NUR 6011/NUR6011 Exam 4 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
most likely cause of this side effect?
A. Inhibition of prostaglandins.
B. Increased production of Angiotensin II.
C. Direct irritation of the bronchial mucosa.
D. Accumulation of bradykinin in the lungs.
Correct Answer: D
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, which leads to
its accumulation in the respiratory tract. This accumulation triggers the dry cough seen in
many patients. Switching the patient to an Angiotensin Receptor Blocker (ARB) usually
resolves this issue.
2. When monitoring a patient on Warfarin therapy, which laboratory value is used to adjust
the dose?
A. Partial Thromboplastin Time (PTT)
B. Bleeding time
C. Platelet count
,D. International Normalized Ratio (INR)
Correct Answer: D
Expert Explanation: The INR is the standard measurement used to monitor the
effectiveness of Warfarin. A therapeutic range is typically between 2.0 and 3.0 for most
indications. PTT is instead used for monitoring unfractionated heparin therapy.
3. Which underlying condition is a primary contraindication for the use of Metformin?
A. Hypertension
B. Severe renal impairment
C. Type 2 Diabetes
D. Hypothyroidism
Correct Answer: B
Expert Explanation: Metformin is primarily excreted by the kidneys and can accumulate
in patients with renal failure. This accumulation significantly increases the risk of
developing potentially fatal lactic acidosis. Providers must monitor glomerular filtration
rates regularly in patients taking this medication.
4. A patient on Atorvastatin reports unexplained muscle pain and weakness. What is the
most appropriate initial action?
A. Advise the patient to increase fluid intake.
B. Check the serum creatine kinase (CK) level.
, C. Instruct the patient to take the medication with food.
D. Switch the patient to a different statin immediately.
Correct Answer: B
Expert Explanation: Muscle pain or myopathy is a known adverse effect of statin therapy
that can progress to rhabdomyolysis. Obtaining a CK level helps determine the severity of
muscle injury. The medication should be held if levels are significantly elevated or
symptoms are severe.
5. What is the classic visual disturbance associated with Digoxin toxicity?
A. Total blindness
B. Double vision
C. Yellow-green halos around lights
D. Loss of peripheral vision
Correct Answer: C
Expert Explanation: Digoxin toxicity can manifest as gastrointestinal distress, cardiac
arrhythmias, and neurological changes. Patients often report seeing yellow, green, or white
halos around objects. Prompt measurement of serum digoxin levels is required when these
symptoms appear.
6. Which diuretic is known for causing hyperkalemia rather than hypokalemia?
A. Furosemide
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient taking Lisinopril for hypertension develops a dry, persistent cough. What is the
most likely cause of this side effect?
A. Inhibition of prostaglandins.
B. Increased production of Angiotensin II.
C. Direct irritation of the bronchial mucosa.
D. Accumulation of bradykinin in the lungs.
Correct Answer: D
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, which leads to
its accumulation in the respiratory tract. This accumulation triggers the dry cough seen in
many patients. Switching the patient to an Angiotensin Receptor Blocker (ARB) usually
resolves this issue.
2. When monitoring a patient on Warfarin therapy, which laboratory value is used to adjust
the dose?
A. Partial Thromboplastin Time (PTT)
B. Bleeding time
C. Platelet count
,D. International Normalized Ratio (INR)
Correct Answer: D
Expert Explanation: The INR is the standard measurement used to monitor the
effectiveness of Warfarin. A therapeutic range is typically between 2.0 and 3.0 for most
indications. PTT is instead used for monitoring unfractionated heparin therapy.
3. Which underlying condition is a primary contraindication for the use of Metformin?
A. Hypertension
B. Severe renal impairment
C. Type 2 Diabetes
D. Hypothyroidism
Correct Answer: B
Expert Explanation: Metformin is primarily excreted by the kidneys and can accumulate
in patients with renal failure. This accumulation significantly increases the risk of
developing potentially fatal lactic acidosis. Providers must monitor glomerular filtration
rates regularly in patients taking this medication.
4. A patient on Atorvastatin reports unexplained muscle pain and weakness. What is the
most appropriate initial action?
A. Advise the patient to increase fluid intake.
B. Check the serum creatine kinase (CK) level.
, C. Instruct the patient to take the medication with food.
D. Switch the patient to a different statin immediately.
Correct Answer: B
Expert Explanation: Muscle pain or myopathy is a known adverse effect of statin therapy
that can progress to rhabdomyolysis. Obtaining a CK level helps determine the severity of
muscle injury. The medication should be held if levels are significantly elevated or
symptoms are severe.
5. What is the classic visual disturbance associated with Digoxin toxicity?
A. Total blindness
B. Double vision
C. Yellow-green halos around lights
D. Loss of peripheral vision
Correct Answer: C
Expert Explanation: Digoxin toxicity can manifest as gastrointestinal distress, cardiac
arrhythmias, and neurological changes. Patients often report seeing yellow, green, or white
halos around objects. Prompt measurement of serum digoxin levels is required when these
symptoms appear.
6. Which diuretic is known for causing hyperkalemia rather than hypokalemia?
A. Furosemide
