NUR 6011/NUR6011 Exam 3 V3 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient with heart failure is prescribed Lisinopril. Which mechanism of action is primarily
responsible for the therapeutic effect of this medication?
A. Antagonism of aldosterone receptors in the kidneys
B. Direct blockade of Angiotensin II receptors
C. Inhibition of the conversion of Angiotensin I to Angiotensin II
D. Inhibition of the sodium-potassium ATPase pump
Correct Answer: C
Expert Explanation: Lisinopril is an ACE inhibitor that prevents the conversion of
Angiotensin I to Angiotensin II, which is a potent vasoconstrictor. By reducing Angiotensin
II levels, the drug promotes vasodilation and reduces afterload on the heart. It also
decreases aldosterone secretion, leading to reduced sodium and water retention.
2. A patient taking Digoxin for atrial fibrillation reports seeing yellow-green halos around
lights. What should the nurse practitioner suspect first?
A. Digoxin toxicity due to narrow therapeutic index
B. A worsening of the patient’s underlying cardiac rhythm
C. A normal side effect of long-term therapy
,D. Development of cataracts or acute glaucoma
Correct Answer: A
Expert Explanation: Visual disturbances such as yellow-green halos are a classic sign of
digoxin toxicity. Because digoxin has a very narrow therapeutic window, even small
changes in serum levels or electrolytes can lead to toxicity. The provider must immediately
check the patient’s digoxin and potassium levels.
3. Which laboratory value is most critical to monitor in a patient newly started on Metformin
for Type 2 Diabetes?
A. Serum amylase and lipase
B. Thyroid Stimulating Hormone (TSH)
C. Glomerular Filtration Rate (eGFR)
D. Complete Blood Count (CBC)
Correct Answer: C
Expert Explanation: Metformin is primarily excreted by the kidneys and can accumulate
in patients with renal impairment, increasing the risk of lactic acidosis. Current guidelines
state that Metformin is contraindicated in patients with an eGFR below 30 mL/min.
Monitoring renal function is essential for safe long-term administration of this drug.
4. A patient is being bridge-started on Warfarin and Heparin for a deep vein thrombosis. Why
are both drugs given simultaneously?
A. To increase the potency of the Warfarin via synergism
, B. To prevent the risk of Heparin-induced thrombocytopenia
C. To reduce the risk of bleeding from high-dose Heparin
D. To provide anticoagulation until Warfarin reaches therapeutic levels
Correct Answer: D
Expert Explanation: Warfarin has a slow onset of action because it takes several days to
deplete existing clotting factors in the blood. Heparin provides immediate anticoagulation
during the ‘bridge’ period while the INR reaches the target range. This approach prevents
new clot formation while the long-term oral medication becomes effective.
5. A patient is prescribed Levothyroxine for hypothyroidism. What instruction is most
important for the nurse practitioner to include in the teaching?
A. Take the medication with a large glass of milk to improve absorption
B. Take the medication on an empty stomach 30-60 minutes before breakfast
C. If a dose is missed, double the dose the following morning
D. Take the medication at bedtime with a snack to avoid GI upset
Correct Answer: B
Expert Explanation: Levothyroxine absorption is significantly reduced when taken with
food, certain minerals, or other medications. To ensure consistent blood levels, patients are
advised to take it in the morning on an empty stomach. This practice helps maintain a
steady-state TSH level within the therapeutic range.
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient with heart failure is prescribed Lisinopril. Which mechanism of action is primarily
responsible for the therapeutic effect of this medication?
A. Antagonism of aldosterone receptors in the kidneys
B. Direct blockade of Angiotensin II receptors
C. Inhibition of the conversion of Angiotensin I to Angiotensin II
D. Inhibition of the sodium-potassium ATPase pump
Correct Answer: C
Expert Explanation: Lisinopril is an ACE inhibitor that prevents the conversion of
Angiotensin I to Angiotensin II, which is a potent vasoconstrictor. By reducing Angiotensin
II levels, the drug promotes vasodilation and reduces afterload on the heart. It also
decreases aldosterone secretion, leading to reduced sodium and water retention.
2. A patient taking Digoxin for atrial fibrillation reports seeing yellow-green halos around
lights. What should the nurse practitioner suspect first?
A. Digoxin toxicity due to narrow therapeutic index
B. A worsening of the patient’s underlying cardiac rhythm
C. A normal side effect of long-term therapy
,D. Development of cataracts or acute glaucoma
Correct Answer: A
Expert Explanation: Visual disturbances such as yellow-green halos are a classic sign of
digoxin toxicity. Because digoxin has a very narrow therapeutic window, even small
changes in serum levels or electrolytes can lead to toxicity. The provider must immediately
check the patient’s digoxin and potassium levels.
3. Which laboratory value is most critical to monitor in a patient newly started on Metformin
for Type 2 Diabetes?
A. Serum amylase and lipase
B. Thyroid Stimulating Hormone (TSH)
C. Glomerular Filtration Rate (eGFR)
D. Complete Blood Count (CBC)
Correct Answer: C
Expert Explanation: Metformin is primarily excreted by the kidneys and can accumulate
in patients with renal impairment, increasing the risk of lactic acidosis. Current guidelines
state that Metformin is contraindicated in patients with an eGFR below 30 mL/min.
Monitoring renal function is essential for safe long-term administration of this drug.
4. A patient is being bridge-started on Warfarin and Heparin for a deep vein thrombosis. Why
are both drugs given simultaneously?
A. To increase the potency of the Warfarin via synergism
, B. To prevent the risk of Heparin-induced thrombocytopenia
C. To reduce the risk of bleeding from high-dose Heparin
D. To provide anticoagulation until Warfarin reaches therapeutic levels
Correct Answer: D
Expert Explanation: Warfarin has a slow onset of action because it takes several days to
deplete existing clotting factors in the blood. Heparin provides immediate anticoagulation
during the ‘bridge’ period while the INR reaches the target range. This approach prevents
new clot formation while the long-term oral medication becomes effective.
5. A patient is prescribed Levothyroxine for hypothyroidism. What instruction is most
important for the nurse practitioner to include in the teaching?
A. Take the medication with a large glass of milk to improve absorption
B. Take the medication on an empty stomach 30-60 minutes before breakfast
C. If a dose is missed, double the dose the following morning
D. Take the medication at bedtime with a snack to avoid GI upset
Correct Answer: B
Expert Explanation: Levothyroxine absorption is significantly reduced when taken with
food, certain minerals, or other medications. To ensure consistent blood levels, patients are
advised to take it in the morning on an empty stomach. This practice helps maintain a
steady-state TSH level within the therapeutic range.
