NUR 6011 Exam 1, 2, & Midterm Guide
Questions and Answers 2026/27 Update
(Package)William Paterson University
NUR 6011 EXAM 1 – Advanced Pharmacology (Cardiovascular, Renal &
Related Topics)
Questions 1–50
1. KL is a 57-year-old male seen in the ED for suspected food poisoning with
nausea/vomiting for 2 days. Labs: K 5.6 mEq/L, SrCr 1.9, BUN 23. ECG shows
second-degree AV block. Digoxin level is 4.1 ng/mL taken ~3 hours post-dose.
Based on this, which is most accurate?
A) The digoxin level was taken too soon; wait at least 6–8 hours
B) With elevated SrCr, GI complaints are likely from uremia
C) It appears this patient is experiencing signs and symptoms of digoxin toxicity
D) The patient should immediately receive lipid rescue
Correct ,,answer,,,: C
Rationale: Bradyarrhythmia (AV block), hyperkalemia, GI symptoms, and a
markedly elevated digoxin level are classic for digoxin toxicity. The clinical
picture is consistent with toxicity and warrants treatment .
2. LP is a 56-year-old type 1 diabetic with HTN new to your practice. He stopped
taking enalapril 8 years ago due to a cough. He has been taking carvedilol for his
BP, which is not very well controlled. Which is correct?
,A) Losartan may be an alternative; carvedilol can be abruptly stopped and losartan
started
B) Enalapril should not be used in diabetics; losartan is safer with less risk of
cough in diabetics
C) Valsartan may be an alternative, so it can be started while the carvedilol is
slowly weaned off
D) Neither losartan nor valsartan is an option since the patient had cough with
enalapril
Correct ,,answer,,,: C
Rationale: ACE-inhibitor–induced cough does not preclude ARB use, so valsartan
(or another ARB) is reasonable. Beta-blockers should not be stopped abruptly in
hypertensive patients .
3. BB is a 48-year-old female with hyperlipidemia started on atorvastatin 80 mg
daily. According to ACC/AHA guidelines, this represents:
A) Low-intensity statin therapy
B) Moderate-intensity statin therapy
C) High-intensity statin therapy
D) An inappropriately high starting dose
Correct ,,answer,,,: C
Rationale: Atorvastatin 40–80 mg daily is classified as high-intensity statin
therapy according to ACC/AHA guidelines .
4. DS has been receiving digoxin, furosemide, and lisinopril for several months to
treat CHF. At 3 months it was noted his SrCr went from 1.2 mg/dL to 2.2 mg/dL.
What could explain this?
A) Digoxin led to pre-renal azotemia
B) Lisinopril caused an acute decompensation in renal function because the patient
had bilateral renal artery stenosis
C) A medication error occurred and the patient was actually given irbesartan
,D) Lisinopril resulted in a high potassium level which then resulted in a decline in
renal function
Correct ,,answer,,,: B
Rationale: ACE inhibitors can precipitate an acute rise in creatinine in patients
with bilateral renal artery stenosis because they reduce efferent arteriolar tone and
intraglomerular pressure .
5. Beta blockers are the drugs of choice for effort-induced angina because they
primarily:
A) Improve myocardial oxygen supply by causing coronary artery vasodilation
B) Decrease myocardial oxygen demand by decreasing heart rate and force of
contractility
C) Decrease oxygen demand by causing peripheral vasodilation
D) Are best for vasospastic angina and not effort-induced angina
Correct ,,answer,,,: B
Rationale: In stable (effort-induced) angina, ischemia is demand-driven. Beta-
blockers lower heart rate and contractility, reducing myocardial oxygen demand
and frequency of angina episodes .
6. Over-the-counter "natural male enhancers" (herbal Viagra) have been evaluated
by the FDA. Which is correct?
A) They are safe because companies state they are natural herbal products
B) They must be approved by the FDA to be sold in the U.S.
C) Safety can be determined from labeled ingredients, which must list all active
agents
D) These products should not be used because some contain undeclared PDE5-
inhibitor drugs
Correct ,,answer,,,: D
Rationale: FDA testing has repeatedly found "herbal Viagra" products adulterated
with sildenafil or analogs not listed on the label, creating serious interaction risks .
, 7. Mr. KL has been started on a beta blocker for CHF. Which statement is true?
A) Atenolol is the only beta blocker that should be used in CHF
B) Despite being used to treat CHF, beta blockers can worsen CHF in some
individuals
C) Beta blockers are contraindicated in CHF
D) Beta blockers interact with ACE inhibitors and should not be used together
Correct ,,answer,,,: B
Rationale: Guideline-directed beta-blockers (carvedilol, bisoprolol, metoprolol
succinate) improve outcomes in HFrEF, but they can acutely worsen symptoms if
started too aggressively .
8. JR is a 45-year-old with new-onset HTN. Based on recent guidelines, which is
correct?
A) Target BP is <150/90 mmHg for all adults
B) First-line therapy includes ACE inhibitors, ARBs, CCBs, or thiazide diuretics
C) Beta-blockers are first-line for all hypertensive patients
D) Patients should start with two medications regardless of BP level
Correct ,,answer,,,: B
Rationale: ACC/AHA guidelines recommend first-line therapy with ACE
inhibitors, ARBs, CCBs, or thiazide diuretics .
9. A patient with heart failure is started on spironolactone. Which statement about
this medication is accurate?
