1|Page
Advanced Pharmacology NSG 533
Exam 2025 Prep Test with 1-0
Questions and Correct Answers/ NSG
533 TEST 1 Prep Latest
EP is a 38-year-p p p
old female patient that comes in for diabetes education and manage
p p p p p p p p p p
ment. She was diagnosed 12 years ago and states lately she is not abl
p p p p p p p p p p p p p
e to control her diet although she continues a 1600 calorie diet with
p p p p p p p p p p p p p
appropriate daily carbohydrate intake (per dietitian prescription) a
p p p p p p p
nd walks 40 minutes every day of the week. She states compliance
p p p p p p p p p p p p
with all medications. She denies any history of hypoglycemia despit
p p p p p p p p p
e being able to identify signs and symptoms and describe appropria
p p p p p p p p p p
te treatment strategies.
p p
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomy due to t
p p p p p p p p p
hyroid cancer p
FmHx: Noncontributory p
SHx: (−) Smoking, alcohol use, past marijuana use while in high sc
p p p p p p p p p p p
hool
Medications: Metformin 850 mg tid, glipizide 20 mg bid, lisinopril p p p p p p p p p p
20 mg daily, sertraline 100 mg daily, multivitamin daily
p p p p p p p p
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
p p p p p p p p p p
Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl 106 mEq/L
p p p p p p p p p p p
, BUN - ..........ANSWER.......Exenatide -
p p p p
pExenatide (Bydureon) once weekly has been able to demonstrate w
p p p p p p p p p
,2|Page
eight loss and decrease A1C% by 0.7% to 1.2% in clinical trials; how
p p p p p p p p p p p p
ever it is contraindicated for EP due to the self-
p p p p p p p p p
reported history of thyroid cancer. p p p p
Dapagliflozin - p
Dapagliflozin (Farxiga) is contraindicated in this patient due to hy
p p p p p p p p p p
perkalemia which could be made worse by this drug. The package ip p p p p p p p p p p
nsert does not indicate a specific potassium concentration cut off to
p p p p p p p p p p p
no longer use this medication; however, there are better choices in t
p p p p p p p p p p p
his patient. p
Sitagliptin - p
pSitagliptin (Januvia) is able to obtain an A1C goal of less than 7% ba
p p p p p p p p p p p p p
sed on clinical trials and currently the patient does not have any cau
p p p p p p p p p p p p
tionary objective measures to not use this medication. DPP-
p p p p p p p p
IV inhibitors are weight neutral. DPP-
p p p p p
IV inhibitors can be used in patients taking sulfonylureas; however,
p p p p p p p p p
pit may be recommended to reduce or stop the sulfonylurea dose.
p p p p p p p p p p
Acarbose - p
Acarbose (Precose) is not recommended for initial management an
p p p p p p p p p
d is associated with significant GI side effects. More information wo
p p p p p p p p p p
uld be needed regarding fasting and post-
p p p p p p
prandial numbers. In addition, adding acarbose would only lower A
p p p p p p p p p
1c by 0.8% at best and therefore would not achieve the desired A1C
p p p p p p p p p p p p p
goal of <7% p p
JR is a 68-year-
p p p
old African American man with a new diagnosis of T2DM. He was cl
p p p p p p p p p p p p
assified as having prediabetes (at risk for developing diabetes) 5 yea
p p p p p p p p p p
rs before the diagnosis and has a strong family history of type 2 diab
p p p p p p p p p p p p p
etes. JR's blood pressure was 150/92 mm Hg. His laboratory results
p p p p p p p p p p
,3|Page
revealed an A1C of 8.1%, normal cholesterol panel, and normal ren
p p p p p p p p p p p
al/hepatic function were noted with today's laboratory test results.
p p p p p p p p
Past medical history: Hypertension (diagnosed 4 y ago) Hyperlipid
p p p p p p p p
emia (diagnosed 2 y ago) Pancreatitis (idiopathic) (acute hospitaliz
p p p p p p p p
ation 3 y ago) p p p
Family history: Type 2 diabetes p p p p
Medication: HCTZ 25 mg daily, simvastatin 10 mg daily p p p p p p p p
Allergies: SMZ/TMP p
Vitals: BP: 150/92 mm Hg P: 78 beats/min RR: 12 rpm Waist Circu
p p p p p p p p p p p p
mference: 46 in Weight: 267 lb Height: 5 ′ 6 ″ BMI: 43.1 kg/m 2
p p p p p p p p p p p p p p
Despite improvements in the past six weeks due to lifestyle changes
p p p p p p p p p p
and exercise, drug therapy is to be started for JR's diabet -
p p p p p p p p p p p p
..........ANSWER.......Metformin is the drug of choice recommended
p p p p p p p
for most patients with diabetes in addition to lifestyle modification
p p p p p p p p p p
s assuming no contraindications or intolerabilities are present upo
p p p p p p p p
n evaluation. Metformin has also shown to provide positive weight
p p p p p p p p p p
neutral/loss effects in obese patients. It is crucial to know the renal
p p p p p p p p p p p p
status of patients commencing metformin therapy to limit the risk
p p p p p p p p p p
of lactic acidosis (JR is without contraindication).
