NSG 533 ADVANCED PHARMACOLOGY
FINAL EXAM PREP QUESTIONS AND
ANSWERS
1. Which mechanism best explains why ACE inhibitors are contraindicated during the second
and third trimesters of pregnancy?
A. They cause maternal hypotension leading to placental abruption.
B. They interfere with fetal renal development and cause oligohydramnios.
C. They lead to premature closure of the ductus arteriosus.
D. They cause neonatal hyperbilirubinemia.
Answer: B
Conceptual Explanation: ACE inhibitors interfere with the fetal renin-angiotensin system,
which is essential for normal fetal renal development, leading to renal failure and lack of
amniotic fluid (oligohydramnios).
2. A patient taking Digoxin presents with nausea, blurred vision, and halo-like visual
disturbances. Which electrolyte imbalance most likely potentiates this toxicity?
A. Hyperkalemia
,B. Hypernatremia
C. Hypocalcemia
D. Hypokalemia
Answer: D
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity because
digoxin competes with potassium for binding sites on the Na+/K+ ATPase pump.
3. What is the primary mechanism of action for Metformin in the treatment of Type 2
Diabetes Mellitus?
A. Decreasing hepatic glucose production and improving insulin sensitivity.
B. Stimulating insulin secretion from pancreatic beta cells.
C. Increasing glucose excretion via the kidneys.
D. Slowing the absorption of carbohydrates in the small intestine.
Answer: A
Conceptual Explanation: Metformin primarily reduces gluconeogenesis in the liver and
increases peripheral glucose uptake/utilization.
4. Which of the following describes the ‘First-Pass Effect’ in pharmacology?
A. The time it takes for a drug to reach peak plasma concentration.
B. The excretion of drugs through the glomerular filtration system.
, C. The initial binding of a drug to plasma albumin.
D. Extensive metabolism of a drug in the liver before it reaches systemic circulation.
Answer: D
Conceptual Explanation: The first-pass effect occurs when an orally administered drug is
metabolized by the liver immediately after absorption, significantly reducing its
bioavailability.
5. A patient is prescribed Amiodarone for ventricular arrhythmias. Which baseline diagnostic
test is most critical due to potential long-term adverse effects?
A. Serial fasting blood glucose
B. Bone mineral density scan
C. Complete Blood Count (CBC)
D. Pulmonary Function Tests (PFTs)
Answer: D
Conceptual Explanation: Amiodarone can cause pulmonary toxicity (interstitial lung
disease/fibrosis), requiring baseline and periodic PFTs.
6. Which drug class is considered first-line for a patient with chronic hypertension and a
history of Type 2 Diabetes due to its renal protective effects?
A. Beta-blockers
B. ACE Inhibitors
FINAL EXAM PREP QUESTIONS AND
ANSWERS
1. Which mechanism best explains why ACE inhibitors are contraindicated during the second
and third trimesters of pregnancy?
A. They cause maternal hypotension leading to placental abruption.
B. They interfere with fetal renal development and cause oligohydramnios.
C. They lead to premature closure of the ductus arteriosus.
D. They cause neonatal hyperbilirubinemia.
Answer: B
Conceptual Explanation: ACE inhibitors interfere with the fetal renin-angiotensin system,
which is essential for normal fetal renal development, leading to renal failure and lack of
amniotic fluid (oligohydramnios).
2. A patient taking Digoxin presents with nausea, blurred vision, and halo-like visual
disturbances. Which electrolyte imbalance most likely potentiates this toxicity?
A. Hyperkalemia
,B. Hypernatremia
C. Hypocalcemia
D. Hypokalemia
Answer: D
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity because
digoxin competes with potassium for binding sites on the Na+/K+ ATPase pump.
3. What is the primary mechanism of action for Metformin in the treatment of Type 2
Diabetes Mellitus?
A. Decreasing hepatic glucose production and improving insulin sensitivity.
B. Stimulating insulin secretion from pancreatic beta cells.
C. Increasing glucose excretion via the kidneys.
D. Slowing the absorption of carbohydrates in the small intestine.
Answer: A
Conceptual Explanation: Metformin primarily reduces gluconeogenesis in the liver and
increases peripheral glucose uptake/utilization.
4. Which of the following describes the ‘First-Pass Effect’ in pharmacology?
A. The time it takes for a drug to reach peak plasma concentration.
B. The excretion of drugs through the glomerular filtration system.
, C. The initial binding of a drug to plasma albumin.
D. Extensive metabolism of a drug in the liver before it reaches systemic circulation.
Answer: D
Conceptual Explanation: The first-pass effect occurs when an orally administered drug is
metabolized by the liver immediately after absorption, significantly reducing its
bioavailability.
5. A patient is prescribed Amiodarone for ventricular arrhythmias. Which baseline diagnostic
test is most critical due to potential long-term adverse effects?
A. Serial fasting blood glucose
B. Bone mineral density scan
C. Complete Blood Count (CBC)
D. Pulmonary Function Tests (PFTs)
Answer: D
Conceptual Explanation: Amiodarone can cause pulmonary toxicity (interstitial lung
disease/fibrosis), requiring baseline and periodic PFTs.
6. Which drug class is considered first-line for a patient with chronic hypertension and a
history of Type 2 Diabetes due to its renal protective effects?
A. Beta-blockers
B. ACE Inhibitors
