
THE UNIVERSITY OF TEXAS AT ARLINGTON GRADUATE NURSING CURRICULUM ||
ALIGNED WITH CURRENT ADVANCED PHARMACOLOGY COMPETENCIES || ORIGINAL
EDUCATIONAL PRACTICE EXAM || COMPREHENSIVE STUDY RESOURCE || CREATED FOR
ACADEMIC REVIEW AND EXAM PREPARATION
,Cardiovascular Pharmacology (Questions 1–10)
QUESTION 1
A 64-year-old patient with hypertension and diabetic nephropathy has persistent
blood pressures averaging 156/94 mmHg despite lifestyle modification. Which
medication class is generally preferred as first-line therapy because of its renal
protective effects?
A. Calcium channel blocker
B. ACE inhibitor
C. Loop diuretic
D. Alpha-1 blocker
Correct Answer: B. ACE inhibitor
Explanation: ACE inhibitors reduce intraglomerular pressure by dilating the efferent
arteriole and have demonstrated renal protective effects in patients with diabetic kidney
disease. Calcium channel blockers lower blood pressure but lack comparable
nephroprotective benefits. Loop diuretics are reserved primarily for edema or reduced
renal function, while alpha-1 blockers are not recommended as first-line
antihypertensive agents.
QUESTION 2
A patient taking lisinopril develops swelling of the lips and tongue without urticaria.
What is the most appropriate immediate action?
A. Continue therapy with close observation.
B. Discontinue lisinopril immediately and evaluate the airway.
C. Reduce the lisinopril dose.
D. Add an antihistamine and continue therapy.
Correct Answer: B. Discontinue lisinopril immediately and evaluate the airway.
,Explanation: Angioedema is a rare but potentially life-threatening adverse effect of ACE
inhibitors. Immediate discontinuation and airway assessment are priorities. Dose
reduction does not eliminate risk, and continuation of therapy is contraindicated.
QUESTION 3
Which antihypertensive medication is most likely to cause reflex tachycardia because
of potent arterial vasodilation?
A. Hydralazine
B. Atenolol
C. Verapamil
D. Lisinopril
Correct Answer: A. Hydralazine
Explanation: Hydralazine directly relaxes arteriolar smooth muscle, often triggering
baroreceptor-mediated sympathetic activation and reflex tachycardia. Beta blockers
reduce heart rate, verapamil slows AV conduction, and ACE inhibitors generally do not
produce significant reflex tachycardia.
QUESTION 4
A patient with heart failure with reduced ejection fraction is beginning guideline-
directed medical therapy. Which medication has been shown to improve survival?
A. Digoxin alone
B. Furosemide alone
C. ACE inhibitor
D. Diltiazem
Correct Answer: C. ACE inhibitor
, Explanation: ACE inhibitors improve survival, decrease remodeling, and reduce
hospitalization in HFrEF. Loop diuretics relieve congestion but have not demonstrated
mortality benefit. Digoxin primarily improves symptoms, while diltiazem is generally
avoided in systolic heart failure.
QUESTION 5
Which electrolyte abnormality should be monitored most closely after initiation of
spironolactone?
A. Hypernatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypophosphatemia
Correct Answer: B. Hyperkalemia
Explanation: Spironolactone antagonizes aldosterone, reducing potassium excretion and
increasing the risk of hyperkalemia, particularly in patients with renal impairment or
those taking ACE inhibitors or ARBs.
QUESTION 6
A patient receiving warfarin begins treatment with trimethoprim-sulfamethoxazole.
Which outcome is most likely?
