NR 565 Week 5, 6, 7 & 8 / NR565 Final
Exam Study Guide Advanced
Pharmacology Questions with Answers
() (Verified Answers)-
Chamberlain
Week 5: Endocrine Pharmacology (Diabetes & Thyroid)
Q1. Which of the following diabetic medications is most likely to cause
hypoglycemia?
A. Biguanides (Metformin)
B. Thiazolidinediones (TZDs)
C. Sulfonylureas
D. DPP-4 inhibitors
Answer: C. Sulfonylureas
Rationale: Sulfonylureas (e.g., glipizide, glyburide) stimulate the pancreas to
release more insulin. This direct insulin release can cause blood glucose to drop
too low, leading to hypoglycemia. Metformin, TZDs, and DPP-4 inhibitors do not
typically cause hypoglycemia when used alone.
Q2. In which patient population is Metformin contraindicated?
A. Diabetics with HbA1c < 7.0%
B. Patients older than 50
,C. Alcoholics
D. Women suffering from infertility
Answer: C. Alcoholics
Rationale: Metformin has a black box warning for lactic acidosis. Alcoholics are at
increased risk because alcohol can also cause lactic acidosis, and chronic alcohol
use is often associated with liver disease, which further increases this risk. It
should also be held in patients with renal disease or hepatic disease.
Q3. A 33-year-old woman previously diagnosed with hyperthyroidism presents
with tachycardia. Which medication should the NP add to the patient's
regimen?
A. Atenolol
B. Levothyroxine
C. Lithium
D. Semaglutide
Answer: A. Atenolol
Rationale: Atenolol is a beta-blocker that can help manage the adrenergic
symptoms of hyperthyroidism, such as tachycardia, palpitations, and anxiety. It
does not treat the overproduction of thyroid hormones but provides symptomatic
relief while other treatments (like methimazole) take effect.
Q4. A patient has a TSH of 0.28 mcIU/mL, a free T4 of 3 ng/dL, and a free T3
over 650 pg/dL. What medication should she be started on?
A. Levothyroxine
B. Methimazole
C. Liothyronine
D. Liotrix
Answer: B. Methimazole
,Rationale: These labs indicate hyperthyroidism (low TSH, high T3/T4).
Methimazole is a first-line antithyroid drug that works by inhibiting thyroid hormone
synthesis, making it appropriate for this patient.
Q5. Which of the following symptoms indicates that a patient may need a lower
dosage of levothyroxine?
A. Bradycardia
B. Cold intolerance
C. Palpitations
D. Weight gain
Answer: C. Palpitations
Rationale: Palpitations are a sign of thyrotoxicosis, meaning the levothyroxine dose
may be too high and causing iatrogenic hyperthyroidism. Other signs of over-
treatment include tachycardia, insomnia, and anxiety. Bradycardia, cold
intolerance, and weight gain are symptoms of hypothyroidism and would indicate a
need for a higher dose.
Week 6: Respiratory Pharmacology (Asthma & COPD)
Q6. Long-acting beta agonists (LABAs) must be prescribed with which
medication class?
A. Glucocorticoids (Inhaled Corticosteroids)
B. Short-acting beta agonists (SABAs)
C. Oral steroids
D. Methylxanthines
Answer: A. Glucocorticoids (Inhaled Corticosteroids)
, Rationale: Due to an increased risk of severe asthma exacerbations and asthma-
related death, LABAs (e.g., salmeterol) should never be used as monotherapy for
asthma. They must always be combined with an inhaled corticosteroid (ICS) in a
single inhaler or taken together.
Q7. What is the most appropriate treatment for exercise-induced asthma?
A. An oral corticosteroid like Prednisone
B. An inhaled short-acting beta-agonist like Albuterol
C. A long-acting muscarinic antagonist like Tiotropium
D. A leukotriene inhibitor like Zafirlukast
Answer: B. An inhaled short-acting beta-agonist like Albuterol
Rationale: SABAs are the standard of care for preventing and treating acute
bronchospasm triggered by exercise. They are used 15-20 minutes before exercise
to prevent symptoms.
Q8. What is the most important teaching point for a patient taking Salmeterol
(Serevent) for asthma?
A. It can be used as a rescue inhaler during an acute attack.
B. It should be taken with food to prevent GI upset.
C. It is not effective during an acute asthma attack.
D. It will cure the underlying inflammation causing asthma.
Answer: C. It is not effective during an acute asthma attack.
Rationale: Salmeterol is a LABA with a slow onset of action. It is a maintenance
medication for long-term control and should never be used as a rescue inhaler for
sudden symptoms. Patients must have a separate SABA (e.g., albuterol) for acute
attacks.
Q9. Which medication is most effective for patients with chronic emphysema?
