NSG 6020 ADVANCED PHARMACOLOGY (3P) EXAM
PREP 2026–2027 COMPREHENSIVE PRACTICE
QUESTIONS, ANSWERS & RATIONALES NURSE
PRACTITIONER SUCCESS GUIDE A+ VERIFIED LATEST
UPDATE
Questions 1–50
1. A patient with hypertension and diabetic nephropathy should be started on which medication class
first?
A. Calcium channel blocker
B. ACE inhibitor
C. Loop diuretic
D. Alpha blocker
Answer: B. ACE inhibitor
Rationale: ACE inhibitors reduce blood pressure and provide renal protection by decreasing
intraglomerular pressure, making them first-line agents for many patients with diabetes and kidney
disease.
2. Which adverse effect is most commonly associated with ACE inhibitors?
A. Bradycardia
B. Hyperkalemia
C. Hypoglycemia
D. Tinnitus
Answer: B. Hyperkalemia
Rationale: ACE inhibitors decrease aldosterone secretion, increasing potassium retention and
potentially causing hyperkalemia.
3. Which medication is contraindicated during pregnancy?
A. Labetalol
B. Methyldopa
C. Enalapril
D. Nifedipine
Answer: C. Enalapril
, Rationale: ACE inhibitors are teratogenic and can cause fetal renal damage, oligohydramnios, and death.
4. A patient taking warfarin begins therapy with trimethoprim-sulfamethoxazole. What is the primary
concern?
A. Reduced INR
B. Increased INR and bleeding risk
C. Hyperglycemia
D. Renal failure
Answer: B. Increased INR and bleeding risk
Rationale: TMP-SMX inhibits warfarin metabolism, increasing anticoagulant effects and bleeding risk.
5. Which laboratory value should be monitored regularly in a patient taking statins?
A. Troponin
B. Hemoglobin
C. Liver enzymes
D. Platelets
Answer: C. Liver enzymes
Rationale: Statins may cause hepatotoxicity; monitoring AST and ALT is recommended.
6. Metformin is contraindicated in patients with:
A. Controlled hypertension
B. Severe renal impairment
C. Hyperlipidemia
D. Asthma
Answer: B. Severe renal impairment
Rationale: Reduced renal function increases the risk of lactic acidosis.
7. Which insulin has the fastest onset of action?
A. Glargine
B. Detemir
C. Lispro
D. NPH
Answer: C. Lispro
PREP 2026–2027 COMPREHENSIVE PRACTICE
QUESTIONS, ANSWERS & RATIONALES NURSE
PRACTITIONER SUCCESS GUIDE A+ VERIFIED LATEST
UPDATE
Questions 1–50
1. A patient with hypertension and diabetic nephropathy should be started on which medication class
first?
A. Calcium channel blocker
B. ACE inhibitor
C. Loop diuretic
D. Alpha blocker
Answer: B. ACE inhibitor
Rationale: ACE inhibitors reduce blood pressure and provide renal protection by decreasing
intraglomerular pressure, making them first-line agents for many patients with diabetes and kidney
disease.
2. Which adverse effect is most commonly associated with ACE inhibitors?
A. Bradycardia
B. Hyperkalemia
C. Hypoglycemia
D. Tinnitus
Answer: B. Hyperkalemia
Rationale: ACE inhibitors decrease aldosterone secretion, increasing potassium retention and
potentially causing hyperkalemia.
3. Which medication is contraindicated during pregnancy?
A. Labetalol
B. Methyldopa
C. Enalapril
D. Nifedipine
Answer: C. Enalapril
, Rationale: ACE inhibitors are teratogenic and can cause fetal renal damage, oligohydramnios, and death.
4. A patient taking warfarin begins therapy with trimethoprim-sulfamethoxazole. What is the primary
concern?
A. Reduced INR
B. Increased INR and bleeding risk
C. Hyperglycemia
D. Renal failure
Answer: B. Increased INR and bleeding risk
Rationale: TMP-SMX inhibits warfarin metabolism, increasing anticoagulant effects and bleeding risk.
5. Which laboratory value should be monitored regularly in a patient taking statins?
A. Troponin
B. Hemoglobin
C. Liver enzymes
D. Platelets
Answer: C. Liver enzymes
Rationale: Statins may cause hepatotoxicity; monitoring AST and ALT is recommended.
6. Metformin is contraindicated in patients with:
A. Controlled hypertension
B. Severe renal impairment
C. Hyperlipidemia
D. Asthma
Answer: B. Severe renal impairment
Rationale: Reduced renal function increases the risk of lactic acidosis.
7. Which insulin has the fastest onset of action?
A. Glargine
B. Detemir
C. Lispro
D. NPH
Answer: C. Lispro
