NURS 6521 Exam 2 V1 | NURS 6521
Advanced Pharmacology | Actual Q&A
with Rationale (NURS6521 Exam 2) |
Walden University
1. An advanced practice nurse is prescribing an ACE inhibitor for a patient with hypertension.
Which adverse effect is most commonly associated with this drug class due to bradykinin
accumulation?
A. Dry, nonproductive cough
B. Peripheral edema
C. Hypokalemia
D. Tachycardia
Answer: A
Rationale: The accumulation of bradykinin in the lungs often leads to a persistent, dry
cough in patients taking ACE inhibitors. This side effect is a common reason for patients to
discontinue the medication and switch to an Angiotensin II Receptor Blocker. The clinician
must educate the patient that this cough is not indicative of an infection but is a direct
result of the medication’s mechanism.
2. A patient with Type 2 Diabetes is scheduled for a CT scan with intravenous contrast. Which
medication should be withheld for 48 hours after the procedure to prevent lactic acidosis?
A. Sitagliptin
,B. Glipizide
C. Pioglitazone
D. Metformin
Answer: D
Rationale: Metformin can interact with contrast media to cause acute renal failure, which
subsequently leads to the accumulation of metformin and lactic acidosis. Protocols typically
require holding the drug on the day of the procedure and for 48 hours following the study.
Renal function should be verified as normal before the medication is restarted by the
healthcare provider.
3. When monitoring a patient on Warfarin therapy, which laboratory value is the primary
indicator of the drug’s therapeutic effectiveness?
A. INR
B. Platelet count
C. Bleeding time
D. aPTT
Answer: A
Rationale: The International Normalized Ratio (INR) is the standardized reporting format
for prothrombin time and is used to guide Warfarin dosing. Maintaining the INR within a
specific target range, usually 2.0 to 3.0, is critical for preventing both thrombosis and
,excessive bleeding. Monitoring must occur frequently during the initiation phase and at
regular intervals once a stable dose is achieved.
4. A patient is prescribed Spironolactone for the management of heart failure. The nurse
should monitor for which electrolyte imbalance?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypomagnesemia
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that works by antagonizing
aldosterone receptors in the distal tubule. Because it inhibits the excretion of potassium,
the risk of developing hyperkalemia is significant, especially if the patient is also taking an
ACE inhibitor. Patients should be advised to avoid salt substitutes containing potassium
chloride while on this therapy.
5. Which instruction is most important for a patient newly prescribed Levothyroxine for
hypothyroidism?
A. Take the medication with a high-fiber meal.
B. Take the medication at bedtime with a snack.
C. Take the medication on an empty stomach in the morning.
, D. Take the medication only when feeling fatigued.
Answer: C
Rationale: Levothyroxine absorption is highly sensitive to the presence of food and other
medications in the gastrointestinal tract. To ensure consistent blood levels, the drug should
be taken at least 30 to 60 minutes before breakfast with a full glass of water. Strict
adherence to this schedule helps maintain the patient in a euthyroid state.
6. A patient with asthma is being treated with a Short-Acting Beta Agonist (SABA). What is
the primary role of this medication?
A. Long-term control of inflammation
B. Acute relief of bronchospasm
C. Prevention of exercise-induced asthma when taken daily
D. Reduction of airway hyper-responsiveness
Answer: B
Rationale: Short-acting beta agonists like albuterol are used as ‘rescue’ medications to
provide rapid bronchodilation during an acute asthma attack. They work by stimulating
beta-2 receptors in the lungs to relax smooth muscle. If a patient requires their rescue
inhaler more than twice a week, it indicates poor asthma control and the need for a
controller medication.
Advanced Pharmacology | Actual Q&A
with Rationale (NURS6521 Exam 2) |
Walden University
1. An advanced practice nurse is prescribing an ACE inhibitor for a patient with hypertension.
Which adverse effect is most commonly associated with this drug class due to bradykinin
accumulation?
A. Dry, nonproductive cough
B. Peripheral edema
C. Hypokalemia
D. Tachycardia
Answer: A
Rationale: The accumulation of bradykinin in the lungs often leads to a persistent, dry
cough in patients taking ACE inhibitors. This side effect is a common reason for patients to
discontinue the medication and switch to an Angiotensin II Receptor Blocker. The clinician
must educate the patient that this cough is not indicative of an infection but is a direct
result of the medication’s mechanism.
2. A patient with Type 2 Diabetes is scheduled for a CT scan with intravenous contrast. Which
medication should be withheld for 48 hours after the procedure to prevent lactic acidosis?
A. Sitagliptin
,B. Glipizide
C. Pioglitazone
D. Metformin
Answer: D
Rationale: Metformin can interact with contrast media to cause acute renal failure, which
subsequently leads to the accumulation of metformin and lactic acidosis. Protocols typically
require holding the drug on the day of the procedure and for 48 hours following the study.
Renal function should be verified as normal before the medication is restarted by the
healthcare provider.
3. When monitoring a patient on Warfarin therapy, which laboratory value is the primary
indicator of the drug’s therapeutic effectiveness?
A. INR
B. Platelet count
C. Bleeding time
D. aPTT
Answer: A
Rationale: The International Normalized Ratio (INR) is the standardized reporting format
for prothrombin time and is used to guide Warfarin dosing. Maintaining the INR within a
specific target range, usually 2.0 to 3.0, is critical for preventing both thrombosis and
,excessive bleeding. Monitoring must occur frequently during the initiation phase and at
regular intervals once a stable dose is achieved.
4. A patient is prescribed Spironolactone for the management of heart failure. The nurse
should monitor for which electrolyte imbalance?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypomagnesemia
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that works by antagonizing
aldosterone receptors in the distal tubule. Because it inhibits the excretion of potassium,
the risk of developing hyperkalemia is significant, especially if the patient is also taking an
ACE inhibitor. Patients should be advised to avoid salt substitutes containing potassium
chloride while on this therapy.
5. Which instruction is most important for a patient newly prescribed Levothyroxine for
hypothyroidism?
A. Take the medication with a high-fiber meal.
B. Take the medication at bedtime with a snack.
C. Take the medication on an empty stomach in the morning.
, D. Take the medication only when feeling fatigued.
Answer: C
Rationale: Levothyroxine absorption is highly sensitive to the presence of food and other
medications in the gastrointestinal tract. To ensure consistent blood levels, the drug should
be taken at least 30 to 60 minutes before breakfast with a full glass of water. Strict
adherence to this schedule helps maintain the patient in a euthyroid state.
6. A patient with asthma is being treated with a Short-Acting Beta Agonist (SABA). What is
the primary role of this medication?
A. Long-term control of inflammation
B. Acute relief of bronchospasm
C. Prevention of exercise-induced asthma when taken daily
D. Reduction of airway hyper-responsiveness
Answer: B
Rationale: Short-acting beta agonists like albuterol are used as ‘rescue’ medications to
provide rapid bronchodilation during an acute asthma attack. They work by stimulating
beta-2 receptors in the lungs to relax smooth muscle. If a patient requires their rescue
inhaler more than twice a week, it indicates poor asthma control and the need for a
controller medication.
