NR566 | NR566 Advanced Pharmacology for Care
of the Family Wk 8 Final Exam v1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient taking an ACE inhibitor like Lisinopril develops a dry, non-productive
cough. What is the physiological cause of this side effect?
A. Inhibition of prostaglandins
B. Accumulation of bradykinin
C. Direct irritation of the bronchial mucosa
D. Increased histamine release
Correct Answer: B
Expert Explanation: ACE inhibitors block the enzyme that converts angiotensin I to
angiotensin II, but this enzyme is also responsible for breaking down bradykinin.
The resulting accumulation of bradykinin in the lungs leads to the classic dry cough
associated with this drug class. This side effect is a common reason for switching
patients from an ACE inhibitor to an Angiotensin Receptor Blocker (ARB).
2. Which of the following instructions is most important for a patient newly prescribed
Levothyroxine for hypothyroidism?
A. Take the medication on an empty stomach, 30-60 minutes before breakfast
,B. Take the medication at bedtime with a glass of milk
C. Take the medication with a full meal to avoid GI upset
D. Take the medication only when feeling symptomatic
Correct Answer: A
Expert Explanation: Levothyroxine absorption is significantly impaired by food,
calcium, and iron supplements. Taking it on an empty stomach in the morning
ensures consistent therapeutic blood levels. Patients should wait at least 30 to 60
minutes before eating or taking other medications to ensure optimal absorption.
3. When prescribing Metformin for a patient with Type 2 Diabetes, which laboratory
value is most critical to monitor due to the risk of lactic acidosis?
A. Serum potassium
B. Alanine aminotransferase (ALT)
C. Glomerular filtration rate (GFR)
D. Fractional excretion of sodium
Correct Answer: C
Expert Explanation: Metformin is primarily excreted by the kidneys and can
accumulate in patients with renal impairment, increasing the risk of potentially fatal
lactic acidosis. Current guidelines suggest Metformin is contraindicated when the
,GFR is below 30 mL/min/1.73m2. Monitoring renal function allows the provider to
adjust dosage or discontinue the drug as kidney function declines.
4. A patient is prescribed Warfarin for atrial fibrillation. Which of the following should
the nurse practitioner emphasize regarding dietary intake?
A. Avoid all foods containing Vitamin K
B. Maintain a consistent intake of Vitamin K-rich foods
C. Increase intake of leafy greens to enhance drug effect
D. Switch to a high-protein, low-carbohydrate diet
Correct Answer: B
Expert Explanation: Warfarin works by inhibiting Vitamin K-dependent clotting
factors, so sudden changes in Vitamin K intake can fluctuate the INR. Patients do not
need to avoid Vitamin K entirely, but they must keep their intake consistent to
maintain a stable therapeutic range. Significant increases in Vitamin K can lead to
subtherapeutic INR levels, increasing the risk of clot formation.
5. Which of the following medications is considered first-line therapy for a patient
with hypertension and a history of chronic kidney disease (CKD)?
A. Amlodipine
B. Lisinopril
, C. Hydrochlorothiazide
D. Metoprolol
Correct Answer: B
Expert Explanation: ACE inhibitors like Lisinopril provide renoprotective effects
by reducing intraglomerular pressure and proteinuria. They are the preferred first-
line treatment for hypertensive patients with CKD, regardless of ethnic background.
Monitoring of serum creatinine and potassium is necessary when initiating these
agents in this population.
6. A patient on Spironolactone for heart failure should be closely monitored for which
electrolyte abnormality?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypocalcemia
Correct Answer: A
Expert Explanation: Spironolactone is a potassium-sparing diuretic that acts as an
aldosterone antagonist in the distal renal tubules. By inhibiting aldosterone, it
of the Family Wk 8 Final Exam v1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient taking an ACE inhibitor like Lisinopril develops a dry, non-productive
cough. What is the physiological cause of this side effect?
A. Inhibition of prostaglandins
B. Accumulation of bradykinin
C. Direct irritation of the bronchial mucosa
D. Increased histamine release
Correct Answer: B
Expert Explanation: ACE inhibitors block the enzyme that converts angiotensin I to
angiotensin II, but this enzyme is also responsible for breaking down bradykinin.
The resulting accumulation of bradykinin in the lungs leads to the classic dry cough
associated with this drug class. This side effect is a common reason for switching
patients from an ACE inhibitor to an Angiotensin Receptor Blocker (ARB).
2. Which of the following instructions is most important for a patient newly prescribed
Levothyroxine for hypothyroidism?
A. Take the medication on an empty stomach, 30-60 minutes before breakfast
,B. Take the medication at bedtime with a glass of milk
C. Take the medication with a full meal to avoid GI upset
D. Take the medication only when feeling symptomatic
Correct Answer: A
Expert Explanation: Levothyroxine absorption is significantly impaired by food,
calcium, and iron supplements. Taking it on an empty stomach in the morning
ensures consistent therapeutic blood levels. Patients should wait at least 30 to 60
minutes before eating or taking other medications to ensure optimal absorption.
3. When prescribing Metformin for a patient with Type 2 Diabetes, which laboratory
value is most critical to monitor due to the risk of lactic acidosis?
A. Serum potassium
B. Alanine aminotransferase (ALT)
C. Glomerular filtration rate (GFR)
D. Fractional excretion of sodium
Correct Answer: C
Expert Explanation: Metformin is primarily excreted by the kidneys and can
accumulate in patients with renal impairment, increasing the risk of potentially fatal
lactic acidosis. Current guidelines suggest Metformin is contraindicated when the
,GFR is below 30 mL/min/1.73m2. Monitoring renal function allows the provider to
adjust dosage or discontinue the drug as kidney function declines.
4. A patient is prescribed Warfarin for atrial fibrillation. Which of the following should
the nurse practitioner emphasize regarding dietary intake?
A. Avoid all foods containing Vitamin K
B. Maintain a consistent intake of Vitamin K-rich foods
C. Increase intake of leafy greens to enhance drug effect
D. Switch to a high-protein, low-carbohydrate diet
Correct Answer: B
Expert Explanation: Warfarin works by inhibiting Vitamin K-dependent clotting
factors, so sudden changes in Vitamin K intake can fluctuate the INR. Patients do not
need to avoid Vitamin K entirely, but they must keep their intake consistent to
maintain a stable therapeutic range. Significant increases in Vitamin K can lead to
subtherapeutic INR levels, increasing the risk of clot formation.
5. Which of the following medications is considered first-line therapy for a patient
with hypertension and a history of chronic kidney disease (CKD)?
A. Amlodipine
B. Lisinopril
, C. Hydrochlorothiazide
D. Metoprolol
Correct Answer: B
Expert Explanation: ACE inhibitors like Lisinopril provide renoprotective effects
by reducing intraglomerular pressure and proteinuria. They are the preferred first-
line treatment for hypertensive patients with CKD, regardless of ethnic background.
Monitoring of serum creatinine and potassium is necessary when initiating these
agents in this population.
6. A patient on Spironolactone for heart failure should be closely monitored for which
electrolyte abnormality?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypocalcemia
Correct Answer: A
Expert Explanation: Spironolactone is a potassium-sparing diuretic that acts as an
aldosterone antagonist in the distal renal tubules. By inhibiting aldosterone, it