A. Ipratropium (Atrovent)
Exam Study Guide Advanced
Pharmacology Questions with Answers
() (Verified Answers)-
Chamberlain
Week 5: Endocrine Pharmacology (Diabetes & Thyroid)
Q1. Which of the following diabetic medications is most likely to cause
hypoglycemia?
A. Biguanides (Metformin)
B. Thiazolidinediones (TZDs)
C. Sulfonylureas
D. DPP-4 inhibitors
Answer: C. Sulfonylureas
Rationale: Sulfonylureas (e.g., glipizide, glyburide) stimulate the pancreas to
release more insulin. This direct insulin release can cause blood glucose to drop
too low, leading to hypoglycemia. Metformin, TZDs, and DPP-4 inhibitors do not
typically cause hypoglycemia when used alone.
Q2. In which patient population is Metformin contraindicated?
A. Diabetics with HbA1c < 7.0%
B. Patients older than 50
,C. Alcoholics
D. Women suffering from infertility
Answer: C. Alcoholics
Rationale: Metformin has a black box warning for lactic acidosis. Alcoholics are at
increased risk because alcohol can also cause lactic acidosis, and chronic alcohol
use is often associated with liver disease, which further increases this risk. It
should also be held in patients with renal disease or hepatic disease.
Q3. A 33-year-old woman previously diagnosed with hyperthyroidism presents
with tachycardia. Which medication should the NP add to the patient's
regimen?
A. Atenolol
B. Levothyroxine
C. Lithium
D. Semaglutide
Answer: A. Atenolol
Rationale: Atenolol is a beta-blocker that can help manage the adrenergic
symptoms of hyperthyroidism, such as tachycardia, palpitations, and anxiety. It
does not treat the overproduction of thyroid hormones but provides symptomatic
relief while other treatments (like methimazole) take effect.
Q4. A patient has a TSH of 0.28 mcIU/mL, a free T4 of 3 ng/dL, and a free T3
over 650 pg/dL. What medication should she be started on?
A. Levothyroxine
B. Methimazole
C. Liothyronine
D. Liotrix
Answer: B. Methimazole
,Rationale: These labs indicate hyperthyroidism (low TSH, high T3/T4).
Methimazole is a first-line antithyroid drug that works by inhibiting thyroid hormone
synthesis, making it appropriate for this patient.
Q5. Which of the following symptoms indicates that a patient may need a lower
dosage of levothyroxine?
A. Bradycardia
B. Cold intolerance
C. Palpitations
D. Weight gain
Answer: C. Palpitations
Rationale: Palpitations are a sign of thyrotoxicosis, meaning the levothyroxine dose
may be too high and causing iatrogenic hyperthyroidism. Other signs of over-
treatment include tachycardia, insomnia, and anxiety. Bradycardia, cold
intolerance, and weight gain are symptoms of hypothyroidism and would indicate a
need for a higher dose.
Week 6: Respiratory Pharmacology (Asthma & COPD)
Q6. Long-acting beta agonists (LABAs) must be prescribed with which
medication class?
A. Glucocorticoids (Inhaled Corticosteroids)
B. Short-acting beta agonists (SABAs)
C. Oral steroids
D. Methylxanthines
Answer: A. Glucocorticoids (Inhaled Corticosteroids)
, Rationale: Due to an increased risk of severe asthma exacerbations and asthma-
related death, LABAs (e.g., salmeterol) should never be used as monotherapy for
asthma. They must always be combined with an inhaled corticosteroid (ICS) in a
single inhaler or taken together.
Q7. What is the most appropriate treatment for exercise-induced asthma?
A. An oral corticosteroid like Prednisone
B. An inhaled short-acting beta-agonist like Albuterol
C. A long-acting muscarinic antagonist like Tiotropium
D. A leukotriene inhibitor like Zafirlukast
Answer: B. An inhaled short-acting beta-agonist like Albuterol
Rationale: SABAs are the standard of care for preventing and treating acute
bronchospasm triggered by exercise. They are used 15-20 minutes before exercise
to prevent symptoms.
Q8. What is the most important teaching point for a patient taking Salmeterol
(Serevent) for asthma?
A. It can be used as a rescue inhaler during an acute attack.
B. It should be taken with food to prevent GI upset.
C. It is not effective during an acute asthma attack.
D. It will cure the underlying inflammation causing asthma.
Answer: C. It is not effective during an acute asthma attack.
Rationale: Salmeterol is a LABA with a slow onset of action. It is a maintenance
medication for long-term control and should never be used as a rescue inhaler for
sudden symptoms. Patients must have a separate SABA (e.g., albuterol) for acute
attacks.
Q9. Which medication is most effective for patients with chronic emphysema?
A. Ipratropium (Atrovent)
