NR566 | NR566 Advanced Pharmacology for Care
of the Family Wk 8 Midterm v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. Which of the following is the most common side effect associated with the use of
ACE inhibitors such as Lisinopril?
A. Peripheral edema
B. Tachycardia
C. Hypokalemia
D. Dry, nonproductive cough
Correct Answer: D
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin in the
lungs, which can lead to a persistent dry cough. This side effect occurs in
approximately 10-20% of patients and is the most common reason for discontinuing
the medication. If the cough becomes intolerable, the provider should consider
switching the patient to an Angiotensin II Receptor Blocker (ARB).
2. A patient with Type 2 Diabetes is prescribed Metformin. Which laboratory value is
most critical to monitor prior to and during therapy?
A. Alanine Aminotransferase (ALT)
,B. Glomerular Filtration Rate (GFR)
C. Serum Potassium
D. Hemoglobin A1c
Correct Answer: B
Expert Explanation: Metformin is primarily excreted by the kidneys, and its use is
contraindicated in patients with severe renal impairment. A GFR less than 30
mL/min/1.73 m² increases the risk of lactic acidosis, a rare but life-threatening
complication. Routine monitoring of renal function ensures that the dosage remains
safe for the patient’s level of kidney health.
3. When prescribing Warfarin (Coumadin), which target INR range is typically
recommended for a patient with non-valvular atrial fibrillation?
A. 1.5 to 2.0
B. 3.0 to 4.5
C. 2.5 to 3.5
D. 2.0 to 3.0
Correct Answer: D
Expert Explanation: For most indications, including atrial fibrillation and venous
thromboembolism, a target INR of 2.0 to 3.0 provides the best balance between
,preventing clots and minimizing bleeding risk. Mechanical heart valves may require
a higher range, such as 2.5 to 3.5. Close monitoring is essential because Warfarin has
a narrow therapeutic index and numerous drug-food interactions.
4. Which class of antihypertensive medications is generally preferred as first-line
therapy for African American patients without chronic kidney disease?
A. ACE Inhibitors
B. Beta-Blockers
C. Calcium Channel Blockers
D. ARBs
Correct Answer: C
Expert Explanation: According to the JNC 8 guidelines, Calcium Channel Blockers
(CCBs) and thiazide-type diuretics are more effective in lowering blood pressure in
the African American population. ACE inhibitors and ARBs are often less effective as
monotherapy in this group due to lower renin levels. However, if the patient has
chronic kidney disease, an ACE inhibitor or ARB would be prioritized regardless of
race.
5. A patient taking a statin reports new-onset muscle pain and weakness. What is the
provider’s most appropriate initial action?
A. Increase the dose to ensure therapeutic effect
, B. Advise the patient to take Ibuprofen
C. Switch to a different statin immediately
D. Obtain a Serum Creatine Kinase (CK) level
Correct Answer: D
Expert Explanation: Statin-associated muscle symptoms (SAMS) can range from
mild myalgia to life-threatening rhabdomyolysis. Obtaining a CK level helps
determine the severity of muscle injury and guides further management. If the CK is
significantly elevated, the statin should be discontinued to prevent renal damage.
6. Which antibiotic is associated with an increased risk of tendon rupture, especially in
older adults?
A. Amoxicillin
B. Ciprofloxacin
C. Azithromycin
D. Doxycycline
Correct Answer: B
Expert Explanation: Fluoroquinolones, such as Ciprofloxacin and Levofloxacin,
carry a Black Box Warning for tendonitis and tendon rupture. This risk is
particularly high in patients over age 60, those taking corticosteroids, and organ
of the Family Wk 8 Midterm v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. Which of the following is the most common side effect associated with the use of
ACE inhibitors such as Lisinopril?
A. Peripheral edema
B. Tachycardia
C. Hypokalemia
D. Dry, nonproductive cough
Correct Answer: D
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin in the
lungs, which can lead to a persistent dry cough. This side effect occurs in
approximately 10-20% of patients and is the most common reason for discontinuing
the medication. If the cough becomes intolerable, the provider should consider
switching the patient to an Angiotensin II Receptor Blocker (ARB).
2. A patient with Type 2 Diabetes is prescribed Metformin. Which laboratory value is
most critical to monitor prior to and during therapy?
A. Alanine Aminotransferase (ALT)
,B. Glomerular Filtration Rate (GFR)
C. Serum Potassium
D. Hemoglobin A1c
Correct Answer: B
Expert Explanation: Metformin is primarily excreted by the kidneys, and its use is
contraindicated in patients with severe renal impairment. A GFR less than 30
mL/min/1.73 m² increases the risk of lactic acidosis, a rare but life-threatening
complication. Routine monitoring of renal function ensures that the dosage remains
safe for the patient’s level of kidney health.
3. When prescribing Warfarin (Coumadin), which target INR range is typically
recommended for a patient with non-valvular atrial fibrillation?
A. 1.5 to 2.0
B. 3.0 to 4.5
C. 2.5 to 3.5
D. 2.0 to 3.0
Correct Answer: D
Expert Explanation: For most indications, including atrial fibrillation and venous
thromboembolism, a target INR of 2.0 to 3.0 provides the best balance between
,preventing clots and minimizing bleeding risk. Mechanical heart valves may require
a higher range, such as 2.5 to 3.5. Close monitoring is essential because Warfarin has
a narrow therapeutic index and numerous drug-food interactions.
4. Which class of antihypertensive medications is generally preferred as first-line
therapy for African American patients without chronic kidney disease?
A. ACE Inhibitors
B. Beta-Blockers
C. Calcium Channel Blockers
D. ARBs
Correct Answer: C
Expert Explanation: According to the JNC 8 guidelines, Calcium Channel Blockers
(CCBs) and thiazide-type diuretics are more effective in lowering blood pressure in
the African American population. ACE inhibitors and ARBs are often less effective as
monotherapy in this group due to lower renin levels. However, if the patient has
chronic kidney disease, an ACE inhibitor or ARB would be prioritized regardless of
race.
5. A patient taking a statin reports new-onset muscle pain and weakness. What is the
provider’s most appropriate initial action?
A. Increase the dose to ensure therapeutic effect
, B. Advise the patient to take Ibuprofen
C. Switch to a different statin immediately
D. Obtain a Serum Creatine Kinase (CK) level
Correct Answer: D
Expert Explanation: Statin-associated muscle symptoms (SAMS) can range from
mild myalgia to life-threatening rhabdomyolysis. Obtaining a CK level helps
determine the severity of muscle injury and guides further management. If the CK is
significantly elevated, the statin should be discontinued to prevent renal damage.
6. Which antibiotic is associated with an increased risk of tendon rupture, especially in
older adults?
A. Amoxicillin
B. Ciprofloxacin
C. Azithromycin
D. Doxycycline
Correct Answer: B
Expert Explanation: Fluoroquinolones, such as Ciprofloxacin and Levofloxacin,
carry a Black Box Warning for tendonitis and tendon rupture. This risk is
particularly high in patients over age 60, those taking corticosteroids, and organ
