NR566 | NR566 Advanced Pharmacology for Care
of the Family Wk 3 Final Exam v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient is prescribed Lisinopril for hypertension but develops a persistent, dry,
non-productive cough. What is the physiological reason for this side effect?
A. Direct irritation of the tracheal mucosa
B. Increased levels of bradykinin
C. Decreased production of prostaglandins
D. Inhibition of the cough reflex center
Correct Answer: B
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, which
accumulates in the lungs and triggers the cough reflex. This side effect is not dose-
dependent and typically requires a switch to an ARB if bothersome. Clinical studies
indicate that this occurs in approximately 10 to 20 percent of patients taking ACE
inhibitors.
2. Which of the following medications is contraindicated for a pregnant woman in her
second trimester due to the risk of fetal renal damage?
A. Losartan
,B. Labetalol
C. Methyldopa
D. Hydralazine
Correct Answer: A
Expert Explanation: Losartan is an Angiotensin II Receptor Blocker (ARB) and is
strictly contraindicated during the second and third trimesters of pregnancy. ARBs
can cause fetal injury, including renal failure and skull hypoplasia, leading to fetal
death. For hypertensive pregnant women, safer alternatives like Methyldopa or
Labetalol are usually preferred.
3. A patient taking Simvastatin reports new-onset muscle pain and weakness. What is
the most appropriate initial laboratory test to order?
A. Alanine aminotransferase (ALT)
B. Complete blood count (CBC)
C. Thyroid-stimulating hormone (TSH)
D. Creatine kinase (CK)
E. Blood urea nitrogen (BUN)
Correct Answer: D
,Expert Explanation: Statins can cause myopathy, which is characterized by muscle
pain and elevated creatine kinase levels. If a patient reports muscle symptoms,
checking the CK level is essential to evaluate for rhabdomyolysis or severe
myopathy. This assessment helps the clinician decide whether to discontinue the
medication or adjust the dose.
4. A patient with a history of asthma is diagnosed with hypertension. Which of the
following beta-blockers should be avoided?
A. Metoprolol succinate
B. Propranolol
C. Atenolol
D. Bisoprolol
Correct Answer: B
Expert Explanation: Propranolol is a non-selective beta-blocker that blocks both
beta-1 and beta-2 receptors. Blocking beta-2 receptors can lead to
bronchoconstriction, which is dangerous for patients with asthma or COPD.
Selective beta-1 blockers like Metoprolol are generally safer but should still be used
with caution.
, 5. When monitoring a patient on Warfarin therapy, which lab value is used to adjust
the dosage?
A. aPTT
B. INR
C. Platelet count
D. D-dimer
Correct Answer: B
Expert Explanation: The International Normalized Ratio (INR) is the standard
measurement used to monitor the effectiveness of Warfarin. It provides a
standardized result regardless of the laboratory reagents used to measure the
Prothrombin Time (PT). Maintaining the INR within the therapeutic range, usually
2.0 to 3.0, is crucial for preventing clots and bleeding.
6. A patient is starting Amiodarone for atrial fibrillation. Which monitoring parameter
is most critical due to potential long-term toxicity?
A. Serum glucose
B. Pulmonary function tests
C. Daily weights
D. Urinalysis
of the Family Wk 3 Final Exam v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient is prescribed Lisinopril for hypertension but develops a persistent, dry,
non-productive cough. What is the physiological reason for this side effect?
A. Direct irritation of the tracheal mucosa
B. Increased levels of bradykinin
C. Decreased production of prostaglandins
D. Inhibition of the cough reflex center
Correct Answer: B
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, which
accumulates in the lungs and triggers the cough reflex. This side effect is not dose-
dependent and typically requires a switch to an ARB if bothersome. Clinical studies
indicate that this occurs in approximately 10 to 20 percent of patients taking ACE
inhibitors.
2. Which of the following medications is contraindicated for a pregnant woman in her
second trimester due to the risk of fetal renal damage?
A. Losartan
,B. Labetalol
C. Methyldopa
D. Hydralazine
Correct Answer: A
Expert Explanation: Losartan is an Angiotensin II Receptor Blocker (ARB) and is
strictly contraindicated during the second and third trimesters of pregnancy. ARBs
can cause fetal injury, including renal failure and skull hypoplasia, leading to fetal
death. For hypertensive pregnant women, safer alternatives like Methyldopa or
Labetalol are usually preferred.
3. A patient taking Simvastatin reports new-onset muscle pain and weakness. What is
the most appropriate initial laboratory test to order?
A. Alanine aminotransferase (ALT)
B. Complete blood count (CBC)
C. Thyroid-stimulating hormone (TSH)
D. Creatine kinase (CK)
E. Blood urea nitrogen (BUN)
Correct Answer: D
,Expert Explanation: Statins can cause myopathy, which is characterized by muscle
pain and elevated creatine kinase levels. If a patient reports muscle symptoms,
checking the CK level is essential to evaluate for rhabdomyolysis or severe
myopathy. This assessment helps the clinician decide whether to discontinue the
medication or adjust the dose.
4. A patient with a history of asthma is diagnosed with hypertension. Which of the
following beta-blockers should be avoided?
A. Metoprolol succinate
B. Propranolol
C. Atenolol
D. Bisoprolol
Correct Answer: B
Expert Explanation: Propranolol is a non-selective beta-blocker that blocks both
beta-1 and beta-2 receptors. Blocking beta-2 receptors can lead to
bronchoconstriction, which is dangerous for patients with asthma or COPD.
Selective beta-1 blockers like Metoprolol are generally safer but should still be used
with caution.
, 5. When monitoring a patient on Warfarin therapy, which lab value is used to adjust
the dosage?
A. aPTT
B. INR
C. Platelet count
D. D-dimer
Correct Answer: B
Expert Explanation: The International Normalized Ratio (INR) is the standard
measurement used to monitor the effectiveness of Warfarin. It provides a
standardized result regardless of the laboratory reagents used to measure the
Prothrombin Time (PT). Maintaining the INR within the therapeutic range, usually
2.0 to 3.0, is crucial for preventing clots and bleeding.
6. A patient is starting Amiodarone for atrial fibrillation. Which monitoring parameter
is most critical due to potential long-term toxicity?
A. Serum glucose
B. Pulmonary function tests
C. Daily weights
D. Urinalysis