p p p p p p
Since his entry A1C is >7.5%, dual therapy is indicated. There are se
p p p p p p p p p p p p
veral potential choices. The second step can be a dipeptidyl peptida
p p p p p p p p p p
se-4 inhibitor, it can be a glucagon-like peptide-1 (GLP-
p p p p p p p p
1) receptor agonist, it can be a TZD, it can be a sulfonylurea agent, it
p p p p p p p p p p p p p p p
can be a SGLT2 inhibitor, or it could be basal insulin. Anything next
p p p p p p p p p p p p
can be tried depending on what suits the circumstance
p p p p p p p p p
, 4|Page
DPP4 inhibitors are weight neutral bet relatively benign side effect
p p p p p p p p p p
profile. Sitagliptin has been associated with case reports of pancrea
p p p p p p p p p
titis, so this specific agent should be avoided. $$$
p p p p p p p p
GLP-
1 analog and has data to support an A1C reduction necessary to gain
p p p p p p p p p p p p
glycemic control and may assist with weight loss goals for this patie
p p p p p p p p p p p p
nt. New information suggests these agents may provide benefits in t
p p p p p p p p p p
hose with ASCVD. JR has a past history of pancreatitis and GLP-
p p p p p p p p p p p
1 analogs are not recommended due to this contraindication
p p p p p p p p
TZDs have data to support an A1C reduction necessary to gain glyce
p p p p p p p p p p p
mic control, but are associated with weight gain, negative effects on
p p p p p p p p p p p
lipids and increased risk of fracture. Until recently, TZDs have also
p p p p p p p p p p p
been linked to increased CV events and use has fallen out of favor
p p p p p p p p p p p p
Sulfonylureas provide excellent A1C lowering, but are also associat p p p p p p p p
ed with weight gain. They also have the potential to cause hypoglyce
p p p p p p p p p p p
mia, so patient education is crucial. Because of his allergies to "sulfa
p p p p p p p p p p p
", use would be contr
p p p p
A patient with type 1 diabetes reports taking propranolol for hypert
p p p p p p p p p p
ension. What concern does this information present for the provide
p p p p p p p p p
r? - p
p..........ANSWER.......A patient with Type 1 DM is insulin dependent p p p p p p p p p
for glucose control and at high risk for hypoglycemic episodes. Prop
p p p p p p p p p p
anolol causes prolonged hypoglycemic episodes. Needs to switch to
p p p p p p p p p
ACE or ARB. p p
Advanced Pharmacology NSG 533
Exam 2025 Prep Test with 1-0
Questions and Correct Answers/ NSG
533 TEST 1 Prep Latest
EP is a 38-year-p p p
old female patient that comes in for diabetes education and manage
p p p p p p p p p p
ment. She was diagnosed 12 years ago and states lately she is not abl
p p p p p p p p p p p p p
e to control her diet although she continues a 1600 calorie diet with
p p p p p p p p p p p p p
appropriate daily carbohydrate intake (per dietitian prescription) a
p p p p p p p
nd walks 40 minutes every day of the week. She states compliance
p p p p p p p p p p p p
with all medications. She denies any history of hypoglycemia despit
p p p p p p p p p
e being able to identify signs and symptoms and describe appropria
p p p p p p p p p p
te treatment strategies.
p p
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomy due to t
p p p p p p p p p
hyroid cancer p
FmHx: Noncontributory p
SHx: (−) Smoking, alcohol use, past marijuana use while in high sc
p p p p p p p p p p p
hool
Medications: Metformin 850 mg tid, glipizide 20 mg bid, lisinopril p p p p p p p p p p
20 mg daily, sertraline 100 mg daily, multivitamin daily
p p p p p p p p
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
p p p p p p p p p p
Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl 106 mEq/L
p p p p p p p p p p p
, BUN - ..........ANSWER.......Exenatide -
p p p p
pExenatide (Bydureon) once weekly has been able to demonstrate w
p p p p p p p p p
,2|Page
eight loss and decrease A1C% by 0.7% to 1.2% in clinical trials; how
p p p p p p p p p p p p
ever it is contraindicated for EP due to the self-
p p p p p p p p p
reported history of thyroid cancer. p p p p
Dapagliflozin - p
Dapagliflozin (Farxiga) is contraindicated in this patient due to hy
p p p p p p p p p p
perkalemia which could be made worse by this drug. The package ip p p p p p p p p p p
nsert does not indicate a specific potassium concentration cut off to
p p p p p p p p p p p
no longer use this medication; however, there are better choices in t
p p p p p p p p p p p
his patient. p
Sitagliptin - p
pSitagliptin (Januvia) is able to obtain an A1C goal of less than 7% ba
p p p p p p p p p p p p p
sed on clinical trials and currently the patient does not have any cau
p p p p p p p p p p p p
tionary objective measures to not use this medication. DPP-
p p p p p p p p
IV inhibitors are weight neutral. DPP-
p p p p p
IV inhibitors can be used in patients taking sulfonylureas; however,
p p p p p p p p p
pit may be recommended to reduce or stop the sulfonylurea dose.
