NR565 | NR565 Advanced Pharmacology
Fundamentals Exam 2 v3 | Questions with Correct
Answers and Expert Explanation for Each Question
| Chamberlain
1. A patient with a history of heart failure is diagnosed with Type 2 Diabetes. Which of
the following medications should be avoided due to the risk of exacerbating heart
failure?
A. Pioglitazone
B. Metformin
C. Sitagliptin
D. Glipizide
Correct Answer: A
Expert Explanation: Pioglitazone is a thiazolidinedione that can cause fluid
retention and peripheral edema. This medication is contraindicated or should be
used with extreme caution in patients with NYHA Class III or IV heart failure. The
fluid overload can worsen heart failure symptoms and lead to decompensation.
2. When prescribing Levothyroxine for a patient with hypothyroidism, which
instruction is most important for the nurse practitioner to include?
A. Take the medication with a full meal to avoid GI upset.
,B. Take the medication on an empty stomach 30-60 minutes before breakfast.
C. Take the medication at bedtime with a glass of milk.
D. Take the medication only when you feel fatigued.
Correct Answer: B
Expert Explanation: Levothyroxine absorption is significantly decreased when
taken with food or certain minerals like calcium. It should be taken on an empty
stomach in the morning to maintain consistent therapeutic levels. Patients should
wait at least 30 to 60 minutes before consuming any food or other medications.
3. A patient is prescribed Ciprofloxacin for a urinary tract infection. Which black box
warning should the provider discuss with the patient?
A. Risk of Stevens-Johnson Syndrome
B. Risk of profound hearing loss
C. Risk of tendon rupture
D. Risk of severe hypoglycemia
Correct Answer: C
Expert Explanation: Fluoroquinolones like Ciprofloxacin carry a black box warning
regarding the increased risk of tendinitis and tendon rupture. This risk is higher in
patients over 60, those taking corticosteroids, and organ transplant recipients.
,Patients should be advised to stop the medication and seek medical attention if they
experience tendon pain or inflammation.
4. Which of the following is the primary mechanism of action for Metformin in the
treatment of Type 2 Diabetes?
A. Stimulating the pancreas to release more insulin
B. Decreasing hepatic glucose production and improving insulin sensitivity
C. Inhibiting the enzyme DPP-4 to increase incretin levels
D. Increasing glucose excretion through the kidneys
Correct Answer: B
Expert Explanation: Metformin belongs to the biguanide class and primarily works
by decreasing glucose production in the liver. It also increases the sensitivity of
peripheral tissues to insulin, allowing for better glucose uptake. Unlike
sulfonylureas, it does not stimulate insulin secretion and therefore has a lower risk
of causing hypoglycemia.
5. A patient with asthma is currently using a Short-Acting Beta-Agonist (SABA) as
needed. Their symptoms are worsening, and they require a daily maintenance inhaler.
Which is the preferred next step in therapy?
A. Inhaled Corticosteroid (ICS)
, B. Long-Acting Beta-Agonist (LABA) monotherapy
C. Oral Corticosteroids
D. Theophylline
Correct Answer: A
Expert Explanation: According to GINA and NAEPP guidelines, an Inhaled
Corticosteroid is the preferred first-line maintenance therapy for persistent asthma.
LABAs should never be used as monotherapy in asthma due to an increased risk of
asthma-related death. ICS help to reduce the underlying airway inflammation that
causes asthma symptoms.
6. A patient being treated with Vancomycin intravenously develops a red, itchy rash
on their face and neck during the infusion. What is the most appropriate action?
A. Stop the infusion and never give Vancomycin again.
B. Increase the infusion rate to finish the dose quickly.
C. Administer epinephrine immediately.
D. Slow the rate of the infusion and monitor the patient.
Correct Answer: D
Expert Explanation: This reaction is known as Vancomycin Flushing Syndrome,
previously called Red Man Syndrome, and is caused by rapid histamine release. It is
Fundamentals Exam 2 v3 | Questions with Correct
Answers and Expert Explanation for Each Question
| Chamberlain
1. A patient with a history of heart failure is diagnosed with Type 2 Diabetes. Which of
the following medications should be avoided due to the risk of exacerbating heart
failure?
