NR 565 Advanced Pharmacology Fundamentals
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Free NR 565 Advanced Pharmacology Fundamentals Questions
What is the total daily dose of insulin for a diabetic patient weighing 286 pounds?
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55 units of basal insulin and 23 units of bolus/mealtime insulin
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86 units of basal insulin and 86 units of bolus/mealtime insulin
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78 units of basal insulin and 78 units of bolus/mealtime insulin
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39 units of basal insulin and 39 units of bolus/mealtime insulin
Explanation
Correct Answer:
D. 39 units of basal insulin and 39 units of bolus/mealtime insulin
Explanation of Correct Answer
The standard starting total daily dose (TDD) of insulin for most adults with diabetes is 0.5 units/kg/day. First, convert 286 pounds to kilograms: 286 ÷ 2.2 ≈ 130 kg. Then calculate 130 × 0.5 = 65 units/day as the TDD. This amount is divided equally between basal and bolus insulin: about 32–33 units each. Since the answer options are rounded differently, the closest correct choice is 39 units basal and 39 units bolus, which provides balanced coverage.
The mechanism of action of dipeptidyl peptidase-4 inhibitor (DPP4i) is best described as:
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promotes insulin secretion by the pancreas
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reduces reabsorption of glucose by decreasing insulin resistance
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enhances actions of incretin hormones to stimulate glucose dependent insulin and suppress glycogen release
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inhibits glucose production in the liver and reduces glucose absorption in the gut
Explanation
Correct Answer:
C. enhances actions of incretin hormones to stimulate glucose dependent insulin and suppress glycogen release
Explanation of Correct Answer
DPP-4 inhibitors work by blocking the enzyme dipeptidyl peptidase-4, which normally degrades incretin hormones such as GLP-1 and GIP. By prolonging incretin activity, these drugs enhance glucose-dependent insulin secretion from pancreatic beta cells and suppress glucagon release from alpha cells. This mechanism improves postprandial glucose control without significant risk of hypoglycemia. Unlike metformin or SGLT-2 inhibitors, DPP-4 inhibitors act specifically through incretin hormone pathways.
Of the following medications, which is most likely to cause hypoglycemia?
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Metformin
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Insulin
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Incretin mimetics
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Thiazolidinediones
Explanation
Correct Answer:
B. Insulin
Explanation of Correct Answer
Insulin is the medication most likely to cause hypoglycemia because it directly lowers blood glucose by promoting cellular uptake and storage of glucose. When insulin doses exceed what the body requires, or if food intake is insufficient, blood sugar can drop to dangerously low levels. Hypoglycemia is the most significant adverse effect of insulin therapy, making careful monitoring and patient education on recognizing symptoms essential in diabetes management.
When starting therapy for COPD and Asthma which therapy should be considered as first line?
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Budesonide
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Salmeterol
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Theophylline
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Levalbuterol
Explanation
Correct Answer:
D. Levalbuterol
Explanation of Correct Answer
Levalbuterol, a short-acting beta-2 agonist (SABA), is the first-line therapy for both asthma and COPD when initiating treatment. SABAs provide rapid bronchodilation by relaxing airway smooth muscle, making them effective for immediate relief of acute symptoms like wheezing and shortness of breath. Long-term controller therapies, such as inhaled corticosteroids (budesonide) or long-acting beta agonists (salmeterol), may be added later depending on disease severity, but initial management always begins with a rescue inhaler like levalbuterol.
Which medication should be used in the treatment of tuberculosis in pregnancy?
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Ethambutol
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Pyridoxine
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Rifapentine
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Rifabutin
Explanation
Correct Answer:
A. Ethambutol
Explanation of Correct Answer
Ethambutol is part of the standard first-line therapy for tuberculosis and is considered safe for use in pregnancy. It is commonly combined with isoniazid and rifampin, and sometimes pyrazinamide, to ensure effective treatment while minimizing fetal risk. Pyridoxine (B6) is a supplement used with isoniazid but is not itself a TB drug. Rifapentine and rifabutin are avoided in pregnancy due to insufficient safety data. Therefore, ethambutol is the correct choice.
Which of the following drugs causes levothyroxine to be absorbed more quickly?
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Iron supplements
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Pantoprazole
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Sertraline
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Digoxin
Explanation
Correct Answer:
C. Sertraline
Explanation of Correct Answer
Sertraline, a selective serotonin reuptake inhibitor (SSRI), can accelerate the metabolism and absorption of levothyroxine, leading to altered thyroid hormone levels. Patients taking both drugs may require dose adjustments of levothyroxine to maintain therapeutic TSH levels. In contrast, iron supplements and proton pump inhibitors like pantoprazole reduce absorption, and digoxin does not directly influence levothyroxine absorption. Careful monitoring is necessary when SSRIs and thyroid replacement therapy are used together.
Which class of medication activates receptors for GLP-1, slows gastric emptying, inhibits glucagon, and stimulates glucose release of insulin?
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Sitagliptin
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Dulaglutide
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Dopalifozin
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Glyburide
Explanation
Correct Answer:
B. Dulaglutide
Explanation of Correct Answer
Dulaglutide is a GLP-1 receptor agonist that mimics the actions of the incretin hormone GLP-1. By binding to GLP-1 receptors, it enhances glucose-dependent insulin secretion, inhibits glucagon release, and slows gastric emptying, which improves satiety and contributes to weight loss. This makes it effective for type 2 diabetes management and sometimes obesity. Unlike DPP-4 inhibitors such as sitagliptin, GLP-1 receptor agonists directly activate the receptor rather than just prolonging endogenous incretin action.
In diabetes, older adults should maintain an A1C
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less than 8%
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less than 7%
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less than or equal to 6.5%
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less than 10%
Explanation
Correct Answer:
A. less than 8%
Explanation of Correct Answer
For older adults with diabetes, the A1C goal is generally less stringent than in younger populations. An A1C of less than 8% is recommended to balance glycemic control with the risks of hypoglycemia and medication side effects, which can be more harmful in older patients. Individualization is key, but this target helps reduce complications while prioritizing safety and quality of life in aging patients with comorbidities or limited life expectancy.
Long acting beta agonists must be prescribed with which medication class?
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Glucocorticoids
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Short acting beta agonists
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Oral steroids
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Methylxanthines
Explanation
Correct Answer:
A. Glucocorticoids
Explanation of Correct Answer
Long-acting beta agonists (LABAs) must always be prescribed in combination with inhaled glucocorticoids when managing asthma. LABAs provide prolonged bronchodilation but, when used alone, are associated with an increased risk of asthma-related deaths. Inhaled corticosteroids control the underlying airway inflammation, reducing this risk and improving overall disease management. Therefore, combination therapy ensures both immediate bronchodilation and long-term inflammation control, making it the standard of care for persistent asthma.
Your breastfeeding patient reports constipation and requests for relief medication. Which medication should be considered?
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Senna
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Colace
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Mineral Oil
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Miralax
Explanation
Correct Answer:
B. Colace
Explanation of Correct Answer
Colace (docusate sodium) is considered safe for use in breastfeeding patients. It is a stool softener that works by increasing water and fat penetration into the stool, making it easier to pass without significant systemic absorption, thus posing minimal risk to the infant. Senna may cause loose stools in infants, mineral oil can interfere with absorption of fat-soluble vitamins, and while Miralax (PEG 3350) is generally safe, Colace is preferred due to its long-standing safety record in breastfeeding.
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