NR566 ADVANCED PHARMACOLOGY FINAL EXAM QUESTIONS
AND 100% CORRECT ANSWERS WITH VERIFIED SOLUTIONS|
ALREADY GRADUATEE A+.
1. A patient with hypertension is prescribed lisinopril. Which mechanism
best explains the drug’s action?
A. Blocks calcium channels in vascular smooth muscle
B. Inhibits angiotensin-converting enzyme
C. Stimulates beta-2 receptors
D. Increases sodium excretion in distal tubules
Correct Answer: B
Explanation: Lisinopril is an ACE inhibitor that blocks the conversion of
angiotensin I to angiotensin II, reducing vasoconstriction and
aldosterone secretion. Other options describe calcium channel blockers,
beta agonists, or diuretics.
2. Which medication is contraindicated in pregnancy due to risk of fetal
renal damage?
A. Methyldopa
B. Labetalol
C. Losartan
D. Nifedipine
Correct Answer: C
Explanation: Losartan is an angiotensin II receptor blocker (ARB) and is
teratogenic, causing fetal renal damage. Methyldopa, labetalol, and
nifedipine are considered safer alternatives.
3. A patient taking warfarin should be monitored using which laboratory
value?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Correct Answer: B
Explanation: INR is used to monitor warfarin therapy. aPTT is used for
heparin monitoring, while platelet count and hemoglobin assess other
hematologic conditions.
1|Page
, 4. Which drug class is most appropriate for first-line treatment of type 2
diabetes?
A. Sulfonylureas
B. Biguanides
C. Thiazolidinediones
D. DPP-4 inhibitors
Correct Answer: B
Explanation: Metformin, a biguanide, is the first-line therapy due to its
efficacy and safety profile. Other classes are typically second-line agents.
5. A patient develops a persistent dry cough while taking enalapril. What is
the best alternative?
A. Propranolol
B. Losartan
C. Hydrochlorothiazide
D. Amlodipine
Correct Answer: B
Explanation: ARBs like losartan do not cause the bradykinin-related
cough associated with ACE inhibitors.
6. Which neurotransmitter is primarily affected by selective serotonin
reuptake inhibitors (SSRIs)?
A. Dopamine
B. Norepinephrine
C. Serotonin
D. Acetylcholine
Correct Answer: C
Explanation: SSRIs block serotonin reuptake, increasing its availability
in synaptic clefts.
7. A patient on digoxin presents with nausea, visual disturbances, and
bradycardia. What is the likely cause?
A. Therapeutic effect
B. Digoxin toxicity
C. Hypokalemia
D. Hypernatremia
2|Page
, Correct Answer: B
Explanation: These are classic signs of digoxin toxicity. Hypokalemia
may worsen toxicity but is not the primary diagnosis here.
8. Which antibiotic is associated with a risk of tendon rupture?
A. Amoxicillin
B. Ciprofloxacin
C. Azithromycin
D. Doxycycline
Correct Answer: B
Explanation: Fluoroquinolones like ciprofloxacin are linked to tendon
rupture, especially in older adults.
9. A patient with asthma should avoid which medication?
A. Albuterol
B. Montelukast
C. Propranolol
D. Fluticasone
Correct Answer: C
Explanation: Non-selective beta-blockers like propranolol can cause
bronchoconstriction and worsen asthma.
10.Which drug is used as an antidote for opioid overdose?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Correct Answer: B
Explanation: Naloxone is an opioid antagonist that reverses opioid
overdose effects.
11.Which statin has the highest risk of drug interactions due to CYP3A4
metabolism?
A. Pravastatin
B. Rosuvastatin
C. Atorvastatin
3|Page
, D. Fluvastatin
Correct Answer: C
Explanation: Atorvastatin is metabolized by CYP3A4, increasing risk of
interactions compared to others like pravastatin.
12.What is the primary action of loop diuretics?
A. Inhibit sodium reabsorption in distal tubule
B. Block sodium-potassium-chloride transporter in loop of Henle
C. Increase aldosterone secretion
D. Decrease potassium excretion
Correct Answer: B
Explanation: Loop diuretics inhibit the Na-K-2Cl transporter in the
ascending loop of Henle, causing potent diuresis.
13.A patient taking lithium should have which level monitored regularly?
A. Sodium
B. Potassium
C. Lithium serum level
D. Calcium
Correct Answer: C
Explanation: Lithium has a narrow therapeutic index and requires close
monitoring to avoid toxicity.
14.Which drug class is most effective for neuropathic pain?
A. NSAIDs
B. Opioids
C. Anticonvulsants
D. Beta-blockers
Correct Answer: C
Explanation: Anticonvulsants like gabapentin are effective for
neuropathic pain due to their action on nerve signaling.
15.Which medication requires avoidance of grapefruit juice?
