NUR 6011/NUR6011 Exam 2 V1 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient taking Lisinopril develops a persistent, dry, nonproductive cough. What is the
primary physiological reason for this side effect?
A. Accumulation of bradykinin in the lungs.
B. Increased production of angiotensin II.
C. Direct irritation of the tracheal lining by the drug.
D. Rapid decrease in systemic blood pressure.
Correct Answer: A
Expert Explanation: ACE inhibitors block the enzyme that breaks down bradykinin,
leading to its accumulation in the respiratory tract. This accumulation triggers the cough
reflex in approximately 10 to 20 percent of patients. If the cough becomes intolerable, the
provider should consider switching the patient to an Angiotensin II Receptor Blocker
(ARB).
2. A patient with a history of asthma requires a beta-blocker for hypertension. Which of the
following drugs is the safest choice for this patient?
A. Metoprolol
B. Propranolol
,C. Nadolol
D. Timolol
Correct Answer: A
Expert Explanation: Metoprolol is a cardioselective beta-1 blocker that has a higher
affinity for receptors in the heart than in the lungs. Non-selective beta-blockers like
Propranolol can block beta-2 receptors in the bronchioles, potentially triggering
bronchospasm. Despite its selectivity, metoprolol should still be used with caution and
monitored closely in asthmatic patients.
3. Which laboratory value must be monitored most closely for a patient receiving Digoxin
therapy to prevent toxicity?
A. Sodium level
B. Calcium level
C. Potassium level
D. Magnesium level
Correct Answer: C
Expert Explanation: Hypokalemia increases the risk of digoxin toxicity because potassium
and digoxin compete for binding sites on the Na+/K+ ATPase pump. When potassium levels
are low, more digoxin binds to the pump, leading to enhanced effects and potential toxicity.
Nurses must educate patients on maintaining adequate dietary intake of potassium while
on this medication.
, 4. A patient is prescribed Atorvastatin (Lipitor). Which of the following symptoms should the
nurse instruct the patient to report immediately?
A. Mild headache
B. Transient nausea
C. Unexplained muscle pain or weakness
D. Intermittent constipation
Correct Answer: C
Expert Explanation: Muscle pain or weakness can be a sign of rhabdomyolysis, a rare but
serious side effect of statin therapy. This condition involves the breakdown of muscle
tissue, which can lead to acute renal failure. Patients should have their creatine kinase (CK)
levels checked if these symptoms occur.
5. What is the primary mechanism of action for Warfarin (Coumadin)?
A. It activates antithrombin III to neutralize factor Xa.
B. It directly inhibits thrombin in the blood.
C. It prevents platelet aggregation by blocking COX-1.
D. It inhibits the synthesis of vitamin K-dependent clotting factors.
Correct Answer: D
Expert Explanation: Warfarin acts by inhibiting the enzyme vitamin K epoxide reductase,
which is necessary for recycling vitamin K. Without active vitamin K, the liver cannot
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient taking Lisinopril develops a persistent, dry, nonproductive cough. What is the
primary physiological reason for this side effect?
A. Accumulation of bradykinin in the lungs.
B. Increased production of angiotensin II.
C. Direct irritation of the tracheal lining by the drug.
D. Rapid decrease in systemic blood pressure.
Correct Answer: A
Expert Explanation: ACE inhibitors block the enzyme that breaks down bradykinin,
leading to its accumulation in the respiratory tract. This accumulation triggers the cough
reflex in approximately 10 to 20 percent of patients. If the cough becomes intolerable, the
provider should consider switching the patient to an Angiotensin II Receptor Blocker
(ARB).
2. A patient with a history of asthma requires a beta-blocker for hypertension. Which of the
following drugs is the safest choice for this patient?
A. Metoprolol
B. Propranolol
,C. Nadolol
D. Timolol
Correct Answer: A
Expert Explanation: Metoprolol is a cardioselective beta-1 blocker that has a higher
affinity for receptors in the heart than in the lungs. Non-selective beta-blockers like
Propranolol can block beta-2 receptors in the bronchioles, potentially triggering
bronchospasm. Despite its selectivity, metoprolol should still be used with caution and
monitored closely in asthmatic patients.
3. Which laboratory value must be monitored most closely for a patient receiving Digoxin
therapy to prevent toxicity?
A. Sodium level
B. Calcium level
C. Potassium level
D. Magnesium level
Correct Answer: C
Expert Explanation: Hypokalemia increases the risk of digoxin toxicity because potassium
and digoxin compete for binding sites on the Na+/K+ ATPase pump. When potassium levels
are low, more digoxin binds to the pump, leading to enhanced effects and potential toxicity.
Nurses must educate patients on maintaining adequate dietary intake of potassium while
on this medication.
, 4. A patient is prescribed Atorvastatin (Lipitor). Which of the following symptoms should the
nurse instruct the patient to report immediately?
A. Mild headache
B. Transient nausea
C. Unexplained muscle pain or weakness
D. Intermittent constipation
Correct Answer: C
Expert Explanation: Muscle pain or weakness can be a sign of rhabdomyolysis, a rare but
serious side effect of statin therapy. This condition involves the breakdown of muscle
tissue, which can lead to acute renal failure. Patients should have their creatine kinase (CK)
levels checked if these symptoms occur.
5. What is the primary mechanism of action for Warfarin (Coumadin)?
A. It activates antithrombin III to neutralize factor Xa.
B. It directly inhibits thrombin in the blood.
C. It prevents platelet aggregation by blocking COX-1.
D. It inhibits the synthesis of vitamin K-dependent clotting factors.
Correct Answer: D
Expert Explanation: Warfarin acts by inhibiting the enzyme vitamin K epoxide reductase,
which is necessary for recycling vitamin K. Without active vitamin K, the liver cannot
