NURS 6521 FINAL EXAM 2026/2027 V3 WINTER QUARTER |
WALDEN UNIVERSITY | ADVANCED PHARMACOLOGY –
COMPLETE EXAM WITH ACCURATE QUESTIONS &
ANSWERS
NURS 6521 FINAL EXAM PRACTICE PAPER
Advanced Pharmacology
Course: NURS 6521 – Advanced Pharmacology
Institution: Walden University
Academic Year: 2026/2027
Version: Original Comprehensive Practice Exam
Format: Multiple-Choice and Short-Answer Questions
Questions: 100
Purpose: Comprehensive exam preparation and self-assessment
Important: This is an original practice examination for study purposes
Table of Contents
1. Cardiovascular Pharmacology — Questions 1–15
2. Endocrine Pharmacology — Questions 16–27
3. Respiratory Pharmacology — Questions 28–37
4. Neurologic and Psychiatric Pharmacology — Questions 38–52
5. Gastrointestinal Pharmacology — Questions 53–60
6. Anti-Infective Pharmacology — Questions 61–75
7. Musculoskeletal and Rheumatologic Pharmacology — Questions 76–82
8. Hematologic Pharmacology — Questions 83–88
9. Renal and Genitourinary Pharmacology — Questions 89–94
, 10. Women's Health and Reproductive Pharmacology — Questions 95–100
Section I — Cardiovascular Pharmacology
Question 1 — Multiple Choice
A patient with hypertension is prescribed lisinopril. Which laboratory value is most important to
monitor after therapy is initiated?
A. Hemoglobin
B. Serum potassium and serum creatinine
C. Serum calcium
D. Platelet count
Correct Answer: B
Rationale: ACE inhibitors can decrease aldosterone production, resulting in potassium retention
and hyperkalemia. They can also reduce intraglomerular pressure and cause a rise in serum
creatinine, particularly in patients with renal artery stenosis, volume depletion, or preexisting
renal disease. Renal function and potassium should therefore be assessed after initiation and dose
changes.
Question 2 — Multiple Choice
Which adverse effect is most characteristic of ACE inhibitors?
A. Constipation
B. Dry, persistent cough
C. Hypoglycemia
D. Hearing loss
Correct Answer: B
Rationale: ACE inhibition decreases degradation of bradykinin. Accumulation of bradykinin
contributes to the characteristic dry cough. Angioedema is another potentially serious adverse
effect. Patients who develop significant facial, tongue, or airway swelling require immediate
medical attention.
Question 3 — Short Answer
Why are ACE inhibitors contraindicated during pregnancy?
,Correct Answer: They can cause fetal renal injury, oligohydramnios, impaired skull
development, and fetal/neonatal morbidity or death.
Rationale: The fetal renin-angiotensin system is important for normal renal development and
fetal blood pressure regulation. ACE inhibition can interfere with fetal renal function and
amniotic fluid production. ACE inhibitors should therefore be avoided during pregnancy,
particularly after the first trimester, and alternative antihypertensive therapy should be used.
Question 4 — Multiple Choice
A patient taking hydrochlorothiazide should be monitored particularly closely for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia only
D. Severe hypoglycemia in every patient
Correct Answer: B
Rationale: Thiazide diuretics increase urinary sodium and water excretion while increasing
potassium excretion. Hypokalemia can cause weakness, muscle cramps, and cardiac
dysrhythmias. Electrolytes and renal function should be monitored periodically.
Question 5 — Multiple Choice
Which antihypertensive medication is generally considered compatible with pregnancy?
A. Lisinopril
B. Losartan
C. Methyldopa
D. Aliskiren
Correct Answer: C
Rationale: Methyldopa has a long history of use in pregnancy and is an accepted treatment
option. ACE inhibitors, ARBs, and direct renin inhibitors are contraindicated because of fetal
toxicity.
Question 6 — Multiple Choice
A patient taking furosemide reports weakness and palpitations. Which laboratory abnormality
could explain these symptoms?
, A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: A
Rationale: Loop diuretics increase urinary potassium excretion. Significant hypokalemia can
produce muscle weakness and potentially dangerous ventricular dysrhythmias. Potassium should
be assessed promptly.
Question 7 — Short Answer
What is the primary pharmacologic action of beta blockers such as metoprolol?
Correct Answer: They block beta-adrenergic receptors, primarily reducing heart rate,
myocardial contractility, and sympathetic stimulation.
Rationale: Beta-1 blockade decreases chronotropy and inotropy and suppresses renin release.
These effects reduce cardiac workload and blood pressure and are useful in hypertension, angina,
selected arrhythmias, and heart failure.
Question 8 — Multiple Choice
Which patient requires particular caution before receiving a nonselective beta blocker?
A. Patient with seasonal allergies
B. Patient with asthma and active bronchospasm
C. Patient with controlled hypothyroidism
D. Patient with mild anemia
Correct Answer: B
Rationale: Nonselective beta blockers inhibit beta-2 receptors in bronchial smooth muscle and
can provoke bronchoconstriction. Patients with asthma or reactive airway disease may therefore
experience clinically significant bronchospasm.
Question 9 — Multiple Choice
A patient taking digoxin develops nausea, visual disturbances, and an irregular pulse. What
should the clinician suspect?
