NURS 5463 Advanced Pharmacology Practice
Exam 2 Question and Answers with
Rationales Top rated Latest Version
Question 1*
A 68-year-old man withheart failure with reduced ejection fraction
(HFrEF)* (LVEF 30%) is taking lisinopril, metoprolol succinate, and
furosemide. He continues to have NYHA Class II symptoms. Which
medication should be added next to reduce mortality, assuming no
contraindications?
A. Digoxin
B. Hydrochlorothiazide
C. Spironolactone
D. Verapamil
#Correct Answer: C. Spironolactone*
#Rationale*
,Mineralocorticoid receptor antagonists (MRAs), such
asspironolactone*, reduce mortality and heart failure hospitalizations
in eligible patients with symptomatic HFrEF. Before initiating therapy,
assess renal function and serum potassium because of the risk of
hyperkalemia.
*Why the other answers are incorrect:*
*A. Digoxin:* May reduce hospitalizations in selected patients but has
not consistently demonstrated a mortality benefit.
*B. Hydrochlorothiazide:* Helps control blood pressure but does not
improve survival in HFrEF.
*D. Verapamil:* Non-dihydropyridine calcium channel blockers may
worsen systolic heart failure.
---
Question 2*
A patient taking warfarin begins trimethoprim-sulfamethoxazole for a
urinary tract infection. What is the most appropriate management?
A. Increase the warfarin dose.
B. Discontinue warfarin permanently.
,C. Monitor the INR closely and adjust the warfarin dose if needed.
D. No change is necessary.
#Correct Answer: C. Monitor the INR closely and adjust the warfarin
dose if needed.*
#Rationale*
Trimethoprim-sulfamethoxazole inhibits warfarin metabolism and
increases bleeding risk. Enhanced INR monitoring and dose adjustment
are commonly required.
*Incorrect options:*
*A:* May increase bleeding risk.
*B:* Permanent discontinuation is not routinely indicated.
*D:* Ignores a clinically significant drug interaction.
---
Question 3*
, A 52-year-old woman with type 2 diabetes has obesity and established
atherosclerotic cardiovascular disease. She takes metformin but has an
HbA1c of 8.4%. Which medication offers additional glycemic control
while promoting weight loss and reducing cardiovascular risk?
A. Glyburide
B. Semaglutide
C. Pioglitazone
D. NPH insulin
#Correct Answer: B. Semaglutide*
#Rationale*
Semaglutide, a GLP-1 receptor agonist, lowers HbA1c, promotes weight
loss, and reduces major adverse cardiovascular events in appropriate
patients with established ASCVD.
*Incorrect options:*
*A:* Can cause hypoglycemia and weight gain.
*C:* Often causes weight gain and fluid retention.
*D:* Effective for glucose lowering but commonly associated with
weight gain and lacks the same cardiovascular benefit.
Exam 2 Question and Answers with
Rationales Top rated Latest Version
Question 1*
A 68-year-old man withheart failure with reduced ejection fraction
(HFrEF)* (LVEF 30%) is taking lisinopril, metoprolol succinate, and
furosemide. He continues to have NYHA Class II symptoms. Which
medication should be added next to reduce mortality, assuming no
contraindications?
A. Digoxin
B. Hydrochlorothiazide
C. Spironolactone
D. Verapamil
#Correct Answer: C. Spironolactone*
#Rationale*
,Mineralocorticoid receptor antagonists (MRAs), such
asspironolactone*, reduce mortality and heart failure hospitalizations
in eligible patients with symptomatic HFrEF. Before initiating therapy,
assess renal function and serum potassium because of the risk of
hyperkalemia.
*Why the other answers are incorrect:*
*A. Digoxin:* May reduce hospitalizations in selected patients but has
not consistently demonstrated a mortality benefit.
*B. Hydrochlorothiazide:* Helps control blood pressure but does not
improve survival in HFrEF.
*D. Verapamil:* Non-dihydropyridine calcium channel blockers may
worsen systolic heart failure.
---
Question 2*
A patient taking warfarin begins trimethoprim-sulfamethoxazole for a
urinary tract infection. What is the most appropriate management?
A. Increase the warfarin dose.
B. Discontinue warfarin permanently.
,C. Monitor the INR closely and adjust the warfarin dose if needed.
D. No change is necessary.
#Correct Answer: C. Monitor the INR closely and adjust the warfarin
dose if needed.*
#Rationale*
Trimethoprim-sulfamethoxazole inhibits warfarin metabolism and
increases bleeding risk. Enhanced INR monitoring and dose adjustment
are commonly required.
*Incorrect options:*
*A:* May increase bleeding risk.
*B:* Permanent discontinuation is not routinely indicated.
*D:* Ignores a clinically significant drug interaction.
---
Question 3*
, A 52-year-old woman with type 2 diabetes has obesity and established
atherosclerotic cardiovascular disease. She takes metformin but has an
HbA1c of 8.4%. Which medication offers additional glycemic control
while promoting weight loss and reducing cardiovascular risk?
A. Glyburide
B. Semaglutide
C. Pioglitazone
D. NPH insulin
#Correct Answer: B. Semaglutide*
#Rationale*
Semaglutide, a GLP-1 receptor agonist, lowers HbA1c, promotes weight
loss, and reduces major adverse cardiovascular events in appropriate
patients with established ASCVD.
*Incorrect options:*
*A:* Can cause hypoglycemia and weight gain.
*C:* Often causes weight gain and fluid retention.
*D:* Effective for glucose lowering but commonly associated with
weight gain and lacks the same cardiovascular benefit.
