NR566 | NR566 Advanced Pharmacology for Care
of the Family Wk 5 Final Exam v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient is prescribed Metformin for Type 2 Diabetes Mellitus. What is the primary
mechanism of action for this medication?
A. Stimulates the pancreas to secrete more insulin
B. Decreases hepatic glucose production and improves insulin sensitivity
C. Delays the absorption of carbohydrates in the small intestine
D. Increases glucose excretion through the kidneys
Correct Answer: B
Expert Explanation: Metformin is a biguanide that works by reducing the amount
of glucose produced by the liver. It also increases the sensitivity of muscle cells to
insulin, allowing for better glucose uptake. Unlike sulfonylureas, it does not typically
cause hypoglycemia because it does not stimulate insulin secretion.
2. Which of the following side effects is most characteristic of ACE inhibitors and often
leads to the discontinuation of the drug?
A. Peripheral edema
B. Dry, nonproductive cough
,C. Hypokalemia
D. Tachycardia
Correct Answer: B
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin and
substance P in the lungs. This accumulation of inflammatory mediators triggers a
persistent, dry cough in about 10-20% of patients. If this occurs, patients are
generally switched to an Angiotensin II Receptor Blocker (ARB).
3. A patient taking Warfarin (Coumadin) is found to have an INR of 5.5 without any
signs of active bleeding. What is the appropriate initial management step?
A. Administer an immediate dose of Vitamin K intravenously
B. Withhold the Warfarin dose and monitor the INR
C. Administer Fresh Frozen Plasma (FFP)
D. Continue the current dose and recheck in 24 hours
Correct Answer: B
Expert Explanation: According to standard guidelines, an INR between 4.5 and
10.0 without significant bleeding is managed by withholding one or two doses of
Warfarin. The INR should then be monitored more frequently until it returns to the
,therapeutic range. Vitamin K is usually reserved for higher INRs or cases involving
active bleeding.
4. Levothyroxine (Synthroid) should be administered in which of the following ways to
ensure optimal absorption?
A. With a full meal to prevent GI upset
B. At bedtime with a glass of milk
C. In the morning on an empty stomach, 30-60 minutes before food
D. Immediately after consuming a high-fiber breakfast
Correct Answer: C
Expert Explanation: Levothyroxine absorption is significantly affected by the
presence of food and certain minerals. It is best absorbed in an acidic environment
on an empty stomach. Taking it 30 to 60 minutes before breakfast ensures
consistent blood levels and therapeutic efficacy.
5. When initiating an SSRI for depression, such as Fluoxetine, what is the most
important information to provide to the patient regarding the onset of action?
A. Therapeutic effects may take 4 to 6 weeks to fully manifest
B. The drug will take effect within 24 hours
C. The patient will feel more energetic immediately
, D. The dose should be doubled if no change is felt in one week
Correct Answer: A
Expert Explanation: SSRIs require several weeks of consistent use to achieve a
steady state and downregulate receptors in the brain. Patients often experience side
effects like nausea or jitteriness before they feel the mood-lifting benefits. Educating
the patient on this timeline is crucial to prevent premature discontinuation of the
medication.
6. Which of the following medications is contraindicated in a patient with a history of
severe asthma?
A. Propranolol
B. Lisinopril
C. Amlodipine
D. Metoprolol Succinate
Correct Answer: A
Expert Explanation: Propranolol is a non-selective beta-blocker that blocks both
beta-1 and beta-2 receptors. Blocking beta-2 receptors in the lungs can cause
bronchoconstriction, which is dangerous for patients with asthma or COPD.
Selective beta-1 blockers are preferred if a beta-blocker is absolutely necessary for
these patients.
of the Family Wk 5 Final Exam v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient is prescribed Metformin for Type 2 Diabetes Mellitus. What is the primary
mechanism of action for this medication?
A. Stimulates the pancreas to secrete more insulin
B. Decreases hepatic glucose production and improves insulin sensitivity
C. Delays the absorption of carbohydrates in the small intestine
D. Increases glucose excretion through the kidneys
Correct Answer: B
Expert Explanation: Metformin is a biguanide that works by reducing the amount
of glucose produced by the liver. It also increases the sensitivity of muscle cells to
insulin, allowing for better glucose uptake. Unlike sulfonylureas, it does not typically
cause hypoglycemia because it does not stimulate insulin secretion.
2. Which of the following side effects is most characteristic of ACE inhibitors and often
leads to the discontinuation of the drug?
A. Peripheral edema
B. Dry, nonproductive cough
,C. Hypokalemia
D. Tachycardia
Correct Answer: B
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin and
substance P in the lungs. This accumulation of inflammatory mediators triggers a
persistent, dry cough in about 10-20% of patients. If this occurs, patients are
generally switched to an Angiotensin II Receptor Blocker (ARB).
3. A patient taking Warfarin (Coumadin) is found to have an INR of 5.5 without any
signs of active bleeding. What is the appropriate initial management step?
A. Administer an immediate dose of Vitamin K intravenously
B. Withhold the Warfarin dose and monitor the INR
C. Administer Fresh Frozen Plasma (FFP)
D. Continue the current dose and recheck in 24 hours
Correct Answer: B
Expert Explanation: According to standard guidelines, an INR between 4.5 and
10.0 without significant bleeding is managed by withholding one or two doses of
Warfarin. The INR should then be monitored more frequently until it returns to the
,therapeutic range. Vitamin K is usually reserved for higher INRs or cases involving
active bleeding.
4. Levothyroxine (Synthroid) should be administered in which of the following ways to
ensure optimal absorption?
A. With a full meal to prevent GI upset
B. At bedtime with a glass of milk
C. In the morning on an empty stomach, 30-60 minutes before food
D. Immediately after consuming a high-fiber breakfast
Correct Answer: C
Expert Explanation: Levothyroxine absorption is significantly affected by the
presence of food and certain minerals. It is best absorbed in an acidic environment
on an empty stomach. Taking it 30 to 60 minutes before breakfast ensures
consistent blood levels and therapeutic efficacy.
5. When initiating an SSRI for depression, such as Fluoxetine, what is the most
important information to provide to the patient regarding the onset of action?
A. Therapeutic effects may take 4 to 6 weeks to fully manifest
B. The drug will take effect within 24 hours
C. The patient will feel more energetic immediately
, D. The dose should be doubled if no change is felt in one week
Correct Answer: A
Expert Explanation: SSRIs require several weeks of consistent use to achieve a
steady state and downregulate receptors in the brain. Patients often experience side
effects like nausea or jitteriness before they feel the mood-lifting benefits. Educating
the patient on this timeline is crucial to prevent premature discontinuation of the
medication.
6. Which of the following medications is contraindicated in a patient with a history of
severe asthma?
A. Propranolol
B. Lisinopril
C. Amlodipine
D. Metoprolol Succinate
Correct Answer: A
Expert Explanation: Propranolol is a non-selective beta-blocker that blocks both
beta-1 and beta-2 receptors. Blocking beta-2 receptors in the lungs can cause
bronchoconstriction, which is dangerous for patients with asthma or COPD.
Selective beta-1 blockers are preferred if a beta-blocker is absolutely necessary for
these patients.
