SOUTH UNIVERSITY NSG 6020 FINAL EXAM NEWEST 2
LATEST VERSIONS (VERSION A AND B) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS,,,
Question 1
A 68-year-old client with multiple comorbidities is prescribed a new
medication. Which pharmacokinetic process is most likely to be altered in
this client due to age-related physiological changes?
A) Absorption rate.
B) Distribution volume.
C) Hepatic metabolism.
D) Renal excretion.
E) Protein binding.
Correct Answer: D) Renal excretion.
Rationale: With aging, there is a physiological decline in renal
function (decreased GFR), which is the most significant
pharmacokinetic change affecting drug elimination in elderly
clients.
Question 2
A nurse practitioner is prescribing a medication that is highly protein-bound
to an elderly client with hypoalbuminemia. Which adjustment should the NP
consider?
A) Increase the dose to achieve therapeutic effect.
B) Administer the medication more frequently.
C) Decrease the dose to reduce the risk of toxicity.
D) Switch to an alternative medication that is also highly protein-bound.
E) Administer the medication with food to increase absorption.
Correct Answer: C) Decrease the dose to reduce the risk of toxicity.
Rationale: In hypoalbuminemia, there are fewer binding sites for
highly protein-bound drugs, leading to a higher concentration of
unbound (active) drug in the circulation, thus increasing the risk of
adverse effects and toxicity.
,Question 3
Which of the following describes the mechanism of action of ACE inhibitors in
managing hypertension?
A) Blocking beta-adrenergic receptors, reducing heart rate and contractility.
B) Directly relaxing vascular smooth muscle, causing vasodilation.
C) Inhibiting the conversion of angiotensin I to angiotensin II, leading to
vasodilation and decreased aldosterone secretion.
D) Increasing the excretion of sodium and water, decreasing blood volume.
E) Blocking calcium channels, causing vasodilation and reduced cardiac
contractility.
Correct Answer: C) Inhibiting the conversion of angiotensin I to
angiotensin II, leading to vasodilation and decreased aldosterone
secretion.
Rationale: ACE inhibitors prevent the formation of the potent
vasoconstrictor angiotensin II and reduce aldosterone-mediated
sodium and water retention, resulting in lowered blood pressure.
Question 4
A client with Type 2 Diabetes Mellitus is prescribed metformin. Which adverse
effect requires the nurse practitioner to monitor renal function closely?
A) Hypoglycemia.
B) Weight gain.
C) Lactic acidosis.
D) Peripheral edema.
E) Headache.
Correct Answer: C) Lactic acidosis.
Rationale: Lactic acidosis is a rare but potentially fatal complication
of metformin, especially in clients with impaired renal function,
which can lead to metformin accumulation. Therefore, renal function
must be monitored.
,Question 5
When prescribing antibiotics, which of the following refers to the lowest
concentration of an antibiotic that inhibits visible bacterial growth?
A) Lethal Dose 50 (LD50).
B) Minimum Bactericidal Concentration (MBC).
C) Minimum Inhibitory Concentration (MIC).
D) Therapeutic Index (TI).
E) Half-life (t1/2).
Correct Answer: C) Minimum Inhibitory Concentration (MIC).
Rationale: The MIC is a key parameter in microbiology that guides
antibiotic selection and dosing, indicating the lowest concentration
of an antibiotic that prevents bacterial growth.
Question 6
A 45-year-old female client is prescribed levothyroxine for hypothyroidism.
Which lab value is primarily used to monitor the therapeutic effectiveness of
this medication?
A) Free T3.
B) Total T4.
C) Thyroid-stimulating hormone (TSH).
D) Calcitonin.
E) Thyroglobulin.
Correct Answer: C) Thyroid-stimulating hormone (TSH).
Rationale: TSH is the most sensitive and specific laboratory
parameter for monitoring thyroid hormone replacement therapy, as
it reflects the feedback loop between the pituitary and thyroid
gland.
Question 7
A nurse practitioner is counseling a client who is taking warfarin. Which over-
the-counter medication should the client be advised to avoid due to an
increased risk of bleeding?
, A) Acetaminophen.
B) Ibuprofen.
C) Antacids.
D) Psyllium.
E) Vitamin C.
Correct Answer: B) Ibuprofen.
Rationale: NSAIDs like ibuprofen inhibit platelet aggregation and
can cause gastrointestinal irritation, significantly increasing the risk
of bleeding when taken concurrently with anticoagulants like
warfarin.
Question 8
Which class of antidepressants is associated with a risk of hypertensive crisis
if tyramine-rich foods are consumed?
A) Selective Serotonin Reuptake Inhibitors (SSRIs).
B) Tricyclic Antidepressants (TCAs).
C) Monoamine Oxidase Inhibitors (MAOIs).
D) Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs).
E) Atypical Antidepressants (e.g., bupropion).
Correct Answer: C) Monoamine Oxidase Inhibitors (MAOIs).
Rationale: MAOIs inhibit the breakdown of tyramine. Ingesting
tyramine-rich foods (e.g., aged cheeses, cured meats, red wine) can
lead to a dangerous buildup of tyramine, triggering a hypertensive
crisis.
Question 9
A client is prescribed a beta-blocker. Which underlying medical condition
would be a contraindication for a non-cardioselective beta-blocker?
A) Hypertension.
B) Angina.
