NR 565 Advanced Pharmacology
Final Actual Exam 2026/2027 |
Verified Questions
Chamberlain University College of Nursing | Verified Q&A
| Graduate-Level Family Nurse Practitioner Students
Introduction
This document presents 100 original items aligned with the NR 565 Advanced Pharmacology
blueprint for the 2026/2027 final actual exam. The content is organized into four balanced
domains: Cardiovascular and Respiratory Pharmacology; Endocrine and Metabolic
Pharmacology; Neurological and Psychiatric Pharmacology; and Gastrointestinal, Renal, and
Infectious Disease Pharmacology. Every item is paired with a rationale grounded in official NR
565 course materials, foundational advanced pharmacology resources such as Rosenthal and
Burchum's Lehne's Pharmacotherapeutics, and current evidence-based clinical guidelines from
the AHA, ADA, and IDSA. This set is designed to reinforce the official NR 565 course objectives
for final actual exam readiness and advanced clinical prescribing proficiency in drug selection,
dosing, monitoring, and patient safety. A full answer key, a domain score tracker, and
supporting citations follow the items.
Actual Questions
Domain: Cardiovascular and Respiratory Pharmacology
1. For a patient with type 2 diabetes and albuminuria, which antihypertensive class
is preferred first-line for renoprotection?
A. Non-dihydropyridine calcium channel blocker
B. Thiazide diuretic
C. Beta-blocker
D. Angiotensin-converting enzyme (ACE) inhibitor
Correct Answer: D
Rationale: ACE inhibitors reduce intraglomerular pressure and albuminuria, slowing the
progression of diabetic kidney disease.
2. A patient started on lisinopril reports a persistent dry cough. This effect is most
likely caused by:
A. Histamine release
B. Accumulation of bradykinin
C. Anticholinergic blockade
NR 565 Advanced Pharmacology Final Actual Exam 2026/2027 | Verified Questions
, D. Beta-2 receptor stimulation
Correct Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin, whose accumulation
irritates the airways and produces a dry cough.
3. Losartan lowers blood pressure primarily by:
A. Inhibiting angiotensin-converting enzyme
B. Blocking aldosterone receptors
C. Antagonizing angiotensin II at the AT1 receptor
D. Inhibiting renin secretion
Correct Answer: C
Rationale: Angiotensin II receptor blockers such as losartan block the AT1 receptor,
reducing vasoconstriction and aldosterone release.
4. Which beta-blocker is relatively cardioselective, acting mainly on beta-1
receptors?
A. Metoprolol
B. Propranolol
C. Nadolol
D. Labetalol
Correct Answer: A
Rationale: Metoprolol selectively blocks beta-1 receptors, whereas propranolol, nadolol,
and labetalol are nonselective.
5. Which beta-blocker poses the highest risk of bronchospasm in a patient with
asthma?
A. Metoprolol
B. Atenolol
C. Bisoprolol
D. Propranolol
Correct Answer: D
Rationale: Propranolol blocks beta-2 receptors in the airways and can precipitate
bronchospasm, so nonselective agents are avoided in asthma.
6. Amlodipine lowers blood pressure primarily by:
A. Blocking beta-1 receptors in the heart
B. Inhibiting the sodium-potassium ATPase
C. Blocking L-type calcium channels in vascular smooth muscle
D. Antagonizing alpha-1 receptors
Correct Answer: C
Rationale: Amlodipine, a dihydropyridine calcium channel blocker, blocks L-type calcium
channels in vascular smooth muscle, causing vasodilation.
7. Which adverse effect is most characteristic of amlodipine?
A. Dry cough
B. Bronchospasm
C. Hyperkalemia
NR 565 Advanced Pharmacology Final Actual Exam 2026/2027 | Verified Questions
, D. Peripheral edema
Correct Answer: D
Rationale: Dihydropyridine calcium channel blockers cause arteriolar dilation that
promotes dependent peripheral edema.
8. Verapamil is avoided in patients with heart failure with reduced ejection
fraction because it:
A. Causes bronchospasm
B. Reduces myocardial contractility
C. Induces hyperkalemia
D. Accelerates heart rate
Correct Answer: B
Rationale: Verapamil is a negative inotrope and can worsen systolic heart failure, so non-
dihydropyridine calcium channel blockers are avoided in HFrEF.
9. A patient taking hydrochlorothiazide should be monitored for which electrolyte
abnormality?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
Correct Answer: A
Rationale: Thiazide diuretics increase renal potassium excretion and commonly cause
hypokalemia.
10. Furosemide produces diuresis by inhibiting:
A. The sodium-chloride cotransporter in the distal tubule
B. Aldosterone receptors in the collecting duct
C. Carbonic anhydrase in the proximal tubule
D. The sodium-potassium-2-chloride cotransporter in the thick ascending limb
Correct Answer: D
Rationale: Furosemide is a loop diuretic that blocks the Na-K-2Cl cotransporter,
producing a potent diuretic effect.
11. A male patient on spironolactone develops breast tenderness. This finding is
explained by:
A. Increased estrogen synthesis
B. The drug's antiandrogenic effects
C. Beta-2 receptor stimulation
D. Histamine release
Correct Answer: B
Rationale: Spironolactone blocks androgen receptors and can cause gynecomastia and
breast tenderness in men.
