---APEAPharmacology Final Exam (Latest
2026) with questions and answers
graded A+/2026 update/100% correct.
**1. A 72-year-old male with heart failure (HFrEF) is started on
sacubitril/valsartan. Which laboratory value must be monitored closely
within 2 weeks of initiation?**
A) Serum potassium and creatinine
B) Liver function tests
C) Hemoglobin A1c
D) BNP
**✅ Answer: A** – *Sacubitril/valsartan can cause hyperkalemia and
angioedema; renal function and potassium must be checked before, 2
weeks after, and monthly thereafter.*
**2. A patient on warfarin has an INR of 4.5 without bleeding. What is
the most appropriate management?**
A) Hold warfarin and give vitamin K 10 mg IV
B) Hold warfarin and restart at lower dose next day
, C) Hold warfarin, recheck INR in 24 hours
D) Give fresh frozen plasma immediately
**✅ Answer: C** – *INR 4.5 without bleeding → hold warfarin,
recheck INR in 1–2 days. Vitamin K is not needed unless INR >10 or high
bleeding risk.*
**3. Which antidepressant is most associated with hyponatremia in
elderly patients?**
A) Bupropion
B) Mirtazapine
C) Sertraline
D) Trazodone
**✅ Answer: C** – *SSRIs, especially sertraline, are linked to SIADH
and hyponatremia, particularly in older adults within the first 2–4
weeks.*
**4. A patient on metformin for type 2 diabetes needs IV contrast for a
CT scan. What should you do?**
A) Stop metformin 24 hours before and restart 48 hours after
B) Continue metformin as usual
C) Stop metformin at time of contrast and restart next day
D) Double metformin dose before contrast
2026) with questions and answers
graded A+/2026 update/100% correct.
**1. A 72-year-old male with heart failure (HFrEF) is started on
sacubitril/valsartan. Which laboratory value must be monitored closely
within 2 weeks of initiation?**
A) Serum potassium and creatinine
B) Liver function tests
C) Hemoglobin A1c
D) BNP
**✅ Answer: A** – *Sacubitril/valsartan can cause hyperkalemia and
angioedema; renal function and potassium must be checked before, 2
weeks after, and monthly thereafter.*
**2. A patient on warfarin has an INR of 4.5 without bleeding. What is
the most appropriate management?**
A) Hold warfarin and give vitamin K 10 mg IV
B) Hold warfarin and restart at lower dose next day
, C) Hold warfarin, recheck INR in 24 hours
D) Give fresh frozen plasma immediately
**✅ Answer: C** – *INR 4.5 without bleeding → hold warfarin,
recheck INR in 1–2 days. Vitamin K is not needed unless INR >10 or high
bleeding risk.*
**3. Which antidepressant is most associated with hyponatremia in
elderly patients?**
A) Bupropion
B) Mirtazapine
C) Sertraline
D) Trazodone
**✅ Answer: C** – *SSRIs, especially sertraline, are linked to SIADH
and hyponatremia, particularly in older adults within the first 2–4
weeks.*
**4. A patient on metformin for type 2 diabetes needs IV contrast for a
CT scan. What should you do?**
A) Stop metformin 24 hours before and restart 48 hours after
B) Continue metformin as usual
C) Stop metformin at time of contrast and restart next day
D) Double metformin dose before contrast
