WGU D116 ADVANCED PHARMACOLOGY
OBJECTIVE ASSESSMENT EXAM QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
1. A 68-year-old patient with chronic heart failure is prescribed digoxin.
Which lab value should be monitored most closely to avoid toxicity?
A. Serum potassium
B. Serum magnesium
C. Serum creatinine
D. Serum albumin
Correct Answer: A. Serum potassium
Rationale:
Hypokalemia increases the risk of digoxin toxicity by enhancing digoxin binding
to myocardial tissue. Potassium levels must be closely monitored in heart failure
patients on digoxin.
2. A patient is receiving heparin therapy. Which finding would require
immediate intervention?
A. Platelet count of 180,000/mm³
B. Activated partial thromboplastin time (aPTT) 1.5 times baseline
C. Hematuria
D. Mild bruising at injection site
Correct Answer: C. Hematuria
Rationale:
Hematuria indicates active bleeding and requires immediate assessment and
possible reversal of anticoagulation. Mild bruising is expected; aPTT 1.5 times
baseline is therapeutic.
,3. A patient is prescribed a statin medication. Which patient statement
indicates the need for further teaching?
A. “I should report unexplained muscle pain.”
B. “I will take this medication at night.”
C. “I can stop taking it once my cholesterol improves.”
D. “I will avoid grapefruit juice.”
Correct Answer: C. “I can stop taking it once my cholesterol improves.”
Rationale:
Statins are lifelong therapy for most patients with high cholesterol; stopping
abruptly increases cardiovascular risk.
4. A patient with asthma uses albuterol frequently (more than 3 times/week).
What does this indicate?
A. Effective asthma control
B. Need for long-term controller therapy
C. Patient is using correct technique
D. The patient has exercise-induced asthma
Correct Answer: B. Need for long-term controller therapy
Rationale:
Frequent use of a rescue inhaler indicates poor asthma control and need for daily
controller therapy (e.g., inhaled corticosteroids).
5. Which medication is contraindicated in pregnancy due to teratogenicity?
A. Lisinopril
B. Metoprolol
C. Ondansetron
D. Heparin
Correct Answer: A. Lisinopril
,Rationale:
ACE inhibitors (e.g., lisinopril) are teratogenic and contraindicated in pregnancy.
Heparin is safe, while metoprolol and ondansetron may be used with caution.
6. A patient is prescribed warfarin. Which medication will most likely
increase its effect?
A. Vitamin K
B. Ibuprofen
C. Rifampin
D. Carbamazepine
Correct Answer: B. Ibuprofen
Rationale:
NSAIDs increase bleeding risk with warfarin by inhibiting platelet function and
causing gastric irritation. Vitamin K decreases warfarin effect; rifampin and
carbamazepine induce hepatic metabolism, decreasing warfarin levels.
7. A patient is started on metformin. Which adverse effect should the nurse
prioritize teaching about?
A. Hypoglycemia
B. Lactic acidosis
C. Weight gain
D. Hyperkalemia
Correct Answer: B. Lactic acidosis
Rationale:
Metformin can rarely cause lactic acidosis, especially in patients with renal
impairment. Hypoglycemia is uncommon unless combined with other agents.
, 8. A patient receives an opioid for postoperative pain. Which symptom
suggests opioid toxicity?
A. Pinpoint pupils
B. Tachycardia
C. Hypertension
D. Diarrhea
Correct Answer: A. Pinpoint pupils
Rationale:
Pinpoint pupils, respiratory depression, and decreased level of consciousness are
classic signs of opioid toxicity.
9. Which class of drugs is most appropriate for long-term management of
GERD?
A. Antacids
B. Proton pump inhibitors
C. H2 blockers
D. Prokinetic agents
Correct Answer: B. Proton pump inhibitors
Rationale:
PPIs provide the most effective long-term acid suppression and mucosal healing
for GERD.
10. A patient with chronic kidney disease is prescribed epoetin alfa. What
should the nurse monitor?
