NURS 5334 Advanced Pharmacology for NPs
Final Exam Questions & Verified Correct Answers
2026/2027 Update | UTA NP Pharmacology Study
Guide & Exam Prep
• This 200-question exam prep guide covers the full scope of NURS 5334 Advanced
Pharmacology for Nurse Practitioners, designed to mirror the rigor and format of
the UTA NP final exam for 2026/2027.
• Work through each question actively — read every option, commit to an answer,
then check the highlighted correct answer and EXPERT RATIONALE to reinforce
clinical reasoning and pharmacology mastery.
NURS 5334 ADVANCED PHARMACOLOGY FOR NURSE PRACTITIONERS FINAL
EXAM — 200 QUESTIONS WITH VERIFIED ANSWERS UTA NP PHARMACOLOGY
STUDY GUIDE & EXAM PREP 2026/2027
1. A patient with type 2 diabetes is started on metformin. Which mechanism
best explains its primary glucose-lowering action?
A. Stimulates pancreatic beta cells to release insulin
B. Blocks alpha-glucosidase in the intestine
C. Increases insulin secretion from the pancreas in a glucose-dependent manner
D. Decreases hepatic glucose production and improves insulin sensitivity
E. Promotes renal glucose excretion via SGLT-2 inhibition
Correct Answer: D. Decreases hepatic glucose production and improves insulin
sensitivity
EXPERT RATIONALE: Metformin primarily works by suppressing hepatic
gluconeogenesis and improving peripheral insulin sensitivity. It does not stimulate
insulin secretion, making hypoglycemia rare when used as monotherapy.
,2. Which of the following beta-blockers is considered cardioselective and most
appropriate for a patient with asthma and hypertension?
A. Carvedilol
B. Propranolol
C. Labetalol
D. Metoprolol succinate
E. Nadolol
Correct Answer: D. Metoprolol succinate
EXPERT RATIONALE: Metoprolol succinate is a beta-1 selective (cardioselective)
blocker, minimizing bronchoconstriction risk in asthmatic patients. Non-selective
beta-blockers like propranolol block beta-2 receptors and can worsen
bronchospasm.
3. A 55-year-old male is prescribed sildenafil for erectile dysfunction. Which
concurrent medication is an absolute contraindication?
A. Aspirin 81 mg
B. Isosorbide mononitrate
C. Lisinopril
D. Atorvastatin
E. Metformin
Correct Answer: B. Isosorbide mononitrate
EXPERT RATIONALE: Sildenafil potentiates the vasodilatory effects of nitrates
by inhibiting PDE-5, leading to severe, potentially fatal hypotension. Co-
administration with any nitrate is absolutely contraindicated.
,4. Which antibiotic class works by inhibiting bacterial cell wall synthesis by
binding to penicillin-binding proteins?
A. Aminoglycosides
B. Macrolides
C. Beta-lactams
D. Fluoroquinolones
E. Tetracyclines
Correct Answer: C. Beta-lactams
EXPERT RATIONALE: Beta-lactam antibiotics (penicillins, cephalosporins,
carbapenems) bind penicillin-binding proteins (PBPs), inhibiting bacterial cell wall
peptidoglycan cross-linking, causing cell lysis and death.
5. A patient on warfarin is started on fluconazole. What is the expected drug
interaction?
A. Decreased warfarin levels due to enzyme induction
B. Increased warfarin effect due to CYP2C9 inhibition
C. No significant interaction
D. Decreased warfarin absorption
E. Increased warfarin clearance
Correct Answer: B. Increased warfarin effect due to CYP2C9 inhibition
EXPERT RATIONALE: Fluconazole is a potent CYP2C9 inhibitor. Warfarin is
primarily metabolized by CYP2C9, so concurrent use raises warfarin plasma levels,
significantly increasing bleeding risk. INR must be closely monitored.
6. Which of the following is a loop diuretic used in the management of heart
failure with fluid overload?
, A. Hydrochlorothiazide
B. Spironolactone
C. Triamterene
D. Furosemide
E. Chlorthalidone
Correct Answer: D. Furosemide
EXPERT RATIONALE: Furosemide inhibits the Na-K-2Cl cotransporter in the
thick ascending limb of the loop of Henle, producing potent diuresis. It is the first-
line diuretic for acute decompensated heart failure and fluid overload.
7. A nurse practitioner prescribes lisinopril to a patient with diabetic
nephropathy. The primary EXPERT RATIONALE for this choice is:
A. It lowers blood glucose levels
B. It increases GFR significantly
C. It reduces intraglomerular pressure and proteinuria
D. It prevents urinary tract infections
E. It enhances renal tubular reabsorption
Correct Answer: C. It reduces intraglomerular pressure and proteinuria
EXPERT RATIONALE: ACE inhibitors like lisinopril dilate the efferent arteriole,
reducing intraglomerular pressure and proteinuria, slowing the progression of
diabetic nephropathy. They are nephroprotective and recommended in CKD with
proteinuria.
8. Which opioid analgesic has the highest oral bioavailability and is commonly
used for moderate-to-severe pain management in outpatient settings?