12. Digoxin increases cardiac contractility by:
A. Blocking L-type calcium channels
B. Inhibiting the sodium-potassium ATPase pump
NR 565 Advanced Pharmacology Final Actual Exam 2026/2027 | Verified Questions
Final Actual Exam 2026/2027 |
Verified Questions
Chamberlain University College of Nursing | Verified Q&A
| Graduate-Level Family Nurse Practitioner Students
Introduction
This document presents 100 original items aligned with the NR 565 Advanced Pharmacology
blueprint for the 2026/2027 final actual exam. The content is organized into four balanced
domains: Cardiovascular and Respiratory Pharmacology; Endocrine and Metabolic
Pharmacology; Neurological and Psychiatric Pharmacology; and Gastrointestinal, Renal, and
Infectious Disease Pharmacology. Every item is paired with a rationale grounded in official NR
565 course materials, foundational advanced pharmacology resources such as Rosenthal and
Burchum's Lehne's Pharmacotherapeutics, and current evidence-based clinical guidelines from
the AHA, ADA, and IDSA. This set is designed to reinforce the official NR 565 course objectives
for final actual exam readiness and advanced clinical prescribing proficiency in drug selection,
dosing, monitoring, and patient safety. A full answer key, a domain score tracker, and
supporting citations follow the items.
Actual Questions
Domain: Cardiovascular and Respiratory Pharmacology
1. For a patient with type 2 diabetes and albuminuria, which antihypertensive class
is preferred first-line for renoprotection?
A. Non-dihydropyridine calcium channel blocker
B. Thiazide diuretic
C. Beta-blocker
D. Angiotensin-converting enzyme (ACE) inhibitor
Correct Answer: D
Rationale: ACE inhibitors reduce intraglomerular pressure and albuminuria, slowing the
progression of diabetic kidney disease.
2. A patient started on lisinopril reports a persistent dry cough. This effect is most
likely caused by:
A. Histamine release
B. Accumulation of bradykinin
C. Anticholinergic blockade
NR 565 Advanced Pharmacology Final Actual Exam 2026/2027 | Verified Questions
, D. Beta-2 receptor stimulation
Correct Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin, whose accumulation
irritates the airways and produces a dry cough.
3. Losartan lowers blood pressure primarily by:
A. Inhibiting angiotensin-converting enzyme
B. Blocking aldosterone receptors
C. Antagonizing angiotensin II at the AT1 receptor
D. Inhibiting renin secretion
Correct Answer: C
Rationale: Angiotensin II receptor blockers such as losartan block the AT1 receptor,
reducing vasoconstriction and aldosterone release.
4. Which beta-blocker is relatively cardioselective, acting mainly on beta-1
receptors?
A. Metoprolol
B. Propranolol
C. Nadolol
D. Labetalol
Correct Answer: A
Rationale: Metoprolol selectively blocks beta-1 receptors, whereas propranolol, nadolol,
and labetalol are nonselective.
5. Which beta-blocker poses the highest risk of bronchospasm in a patient with
asthma?
A. Metoprolol
B. Atenolol
C. Bisoprolol
D. Propranolol
Correct Answer: D
Rationale: Propranolol blocks beta-2 receptors in the airways and can precipitate
bronchospasm, so nonselective agents are avoided in asthma.
6. Amlodipine lowers blood pressure primarily by:
A. Blocking beta-1 receptors in the heart
B. Inhibiting the sodium-potassium ATPase
C. Blocking L-type calcium channels in vascular smooth muscle
D. Antagonizing alpha-1 receptors
Correct Answer: C
Rationale: Amlodipine, a dihydropyridine calcium channel blocker, blocks L-type calcium
channels in vascular smooth muscle, causing vasodilation.
7. Which adverse effect is most characteristic of amlodipine?
A. Dry cough
B. Bronchospasm
C. Hyperkalemia
NR 565 Advanced Pharmacology Final Actual Exam 2026/2027 | Verified Questions
, D. Peripheral edema
Correct Answer: D
Rationale: Dihydropyridine calcium channel blockers cause arteriolar dilation that
promotes dependent peripheral edema.
8. Verapamil is avoided in patients with heart failure with reduced ejection
fraction because it:
A. Causes bronchospasm
B. Reduces myocardial contractility
C. Induces hyperkalemia
D. Accelerates heart rate
Correct Answer: B
Rationale: Verapamil is a negative inotrope and can worsen systolic heart failure, so non-
dihydropyridine calcium channel blockers are avoided in HFrEF.
9. A patient taking hydrochlorothiazide should be monitored for which electrolyte
abnormality?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
Correct Answer: A
Rationale: Thiazide diuretics increase renal potassium excretion and commonly cause
hypokalemia.
10. Furosemide produces diuresis by inhibiting:
A. The sodium-chloride cotransporter in the distal tubule
B. Aldosterone receptors in the collecting duct
C. Carbonic anhydrase in the proximal tubule
D. The sodium-potassium-2-chloride cotransporter in the thick ascending limb
Correct Answer: D
Rationale: Furosemide is a loop diuretic that blocks the Na-K-2Cl cotransporter,
producing a potent diuretic effect.
11. A male patient on spironolactone develops breast tenderness. This finding is
explained by:
A. Increased estrogen synthesis
B. The drug's antiandrogenic effects
C. Beta-2 receptor stimulation
D. Histamine release
Correct Answer: B
Rationale: Spironolactone blocks androgen receptors and can cause gynecomastia and
breast tenderness in men.
12. Digoxin increases cardiac contractility by:
A. Blocking L-type calcium channels
B. Inhibiting the sodium-potassium ATPase pump
NR 565 Advanced Pharmacology Final Actual Exam 2026/2027 | Verified Questions
