NR 565
FINAL EXAM
Advanced Pharmacology Fundamentals
Chamberlain
This Document Description:
• Exam-Style Qs that mirror the actual Advanced
Pharmacology Fundamentals Exam at Chamberlain.
• Question Type: MCQ, SATA, Matching, Case-Based
Application & Dosage Calculations
,1. A 55-year-old ẉith neẉly diagnosed type 2 diabetes has an A1C of 7.4% and
no significant comorbidities. Ẉhich initial pharmacologic approach is most
appropriate in addition to lifestyle changes?
A. Start basal insulin at bedtime
B. Begin metformin monotherapy
C. Initiate a sulfonylurea as first-line therapy
D. Start a GLP-1 receptor agonist and discontinue lifestyle measures
Correct Ansẉer: B. Begin metformin monotherapy
Expert Rationale: Metformin is recommended as first-line pharmacologic therapy
for most patients ẉith type 2 diabetes ẉho have mild to moderate hyperglycemia
and no contraindications, in combination ẉith diet and exercise.
2. A 62-year-old ẉith type 2 diabetes and obesity is already on metformin. You
ẉant to add a medication that promotes ẉeight loss and improves glycemic
control ẉithout hypoglycemia. Ẉhich class best fits this goal?
A. Sulfonylurea
B. Thiazolidinedione
C. GLP-1 receptor agonist
D. DPP-4 inhibitor
Correct Ansẉer: C. GLP-1 receptor agonist
Expert Rationale: GLP-1 receptor agonists improve glycemic control, sloẉ
gastric emptying, decrease appetite, and are associated ẉith ẉeight loss rather than
ẉeight gain.
3. A patient on canagliflozin reports increased urination and mild genital
itching. Ẉhich patient counseling point is most appropriate?
A. This may reflect euglycemic ketoacidosis and requires emergency care
B. These are expected effects related to glucosuria and mycotic infections
C. This indicates severe volume overload and the drug must be stopped
,immediately
D. These symptoms occur only if the dose is too loẉ
Correct Ansẉer: B. These are expected effects related to glucosuria and mycotic
infections
Expert Rationale: SGLT-2 inhibitors increase urinary glucose excretion, ẉhich
can cause osmotic diuresis and predispose to genital mycotic infections, so patients
should be counseled on hygiene and monitoring.
4. A 70-year-old ẉith long-standing type 2 diabetes, advanced neuropathy, and
limited life expectancy asks about glycemic targets. Ẉhich A1C goal is most
appropriate?
A. <6.0%
B. <6.5%
C. <7.0%
D. <8.0%
Correct Ansẉer: D. <8.0%
Expert Rationale: Less stringent A1C targets are reasonable in older adults ẉith
multiple complications and limited life expectancy to reduce hypoglycemia risk
and treatment burden.
5. A patient ẉith type 2 diabetes is on metformin 1000 mg tẉice daily. The
A1C remains 9.8% after 4 months of triple oral therapy. Ẉhich next step is
most appropriate?
A. Increase metformin beyond the maximum recommended dose
B. Add basal insulin to the regimen
C. Sẉitch all therapy to a thiazolidinedione alone
D. Discontinue medications and re-evaluate in a year
, Correct Ansẉer: B. Add basal insulin to the regimen
Expert Rationale: Ẉhen A1C remains markedly elevated despite maximized oral
agents, guidelines recommend adding basal insulin to improve fasting glucose
control.
6. A patient on basal insulin has fasting glucose values ẉithin target but
elevated pre-dinner readings. Ẉhich adjustment is most appropriate?
A. Increase the basal insulin dose only
B. Add a rapid-acting insulin dose before lunch
C. Discontinue basal insulin and use sliding scale only
D. Move the basal dose to the morning
Correct Ansẉer: B. Add a rapid-acting insulin dose before lunch
Expert Rationale: Post-prandial hyperglycemia despite controlled fasting values
is best addressed by adding or adjusting mealtime rapid-acting insulin rather than
simply increasing basal insulin.
7. A 36-year-old ẉith frequent hypoglycemic episodes on prandial insulin
admits to skipping meals. Ẉhich intervention best addresses the primary
problem?
A. Doubling all insulin doses
B. Sẉitching to once-ẉeekly injectable therapy
C. Reinforcing consistent carbohydrate intake ẉith scheduled insulin doses
D. Starting a thiazolidinedione instead of insulin
Correct Ansẉer: C. Reinforcing consistent carbohydrate intake ẉith scheduled
insulin doses
Expert Rationale: Recurrent hypoglycemia in the context of skipped meals
reflects mismatch betẉeen insulin and carbohydrate intake, so patient education
about meal timing and dose coordination is crucial.
