NR566 | NR566 Advanced Pharmacology for Care
of the Family Exam 3 Version 3 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A 55-year-old patient with type 2 diabetes and a history of heart failure requires a
second-line agent after metformin. Which medication class provides the best evidence
for reducing heart failure hospitalizations?
A. Sulfonylureas
B. SGLT2 inhibitors
C. DPP-4 inhibitors
D. Thiazolidinediones
Correct Answer: B
Expert Explanation: SGLT2 inhibitors like empagliflozin have been shown to
significantly reduce the risk of heart failure hospitalizations and cardiovascular
death. In contrast, Thiazolidinediones like pioglitazone are actually contraindicated
in patients with symptomatic heart failure due to fluid retention. Clinicians should
monitor renal function and assess for signs of urinary tract infections when
initiating SGLT2 therapy.
,2. Which of the following is a primary mechanism of action for Metformin in the
treatment of Type 2 Diabetes?
A. Stimulating insulin secretion from the pancreas
B. Decreasing hepatic glucose production
C. Slowing gastric emptying
D. Increasing glucose excretion in the urine
Correct Answer: B
Expert Explanation: Metformin works primarily by inhibiting gluconeogenesis in
the liver and improving insulin sensitivity in peripheral tissues. It does not cause
insulin release from the pancreas, which is why it has a low risk of hypoglycemia
when used alone. Patients should be counseled on the potential for gastrointestinal
side effects and the importance of monitoring B12 levels over time.
3. A patient is prescribed Levothyroxine for the treatment of hypothyroidism. When
should they be instructed to take this medication to ensure optimal absorption?
A. In the morning, at least 30-60 minutes before breakfast
B. At bedtime with a snack
C. With the largest meal of the day
D. Immediately after drinking a cup of coffee
,Correct Answer: A
Expert Explanation: Levothyroxine absorption is best on an empty stomach to
avoid interference from food and other medications. Many common substances like
calcium, iron, and coffee can significantly impair the absorption of thyroid hormone.
If a patient cannot take it in the morning, they must remain consistent with
whatever timing they choose and monitor TSH levels closely.
4. Which side effect is most characteristic of the GLP-1 receptor agonist class, such as
Liraglutide?
A. Significant weight gain
B. Peripheral edema
C. Gastrointestinal distress including nausea and vomiting
D. Increased risk of bone fractures
Correct Answer: C
Expert Explanation: GLP-1 agonists slow gastric emptying and act on the central
nervous system, often leading to nausea, vomiting, and diarrhea. These side effects
are usually dose-dependent and tend to improve over several weeks of therapy.
Patients should be advised to eat smaller portions and stop eating when they feel
full to mitigate these symptoms.
, 5. A patient with newly diagnosed Graves’ disease is in her first trimester of
pregnancy. Which antithyroid medication is the preferred choice for this patient?
A. Methimazole
B. Radioactive Iodine
C. Propylthiouracil (PTU)
D. Levothyroxine
Correct Answer: C
Expert Explanation: PTU is the preferred antithyroid drug during the first
trimester of pregnancy because Methimazole is associated with a higher risk of birth
defects such as aplasia cutis. After the first trimester, many providers switch the
patient to Methimazole to avoid the risk of liver toxicity associated with PTU. Liver
function tests and thyroid levels should be monitored frequently throughout the
pregnancy.
6. What is the black box warning associated with all Thiazolidinediones (TZDs) like
Rosiglitazone?
A. Congestive heart failure
B. Lactic acidosis
C. Thyroid C-cell tumors
of the Family Exam 3 Version 3 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A 55-year-old patient with type 2 diabetes and a history of heart failure requires a
second-line agent after metformin. Which medication class provides the best evidence
for reducing heart failure hospitalizations?
A. Sulfonylureas
B. SGLT2 inhibitors
C. DPP-4 inhibitors
D. Thiazolidinediones
Correct Answer: B
Expert Explanation: SGLT2 inhibitors like empagliflozin have been shown to
significantly reduce the risk of heart failure hospitalizations and cardiovascular
death. In contrast, Thiazolidinediones like pioglitazone are actually contraindicated
in patients with symptomatic heart failure due to fluid retention. Clinicians should
monitor renal function and assess for signs of urinary tract infections when
initiating SGLT2 therapy.
,2. Which of the following is a primary mechanism of action for Metformin in the
treatment of Type 2 Diabetes?
A. Stimulating insulin secretion from the pancreas
B. Decreasing hepatic glucose production
C. Slowing gastric emptying
D. Increasing glucose excretion in the urine
Correct Answer: B
Expert Explanation: Metformin works primarily by inhibiting gluconeogenesis in
the liver and improving insulin sensitivity in peripheral tissues. It does not cause
insulin release from the pancreas, which is why it has a low risk of hypoglycemia
when used alone. Patients should be counseled on the potential for gastrointestinal
side effects and the importance of monitoring B12 levels over time.
3. A patient is prescribed Levothyroxine for the treatment of hypothyroidism. When
should they be instructed to take this medication to ensure optimal absorption?
A. In the morning, at least 30-60 minutes before breakfast
B. At bedtime with a snack
C. With the largest meal of the day
D. Immediately after drinking a cup of coffee
,Correct Answer: A
Expert Explanation: Levothyroxine absorption is best on an empty stomach to
avoid interference from food and other medications. Many common substances like
calcium, iron, and coffee can significantly impair the absorption of thyroid hormone.
If a patient cannot take it in the morning, they must remain consistent with
whatever timing they choose and monitor TSH levels closely.
4. Which side effect is most characteristic of the GLP-1 receptor agonist class, such as
Liraglutide?
A. Significant weight gain
B. Peripheral edema
C. Gastrointestinal distress including nausea and vomiting
D. Increased risk of bone fractures
Correct Answer: C
Expert Explanation: GLP-1 agonists slow gastric emptying and act on the central
nervous system, often leading to nausea, vomiting, and diarrhea. These side effects
are usually dose-dependent and tend to improve over several weeks of therapy.
Patients should be advised to eat smaller portions and stop eating when they feel
full to mitigate these symptoms.
, 5. A patient with newly diagnosed Graves’ disease is in her first trimester of
pregnancy. Which antithyroid medication is the preferred choice for this patient?
A. Methimazole
B. Radioactive Iodine
C. Propylthiouracil (PTU)
D. Levothyroxine
Correct Answer: C
Expert Explanation: PTU is the preferred antithyroid drug during the first
trimester of pregnancy because Methimazole is associated with a higher risk of birth
defects such as aplasia cutis. After the first trimester, many providers switch the
patient to Methimazole to avoid the risk of liver toxicity associated with PTU. Liver
function tests and thyroid levels should be monitored frequently throughout the
pregnancy.
6. What is the black box warning associated with all Thiazolidinediones (TZDs) like
Rosiglitazone?
A. Congestive heart failure
B. Lactic acidosis
C. Thyroid C-cell tumors
