NR566 | NR566 Advanced Pharmacology for Care
of the Family Wk 5 Midterm v3 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. When prescribing an ACE inhibitor to a patient with diabetes, which benefit is most
significant?
A. Renoprotection
B. Weight loss
C. Decreased insulin resistance
D. Increased potassium excretion
Correct Answer: A
Expert Explanation: ACE inhibitors are highly beneficial for patients with diabetes
because they provide significant renoprotection. They work by dilating the efferent
arteriole in the kidney, which reduces intraglomerular pressure. This mechanism
helps slow the progression of diabetic nephropathy over time.
2. A patient taking an ACE inhibitor develops a dry, hacking cough. What is the most
likely cause?
A. Increased sodium retention
B. Allergic reaction to the drug
,C. Direct irritation of the throat
D. Accumulation of bradykinin
Correct Answer: D
Expert Explanation: The ACE inhibitor-induced cough is caused by the
accumulation of bradykinin in the lungs. This occurs because ACE is responsible for
breaking down bradykinin, and blocking the enzyme stops this process. If this
occurs, switching the patient to an Angiotensin Receptor Blocker (ARB) is usually
the next step.
3. Which beta-blocker is considered cardioselective, making it safer for patients with
stable asthma?
A. Metoprolol
B. Propranolol
C. Nadolol
D. Timolol
Correct Answer: A
Expert Explanation: Metoprolol is a cardioselective beta-blocker that primarily
targets Beta-1 receptors in the heart. This selectivity makes it less likely to cause
bronchoconstriction in patients with underlying respiratory issues like asthma. In
,contrast, non-selective beta-blockers like Propranolol can block Beta-2 receptors in
the lungs, triggering bronchospasm.
4. What is the primary mechanism of action for Thiazide diuretics in treating
hypertension?
A. Blocking calcium channels
B. Inhibiting the sodium-chloride symporter in the distal tubule
C. Inhibiting the sodium-potassium-chloride pump
D. Antagonizing aldosterone receptors
Correct Answer: B
Expert Explanation: Thiazide diuretics work by inhibiting the sodium-chloride
symporter in the distal convoluted tubule of the kidney. This action promotes the
excretion of sodium and water, thereby reducing blood volume and blood pressure.
They are often used as first-line therapy for uncomplicated hypertension.
5. Which adverse effect is a primary concern for patients taking Spironolactone?
A. Hyperkalemia
B. Hypokalemia
C. Hypocalcemia
D. Hyperglycemia
, Correct Answer: A
Expert Explanation: Spironolactone is a potassium-sparing diuretic that acts as an
aldosterone antagonist. Because it inhibits potassium excretion, the most significant
risk associated with its use is hyperkalemia. Patients must be monitored closely for
elevated potassium levels, especially if they are also taking ACE inhibitors.
6. A patient on Verapamil for hypertension complains of severe constipation. This is a
known side effect of which drug class?
A. Non-Dihydropyridine Calcium Channel Blockers
B. Dihydropyridine Calcium Channel Blockers
C. ACE inhibitors
D. Beta-blockers
Correct Answer: A
Expert Explanation: Verapamil is a non-dihydropyridine calcium channel blocker
that often causes constipation. It slows the movement of calcium into the smooth
muscle cells of the gastrointestinal tract, leading to reduced motility. This side effect
is particularly common in elderly patients using this medication.
7. Before starting a patient on a Statin, which baseline lab value must be obtained?
A. Alanine Aminotransferase (ALT)
of the Family Wk 5 Midterm v3 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. When prescribing an ACE inhibitor to a patient with diabetes, which benefit is most
significant?
A. Renoprotection
B. Weight loss
C. Decreased insulin resistance
D. Increased potassium excretion
Correct Answer: A
Expert Explanation: ACE inhibitors are highly beneficial for patients with diabetes
because they provide significant renoprotection. They work by dilating the efferent
arteriole in the kidney, which reduces intraglomerular pressure. This mechanism
helps slow the progression of diabetic nephropathy over time.
2. A patient taking an ACE inhibitor develops a dry, hacking cough. What is the most
likely cause?
A. Increased sodium retention
B. Allergic reaction to the drug
,C. Direct irritation of the throat
D. Accumulation of bradykinin
Correct Answer: D
Expert Explanation: The ACE inhibitor-induced cough is caused by the
accumulation of bradykinin in the lungs. This occurs because ACE is responsible for
breaking down bradykinin, and blocking the enzyme stops this process. If this
occurs, switching the patient to an Angiotensin Receptor Blocker (ARB) is usually
the next step.
3. Which beta-blocker is considered cardioselective, making it safer for patients with
stable asthma?
A. Metoprolol
B. Propranolol
C. Nadolol
D. Timolol
Correct Answer: A
Expert Explanation: Metoprolol is a cardioselective beta-blocker that primarily
targets Beta-1 receptors in the heart. This selectivity makes it less likely to cause
bronchoconstriction in patients with underlying respiratory issues like asthma. In
,contrast, non-selective beta-blockers like Propranolol can block Beta-2 receptors in
the lungs, triggering bronchospasm.
4. What is the primary mechanism of action for Thiazide diuretics in treating
hypertension?
A. Blocking calcium channels
B. Inhibiting the sodium-chloride symporter in the distal tubule
C. Inhibiting the sodium-potassium-chloride pump
D. Antagonizing aldosterone receptors
Correct Answer: B
Expert Explanation: Thiazide diuretics work by inhibiting the sodium-chloride
symporter in the distal convoluted tubule of the kidney. This action promotes the
excretion of sodium and water, thereby reducing blood volume and blood pressure.
They are often used as first-line therapy for uncomplicated hypertension.
5. Which adverse effect is a primary concern for patients taking Spironolactone?
A. Hyperkalemia
B. Hypokalemia
C. Hypocalcemia
D. Hyperglycemia
, Correct Answer: A
Expert Explanation: Spironolactone is a potassium-sparing diuretic that acts as an
aldosterone antagonist. Because it inhibits potassium excretion, the most significant
risk associated with its use is hyperkalemia. Patients must be monitored closely for
elevated potassium levels, especially if they are also taking ACE inhibitors.
6. A patient on Verapamil for hypertension complains of severe constipation. This is a
known side effect of which drug class?
A. Non-Dihydropyridine Calcium Channel Blockers
B. Dihydropyridine Calcium Channel Blockers
C. ACE inhibitors
D. Beta-blockers
Correct Answer: A
Expert Explanation: Verapamil is a non-dihydropyridine calcium channel blocker
that often causes constipation. It slows the movement of calcium into the smooth
muscle cells of the gastrointestinal tract, leading to reduced motility. This side effect
is particularly common in elderly patients using this medication.
7. Before starting a patient on a Statin, which baseline lab value must be obtained?
A. Alanine Aminotransferase (ALT)
