NR566 Advanced Pharmacology for Care of the
Family Wk 4 Midterm v1 Questions with Correct
Answers and Expert Explanation for Each Question
1. A patient with a history of hypertension and asthma is being started on a beta-
blocker. Which of the following medications would be the safest choice?
A. Propranolol
B. Nadolol
C. Metoprolol
D. Timolol
Correct Answer: C
Expert Explanation: Metoprolol is a cardioselective beta-1 blocker, which
primarily targets the heart and has less effect on beta-2 receptors in the lungs. Non-
selective beta-blockers like propranolol can cause bronchoconstriction by blocking
beta-2 receptors, potentially exacerbating asthma symptoms. When treating
patients with reactive airway disease, cardioselective agents are preferred to
minimize respiratory complications.
2. Which laboratory value must be monitored closely for a patient starting an ACE
inhibitor like Lisinopril?
A. Liver Enzymes
,B. Serum Potassium
C. Serum Calcium
D. Platelet count
Correct Answer: B
Expert Explanation: ACE inhibitors can lead to hyperkalemia because they inhibit
the release of aldosterone, which normally promotes potassium excretion. Patients
must have their serum potassium and renal function checked shortly after starting
therapy or increasing the dose. High potassium levels can lead to dangerous cardiac
arrhythmias if left unmanaged.
3. A patient is prescribed Warfarin for atrial fibrillation. What is the target
International Normalized Ratio (INR) for most patients on this therapy?
A. 2.0 to 3.0
B. 1.0 to 2.0
C. 3.5 to 4.5
D. 0.5 to 1.5
Correct Answer: A
Expert Explanation: The standard therapeutic range for INR in patients taking
warfarin for atrial fibrillation or venous thromboembolism is 2.0 to 3.0. Maintaining
,this range balances the risk of thromboembolic events against the risk of bleeding.
Frequent monitoring is required due to the narrow therapeutic index and numerous
drug-food interactions.
4. A 55-year-old patient reports muscle pain and weakness after starting Atorvastatin
40mg daily. What is the priority nursing action?
A. Advise the patient to take the medication with food
B. Increase the patient’s intake of Vitamin D
C. Switch the patient to a different statin immediately
D. Check the patient’s creatine kinase (CK) level
Correct Answer: D
Expert Explanation: Statins can cause myopathy, which is characterized by muscle
pain and elevated creatine kinase (CK) levels. In severe cases, this can progress to
rhabdomyolysis, leading to renal failure. Assessing the CK level helps the clinician
determine the severity of the muscle injury and decide whether to discontinue the
drug.
5. What is the mechanism of action of Metformin in the treatment of Type 2 Diabetes?
A. Stimulates insulin secretion from the pancreas
B. Increases glucose excretion through the urine
, C. Delays the absorption of carbohydrates in the gut
D. Decreases hepatic glucose production and increases insulin sensitivity
Correct Answer: D
Expert Explanation: Metformin works primarily by inhibiting gluconeogenesis in
the liver and improving insulin sensitivity in peripheral tissues. It does not stimulate
insulin release, which makes it less likely to cause hypoglycemia compared to
sulfonylureas. It is often the first-line medication for Type 2 Diabetes due to its
efficacy and weight-neutral profile.
6. Which of the following instructions is essential for a patient prescribed Alendronate
for osteoporosis?
A. Take the medication with a full glass of milk
B. Lie down for 30 minutes after taking the dose
C. Take the medication on an empty stomach with 8 oz of water
D. Take the dose at bedtime to avoid GI upset
Correct Answer: C
Expert Explanation: Bisphosphonates like alendronate must be taken on an empty
stomach with plain water to ensure proper absorption. Patients must remain
upright for at least 30 minutes after ingestion to prevent esophageal irritation and
Family Wk 4 Midterm v1 Questions with Correct
Answers and Expert Explanation for Each Question
1. A patient with a history of hypertension and asthma is being started on a beta-
blocker. Which of the following medications would be the safest choice?
A. Propranolol
B. Nadolol
C. Metoprolol
D. Timolol
Correct Answer: C
Expert Explanation: Metoprolol is a cardioselective beta-1 blocker, which
primarily targets the heart and has less effect on beta-2 receptors in the lungs. Non-
selective beta-blockers like propranolol can cause bronchoconstriction by blocking
beta-2 receptors, potentially exacerbating asthma symptoms. When treating
patients with reactive airway disease, cardioselective agents are preferred to
minimize respiratory complications.
2. Which laboratory value must be monitored closely for a patient starting an ACE
inhibitor like Lisinopril?
A. Liver Enzymes
,B. Serum Potassium
C. Serum Calcium
D. Platelet count
Correct Answer: B
Expert Explanation: ACE inhibitors can lead to hyperkalemia because they inhibit
the release of aldosterone, which normally promotes potassium excretion. Patients
must have their serum potassium and renal function checked shortly after starting
therapy or increasing the dose. High potassium levels can lead to dangerous cardiac
arrhythmias if left unmanaged.
3. A patient is prescribed Warfarin for atrial fibrillation. What is the target
International Normalized Ratio (INR) for most patients on this therapy?
A. 2.0 to 3.0
B. 1.0 to 2.0
C. 3.5 to 4.5
D. 0.5 to 1.5
Correct Answer: A
Expert Explanation: The standard therapeutic range for INR in patients taking
warfarin for atrial fibrillation or venous thromboembolism is 2.0 to 3.0. Maintaining
,this range balances the risk of thromboembolic events against the risk of bleeding.
Frequent monitoring is required due to the narrow therapeutic index and numerous
drug-food interactions.
4. A 55-year-old patient reports muscle pain and weakness after starting Atorvastatin
40mg daily. What is the priority nursing action?
A. Advise the patient to take the medication with food
B. Increase the patient’s intake of Vitamin D
C. Switch the patient to a different statin immediately
D. Check the patient’s creatine kinase (CK) level
Correct Answer: D
Expert Explanation: Statins can cause myopathy, which is characterized by muscle
pain and elevated creatine kinase (CK) levels. In severe cases, this can progress to
rhabdomyolysis, leading to renal failure. Assessing the CK level helps the clinician
determine the severity of the muscle injury and decide whether to discontinue the
drug.
5. What is the mechanism of action of Metformin in the treatment of Type 2 Diabetes?
A. Stimulates insulin secretion from the pancreas
B. Increases glucose excretion through the urine
, C. Delays the absorption of carbohydrates in the gut
D. Decreases hepatic glucose production and increases insulin sensitivity
Correct Answer: D
Expert Explanation: Metformin works primarily by inhibiting gluconeogenesis in
the liver and improving insulin sensitivity in peripheral tissues. It does not stimulate
insulin release, which makes it less likely to cause hypoglycemia compared to
sulfonylureas. It is often the first-line medication for Type 2 Diabetes due to its
efficacy and weight-neutral profile.
6. Which of the following instructions is essential for a patient prescribed Alendronate
for osteoporosis?
A. Take the medication with a full glass of milk
B. Lie down for 30 minutes after taking the dose
C. Take the medication on an empty stomach with 8 oz of water
D. Take the dose at bedtime to avoid GI upset
Correct Answer: C
Expert Explanation: Bisphosphonates like alendronate must be taken on an empty
stomach with plain water to ensure proper absorption. Patients must remain
upright for at least 30 minutes after ingestion to prevent esophageal irritation and
