NR566 | NR566 Advanced Pharmacology for Care
of the Family Wk 7 Midterm v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient with a history of heart failure is prescribed an ACE inhibitor. Which
electrolyte abnormality should the nurse practitioner monitor for most closely?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D. Hyperkalemia
Correct Answer: D
Expert Explanation: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, which leads to a decrease in aldosterone secretion. Since aldosterone
is responsible for excreting potassium, its reduction leads to potassium retention.
Monitoring for hyperkalemia is essential, especially in patients with renal
impairment or those taking potassium-sparing diuretics.
2. Which of the following describes the mechanism of action of Metformin?
A. Stimulates insulin secretion from pancreatic beta cells
,B. Increases glucose uptake in peripheral tissues and decreases hepatic glucose
production
C. Delays carbohydrate absorption in the small intestine
D. Inhibits the SGLT2 transporter in the kidneys
Correct Answer: B
Expert Explanation: Metformin is a biguanide that primarily works by decreasing
hepatic glucose production and increasing insulin sensitivity in peripheral tissues.
Unlike sulfonylureas, it does not stimulate insulin secretion and therefore has a
lower risk of hypoglycemia. It is considered first-line therapy for Type 2 Diabetes
Mellitus due to its efficacy and safety profile.
3. A 65-year-old male is starting a statin for hyperlipidemia. Which baseline laboratory
test is mandatory before starting this therapy?
A. Serum Creatinine
B. Thyroid Stimulating Hormone (TSH)
C. Alanine Aminotransferase (ALT)
D. Complete Blood Count (CBC)
Correct Answer: C
,Expert Explanation: The FDA recommends checking baseline liver enzymes,
specifically ALT, before initiating statin therapy to assess for pre-existing liver
disease. While routine periodic monitoring is no longer required unless
symptomatic, the baseline assessment is critical for safety. This helps in identifying
patients who may be at higher risk for hepatotoxicity.
4. Which medication is considered a ‘rescue’ inhaler for a patient experiencing an
acute asthma exacerbation?
A. Salmeterol
B. Fluticasone
C. Albuterol
D. Tiotropium
Correct Answer: C
Expert Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides
rapid bronchodilation by relaxing smooth muscle in the airway. It is the drug of
choice for acute symptoms and ‘rescue’ situations rather than long-term
maintenance. Patients must be educated that frequent use of a rescue inhaler
indicates poorly controlled asthma.
, 5. When prescribing warfarin, the clinician must monitor which of the following to
ensure therapeutic dosing?
A. aPTT
B. Platelet count
C. Bleeding time
D. INR
Correct Answer: D
Expert Explanation: The International Normalized Ratio (INR) is the standardized
method for monitoring the anticoagulant effect of warfarin. For most indications,
such as atrial fibrillation, the target INR range is 2.0 to 3.0. Frequent monitoring is
required due to warfarin’s narrow therapeutic index and numerous drug-drug or
drug-food interactions.
6. Which of the following is a potential side effect of a calcium channel blocker like
amlodipine?
A. Dry cough
B. Hyperuricemia
C. Peripheral edema
D. Hypoglycemia
of the Family Wk 7 Midterm v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient with a history of heart failure is prescribed an ACE inhibitor. Which
electrolyte abnormality should the nurse practitioner monitor for most closely?
A. Hypokalemia
B. Hypocalcemia
C. Hyponatremia
D. Hyperkalemia
Correct Answer: D
Expert Explanation: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, which leads to a decrease in aldosterone secretion. Since aldosterone
is responsible for excreting potassium, its reduction leads to potassium retention.
Monitoring for hyperkalemia is essential, especially in patients with renal
impairment or those taking potassium-sparing diuretics.
2. Which of the following describes the mechanism of action of Metformin?
A. Stimulates insulin secretion from pancreatic beta cells
,B. Increases glucose uptake in peripheral tissues and decreases hepatic glucose
production
C. Delays carbohydrate absorption in the small intestine
D. Inhibits the SGLT2 transporter in the kidneys
Correct Answer: B
Expert Explanation: Metformin is a biguanide that primarily works by decreasing
hepatic glucose production and increasing insulin sensitivity in peripheral tissues.
Unlike sulfonylureas, it does not stimulate insulin secretion and therefore has a
lower risk of hypoglycemia. It is considered first-line therapy for Type 2 Diabetes
Mellitus due to its efficacy and safety profile.
3. A 65-year-old male is starting a statin for hyperlipidemia. Which baseline laboratory
test is mandatory before starting this therapy?
A. Serum Creatinine
B. Thyroid Stimulating Hormone (TSH)
C. Alanine Aminotransferase (ALT)
D. Complete Blood Count (CBC)
Correct Answer: C
,Expert Explanation: The FDA recommends checking baseline liver enzymes,
specifically ALT, before initiating statin therapy to assess for pre-existing liver
disease. While routine periodic monitoring is no longer required unless
symptomatic, the baseline assessment is critical for safety. This helps in identifying
patients who may be at higher risk for hepatotoxicity.
4. Which medication is considered a ‘rescue’ inhaler for a patient experiencing an
acute asthma exacerbation?
A. Salmeterol
B. Fluticasone
C. Albuterol
D. Tiotropium
Correct Answer: C
Expert Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides
rapid bronchodilation by relaxing smooth muscle in the airway. It is the drug of
choice for acute symptoms and ‘rescue’ situations rather than long-term
maintenance. Patients must be educated that frequent use of a rescue inhaler
indicates poorly controlled asthma.
, 5. When prescribing warfarin, the clinician must monitor which of the following to
ensure therapeutic dosing?
A. aPTT
B. Platelet count
C. Bleeding time
D. INR
Correct Answer: D
Expert Explanation: The International Normalized Ratio (INR) is the standardized
method for monitoring the anticoagulant effect of warfarin. For most indications,
such as atrial fibrillation, the target INR range is 2.0 to 3.0. Frequent monitoring is
required due to warfarin’s narrow therapeutic index and numerous drug-drug or
drug-food interactions.
6. Which of the following is a potential side effect of a calcium channel blocker like
amlodipine?
A. Dry cough
B. Hyperuricemia
C. Peripheral edema
D. Hypoglycemia