A. Serum potassium
B. Hemoglobin level
C. Serum calcium
D. White blood cell count
Correct Answer: B. Hemoglobin level
OBJECTIVE ASSESSMENT EXAM QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES
GRADED A+ LATEST
1. A 68-year-old patient with chronic heart failure is prescribed digoxin.
Which lab value should be monitored most closely to avoid toxicity?
A. Serum potassium
B. Serum magnesium
C. Serum creatinine
D. Serum albumin
Correct Answer: A. Serum potassium
Rationale:
Hypokalemia increases the risk of digoxin toxicity by enhancing digoxin binding
to myocardial tissue. Potassium levels must be closely monitored in heart failure
patients on digoxin.
2. A patient is receiving heparin therapy. Which finding would require
immediate intervention?
A. Platelet count of 180,000/mm³
B. Activated partial thromboplastin time (aPTT) 1.5 times baseline
C. Hematuria
D. Mild bruising at injection site
Correct Answer: C. Hematuria
Rationale:
Hematuria indicates active bleeding and requires immediate assessment and
possible reversal of anticoagulation. Mild bruising is expected; aPTT 1.5 times
baseline is therapeutic.
,3. A patient is prescribed a statin medication. Which patient statement
indicates the need for further teaching?
A. “I should report unexplained muscle pain.”
B. “I will take this medication at night.”
C. “I can stop taking it once my cholesterol improves.”
D. “I will avoid grapefruit juice.”
Correct Answer: C. “I can stop taking it once my cholesterol improves.”
Rationale:
Statins are lifelong therapy for most patients with high cholesterol; stopping
abruptly increases cardiovascular risk.
4. A patient with asthma uses albuterol frequently (more than 3 times/week).
What does this indicate?
A. Effective asthma control
B. Need for long-term controller therapy
C. Patient is using correct technique
D. The patient has exercise-induced asthma
Correct Answer: B. Need for long-term controller therapy
Rationale:
Frequent use of a rescue inhaler indicates poor asthma control and need for daily
controller therapy (e.g., inhaled corticosteroids).
5. Which medication is contraindicated in pregnancy due to teratogenicity?
A. Lisinopril
B. Metoprolol
C. Ondansetron
D. Heparin
Correct Answer: A. Lisinopril
,Rationale:
ACE inhibitors (e.g., lisinopril) are teratogenic and contraindicated in pregnancy.
Heparin is safe, while metoprolol and ondansetron may be used with caution.
6. A patient is prescribed warfarin. Which medication will most likely
increase its effect?
A. Vitamin K
B. Ibuprofen
C. Rifampin
D. Carbamazepine
Correct Answer: B. Ibuprofen
Rationale:
NSAIDs increase bleeding risk with warfarin by inhibiting platelet function and
causing gastric irritation. Vitamin K decreases warfarin effect; rifampin and
carbamazepine induce hepatic metabolism, decreasing warfarin levels.
7. A patient is started on metformin. Which adverse effect should the nurse
prioritize teaching about?
A. Hypoglycemia
B. Lactic acidosis
C. Weight gain
D. Hyperkalemia
Correct Answer: B. Lactic acidosis
Rationale:
Metformin can rarely cause lactic acidosis, especially in patients with renal
impairment. Hypoglycemia is uncommon unless combined with other agents.
, 8. A patient receives an opioid for postoperative pain. Which symptom
suggests opioid toxicity?
A. Pinpoint pupils
B. Tachycardia
C. Hypertension
D. Diarrhea
Correct Answer: A. Pinpoint pupils
Rationale:
Pinpoint pupils, respiratory depression, and decreased level of consciousness are
classic signs of opioid toxicity.
9. Which class of drugs is most appropriate for long-term management of
GERD?
A. Antacids
B. Proton pump inhibitors
C. H2 blockers
D. Prokinetic agents
Correct Answer: B. Proton pump inhibitors
Rationale:
PPIs provide the most effective long-term acid suppression and mucosal healing
for GERD.
10. A patient with chronic kidney disease is prescribed epoetin alfa. What
should the nurse monitor?
A. Serum potassium
B. Hemoglobin level
C. Serum calcium
D. White blood cell count
Correct Answer: B. Hemoglobin level
