NR566 | NR566 Advanced Pharmacology for Care
of the Family Wk 6 Midterm v1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A 55-year-old male with hypertension and a history of angioedema is being
evaluated for a new antihypertensive. Which of the following classes should be strictly
avoided in this patient?
A. Calcium Channel Blockers
B. Thiazide Diuretics
C. ACE Inhibitors
D. Beta Blockers
Correct Answer: C
Expert Explanation: ACE inhibitors are strongly associated with the development
of angioedema due to the accumulation of bradykinin. If a patient has a known
history of angioedema, regardless of the cause, ACE inhibitors should be avoided to
prevent a life-threatening airway emergency. This class of medication is generally
replaced by ARBs in patients who develop a cough, but prior angioedema is a major
contraindication.
,2. Which medication is recommended as the first-line pharmacologic treatment for a
patient newly diagnosed with Type 2 Diabetes and an A1C of 7.5%?
A. Metformin
B. Pioglitazone
C. Glipizide
D. Liraglutide
Correct Answer: A
Expert Explanation: Metformin is the gold standard first-line treatment for Type 2
Diabetes according to the ADA guidelines. It works by reducing hepatic glucose
production and improving insulin sensitivity without the risk of hypoglycemia. It is
favored due to its long-term safety profile, efficacy, and weight-neutral or weight-
loss benefits.
3. A patient taking Warfarin for atrial fibrillation presents with an INR of 1.2. Which of
the following dietary or supplement habits might explain this subtherapeutic level?
A. Consumption of grapefruit juice
B. Daily use of Ginkgo Biloba
C. High intake of cranberry juice
D. Increased consumption of leafy green vegetables
,Correct Answer: D
Expert Explanation: Leafy green vegetables like spinach and kale are high in
Vitamin K, which acts as the direct antagonist to Warfarin. An increased intake of
Vitamin K facilitates the production of clotting factors, thereby lowering the INR and
making the therapy subtherapeutic. Patients on Warfarin must maintain a
consistent intake of Vitamin K to keep their INR within the therapeutic range.
4. Which side effect is a common reason for patients to discontinue the use of inhaled
corticosteroids (ICS) for asthma management?
A. Weight gain
B. Hyperglycemia
C. Oropharyngeal candidiasis
D. Tachycardia
Correct Answer: C
Expert Explanation: Oropharyngeal candidiasis, also known as thrush, is a
common local side effect of inhaled corticosteroids. It occurs because the steroid
residue in the mouth suppresses the local immune response, allowing yeast
overgrowth. Patients are advised to rinse their mouths and spit after each use to
reduce this risk.
, 5. A patient is prescribed Amiodarone for rhythm control. Which organ system
requires baseline and periodic monitoring due to potential toxicity?
A. Thyroid
B. Pancreas
C. Musculoskeletal system
D. Bone marrow
Correct Answer: A
Expert Explanation: Amiodarone contains a high concentration of iodine and can
cause both hypothyroidism and hyperthyroidism. Baseline and periodic thyroid
function tests (TSH, T4) are essential for patients on long-term therapy.
Additionally, Amiodarone can cause pulmonary toxicity and hepatotoxicity,
requiring chest X-rays and liver enzyme monitoring.
6. Which of the following is the most appropriate initial treatment for a patient with
mild persistent asthma?
A. Low-dose Inhaled Corticosteroid (ICS) plus SABA as needed
B. LABA monotherapy
C. Oral Prednisone
D. Theophylline
of the Family Wk 6 Midterm v1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A 55-year-old male with hypertension and a history of angioedema is being
evaluated for a new antihypertensive. Which of the following classes should be strictly
avoided in this patient?
A. Calcium Channel Blockers
B. Thiazide Diuretics
C. ACE Inhibitors
D. Beta Blockers
Correct Answer: C
Expert Explanation: ACE inhibitors are strongly associated with the development
of angioedema due to the accumulation of bradykinin. If a patient has a known
history of angioedema, regardless of the cause, ACE inhibitors should be avoided to
prevent a life-threatening airway emergency. This class of medication is generally
replaced by ARBs in patients who develop a cough, but prior angioedema is a major
contraindication.
,2. Which medication is recommended as the first-line pharmacologic treatment for a
patient newly diagnosed with Type 2 Diabetes and an A1C of 7.5%?
A. Metformin
B. Pioglitazone
C. Glipizide
D. Liraglutide
Correct Answer: A
Expert Explanation: Metformin is the gold standard first-line treatment for Type 2
Diabetes according to the ADA guidelines. It works by reducing hepatic glucose
production and improving insulin sensitivity without the risk of hypoglycemia. It is
favored due to its long-term safety profile, efficacy, and weight-neutral or weight-
loss benefits.
3. A patient taking Warfarin for atrial fibrillation presents with an INR of 1.2. Which of
the following dietary or supplement habits might explain this subtherapeutic level?
A. Consumption of grapefruit juice
B. Daily use of Ginkgo Biloba
C. High intake of cranberry juice
D. Increased consumption of leafy green vegetables
,Correct Answer: D
Expert Explanation: Leafy green vegetables like spinach and kale are high in
Vitamin K, which acts as the direct antagonist to Warfarin. An increased intake of
Vitamin K facilitates the production of clotting factors, thereby lowering the INR and
making the therapy subtherapeutic. Patients on Warfarin must maintain a
consistent intake of Vitamin K to keep their INR within the therapeutic range.
4. Which side effect is a common reason for patients to discontinue the use of inhaled
corticosteroids (ICS) for asthma management?
A. Weight gain
B. Hyperglycemia
C. Oropharyngeal candidiasis
D. Tachycardia
Correct Answer: C
Expert Explanation: Oropharyngeal candidiasis, also known as thrush, is a
common local side effect of inhaled corticosteroids. It occurs because the steroid
residue in the mouth suppresses the local immune response, allowing yeast
overgrowth. Patients are advised to rinse their mouths and spit after each use to
reduce this risk.
, 5. A patient is prescribed Amiodarone for rhythm control. Which organ system
requires baseline and periodic monitoring due to potential toxicity?
A. Thyroid
B. Pancreas
C. Musculoskeletal system
D. Bone marrow
Correct Answer: A
Expert Explanation: Amiodarone contains a high concentration of iodine and can
cause both hypothyroidism and hyperthyroidism. Baseline and periodic thyroid
function tests (TSH, T4) are essential for patients on long-term therapy.
Additionally, Amiodarone can cause pulmonary toxicity and hepatotoxicity,
requiring chest X-rays and liver enzyme monitoring.
6. Which of the following is the most appropriate initial treatment for a patient with
mild persistent asthma?
A. Low-dose Inhaled Corticosteroid (ICS) plus SABA as needed
B. LABA monotherapy
C. Oral Prednisone
D. Theophylline