A. Decreased INR
B. Increased INR with bleeding risk
C. No clinically important interaction
D. Reduced anticoagulant effect
Correct Answer: B. Increased INR with bleeding risk
COMPLETE PRACTICE EXAM | ORIGINAL QUESTIONS &
DETAILED ANSWERS | 2026/2027 EDITION
Examiner/Administrator: The University of Texas at Arlington (Course-Based Graduate
Nursing Assessment)
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
2026/2027 EDITION
COMPLETE ADVANCED PHARMACOLOGY PRACTICE EXAM
30 Original Multiple-Choice Questions (Part 1)
Passing Score: 80%
Testing Time: 75 Minutes
Blueprint Topics
Cardiovascular Pharmacology
Antihypertensive Agents
Heart Failure Medications
Antiarrhythmics
Anticoagulants & Antiplatelets
Lipid-Lowering Therapy
Diabetes Pharmacology
Endocrine Pharmacology
Pharmacokinetics & Drug Interactions
Advanced Clinical Therapeutics
THE UNIVERSITY OF TEXAS AT ARLINGTON GRADUATE NURSING CURRICULUM ||
ALIGNED WITH CURRENT ADVANCED PHARMACOLOGY COMPETENCIES || ORIGINAL
EDUCATIONAL PRACTICE EXAM || COMPREHENSIVE STUDY RESOURCE || CREATED FOR
ACADEMIC REVIEW AND EXAM PREPARATION
,Cardiovascular Pharmacology (Questions 1–10)
QUESTION 1
A 64-year-old patient with hypertension and diabetic nephropathy has persistent
blood pressures averaging 156/94 mmHg despite lifestyle modification. Which
medication class is generally preferred as first-line therapy because of its renal
protective effects?
A. Calcium channel blocker
B. ACE inhibitor
C. Loop diuretic
D. Alpha-1 blocker
Correct Answer: B. ACE inhibitor
Explanation: ACE inhibitors reduce intraglomerular pressure by dilating the efferent
arteriole and have demonstrated renal protective effects in patients with diabetic kidney
disease. Calcium channel blockers lower blood pressure but lack comparable
nephroprotective benefits. Loop diuretics are reserved primarily for edema or reduced
renal function, while alpha-1 blockers are not recommended as first-line
antihypertensive agents.
QUESTION 2
A patient taking lisinopril develops swelling of the lips and tongue without urticaria.
What is the most appropriate immediate action?
A. Continue therapy with close observation.
B. Discontinue lisinopril immediately and evaluate the airway.
C. Reduce the lisinopril dose.
D. Add an antihistamine and continue therapy.
Correct Answer: B. Discontinue lisinopril immediately and evaluate the airway.
,Explanation: Angioedema is a rare but potentially life-threatening adverse effect of ACE
inhibitors. Immediate discontinuation and airway assessment are priorities. Dose
reduction does not eliminate risk, and continuation of therapy is contraindicated.
QUESTION 3
Which antihypertensive medication is most likely to cause reflex tachycardia because
of potent arterial vasodilation?
A. Hydralazine
B. Atenolol
C. Verapamil
D. Lisinopril
Correct Answer: A. Hydralazine
Explanation: Hydralazine directly relaxes arteriolar smooth muscle, often triggering
baroreceptor-mediated sympathetic activation and reflex tachycardia. Beta blockers
reduce heart rate, verapamil slows AV conduction, and ACE inhibitors generally do not
produce significant reflex tachycardia.
QUESTION 4
A patient with heart failure with reduced ejection fraction is beginning guideline-
directed medical therapy. Which medication has been shown to improve survival?
A. Digoxin alone
B. Furosemide alone
C. ACE inhibitor
D. Diltiazem
Correct Answer: C. ACE inhibitor
, Explanation: ACE inhibitors improve survival, decrease remodeling, and reduce
hospitalization in HFrEF. Loop diuretics relieve congestion but have not demonstrated
mortality benefit. Digoxin primarily improves symptoms, while diltiazem is generally
avoided in systolic heart failure.
QUESTION 5
Which electrolyte abnormality should be monitored most closely after initiation of
spironolactone?
A. Hypernatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypophosphatemia
Correct Answer: B. Hyperkalemia
Explanation: Spironolactone antagonizes aldosterone, reducing potassium excretion and
increasing the risk of hyperkalemia, particularly in patients with renal impairment or
those taking ACE inhibitors or ARBs.
QUESTION 6
A patient receiving warfarin begins treatment with trimethoprim-sulfamethoxazole.
Which outcome is most likely?
A. Decreased INR
B. Increased INR with bleeding risk
C. No clinically important interaction
D. Reduced anticoagulant effect
Correct Answer: B. Increased INR with bleeding risk
