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NU 641 Advanced Clinical Pharmacology
Exam Questions With Solutions - Regis
College
Question 1
A patient with atrial fibrillation and a mechanical heart valve requires
anticoagulation. Which medication is contraindicated in this population?
A. Warfarin
B. Apixaban
C. Heparin
D. Enoxaparin
Correct Answer: B
Rationale: Direct oral anticoagulants (DOACs) like apixaban are contraindicated in
patients with mechanical heart valves due to increased risk of valve thrombosis
and thromboembolic events. Warfarin is the standard of care.
Question 2
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A patient with type 2 diabetes and chronic kidney disease (eGFR 35
mL/min/1.73m²) requires an injectable GLP-1 receptor agonist. Which agent is
most appropriate?
A. Exenatide
B. Liraglutide
C. Semaglutide
D. Dulaglutide
Correct Answer: D
Rationale: Dulaglutide is safe for use in patients with eGFR ≥15 without dose
adjustment. Exenatide is contraindicated with eGFR <30, liraglutide is not
recommended with eGFR <15, and semaglutide has limited data in severe renal
impairment.
Question 3
Which drug interaction is most likely to precipitate serotonin syndrome when
added to a patient's regimen of sertraline?
A. Sumatriptan
B. Tramadol
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C. Warfarin
D. Metoprolol
Correct Answer: B
Rationale: Tramadol inhibits serotonin reuptake and can precipitate serotonin
syndrome when combined with an SSRI like sertraline.
Question 4
A 70-year-old patient with type 2 diabetes and a history of multiple falls is
currently on glimepiride. The nurse practitioner should consider changing this
medication for which reason?
A. Glimepiride causes significant weight loss
B. Sulfonylureas increase the risk of hypoglycemia in elderly patients
C. Glimepiride is nephrotoxic and damages the kidneys
D. It frequently causes lactic acidosis in older adults
Correct Answer: B
Rationale: Sulfonylureas like glimepiride can cause prolonged and severe
hypoglycemia, especially in elderly patients. This increases fall risk and should
prompt consideration of safer alternatives.
NU 641 Advanced Clinical Pharmacology
Exam Questions With Solutions - Regis
College
Question 1
A patient with atrial fibrillation and a mechanical heart valve requires
anticoagulation. Which medication is contraindicated in this population?
A. Warfarin
B. Apixaban
C. Heparin
D. Enoxaparin
Correct Answer: B
Rationale: Direct oral anticoagulants (DOACs) like apixaban are contraindicated in
patients with mechanical heart valves due to increased risk of valve thrombosis
and thromboembolic events. Warfarin is the standard of care.
Question 2
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A patient with type 2 diabetes and chronic kidney disease (eGFR 35
mL/min/1.73m²) requires an injectable GLP-1 receptor agonist. Which agent is
most appropriate?
A. Exenatide
B. Liraglutide
C. Semaglutide
D. Dulaglutide
Correct Answer: D
Rationale: Dulaglutide is safe for use in patients with eGFR ≥15 without dose
adjustment. Exenatide is contraindicated with eGFR <30, liraglutide is not
recommended with eGFR <15, and semaglutide has limited data in severe renal
impairment.
Question 3
Which drug interaction is most likely to precipitate serotonin syndrome when
added to a patient's regimen of sertraline?
A. Sumatriptan
B. Tramadol
, 3|Page
C. Warfarin
D. Metoprolol
Correct Answer: B
Rationale: Tramadol inhibits serotonin reuptake and can precipitate serotonin
syndrome when combined with an SSRI like sertraline.
Question 4
A 70-year-old patient with type 2 diabetes and a history of multiple falls is
currently on glimepiride. The nurse practitioner should consider changing this
medication for which reason?
A. Glimepiride causes significant weight loss
B. Sulfonylureas increase the risk of hypoglycemia in elderly patients
C. Glimepiride is nephrotoxic and damages the kidneys
D. It frequently causes lactic acidosis in older adults
Correct Answer: B
Rationale: Sulfonylureas like glimepiride can cause prolonged and severe
hypoglycemia, especially in elderly patients. This increases fall risk and should
prompt consideration of safer alternatives.