A. Morphine
Final Exam Questions & Verified Correct Answers
2026/2027 Update | UTA NP Pharmacology Study
Guide & Exam Prep
• This 200-question exam prep guide covers the full scope of NURS 5334 Advanced
Pharmacology for Nurse Practitioners, designed to mirror the rigor and format of
the UTA NP final exam for 2026/2027.
• Work through each question actively — read every option, commit to an answer,
then check the highlighted correct answer and EXPERT RATIONALE to reinforce
clinical reasoning and pharmacology mastery.
NURS 5334 ADVANCED PHARMACOLOGY FOR NURSE PRACTITIONERS FINAL
EXAM — 200 QUESTIONS WITH VERIFIED ANSWERS UTA NP PHARMACOLOGY
STUDY GUIDE & EXAM PREP 2026/2027
1. A patient with type 2 diabetes is started on metformin. Which mechanism
best explains its primary glucose-lowering action?
A. Stimulates pancreatic beta cells to release insulin
B. Blocks alpha-glucosidase in the intestine
C. Increases insulin secretion from the pancreas in a glucose-dependent manner
D. Decreases hepatic glucose production and improves insulin sensitivity
E. Promotes renal glucose excretion via SGLT-2 inhibition
Correct Answer: D. Decreases hepatic glucose production and improves insulin
sensitivity
EXPERT RATIONALE: Metformin primarily works by suppressing hepatic
gluconeogenesis and improving peripheral insulin sensitivity. It does not stimulate
insulin secretion, making hypoglycemia rare when used as monotherapy.
,2. Which of the following beta-blockers is considered cardioselective and most
appropriate for a patient with asthma and hypertension?
A. Carvedilol
B. Propranolol
C. Labetalol
D. Metoprolol succinate
E. Nadolol
Correct Answer: D. Metoprolol succinate
EXPERT RATIONALE: Metoprolol succinate is a beta-1 selective (cardioselective)
blocker, minimizing bronchoconstriction risk in asthmatic patients. Non-selective
beta-blockers like propranolol block beta-2 receptors and can worsen
bronchospasm.
3. A 55-year-old male is prescribed sildenafil for erectile dysfunction. Which
concurrent medication is an absolute contraindication?
A. Aspirin 81 mg
B. Isosorbide mononitrate
C. Lisinopril
D. Atorvastatin
E. Metformin
Correct Answer: B. Isosorbide mononitrate
EXPERT RATIONALE: Sildenafil potentiates the vasodilatory effects of nitrates
by inhibiting PDE-5, leading to severe, potentially fatal hypotension. Co-
administration with any nitrate is absolutely contraindicated.
,4. Which antibiotic class works by inhibiting bacterial cell wall synthesis by
binding to penicillin-binding proteins?
A. Aminoglycosides
B. Macrolides
C. Beta-lactams
D. Fluoroquinolones
E. Tetracyclines
Correct Answer: C. Beta-lactams
EXPERT RATIONALE: Beta-lactam antibiotics (penicillins, cephalosporins,
carbapenems) bind penicillin-binding proteins (PBPs), inhibiting bacterial cell wall
peptidoglycan cross-linking, causing cell lysis and death.
5. A patient on warfarin is started on fluconazole. What is the expected drug
interaction?
A. Decreased warfarin levels due to enzyme induction
B. Increased warfarin effect due to CYP2C9 inhibition
C. No significant interaction
D. Decreased warfarin absorption
E. Increased warfarin clearance
Correct Answer: B. Increased warfarin effect due to CYP2C9 inhibition
EXPERT RATIONALE: Fluconazole is a potent CYP2C9 inhibitor. Warfarin is
primarily metabolized by CYP2C9, so concurrent use raises warfarin plasma levels,
significantly increasing bleeding risk. INR must be closely monitored.
6. Which of the following is a loop diuretic used in the management of heart
failure with fluid overload?
, A. Hydrochlorothiazide
B. Spironolactone
C. Triamterene
D. Furosemide
E. Chlorthalidone
Correct Answer: D. Furosemide
EXPERT RATIONALE: Furosemide inhibits the Na-K-2Cl cotransporter in the
thick ascending limb of the loop of Henle, producing potent diuresis. It is the first-
line diuretic for acute decompensated heart failure and fluid overload.
7. A nurse practitioner prescribes lisinopril to a patient with diabetic
nephropathy. The primary EXPERT RATIONALE for this choice is:
A. It lowers blood glucose levels
B. It increases GFR significantly
C. It reduces intraglomerular pressure and proteinuria
D. It prevents urinary tract infections
E. It enhances renal tubular reabsorption
Correct Answer: C. It reduces intraglomerular pressure and proteinuria
EXPERT RATIONALE: ACE inhibitors like lisinopril dilate the efferent arteriole,
reducing intraglomerular pressure and proteinuria, slowing the progression of
diabetic nephropathy. They are nephroprotective and recommended in CKD with
proteinuria.
8. Which opioid analgesic has the highest oral bioavailability and is commonly
used for moderate-to-severe pain management in outpatient settings?
A. Morphine
