NR 508 FINAL EXAM NEWEST 2025 TEST BANK|
NR508 ADVANCED PHARMACOLOGY FINAL EXAM
REVIEW WITH COMPLETE 450 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (BRAND NEW!!)
Question 1
A 72-year-old patient with heart failure is prescribed digoxin
(Lanoxin). The nurse practitioner knows that which factor places
this patient at highest risk for digoxin toxicity?
A) Age over 70 years
B) Concurrent use of a loop diuretic
C) Estimated glomerular filtration rate (eGFR) of 35 mL/min
D) Use of a beta-blocker
Answer: C
Rationale: Digoxin is primarily renally excreted. An eGFR of 35
mL/min indicates significant renal impairment, which is the
greatest risk factor for digoxin toxicity. Age and diuretics
contribute but are less significant than renal function.
Question 2
1
,A patient with type 2 diabetes is prescribed metformin
(Glucophage). Which laboratory value should be checked before
initiating therapy?
A) Hemoglobin A1c
B) Serum creatinine
C) Liver function tests
D) Fasting blood glucose
Answer: B
Rationale: Metformin is contraindicated in patients with
significant renal impairment (eGFR <30 mL/min) due to risk of
lactic acidosis. Serum creatinine/eGFR must be checked before
initiation.
Question 3
A 28-year-old woman with major depressive disorder is started
on sertraline (Zoloft). She asks about sexual side effects. What is
the most accurate response?
A) "Sexual side effects are rare with sertraline."
B) "Up to 50% of patients experience sexual dysfunction,
including delayed ejaculation and decreased libido."
2
,C) "Sexual side effects only occur with higher doses."
D) "Sertraline has no reported sexual side effects."
Answer: B
Rationale: SSRIs, including sertraline, cause sexual side effects in
up to 50–70% of patients. Common effects include delayed
ejaculation, anorgasmia, and decreased libido.
Question 4
A patient is prescribed warfarin (Coumadin) for atrial fibrillation.
The international normalized ratio (INR) is 4.5. The patient has no
signs of bleeding. What is the most appropriate management?
A) Administer vitamin K 10 mg orally
B) Hold warfarin for 1–2 days and recheck INR
C) Administer fresh frozen plasma
D) Increase warfarin dose
Answer: B
Rationale: For INR 4.5–5.0 without bleeding, hold warfarin for
1–2 days and recheck. Vitamin K is reserved for INR >10 or with
bleeding. FFP is for life-threatening bleeding.
3
, Question 5
A 45-year-old patient with hypertension is prescribed lisinopril
(Prinivil, Zestril). Which adverse effect requires discontinuation of
the medication?
A) Dry cough
B) Angioedema
C) Hyperkalemia
D) Headache
Answer: B
Rationale: Angioedema (swelling of lips, tongue, airway) is a
life-threatening adverse effect of ACE inhibitors and requires
immediate discontinuation. Dry cough is common but not life-
threatening.
Question 6
A patient with asthma is prescribed albuterol (Proventil, Ventolin)
as a rescue inhaler. Which statement indicates proper
understanding?
A) "I will use this inhaler every day to prevent asthma attacks."
B) "I will rinse my mouth after using this medication."
4
NR508 ADVANCED PHARMACOLOGY FINAL EXAM
REVIEW WITH COMPLETE 450 REAL EXAM QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ (BRAND NEW!!)
Question 1
A 72-year-old patient with heart failure is prescribed digoxin
(Lanoxin). The nurse practitioner knows that which factor places
this patient at highest risk for digoxin toxicity?
A) Age over 70 years
B) Concurrent use of a loop diuretic
C) Estimated glomerular filtration rate (eGFR) of 35 mL/min
D) Use of a beta-blocker
Answer: C
Rationale: Digoxin is primarily renally excreted. An eGFR of 35
mL/min indicates significant renal impairment, which is the
greatest risk factor for digoxin toxicity. Age and diuretics
contribute but are less significant than renal function.
Question 2
1
,A patient with type 2 diabetes is prescribed metformin
(Glucophage). Which laboratory value should be checked before
initiating therapy?
A) Hemoglobin A1c
B) Serum creatinine
C) Liver function tests
D) Fasting blood glucose
Answer: B
Rationale: Metformin is contraindicated in patients with
significant renal impairment (eGFR <30 mL/min) due to risk of
lactic acidosis. Serum creatinine/eGFR must be checked before
initiation.
Question 3
A 28-year-old woman with major depressive disorder is started
on sertraline (Zoloft). She asks about sexual side effects. What is
the most accurate response?
A) "Sexual side effects are rare with sertraline."
B) "Up to 50% of patients experience sexual dysfunction,
including delayed ejaculation and decreased libido."
2
,C) "Sexual side effects only occur with higher doses."
D) "Sertraline has no reported sexual side effects."
Answer: B
Rationale: SSRIs, including sertraline, cause sexual side effects in
up to 50–70% of patients. Common effects include delayed
ejaculation, anorgasmia, and decreased libido.
Question 4
A patient is prescribed warfarin (Coumadin) for atrial fibrillation.
The international normalized ratio (INR) is 4.5. The patient has no
signs of bleeding. What is the most appropriate management?
A) Administer vitamin K 10 mg orally
B) Hold warfarin for 1–2 days and recheck INR
C) Administer fresh frozen plasma
D) Increase warfarin dose
Answer: B
Rationale: For INR 4.5–5.0 without bleeding, hold warfarin for
1–2 days and recheck. Vitamin K is reserved for INR >10 or with
bleeding. FFP is for life-threatening bleeding.
3
, Question 5
A 45-year-old patient with hypertension is prescribed lisinopril
(Prinivil, Zestril). Which adverse effect requires discontinuation of
the medication?
A) Dry cough
B) Angioedema
C) Hyperkalemia
D) Headache
Answer: B
Rationale: Angioedema (swelling of lips, tongue, airway) is a
life-threatening adverse effect of ACE inhibitors and requires
immediate discontinuation. Dry cough is common but not life-
threatening.
Question 6
A patient with asthma is prescribed albuterol (Proventil, Ventolin)
as a rescue inhaler. Which statement indicates proper
understanding?
A) "I will use this inhaler every day to prevent asthma attacks."
B) "I will rinse my mouth after using this medication."
4