p p p p p p p p p p
Acarbose - p
Acarbose (Precose) is not recommended for initial management an
p p p p p p p p p
d is associated with significant GI side effects. More information wo
p p p p p p p p p p
uld be needed regarding fasting and post-
p p p p p p
prandial numbers. In addition, adding acarbose would only lower A
p p p p p p p p p
1c by 0.8% at best and therefore would not achieve the desired A1C
p p p p p p p p p p p p p
goal of <7% p p
JR is a 68-year-
p p p
old African American man with a new diagnosis of T2DM. He was cl
p p p p p p p p p p p p
assified as having prediabetes (at risk for developing diabetes) 5 yea
p p p p p p p p p p
rs before the diagnosis and has a strong family history of type 2 diab
p p p p p p p p p p p p p
etes. JR's blood pressure was 150/92 mm Hg. His laboratory results
p p p p p p p p p p
,3|Page
revealed an A1C of 8.1%, normal cholesterol panel, and normal ren
p p p p p p p p p p p
al/hepatic function were noted with today's laboratory test results.
p p p p p p p p
Past medical history: Hypertension (diagnosed 4 y ago) Hyperlipid
p p p p p p p p
emia (diagnosed 2 y ago) Pancreatitis (idiopathic) (acute hospitaliz
p p p p p p p p
ation 3 y ago) p p p
Family history: Type 2 diabetes p p p p
Medication: HCTZ 25 mg daily, simvastatin 10 mg daily p p p p p p p p
Allergies: SMZ/TMP p
Vitals: BP: 150/92 mm Hg P: 78 beats/min RR: 12 rpm Waist Circu
p p p p p p p p p p p p
mference: 46 in Weight: 267 lb Height: 5 ′ 6 ″ BMI: 43.1 kg/m 2
p p p p p p p p p p p p p p
Despite improvements in the past six weeks due to lifestyle changes
p p p p p p p p p p
and exercise, drug therapy is to be started for JR's diabet -
p p p p p p p p p p p p
..........ANSWER.......Metformin is the drug of choice recommended
p p p p p p p
for most patients with diabetes in addition to lifestyle modification
p p p p p p p p p p
s assuming no contraindications or intolerabilities are present upo
p p p p p p p p
n evaluation. Metformin has also shown to provide positive weight
p p p p p p p p p p
neutral/loss effects in obese patients. It is crucial to know the renal
p p p p p p p p p p p p
status of patients commencing metformin therapy to limit the risk
p p p p p p p p p p
of lactic acidosis (JR is without contraindication).
p p p p p p
Since his entry A1C is >7.5%, dual therapy is indicated. There are se
p p p p p p p p p p p p
veral potential choices. The second step can be a dipeptidyl peptida
p p p p p p p p p p
se-4 inhibitor, it can be a glucagon-like peptide-1 (GLP-
p p p p p p p p
1) receptor agonist, it can be a TZD, it can be a sulfonylurea agent, it
p p p p p p p p p p p p p p p
can be a SGLT2 inhibitor, or it could be basal insulin. Anything next
p p p p p p p p p p p p
can be tried depending on what suits the circumstance
p p p p p p p p p
, 4|Page
DPP4 inhibitors are weight neutral bet relatively benign side effect
p p p p p p p p p p
profile. Sitagliptin has been associated with case reports of pancrea
p p p p p p p p p
titis, so this specific agent should be avoided. $$$
p p p p p p p p
GLP-
1 analog and has data to support an A1C reduction necessary to gain
p p p p p p p p p p p p
glycemic control and may assist with weight loss goals for this patie
p p p p p p p p p p p p
nt. New information suggests these agents may provide benefits in t
p p p p p p p p p p
hose with ASCVD. JR has a past history of pancreatitis and GLP-
p p p p p p p p p p p
1 analogs are not recommended due to this contraindication
p p p p p p p p
TZDs have data to support an A1C reduction necessary to gain glyce
p p p p p p p p p p p
mic control, but are associated with weight gain, negative effects on
p p p p p p p p p p p
lipids and increased risk of fracture. Until recently, TZDs have also
p p p p p p p p p p p
been linked to increased CV events and use has fallen out of favor
p p p p p p p p p p p p
Sulfonylureas provide excellent A1C lowering, but are also associat p p p p p p p p
ed with weight gain. They also have the potential to cause hypoglyce
p p p p p p p p p p p
mia, so patient education is crucial. Because of his allergies to "sulfa
p p p p p p p p p p p
", use would be contr
p p p p
A patient with type 1 diabetes reports taking propranolol for hypert
p p p p p p p p p p
ension. What concern does this information present for the provide
p p p p p p p p p
r? - p
p..........ANSWER.......A patient with Type 1 DM is insulin dependent p p p p p p p p p
for glucose control and at high risk for hypoglycemic episodes. Prop
p p p p p p p p p p
anolol causes prolonged hypoglycemic episodes. Needs to switch to
p p p p p p p p p
ACE or ARB. p p
