NUR 6011/NUR6011 Exam 3 V2 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient taking Lisinopril for hypertension develops a dry, persistent cough. What is the
physiological mechanism responsible for this side effect?
A. Inhibition of aldosterone secretion
B. Direct irritation of the bronchial mucosa
C. Accumulation of bradykinin in the respiratory tract
D. Inhibition of prostaglandin synthesis
Correct Answer: C
Expert Explanation: ACE inhibitors block the enzyme that breaks down bradykinin,
leading to its accumulation in the lungs. This buildup sensitizes sensory neurons and
triggers the characteristic dry cough seen in many patients. If this side effect becomes
intolerable, the healthcare provider usually switches the patient to an Angiotensin II
Receptor Blocker (ARB).
2. Before initiating therapy with Atorvastatin, which laboratory test is most essential to
obtain as a baseline?
A. Serum creatinine and BUN
B. Complete blood count
,C. Liver function tests (ALT/AST)
D. Thyroid stimulating hormone
Correct Answer: C
Expert Explanation: Statins are metabolized in the liver and can occasionally cause
hepatotoxicity or elevated liver enzymes. It is standard practice to establish a baseline of
liver function before starting therapy to monitor for changes. Patients should also be
educated to report any signs of jaundice or unexplained abdominal pain immediately.
3. A patient with a history of asthma is diagnosed with hypertension. Which of the following
beta-blockers should be avoided to prevent bronchospasm?
A. Propranolol
B. Atenolol
C. Metoprolol
D. Bisoprolol
Correct Answer: A
Expert Explanation: Propranolol is a non-selective beta-blocker that antagonizes both
Beta-1 and Beta-2 receptors. Blocking Beta-2 receptors in the lungs can lead to significant
bronchoconstriction, which is dangerous for patients with asthma or COPD. Selective Beta-
1 blockers like Metoprolol are generally preferred in these populations if a beta-blocker is
necessary.
, 4. What is the therapeutic target International Normalized Ratio (INR) for a patient taking
Warfarin for atrial fibrillation?
A. 1.0 to 2.0
B. 3.5 to 4.5
C. 2.0 to 3.0
D. 0.5 to 1.5
Correct Answer: C
Expert Explanation: For standard anticoagulation in atrial fibrillation, a target INR of 2.0
to 3.0 is recommended to balance stroke prevention and bleeding risk. Values below this
range increase the risk of thromboembolism, while values above it significantly increase
the risk of hemorrhage. Frequent monitoring is required due to the narrow therapeutic
index and numerous drug-food interactions.
5. Metformin is contraindicated in patients with significant renal impairment primarily
because of the risk of which condition?
A. Lactic acidosis
B. Rhabdomyolysis
C. Hypoglycemia
D. Nephrotic syndrome
Correct Answer: A
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient taking Lisinopril for hypertension develops a dry, persistent cough. What is the
physiological mechanism responsible for this side effect?
A. Inhibition of aldosterone secretion
B. Direct irritation of the bronchial mucosa
C. Accumulation of bradykinin in the respiratory tract
D. Inhibition of prostaglandin synthesis
Correct Answer: C
Expert Explanation: ACE inhibitors block the enzyme that breaks down bradykinin,
leading to its accumulation in the lungs. This buildup sensitizes sensory neurons and
triggers the characteristic dry cough seen in many patients. If this side effect becomes
intolerable, the healthcare provider usually switches the patient to an Angiotensin II
Receptor Blocker (ARB).
2. Before initiating therapy with Atorvastatin, which laboratory test is most essential to
obtain as a baseline?
A. Serum creatinine and BUN
B. Complete blood count
,C. Liver function tests (ALT/AST)
D. Thyroid stimulating hormone
Correct Answer: C
Expert Explanation: Statins are metabolized in the liver and can occasionally cause
hepatotoxicity or elevated liver enzymes. It is standard practice to establish a baseline of
liver function before starting therapy to monitor for changes. Patients should also be
educated to report any signs of jaundice or unexplained abdominal pain immediately.
3. A patient with a history of asthma is diagnosed with hypertension. Which of the following
beta-blockers should be avoided to prevent bronchospasm?
A. Propranolol
B. Atenolol
C. Metoprolol
D. Bisoprolol
Correct Answer: A
Expert Explanation: Propranolol is a non-selective beta-blocker that antagonizes both
Beta-1 and Beta-2 receptors. Blocking Beta-2 receptors in the lungs can lead to significant
bronchoconstriction, which is dangerous for patients with asthma or COPD. Selective Beta-
1 blockers like Metoprolol are generally preferred in these populations if a beta-blocker is
necessary.
, 4. What is the therapeutic target International Normalized Ratio (INR) for a patient taking
Warfarin for atrial fibrillation?
A. 1.0 to 2.0
B. 3.5 to 4.5
C. 2.0 to 3.0
D. 0.5 to 1.5
Correct Answer: C
Expert Explanation: For standard anticoagulation in atrial fibrillation, a target INR of 2.0
to 3.0 is recommended to balance stroke prevention and bleeding risk. Values below this
range increase the risk of thromboembolism, while values above it significantly increase
the risk of hemorrhage. Frequent monitoring is required due to the narrow therapeutic
index and numerous drug-food interactions.
5. Metformin is contraindicated in patients with significant renal impairment primarily
because of the risk of which condition?
A. Lactic acidosis
B. Rhabdomyolysis
C. Hypoglycemia
D. Nephrotic syndrome
Correct Answer: A