A. Metformin
B. Simvastatin
C. Insulin
4|Page
AND 100% CORRECT ANSWERS WITH VERIFIED SOLUTIONS|
ALREADY GRADUATEE A+.
1. A patient with hypertension is prescribed lisinopril. Which mechanism
best explains the drug’s action?
A. Blocks calcium channels in vascular smooth muscle
B. Inhibits angiotensin-converting enzyme
C. Stimulates beta-2 receptors
D. Increases sodium excretion in distal tubules
Correct Answer: B
Explanation: Lisinopril is an ACE inhibitor that blocks the conversion of
angiotensin I to angiotensin II, reducing vasoconstriction and
aldosterone secretion. Other options describe calcium channel blockers,
beta agonists, or diuretics.
2. Which medication is contraindicated in pregnancy due to risk of fetal
renal damage?
A. Methyldopa
B. Labetalol
C. Losartan
D. Nifedipine
Correct Answer: C
Explanation: Losartan is an angiotensin II receptor blocker (ARB) and is
teratogenic, causing fetal renal damage. Methyldopa, labetalol, and
nifedipine are considered safer alternatives.
3. A patient taking warfarin should be monitored using which laboratory
value?
A. aPTT
B. INR
C. Platelet count
D. Hemoglobin
Correct Answer: B
Explanation: INR is used to monitor warfarin therapy. aPTT is used for
heparin monitoring, while platelet count and hemoglobin assess other
hematologic conditions.
1|Page
, 4. Which drug class is most appropriate for first-line treatment of type 2
diabetes?
A. Sulfonylureas
B. Biguanides
C. Thiazolidinediones
D. DPP-4 inhibitors
Correct Answer: B
Explanation: Metformin, a biguanide, is the first-line therapy due to its
efficacy and safety profile. Other classes are typically second-line agents.
5. A patient develops a persistent dry cough while taking enalapril. What is
the best alternative?
A. Propranolol
B. Losartan
C. Hydrochlorothiazide
D. Amlodipine
Correct Answer: B
Explanation: ARBs like losartan do not cause the bradykinin-related
cough associated with ACE inhibitors.
6. Which neurotransmitter is primarily affected by selective serotonin
reuptake inhibitors (SSRIs)?
A. Dopamine
B. Norepinephrine
C. Serotonin
D. Acetylcholine
Correct Answer: C
Explanation: SSRIs block serotonin reuptake, increasing its availability
in synaptic clefts.
7. A patient on digoxin presents with nausea, visual disturbances, and
bradycardia. What is the likely cause?
A. Therapeutic effect
B. Digoxin toxicity
C. Hypokalemia
D. Hypernatremia
2|Page
, Correct Answer: B
Explanation: These are classic signs of digoxin toxicity. Hypokalemia
may worsen toxicity but is not the primary diagnosis here.
8. Which antibiotic is associated with a risk of tendon rupture?
A. Amoxicillin
B. Ciprofloxacin
C. Azithromycin
D. Doxycycline
Correct Answer: B
Explanation: Fluoroquinolones like ciprofloxacin are linked to tendon
rupture, especially in older adults.
9. A patient with asthma should avoid which medication?
A. Albuterol
B. Montelukast
C. Propranolol
D. Fluticasone
Correct Answer: C
Explanation: Non-selective beta-blockers like propranolol can cause
bronchoconstriction and worsen asthma.
10.Which drug is used as an antidote for opioid overdose?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Correct Answer: B
Explanation: Naloxone is an opioid antagonist that reverses opioid
overdose effects.
11.Which statin has the highest risk of drug interactions due to CYP3A4
metabolism?
A. Pravastatin
B. Rosuvastatin
C. Atorvastatin
3|Page
, D. Fluvastatin
Correct Answer: C
Explanation: Atorvastatin is metabolized by CYP3A4, increasing risk of
interactions compared to others like pravastatin.
12.What is the primary action of loop diuretics?
A. Inhibit sodium reabsorption in distal tubule
B. Block sodium-potassium-chloride transporter in loop of Henle
C. Increase aldosterone secretion
D. Decrease potassium excretion
Correct Answer: B
Explanation: Loop diuretics inhibit the Na-K-2Cl transporter in the
ascending loop of Henle, causing potent diuresis.
13.A patient taking lithium should have which level monitored regularly?
A. Sodium
B. Potassium
C. Lithium serum level
D. Calcium
Correct Answer: C
Explanation: Lithium has a narrow therapeutic index and requires close
monitoring to avoid toxicity.
14.Which drug class is most effective for neuropathic pain?
A. NSAIDs
B. Opioids
C. Anticonvulsants
D. Beta-blockers
Correct Answer: C
Explanation: Anticonvulsants like gabapentin are effective for
neuropathic pain due to their action on nerve signaling.
15.Which medication requires avoidance of grapefruit juice?
A. Metformin
B. Simvastatin
C. Insulin
4|Page
