NURS 5334 Exam 2 | Advanced Pharmacology | Original Practice Examination Page 1
, NURS 5334 EXAM 2
Advanced Pharmacology for Nurse Practitioners
University of Texas at Arlington (UTA) 100-Question
Practice Examination
2026/2027 Edition
Hypertension
1. A 56-year-old patient with uncomplicated hypertension and no compelling comorbidity needs
initial drug therapy. Which class is a standard first-line option?
A) Clonidine as routine first choice
B) A thiazide-type diuretic
C) Hydralazine monotherapy
D) Digoxin
Correct Answer: B) A thiazide-type diuretic
Rationale: Thiazide-type diuretics are among standard first-line options for uncomplicated hypertension, along with
ACE inhibitors, ARBs, and calcium-channel blockers. Centrally acting agents and direct vasodilators are generally
reserved for selected or resistant cases because of adverse-effect and adherence concerns.
2. A patient develops persistent dry cough after starting lisinopril. Which alternative most directly
preserves renin-angiotensin system blockade?
A) Verapamil
B) Hydrochlorothiazide
C) Losartan
D) Propranolol
Correct Answer: C) Losartan
Rationale: ACE inhibitor cough is related to bradykinin accumulation. An ARB such as losartan blocks angiotensin II
receptors without inhibiting bradykinin breakdown, so it is commonly substituted when cough limits ACE inhibitor use.
3. A patient taking lisinopril develops swelling of the lips and tongue. What is the priority
medication action?
A) Reduce the dose by half and continue
B) Discontinue the ACE inhibitor immediately
C) Add a thiazide and observe
D) Switch to another ACE inhibitor
Correct Answer: B) Discontinue the ACE inhibitor immediately
Rationale: Angioedema is a potentially life-threatening ACE inhibitor reaction because airway compromise can
progress rapidly. The ACE inhibitor should be stopped and the patient urgently assessed. Rechallenge with another
ACE inhibitor is not appropriate.
4. A patient receives spironolactone together with an ACE inhibitor. Which laboratory value
requires especially close monitoring?
A) Serum calcium
NURS 5334 Exam 2 | Advanced Pharmacology | Original Practice Examination Page 2
, B) Hemoglobin A1c only
C) Amylase
D) Serum potassium
Correct Answer: D) Serum potassium
Rationale: Both ACE inhibitors and spironolactone can increase serum potassium. Combined therapy may be
appropriate in selected cardiovascular conditions, but renal function and potassium must be monitored because
hyperkalemia can become clinically dangerous.
5. A patient with hypertension and recurrent gout is taking hydrochlorothiazide. Which adverse
metabolic effect is most relevant?
A) Hyperuricemia
B) Severe hypoglycemia
C) Hypermagnesemia
D) Hypouricemia
Correct Answer: A) Hyperuricemia
Rationale: Thiazide diuretics can decrease uric acid excretion and raise serum urate, potentially aggravating gout.
This does not make them universally contraindicated, but recurrent gout should influence drug selection and
monitoring.
6. A patient taking amlodipine reports new ankle swelling without dyspnea or weight gain. Which
explanation is most likely?
A) Serotonin syndrome
B) Dihydropyridine-related peripheral edema
C) Acute renal failure from potassium loss
D) Digoxin toxicity
Correct Answer: B) Dihydropyridine-related peripheral edema
Rationale: Dihydropyridine calcium-channel blockers can cause dose-related peripheral edema through arteriolar
dilation and increased capillary hydrostatic pressure. The edema is not necessarily due to heart failure and often
requires dose adjustment or a regimen change.
7. A patient with asthma needs antihypertensive therapy. Which drug deserves caution because it
blocks beta-2 receptors?
A) Amlodipine
B) Chlorthalidone
C) Losartan
D) Propranolol
Correct Answer: D) Propranolol
Rationale: Propranolol is a nonselective beta blocker and can antagonize beta-2-mediated bronchodilation,
potentially worsening bronchospasm. Cardioselective beta blockers may sometimes be used cautiously when
compelling indications exist, but nonselective agents are less attractive in asthma.
8. A patient on clonidine abruptly stops taking it after several months. Which complication is most
concerning?
