NSG 533 EXAM 2 (WILKES) NEWEST 2026 ACTUAL
EXAM| NSG533 ADVANCED PHARMACOLOGY EXAM
2 REVIEW WITH COMPLETE REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+ (MOST RECENT!!)
1. A patient is prescribed metoprolol for heart failure. Which
finding indicates the medication is having a therapeutic
effect?
A) Increased heart rate
B) Decreased blood pressure and improved ejection fraction
C) Bronchospasm
D) Hyperglycemia
Correct Answer: B
Rationale: Metoprolol is a beta-1 selective blocker that reduces
heart rate, blood pressure, and myocardial oxygen demand,
improving left ventricular ejection fraction in heart failure
patients .
2. A patient taking lisinopril develops a persistent dry cough.
What is the appropriate next step?
A) Continue lisinopril, the cough is harmless
B) Switch to an angiotensin II receptor blocker (ARB) such as
1
,losartan
C) Add an antitussive medication
D) Double the dose of lisinopril
Correct Answer: B
Rationale: A persistent dry cough is a common side effect of ACE
inhibitors due to bradykinin accumulation; switching to an ARB
eliminates the cough while maintaining blood pressure control .
3. Which statement about warfarin is correct?
A) Its effects are immediate after the first dose
B) It is monitored using aPTT
C) It works by inhibiting vitamin K-dependent clotting factors (II,
VII, IX, X)
D) It has no food interactions
Correct Answer: C
Rationale: Warfarin inhibits vitamin K epoxide reductase,
reducing the synthesis of vitamin K-dependent clotting factors. It
has a delayed onset and is monitored using INR, not aPTT .
4. A patient with type 2 diabetes and heart failure is
prescribed metformin. Which lab value should be monitored
closely?
A) Serum creatinine (risk of lactic acidosis)
2
,B) HbA1c only
C) Fasting blood glucose only
D) Liver enzymes
Correct Answer: A
Rationale: Metformin can cause lactic acidosis in patients with
renal impairment. Serum creatinine (and eGFR) must be
monitored, especially in patients with heart failure who are at
risk for renal hypoperfusion .
5. A patient on digoxin develops nausea, vomiting, and
yellow-tinged vision. What lab value should be checked
immediately?
A) Digoxin level
B) Potassium level
C) Both A and B
D) Calcium level
Correct Answer: C
Rationale: Nausea, vomiting, and visual disturbances
(xanthopsia) are signs of digoxin toxicity. Both digoxin level and
potassium should be checked because hypokalemia increases the
risk of toxicity .
3
, 6. Which medication is a direct thrombin inhibitor used for
anticoagulation?
A) Heparin
B) Warfarin
C) Dabigatran
D) Clopidogrel
Correct Answer: C
Rationale: Dabigatran (Pradaxa) is a direct thrombin (factor IIa)
inhibitor. Heparin works via antithrombin III, warfarin inhibits
vitamin K, and clopidogrel is an antiplatelet agent .
7. A patient prescribed an SSRI for major depressive disorder
reports sexual dysfunction. Which SSRI is least likely to cause
this side effect?
A) Paroxetine
B) Sertraline
C) Fluoxetine
D) Escitalopram – all SSRIs can cause sexual dysfunction but some
data suggest less with escitalopram? Actually escitalopram and
sertraline can cause it; paroxetine has highest rate. The least is
often considered citalopram/escitalopram? but the question
expects standard answer: bupropion is often added. Since only
SSRIs listed, the correct answer is fluoxetine? Not exactly – no
4
EXAM| NSG533 ADVANCED PHARMACOLOGY EXAM
2 REVIEW WITH COMPLETE REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/ ALREADY
GRADED A+ (MOST RECENT!!)
1. A patient is prescribed metoprolol for heart failure. Which
finding indicates the medication is having a therapeutic
effect?
A) Increased heart rate
B) Decreased blood pressure and improved ejection fraction
C) Bronchospasm
D) Hyperglycemia
Correct Answer: B
Rationale: Metoprolol is a beta-1 selective blocker that reduces
heart rate, blood pressure, and myocardial oxygen demand,
improving left ventricular ejection fraction in heart failure
patients .
2. A patient taking lisinopril develops a persistent dry cough.
What is the appropriate next step?
A) Continue lisinopril, the cough is harmless
B) Switch to an angiotensin II receptor blocker (ARB) such as
1
,losartan
C) Add an antitussive medication
D) Double the dose of lisinopril
Correct Answer: B
Rationale: A persistent dry cough is a common side effect of ACE
inhibitors due to bradykinin accumulation; switching to an ARB
eliminates the cough while maintaining blood pressure control .
3. Which statement about warfarin is correct?
A) Its effects are immediate after the first dose
B) It is monitored using aPTT
C) It works by inhibiting vitamin K-dependent clotting factors (II,
VII, IX, X)
D) It has no food interactions
Correct Answer: C
Rationale: Warfarin inhibits vitamin K epoxide reductase,
reducing the synthesis of vitamin K-dependent clotting factors. It
has a delayed onset and is monitored using INR, not aPTT .
4. A patient with type 2 diabetes and heart failure is
prescribed metformin. Which lab value should be monitored
closely?
A) Serum creatinine (risk of lactic acidosis)
2
,B) HbA1c only
C) Fasting blood glucose only
D) Liver enzymes
Correct Answer: A
Rationale: Metformin can cause lactic acidosis in patients with
renal impairment. Serum creatinine (and eGFR) must be
monitored, especially in patients with heart failure who are at
risk for renal hypoperfusion .
5. A patient on digoxin develops nausea, vomiting, and
yellow-tinged vision. What lab value should be checked
immediately?
A) Digoxin level
B) Potassium level
C) Both A and B
D) Calcium level
Correct Answer: C
Rationale: Nausea, vomiting, and visual disturbances
(xanthopsia) are signs of digoxin toxicity. Both digoxin level and
potassium should be checked because hypokalemia increases the
risk of toxicity .
3
, 6. Which medication is a direct thrombin inhibitor used for
anticoagulation?
A) Heparin
B) Warfarin
C) Dabigatran
D) Clopidogrel
Correct Answer: C
Rationale: Dabigatran (Pradaxa) is a direct thrombin (factor IIa)
inhibitor. Heparin works via antithrombin III, warfarin inhibits
vitamin K, and clopidogrel is an antiplatelet agent .
7. A patient prescribed an SSRI for major depressive disorder
reports sexual dysfunction. Which SSRI is least likely to cause
this side effect?
A) Paroxetine
B) Sertraline
C) Fluoxetine
D) Escitalopram – all SSRIs can cause sexual dysfunction but some
data suggest less with escitalopram? Actually escitalopram and
sertraline can cause it; paroxetine has highest rate. The least is
often considered citalopram/escitalopram? but the question
expects standard answer: bupropion is often added. Since only
SSRIs listed, the correct answer is fluoxetine? Not exactly – no
4
