NUR 6011/NUR6011 Final Exam V2 |
Advance Pharmacology Q&A with
Rationale | William Paterson University
1. A patient is prescribed an ACE inhibitor for hypertension. Which mechanism explains the
development of a persistent dry cough?
A. Inhibition of prostaglandins in the lung tissue
B. Increased production of angiotensin II in the alveoli
C. Direct irritation of the bronchial mucosa by the drug
D. Accumulation of bradykinin in the respiratory tract
Correct Answer: D
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, which is a
potent vasodilator and inflammatory mediator. When bradykinin accumulates in the
respiratory tract, it can trigger a persistent and dry cough in susceptible patients. This side
effect is a common reason for switching a patient to an Angiotensin II Receptor Blocker
(ARB).
2. A patient on long-term warfarin therapy has an INR of 7.5 but no active bleeding. What is
the most appropriate initial intervention?
A. Hold the warfarin dose and administer oral Vitamin K
B. Administer Protamine Sulfate immediately
,C. Administer Vitamin K via rapid intravenous push
D. Perform an immediate blood transfusion
Correct Answer: A
Expert Explanation: For an INR significantly above the therapeutic range without
bleeding, holding the dose and giving oral Vitamin K is generally recommended. Oral
administration is safer than intravenous administration, which carries a risk of
anaphylaxis. This approach allows the INR to gradually return to the therapeutic range
within 24 to 48 hours.
3. Which assessment finding is most indicative of digoxin toxicity in a patient with heart
failure?
A. Hyperkalemia and increased urinary output
B. Anorexia, nausea, and visual disturbances
C. Hypertension and tachycardia
D. Peripheral edema and weight gain
Correct Answer: B
Expert Explanation: Digoxin toxicity often manifests early with gastrointestinal symptoms
like anorexia and nausea. Patients may also report visual changes such as seeing yellow-
green halos around lights. These clinical signs are critical indicators that the serum digoxin
levels may be above the therapeutic range.
, 4. What is the primary mechanism of action for Metformin in managing Type 2 Diabetes?
A. Decreasing hepatic glucose production and improving insulin sensitivity
B. Stimulating the beta cells of the pancreas to release insulin
C. Inhibiting the enzyme alpha-glucosidase in the small intestine
D. Increasing the renal excretion of glucose through urine
Correct Answer: A
Expert Explanation: Metformin primarily works by decreasing the amount of glucose
produced by the liver. It also improves the sensitivity of peripheral tissues to insulin,
allowing for better glucose uptake. Unlike sulfonylureas, it does not stimulate insulin
secretion and therefore has a lower risk of causing hypoglycemia.
5. When prescribing a statin for dyslipidemia, which lab value must be monitored due to the
risk of hepatotoxicity?
A. Serum creatinine and BUN
B. Alanine aminotransferase (ALT)
C. Complete blood count (CBC)
D. Amylase and lipase
Correct Answer: B
Expert Explanation: Statins can occasionally cause elevations in liver enzymes, indicating
potential hepatic injury. Monitoring ALT at the start of therapy and when clinically
Advance Pharmacology Q&A with
Rationale | William Paterson University
1. A patient is prescribed an ACE inhibitor for hypertension. Which mechanism explains the
development of a persistent dry cough?
A. Inhibition of prostaglandins in the lung tissue
B. Increased production of angiotensin II in the alveoli
C. Direct irritation of the bronchial mucosa by the drug
D. Accumulation of bradykinin in the respiratory tract
Correct Answer: D
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, which is a
potent vasodilator and inflammatory mediator. When bradykinin accumulates in the
respiratory tract, it can trigger a persistent and dry cough in susceptible patients. This side
effect is a common reason for switching a patient to an Angiotensin II Receptor Blocker
(ARB).
2. A patient on long-term warfarin therapy has an INR of 7.5 but no active bleeding. What is
the most appropriate initial intervention?
A. Hold the warfarin dose and administer oral Vitamin K
B. Administer Protamine Sulfate immediately
,C. Administer Vitamin K via rapid intravenous push
D. Perform an immediate blood transfusion
Correct Answer: A
Expert Explanation: For an INR significantly above the therapeutic range without
bleeding, holding the dose and giving oral Vitamin K is generally recommended. Oral
administration is safer than intravenous administration, which carries a risk of
anaphylaxis. This approach allows the INR to gradually return to the therapeutic range
within 24 to 48 hours.
3. Which assessment finding is most indicative of digoxin toxicity in a patient with heart
failure?
A. Hyperkalemia and increased urinary output
B. Anorexia, nausea, and visual disturbances
C. Hypertension and tachycardia
D. Peripheral edema and weight gain
Correct Answer: B
Expert Explanation: Digoxin toxicity often manifests early with gastrointestinal symptoms
like anorexia and nausea. Patients may also report visual changes such as seeing yellow-
green halos around lights. These clinical signs are critical indicators that the serum digoxin
levels may be above the therapeutic range.
, 4. What is the primary mechanism of action for Metformin in managing Type 2 Diabetes?
A. Decreasing hepatic glucose production and improving insulin sensitivity
B. Stimulating the beta cells of the pancreas to release insulin
C. Inhibiting the enzyme alpha-glucosidase in the small intestine
D. Increasing the renal excretion of glucose through urine
Correct Answer: A
Expert Explanation: Metformin primarily works by decreasing the amount of glucose
produced by the liver. It also improves the sensitivity of peripheral tissues to insulin,
allowing for better glucose uptake. Unlike sulfonylureas, it does not stimulate insulin
secretion and therefore has a lower risk of causing hypoglycemia.
5. When prescribing a statin for dyslipidemia, which lab value must be monitored due to the
risk of hepatotoxicity?
A. Serum creatinine and BUN
B. Alanine aminotransferase (ALT)
C. Complete blood count (CBC)
D. Amylase and lipase
Correct Answer: B
Expert Explanation: Statins can occasionally cause elevations in liver enzymes, indicating
potential hepatic injury. Monitoring ALT at the start of therapy and when clinically