A) Spironolactone is a loop diuretic used for acute pulmonary edema
B) Spironolactone may decrease CHF progression and has less risk of
gynecomastia than eplerenone
C) Eplerenone may decrease CHF progression and has less risk of gynecomastia
than spironolactone
D) Both drugs have the same gynecomastia risk
Questions and Answers 2026/27 Update
(Package)William Paterson University
NUR 6011 EXAM 1 – Advanced Pharmacology (Cardiovascular, Renal &
Related Topics)
Questions 1–50
1. KL is a 57-year-old male seen in the ED for suspected food poisoning with
nausea/vomiting for 2 days. Labs: K 5.6 mEq/L, SrCr 1.9, BUN 23. ECG shows
second-degree AV block. Digoxin level is 4.1 ng/mL taken ~3 hours post-dose.
Based on this, which is most accurate?
A) The digoxin level was taken too soon; wait at least 6–8 hours
B) With elevated SrCr, GI complaints are likely from uremia
C) It appears this patient is experiencing signs and symptoms of digoxin toxicity
D) The patient should immediately receive lipid rescue
Correct ,,answer,,,: C
Rationale: Bradyarrhythmia (AV block), hyperkalemia, GI symptoms, and a
markedly elevated digoxin level are classic for digoxin toxicity. The clinical
picture is consistent with toxicity and warrants treatment .
2. LP is a 56-year-old type 1 diabetic with HTN new to your practice. He stopped
taking enalapril 8 years ago due to a cough. He has been taking carvedilol for his
BP, which is not very well controlled. Which is correct?
,A) Losartan may be an alternative; carvedilol can be abruptly stopped and losartan
started
B) Enalapril should not be used in diabetics; losartan is safer with less risk of
cough in diabetics
C) Valsartan may be an alternative, so it can be started while the carvedilol is
slowly weaned off
D) Neither losartan nor valsartan is an option since the patient had cough with
enalapril
Correct ,,answer,,,: C
Rationale: ACE-inhibitor–induced cough does not preclude ARB use, so valsartan
(or another ARB) is reasonable. Beta-blockers should not be stopped abruptly in
hypertensive patients .
3. BB is a 48-year-old female with hyperlipidemia started on atorvastatin 80 mg
daily. According to ACC/AHA guidelines, this represents:
A) Low-intensity statin therapy
B) Moderate-intensity statin therapy
C) High-intensity statin therapy
D) An inappropriately high starting dose
Correct ,,answer,,,: C
Rationale: Atorvastatin 40–80 mg daily is classified as high-intensity statin
therapy according to ACC/AHA guidelines .
4. DS has been receiving digoxin, furosemide, and lisinopril for several months to
treat CHF. At 3 months it was noted his SrCr went from 1.2 mg/dL to 2.2 mg/dL.
What could explain this?
A) Digoxin led to pre-renal azotemia
B) Lisinopril caused an acute decompensation in renal function because the patient
had bilateral renal artery stenosis
C) A medication error occurred and the patient was actually given irbesartan
,D) Lisinopril resulted in a high potassium level which then resulted in a decline in
renal function
Correct ,,answer,,,: B
Rationale: ACE inhibitors can precipitate an acute rise in creatinine in patients
with bilateral renal artery stenosis because they reduce efferent arteriolar tone and
intraglomerular pressure .
5. Beta blockers are the drugs of choice for effort-induced angina because they
primarily:
A) Improve myocardial oxygen supply by causing coronary artery vasodilation
B) Decrease myocardial oxygen demand by decreasing heart rate and force of
contractility
C) Decrease oxygen demand by causing peripheral vasodilation
D) Are best for vasospastic angina and not effort-induced angina
Correct ,,answer,,,: B
Rationale: In stable (effort-induced) angina, ischemia is demand-driven. Beta-
blockers lower heart rate and contractility, reducing myocardial oxygen demand
and frequency of angina episodes .
6. Over-the-counter "natural male enhancers" (herbal Viagra) have been evaluated
by the FDA. Which is correct?
A) They are safe because companies state they are natural herbal products
B) They must be approved by the FDA to be sold in the U.S.
C) Safety can be determined from labeled ingredients, which must list all active
agents
D) These products should not be used because some contain undeclared PDE5-
inhibitor drugs
Correct ,,answer,,,: D
Rationale: FDA testing has repeatedly found "herbal Viagra" products adulterated
with sildenafil or analogs not listed on the label, creating serious interaction risks .
, 7. Mr. KL has been started on a beta blocker for CHF. Which statement is true?
A) Atenolol is the only beta blocker that should be used in CHF
B) Despite being used to treat CHF, beta blockers can worsen CHF in some
individuals
C) Beta blockers are contraindicated in CHF
D) Beta blockers interact with ACE inhibitors and should not be used together
Correct ,,answer,,,: B
Rationale: Guideline-directed beta-blockers (carvedilol, bisoprolol, metoprolol
succinate) improve outcomes in HFrEF, but they can acutely worsen symptoms if
started too aggressively .
8. JR is a 45-year-old with new-onset HTN. Based on recent guidelines, which is
correct?
A) Target BP is <150/90 mmHg for all adults
B) First-line therapy includes ACE inhibitors, ARBs, CCBs, or thiazide diuretics
C) Beta-blockers are first-line for all hypertensive patients
D) Patients should start with two medications regardless of BP level
Correct ,,answer,,,: B
Rationale: ACC/AHA guidelines recommend first-line therapy with ACE
inhibitors, ARBs, CCBs, or thiazide diuretics .
9. A patient with heart failure is started on spironolactone. Which statement about
this medication is accurate?
A) Spironolactone is a loop diuretic used for acute pulmonary edema
B) Spironolactone may decrease CHF progression and has less risk of
gynecomastia than eplerenone
C) Eplerenone may decrease CHF progression and has less risk of gynecomastia
than spironolactone
D) Both drugs have the same gynecomastia risk