WALDEN UNIVERSITY | ADVANCED PHARMACOLOGY –
COMPLETE EXAM WITH ACCURATE QUESTIONS &
ANSWERS
NURS 6521 FINAL EXAM PRACTICE PAPER
Advanced Pharmacology
Course: NURS 6521 – Advanced Pharmacology
Institution: Walden University
Academic Year: 2026/2027
Version: Original Comprehensive Practice Exam
Format: Multiple-Choice and Short-Answer Questions
Questions: 100
Purpose: Comprehensive exam preparation and self-assessment
Important: This is an original practice examination for study purposes
Table of Contents
1. Cardiovascular Pharmacology — Questions 1–15
2. Endocrine Pharmacology — Questions 16–27
3. Respiratory Pharmacology — Questions 28–37
4. Neurologic and Psychiatric Pharmacology — Questions 38–52
5. Gastrointestinal Pharmacology — Questions 53–60
6. Anti-Infective Pharmacology — Questions 61–75
7. Musculoskeletal and Rheumatologic Pharmacology — Questions 76–82
8. Hematologic Pharmacology — Questions 83–88
9. Renal and Genitourinary Pharmacology — Questions 89–94
, 10. Women's Health and Reproductive Pharmacology — Questions 95–100
Section I — Cardiovascular Pharmacology
Question 1 — Multiple Choice
A patient with hypertension is prescribed lisinopril. Which laboratory value is most important to
monitor after therapy is initiated?
A. Hemoglobin
B. Serum potassium and serum creatinine
C. Serum calcium
D. Platelet count
Correct Answer: B
Rationale: ACE inhibitors can decrease aldosterone production, resulting in potassium retention
and hyperkalemia. They can also reduce intraglomerular pressure and cause a rise in serum
creatinine, particularly in patients with renal artery stenosis, volume depletion, or preexisting
renal disease. Renal function and potassium should therefore be assessed after initiation and dose
changes.
Question 2 — Multiple Choice
Which adverse effect is most characteristic of ACE inhibitors?
A. Constipation
B. Dry, persistent cough
C. Hypoglycemia
D. Hearing loss
Correct Answer: B
Rationale: ACE inhibition decreases degradation of bradykinin. Accumulation of bradykinin
contributes to the characteristic dry cough. Angioedema is another potentially serious adverse
effect. Patients who develop significant facial, tongue, or airway swelling require immediate
medical attention.
Question 3 — Short Answer
Why are ACE inhibitors contraindicated during pregnancy?
,Correct Answer: They can cause fetal renal injury, oligohydramnios, impaired skull
development, and fetal/neonatal morbidity or death.
Rationale: The fetal renin-angiotensin system is important for normal renal development and
fetal blood pressure regulation. ACE inhibition can interfere with fetal renal function and
amniotic fluid production. ACE inhibitors should therefore be avoided during pregnancy,
particularly after the first trimester, and alternative antihypertensive therapy should be used.
Question 4 — Multiple Choice
A patient taking hydrochlorothiazide should be monitored particularly closely for:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia only
D. Severe hypoglycemia in every patient
Correct Answer: B
Rationale: Thiazide diuretics increase urinary sodium and water excretion while increasing
potassium excretion. Hypokalemia can cause weakness, muscle cramps, and cardiac
dysrhythmias. Electrolytes and renal function should be monitored periodically.
Question 5 — Multiple Choice
Which antihypertensive medication is generally considered compatible with pregnancy?
A. Lisinopril
B. Losartan
C. Methyldopa
D. Aliskiren
Correct Answer: C
Rationale: Methyldopa has a long history of use in pregnancy and is an accepted treatment
option. ACE inhibitors, ARBs, and direct renin inhibitors are contraindicated because of fetal
toxicity.
Question 6 — Multiple Choice
A patient taking furosemide reports weakness and palpitations. Which laboratory abnormality
could explain these symptoms?
, A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: A
Rationale: Loop diuretics increase urinary potassium excretion. Significant hypokalemia can
produce muscle weakness and potentially dangerous ventricular dysrhythmias. Potassium should
be assessed promptly.
Question 7 — Short Answer
What is the primary pharmacologic action of beta blockers such as metoprolol?
Correct Answer: They block beta-adrenergic receptors, primarily reducing heart rate,
myocardial contractility, and sympathetic stimulation.
Rationale: Beta-1 blockade decreases chronotropy and inotropy and suppresses renin release.
These effects reduce cardiac workload and blood pressure and are useful in hypertension, angina,
selected arrhythmias, and heart failure.
Question 8 — Multiple Choice
Which patient requires particular caution before receiving a nonselective beta blocker?
A. Patient with seasonal allergies
B. Patient with asthma and active bronchospasm
C. Patient with controlled hypothyroidism
D. Patient with mild anemia
Correct Answer: B
Rationale: Nonselective beta blockers inhibit beta-2 receptors in bronchial smooth muscle and
can provoke bronchoconstriction. Patients with asthma or reactive airway disease may therefore
experience clinically significant bronchospasm.
Question 9 — Multiple Choice
A patient taking digoxin develops nausea, visual disturbances, and an irregular pulse. What
should the clinician suspect?
