NR 508 PHARM WEEK 3 EXAM QUESTIONS
AND ANSWERS UPDATED (2024/2025)
(VERIFIED ANSWERS)
Which of the following classes of drugs is contraindicated in heart failure?
1. Nitrates
2. Long-acting dihydropyridines
3. Calcium channel blockers
4. Alpha-beta blockers - ANS ✓3. Calcium channel blockers
Heart failure is a leading cause of death and hospitalization in older adults
(greater than 65 years old). The drug of choice for this population is:
1. Aldosterone antagonists
2. Eplerenone
3. ACE inhibitors
4. ARBs - ANS ✓3. ACE inhibitors
ACE inhibitors are contraindicated in pregnancy. While treatment of heart
failure during pregnancy is best done by a specialist, which of the following
drug classes is considered to be safe, at least in the later parts of
pregnancy?
1. Diuretics
2. ARBs
3. Beta blockers
4. Nitrates - ANS ✓3. Beta blockers
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Heart failure is a chronic condition that can be adequately managed in
primary care. However, consultation with or referral to a cardiologist is
appropriate when:
1. Symptoms markedly worsen or the patient becomes hypotensive and has
syncope
2. There is evidence of progressive renal insufficiency or failure
3. The patient remains symptomatic on optimal doses of an ACE inhibitor, a
beta blocker, and a diuretic
4. Any of the above - ANS ✓4. Any of the above
ACE inhibitors are a foundational medication in HF. Which group of
patients cannot take them safely?
1. Elderly patients with reduced renal clearance
2. Pregnant women
3. Women under age 30
4. 1 and 2 - ANS ✓4. 1 and 2
What assessment that can be done at home is the most reliable for making
decisions to change HF medications?
1. Weight
2. BP
3. Heart rate
4. Serum Glucose - ANS ✓1. Weight
Evidence is strong that the timing of HF interventions are best initiated
when:
1. The person enters stage C
2. The person has functional disabilities
3. At the earliest indication
4. When stage IV is determined - ANS ✓3. At the earliest indication
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HF patients frequently take more than one drug. When are anticoagulants
typically used?
1. When the patient enters stage III
2. Only in cases of diastolic failure
3. When there is concurrent A Fib
4. In all cases - ANS ✓3. When there is concurrent A Fib
What can chest x-rays contribute to the diagnosis and management of HF?
1. They have no role.
2. They can give very precise pictures of pulmonary fluid status.
3. They provide an idea of general cardiac size and pulmonary great vessel
distribution.
4. They can confirm the diagnosis. - ANS ✓3. They provide an idea of general
cardiac size and pulmonary great vessel distribution.
The overall goal of treating hyperlipidemia is:
1. Maintain an LDL level of less than 160 mg/dL
2. To reduce atherogenesis
3. Lowering apo B, one of the apoliproteins
4. All of the above - ANS ✓2. To reduce atherogenesis
When considering which cholesterol-lowering drug to prescribe, which
factor determines the type and intensity of treatment?
1. Total LDL
2. Fasting HDL
3. Coronary artery disease risk level
4. Fasting total cholesterol - ANS ✓3. Coronary artery disease risk level
First-line therapy for hyperlipidemia is:
1. Statins
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2. Niacin
3. Lifestyle changes
4. Bile acid-binding resins - ANS ✓3. Lifestyle changes
James is a 45-year-old patient with an LDL level of 120 and normal
triglycerides. Appropriate first-line therapy for James may include diet
counseling, increased physical activity, and:
1. A statin
2. Niacin
3. Sterols
4. A fibric acid derivative - ANS ✓3. Sterols
Joanne is a 60-year-old patient with an LDL of 132 and a family history of
coronary artery disease. She has already tried diet changes (increased fiber
and plant sterols) to lower her LDL and after 6 months her LDL is slightly
higher. The next step in her treatment would be:
1. A statin
2. Niacin
3. Sterols
4. A fibric acid derivative - ANS ✓1. A statin
Sharlene is a 65-year-old patient who has been on a lipid-lowering diet and
using plant sterol margarine daily for the past 3 months. Her LDL is 135
mg/dL. An appropriate treatment for her would be:
1. A statin
2. Niacin
3. A fibric acid derivative
4. Determined by her risk factors - ANS ✓4. Determined by her risk factors
Phil is a 54-year-old male with multiple risk factors who has been on a
high-dose statin for 3 months to treat his high LDL level. His LDL is 135
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