NR 566 Medication Management Assessment
— Exam Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
1. Pharmacokinetics
A 72-year-old patient with stage 3 chronic kidney disease is
prescribed a medication that is primarily eliminated by the
kidneys. Which pharmacokinetic consideration is most
important?
A. Increased hepatic metabolism
B. Increased renal clearance
C. Reduced drug clearance and increased risk of accumulation
D. Increased gastrointestinal absorption
Correct answer: C. Reduced drug clearance and increased risk
of accumulation
Rationale: Renal impairment can substantially reduce the
elimination of medications or active metabolites that depend on
renal excretion. When clearance decreases, the drug can
accumulate and produce excessive pharmacologic effects or
toxicity. The prescriber should review renal function, determine
,whether dose reduction or increased dosing intervals are
necessary, and monitor for adverse effects. This principle is
particularly important for medications with a narrow
therapeutic index.
2. Pharmacodynamics
Which statement best describes pharmacodynamics?
A. How the body absorbs and eliminates medications
B. How medications are distributed through body
compartments
C. How medications are metabolized by hepatic enzymes
D. How a medication produces effects on the body
Correct answer: D. How a medication produces effects on the
body
Rationale: Pharmacodynamics describes the relationship
between a drug and its biologic target and includes mechanisms
of action, receptor interactions, dose-response relationships,
therapeutic effects, and adverse effects. Pharmacokinetics, by
contrast, describes what the body does to the drug through
absorption, distribution, metabolism, and excretion.
Understanding pharmacodynamics helps the advanced practice
nurse anticipate therapeutic responses and adverse reactions.
,3. ACE Inhibitors
A patient taking lisinopril develops a persistent dry cough.
Which action is most appropriate?
A. Add an antihistamine
B. Increase the lisinopril dose
C. Consider discontinuing lisinopril and changing to an
appropriate ARB
D. Add another ACE inhibitor
Correct answer: C. Consider discontinuing lisinopril and
changing to an appropriate ARB
Rationale: ACE inhibitors can cause a persistent dry cough
because inhibition of angiotensin-converting enzyme increases
bradykinin concentrations. If the cough is troublesome, an
angiotensin receptor blocker may be considered because ARBs
do not inhibit bradykinin breakdown to the same extent. The
patient should not simply receive another ACE inhibitor because
the class effect may persist. The medication history and clinical
indication should be reviewed before selecting an alternative.
4. ACE-Inhibitor Emergency
A patient taking lisinopril presents with sudden swelling of the
lips and tongue and difficulty breathing. What is the priority
action?
, A. Reassure the patient that this is an expected effect
B. Administer the next lisinopril dose
C. Treat as a medical emergency and discontinue the ACE
inhibitor
D. Recommend taking the medication with food
Correct answer: C. Treat as a medical emergency and
discontinue the ACE inhibitor
Rationale: Angioedema involving the tongue or airway can
rapidly become life-threatening. ACE inhibitors are a recognized
cause of bradykinin-mediated angioedema, which may occur
even after prolonged therapy. The medication should be
discontinued, the airway and breathing assessed immediately,
and emergency management initiated according to the severity
of the presentation. Simply observing the patient or
administering another dose is unsafe.
5. ARBs
Which adverse effect should be monitored particularly closely
in a patient taking losartan?
A. Severe hypoglycemia
B. Hyperkalemia
C. Gingival hyperplasia
D. Ototoxicity
— Exam Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
1. Pharmacokinetics
A 72-year-old patient with stage 3 chronic kidney disease is
prescribed a medication that is primarily eliminated by the
kidneys. Which pharmacokinetic consideration is most
important?
A. Increased hepatic metabolism
B. Increased renal clearance
C. Reduced drug clearance and increased risk of accumulation
D. Increased gastrointestinal absorption
Correct answer: C. Reduced drug clearance and increased risk
of accumulation
Rationale: Renal impairment can substantially reduce the
elimination of medications or active metabolites that depend on
renal excretion. When clearance decreases, the drug can
accumulate and produce excessive pharmacologic effects or
toxicity. The prescriber should review renal function, determine
,whether dose reduction or increased dosing intervals are
necessary, and monitor for adverse effects. This principle is
particularly important for medications with a narrow
therapeutic index.
2. Pharmacodynamics
Which statement best describes pharmacodynamics?
A. How the body absorbs and eliminates medications
B. How medications are distributed through body
compartments
C. How medications are metabolized by hepatic enzymes
D. How a medication produces effects on the body
Correct answer: D. How a medication produces effects on the
body
Rationale: Pharmacodynamics describes the relationship
between a drug and its biologic target and includes mechanisms
of action, receptor interactions, dose-response relationships,
therapeutic effects, and adverse effects. Pharmacokinetics, by
contrast, describes what the body does to the drug through
absorption, distribution, metabolism, and excretion.
Understanding pharmacodynamics helps the advanced practice
nurse anticipate therapeutic responses and adverse reactions.
,3. ACE Inhibitors
A patient taking lisinopril develops a persistent dry cough.
Which action is most appropriate?
A. Add an antihistamine
B. Increase the lisinopril dose
C. Consider discontinuing lisinopril and changing to an
appropriate ARB
D. Add another ACE inhibitor
Correct answer: C. Consider discontinuing lisinopril and
changing to an appropriate ARB
Rationale: ACE inhibitors can cause a persistent dry cough
because inhibition of angiotensin-converting enzyme increases
bradykinin concentrations. If the cough is troublesome, an
angiotensin receptor blocker may be considered because ARBs
do not inhibit bradykinin breakdown to the same extent. The
patient should not simply receive another ACE inhibitor because
the class effect may persist. The medication history and clinical
indication should be reviewed before selecting an alternative.
4. ACE-Inhibitor Emergency
A patient taking lisinopril presents with sudden swelling of the
lips and tongue and difficulty breathing. What is the priority
action?
, A. Reassure the patient that this is an expected effect
B. Administer the next lisinopril dose
C. Treat as a medical emergency and discontinue the ACE
inhibitor
D. Recommend taking the medication with food
Correct answer: C. Treat as a medical emergency and
discontinue the ACE inhibitor
Rationale: Angioedema involving the tongue or airway can
rapidly become life-threatening. ACE inhibitors are a recognized
cause of bradykinin-mediated angioedema, which may occur
even after prolonged therapy. The medication should be
discontinued, the airway and breathing assessed immediately,
and emergency management initiated according to the severity
of the presentation. Simply observing the patient or
administering another dose is unsafe.
5. ARBs
Which adverse effect should be monitored particularly closely
in a patient taking losartan?
A. Severe hypoglycemia
B. Hyperkalemia
C. Gingival hyperplasia
D. Ototoxicity