A. Pioglitazone
B. Metformin
C. Sitagliptin
D. Glipizide
Correct Answer: A
Expert Explanation: Pioglitazone is a thiazolidinedione that can cause fluid
retention and peripheral edema. This medication is contraindicated or should be
used with extreme caution in patients with NYHA Class III or IV heart failure. The
fluid overload can worsen heart failure symptoms and lead to decompensation.
2. When prescribing Levothyroxine for a patient with hypothyroidism, which
instruction is most important for the nurse practitioner to include?
A. Take the medication with a full meal to avoid GI upset.
,B. Take the medication on an empty stomach 30-60 minutes before breakfast.
C. Take the medication at bedtime with a glass of milk.
D. Take the medication only when you feel fatigued.
Correct Answer: B
Expert Explanation: Levothyroxine absorption is significantly decreased when
taken with food or certain minerals like calcium. It should be taken on an empty
stomach in the morning to maintain consistent therapeutic levels. Patients should
wait at least 30 to 60 minutes before consuming any food or other medications.
3. A patient is prescribed Ciprofloxacin for a urinary tract infection. Which black box
warning should the provider discuss with the patient?
A. Risk of Stevens-Johnson Syndrome
B. Risk of profound hearing loss
C. Risk of tendon rupture
D. Risk of severe hypoglycemia
Correct Answer: C
Expert Explanation: Fluoroquinolones like Ciprofloxacin carry a black box warning
regarding the increased risk of tendinitis and tendon rupture. This risk is higher in
patients over 60, those taking corticosteroids, and organ transplant recipients.
,Patients should be advised to stop the medication and seek medical attention if they
experience tendon pain or inflammation.
4. Which of the following is the primary mechanism of action for Metformin in the
treatment of Type 2 Diabetes?
A. Stimulating the pancreas to release more insulin
B. Decreasing hepatic glucose production and improving insulin sensitivity
C. Inhibiting the enzyme DPP-4 to increase incretin levels
D. Increasing glucose excretion through the kidneys
Correct Answer: B
Expert Explanation: Metformin belongs to the biguanide class and primarily works
by decreasing glucose production in the liver. It also increases the sensitivity of
peripheral tissues to insulin, allowing for better glucose uptake. Unlike
sulfonylureas, it does not stimulate insulin secretion and therefore has a lower risk
of causing hypoglycemia.
5. A patient with asthma is currently using a Short-Acting Beta-Agonist (SABA) as
needed. Their symptoms are worsening, and they require a daily maintenance inhaler.
Which is the preferred next step in therapy?
A. Inhaled Corticosteroid (ICS)
, B. Long-Acting Beta-Agonist (LABA) monotherapy
C. Oral Corticosteroids
D. Theophylline
Correct Answer: A
Expert Explanation: According to GINA and NAEPP guidelines, an Inhaled
Corticosteroid is the preferred first-line maintenance therapy for persistent asthma.
LABAs should never be used as monotherapy in asthma due to an increased risk of
asthma-related death. ICS help to reduce the underlying airway inflammation that
causes asthma symptoms.
6. A patient being treated with Vancomycin intravenously develops a red, itchy rash
on their face and neck during the infusion. What is the most appropriate action?
A. Stop the infusion and never give Vancomycin again.
B. Increase the infusion rate to finish the dose quickly.
C. Administer epinephrine immediately.
D. Slow the rate of the infusion and monitor the patient.
Correct Answer: D
Expert Explanation: This reaction is known as Vancomycin Flushing Syndrome,
previously called Red Man Syndrome, and is caused by rapid histamine release. It is