C) Migraine prophylaxis.
D) Asthma.
LATEST VERSIONS (VERSION A AND B) ACTUAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS,,,
Question 1
A 68-year-old client with multiple comorbidities is prescribed a new
medication. Which pharmacokinetic process is most likely to be altered in
this client due to age-related physiological changes?
A) Absorption rate.
B) Distribution volume.
C) Hepatic metabolism.
D) Renal excretion.
E) Protein binding.
Correct Answer: D) Renal excretion.
Rationale: With aging, there is a physiological decline in renal
function (decreased GFR), which is the most significant
pharmacokinetic change affecting drug elimination in elderly
clients.
Question 2
A nurse practitioner is prescribing a medication that is highly protein-bound
to an elderly client with hypoalbuminemia. Which adjustment should the NP
consider?
A) Increase the dose to achieve therapeutic effect.
B) Administer the medication more frequently.
C) Decrease the dose to reduce the risk of toxicity.
D) Switch to an alternative medication that is also highly protein-bound.
E) Administer the medication with food to increase absorption.
Correct Answer: C) Decrease the dose to reduce the risk of toxicity.
Rationale: In hypoalbuminemia, there are fewer binding sites for
highly protein-bound drugs, leading to a higher concentration of
unbound (active) drug in the circulation, thus increasing the risk of
adverse effects and toxicity.
,Question 3
Which of the following describes the mechanism of action of ACE inhibitors in
managing hypertension?
A) Blocking beta-adrenergic receptors, reducing heart rate and contractility.
B) Directly relaxing vascular smooth muscle, causing vasodilation.
C) Inhibiting the conversion of angiotensin I to angiotensin II, leading to
vasodilation and decreased aldosterone secretion.
D) Increasing the excretion of sodium and water, decreasing blood volume.
E) Blocking calcium channels, causing vasodilation and reduced cardiac
contractility.
Correct Answer: C) Inhibiting the conversion of angiotensin I to
angiotensin II, leading to vasodilation and decreased aldosterone
secretion.
Rationale: ACE inhibitors prevent the formation of the potent
vasoconstrictor angiotensin II and reduce aldosterone-mediated
sodium and water retention, resulting in lowered blood pressure.
Question 4
A client with Type 2 Diabetes Mellitus is prescribed metformin. Which adverse
effect requires the nurse practitioner to monitor renal function closely?
A) Hypoglycemia.
B) Weight gain.
C) Lactic acidosis.
D) Peripheral edema.
E) Headache.
Correct Answer: C) Lactic acidosis.
Rationale: Lactic acidosis is a rare but potentially fatal complication
of metformin, especially in clients with impaired renal function,
which can lead to metformin accumulation. Therefore, renal function
must be monitored.
,Question 5
When prescribing antibiotics, which of the following refers to the lowest
concentration of an antibiotic that inhibits visible bacterial growth?
A) Lethal Dose 50 (LD50).
B) Minimum Bactericidal Concentration (MBC).
C) Minimum Inhibitory Concentration (MIC).
D) Therapeutic Index (TI).
E) Half-life (t1/2).
Correct Answer: C) Minimum Inhibitory Concentration (MIC).
Rationale: The MIC is a key parameter in microbiology that guides
antibiotic selection and dosing, indicating the lowest concentration
of an antibiotic that prevents bacterial growth.
Question 6
A 45-year-old female client is prescribed levothyroxine for hypothyroidism.
Which lab value is primarily used to monitor the therapeutic effectiveness of
this medication?
A) Free T3.
B) Total T4.
C) Thyroid-stimulating hormone (TSH).
D) Calcitonin.
E) Thyroglobulin.
Correct Answer: C) Thyroid-stimulating hormone (TSH).
Rationale: TSH is the most sensitive and specific laboratory
parameter for monitoring thyroid hormone replacement therapy, as
it reflects the feedback loop between the pituitary and thyroid
gland.
Question 7
A nurse practitioner is counseling a client who is taking warfarin. Which over-
the-counter medication should the client be advised to avoid due to an
increased risk of bleeding?
, A) Acetaminophen.
B) Ibuprofen.
C) Antacids.
D) Psyllium.
E) Vitamin C.
Correct Answer: B) Ibuprofen.
Rationale: NSAIDs like ibuprofen inhibit platelet aggregation and
can cause gastrointestinal irritation, significantly increasing the risk
of bleeding when taken concurrently with anticoagulants like
warfarin.
Question 8
Which class of antidepressants is associated with a risk of hypertensive crisis
if tyramine-rich foods are consumed?
A) Selective Serotonin Reuptake Inhibitors (SSRIs).
B) Tricyclic Antidepressants (TCAs).
C) Monoamine Oxidase Inhibitors (MAOIs).
D) Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs).
E) Atypical Antidepressants (e.g., bupropion).
Correct Answer: C) Monoamine Oxidase Inhibitors (MAOIs).
Rationale: MAOIs inhibit the breakdown of tyramine. Ingesting
tyramine-rich foods (e.g., aged cheeses, cured meats, red wine) can
lead to a dangerous buildup of tyramine, triggering a hypertensive
crisis.
Question 9
A client is prescribed a beta-blocker. Which underlying medical condition
would be a contraindication for a non-cardioselective beta-blocker?
A) Hypertension.
B) Angina.
C) Migraine prophylaxis.
D) Asthma.