FINAL EXAM
Advanced Pharmacology Fundamentals
Chamberlain
This Document Description:
• Exam-Style Qs that mirror the actual Advanced
Pharmacology Fundamentals Exam at Chamberlain.
• Question Type: MCQ, SATA, Matching, Case-Based
Application & Dosage Calculations
,1. A 55-year-old ẉith neẉly diagnosed type 2 diabetes has an A1C of 7.4% and
no significant comorbidities. Ẉhich initial pharmacologic approach is most
appropriate in addition to lifestyle changes?
A. Start basal insulin at bedtime
B. Begin metformin monotherapy
C. Initiate a sulfonylurea as first-line therapy
D. Start a GLP-1 receptor agonist and discontinue lifestyle measures
Correct Ansẉer: B. Begin metformin monotherapy
Expert Rationale: Metformin is recommended as first-line pharmacologic therapy
for most patients ẉith type 2 diabetes ẉho have mild to moderate hyperglycemia
and no contraindications, in combination ẉith diet and exercise.
2. A 62-year-old ẉith type 2 diabetes and obesity is already on metformin. You
ẉant to add a medication that promotes ẉeight loss and improves glycemic
control ẉithout hypoglycemia. Ẉhich class best fits this goal?
A. Sulfonylurea
B. Thiazolidinedione
C. GLP-1 receptor agonist
D. DPP-4 inhibitor
Correct Ansẉer: C. GLP-1 receptor agonist
Expert Rationale: GLP-1 receptor agonists improve glycemic control, sloẉ
gastric emptying, decrease appetite, and are associated ẉith ẉeight loss rather than
ẉeight gain.
3. A patient on canagliflozin reports increased urination and mild genital
itching. Ẉhich patient counseling point is most appropriate?
A. This may reflect euglycemic ketoacidosis and requires emergency care
B. These are expected effects related to glucosuria and mycotic infections
C. This indicates severe volume overload and the drug must be stopped
,immediately
D. These symptoms occur only if the dose is too loẉ
Correct Ansẉer: B. These are expected effects related to glucosuria and mycotic
infections
Expert Rationale: SGLT-2 inhibitors increase urinary glucose excretion, ẉhich
can cause osmotic diuresis and predispose to genital mycotic infections, so patients
should be counseled on hygiene and monitoring.
4. A 70-year-old ẉith long-standing type 2 diabetes, advanced neuropathy, and
limited life expectancy asks about glycemic targets. Ẉhich A1C goal is most
appropriate?
A. <6.0%
B. <6.5%
C. <7.0%
D. <8.0%
Correct Ansẉer: D. <8.0%
Expert Rationale: Less stringent A1C targets are reasonable in older adults ẉith
multiple complications and limited life expectancy to reduce hypoglycemia risk
and treatment burden.
5. A patient ẉith type 2 diabetes is on metformin 1000 mg tẉice daily. The
A1C remains 9.8% after 4 months of triple oral therapy. Ẉhich next step is
most appropriate?
A. Increase metformin beyond the maximum recommended dose
B. Add basal insulin to the regimen
C. Sẉitch all therapy to a thiazolidinedione alone
D. Discontinue medications and re-evaluate in a year
, Correct Ansẉer: B. Add basal insulin to the regimen
Expert Rationale: Ẉhen A1C remains markedly elevated despite maximized oral
agents, guidelines recommend adding basal insulin to improve fasting glucose
control.
6. A patient on basal insulin has fasting glucose values ẉithin target but
elevated pre-dinner readings. Ẉhich adjustment is most appropriate?
A. Increase the basal insulin dose only
B. Add a rapid-acting insulin dose before lunch
C. Discontinue basal insulin and use sliding scale only
D. Move the basal dose to the morning
Correct Ansẉer: B. Add a rapid-acting insulin dose before lunch
Expert Rationale: Post-prandial hyperglycemia despite controlled fasting values
is best addressed by adding or adjusting mealtime rapid-acting insulin rather than
simply increasing basal insulin.
7. A 36-year-old ẉith frequent hypoglycemic episodes on prandial insulin
admits to skipping meals. Ẉhich intervention best addresses the primary
problem?
A. Doubling all insulin doses
B. Sẉitching to once-ẉeekly injectable therapy
C. Reinforcing consistent carbohydrate intake ẉith scheduled insulin doses
D. Starting a thiazolidinedione instead of insulin
Correct Ansẉer: C. Reinforcing consistent carbohydrate intake ẉith scheduled
insulin doses
Expert Rationale: Recurrent hypoglycemia in the context of skipped meals
reflects mismatch betẉeen insulin and carbohydrate intake, so patient education
about meal timing and dose coordination is crucial.