NURS 5334 Exam 2 | Advanced Pharmacology | Original Practice Examination Page 3
, NURS 5334 EXAM 2
Advanced Pharmacology for Nurse Practitioners
University of Texas at Arlington (UTA) 100-Question
Practice Examination
2026/2027 Edition
Hypertension
1. A 56-year-old patient with uncomplicated hypertension and no compelling comorbidity needs
initial drug therapy. Which class is a standard first-line option?
A) Clonidine as routine first choice
B) A thiazide-type diuretic
C) Hydralazine monotherapy
D) Digoxin
Correct Answer: B) A thiazide-type diuretic
Rationale: Thiazide-type diuretics are among standard first-line options for uncomplicated hypertension, along with
ACE inhibitors, ARBs, and calcium-channel blockers. Centrally acting agents and direct vasodilators are generally
reserved for selected or resistant cases because of adverse-effect and adherence concerns.
2. A patient develops persistent dry cough after starting lisinopril. Which alternative most directly
preserves renin-angiotensin system blockade?
A) Verapamil
B) Hydrochlorothiazide
C) Losartan
D) Propranolol
Correct Answer: C) Losartan
Rationale: ACE inhibitor cough is related to bradykinin accumulation. An ARB such as losartan blocks angiotensin II
receptors without inhibiting bradykinin breakdown, so it is commonly substituted when cough limits ACE inhibitor use.
3. A patient taking lisinopril develops swelling of the lips and tongue. What is the priority
medication action?
A) Reduce the dose by half and continue
B) Discontinue the ACE inhibitor immediately
C) Add a thiazide and observe
D) Switch to another ACE inhibitor
Correct Answer: B) Discontinue the ACE inhibitor immediately
Rationale: Angioedema is a potentially life-threatening ACE inhibitor reaction because airway compromise can
progress rapidly. The ACE inhibitor should be stopped and the patient urgently assessed. Rechallenge with another
ACE inhibitor is not appropriate.
4. A patient receives spironolactone together with an ACE inhibitor. Which laboratory value
requires especially close monitoring?
A) Serum calcium
NURS 5334 Exam 2 | Advanced Pharmacology | Original Practice Examination Page 2
, B) Hemoglobin A1c only
C) Amylase
D) Serum potassium
Correct Answer: D) Serum potassium
Rationale: Both ACE inhibitors and spironolactone can increase serum potassium. Combined therapy may be
appropriate in selected cardiovascular conditions, but renal function and potassium must be monitored because
hyperkalemia can become clinically dangerous.
5. A patient with hypertension and recurrent gout is taking hydrochlorothiazide. Which adverse
metabolic effect is most relevant?
A) Hyperuricemia
B) Severe hypoglycemia
C) Hypermagnesemia
D) Hypouricemia
Correct Answer: A) Hyperuricemia
Rationale: Thiazide diuretics can decrease uric acid excretion and raise serum urate, potentially aggravating gout.
This does not make them universally contraindicated, but recurrent gout should influence drug selection and
monitoring.
6. A patient taking amlodipine reports new ankle swelling without dyspnea or weight gain. Which
explanation is most likely?
A) Serotonin syndrome
B) Dihydropyridine-related peripheral edema
C) Acute renal failure from potassium loss
D) Digoxin toxicity
Correct Answer: B) Dihydropyridine-related peripheral edema
Rationale: Dihydropyridine calcium-channel blockers can cause dose-related peripheral edema through arteriolar
dilation and increased capillary hydrostatic pressure. The edema is not necessarily due to heart failure and often
requires dose adjustment or a regimen change.
7. A patient with asthma needs antihypertensive therapy. Which drug deserves caution because it
blocks beta-2 receptors?
A) Amlodipine
B) Chlorthalidone
C) Losartan
D) Propranolol
Correct Answer: D) Propranolol
Rationale: Propranolol is a nonselective beta blocker and can antagonize beta-2-mediated bronchodilation,
potentially worsening bronchospasm. Cardioselective beta blockers may sometimes be used cautiously when
compelling indications exist, but nonselective agents are less attractive in asthma.
8. A patient on clonidine abruptly stops taking it after several months. Which complication is most
concerning?
NURS 5334 Exam 2 | Advanced Pharmacology | Original Practice Examination Page 3
