Advanced Pharmacology D116 Problem set study Exam
Questions and complete solution Guaranteed Success
2025/2026
A patient develops an asthma exacerbation. The patient's medication history lists an
inhaled glucocorticoid, montelukast, and a short acting β2 agonist as needed via
metered-dose inhaler (MDI). The patient's respiratory rate is 18 breaths/minute, heart
rate is 96 beats/minute, and an oxygen saturation is 95%. The provider auscultates mild
expiratory wheezes bilaterally. What action will the provider take first correct answer
C. Question the patient about how much albuterol has been used.
Feedback: To determine the next course of action, it is important to assess the drugs
given before these symptoms were observed. Patients who continue to wheeze after
using a SABA need systemic glucocorticoids and nebulized albuterol. If a SABA has not
been used, that will be the first intervention. LABAs are not used for exacerbations. If a
patient reports using a SABA without good results, evaluating the MDI technique may
be warranted.
A patient with asthma reports daily symptoms requiring a short-acting β2-agonist for
relief. The patient has used oral glucocorticoids three times in the past 3 months and
reports awakening at night with symptoms about once a week. The patient's forced
expiratory volume in 1 second (FEV1) is 75% of predicted values. Which regimen does
the provider determine is best for this patient correct answer
B. Daily low-dose inhaled glucocorticoid/LABA with a SABA as needed
Feedback: This patient has moderate persistent asthma, which requires step 3
management for initial treatment. Step 3 includes daily inhalation of a low-dose
glucocorticoid/LABA combination supplemented with a SABA as needed. A daily low-
dose glucocorticoid with an as-needed SABA is used for step 2 management. A daily
medium-dose glucocorticoid/LABA is used for step 4 management. Patients requiring
step 1 management do not need daily medications.
,A pregnant patient discusses nutrition and vitamin supplements with her provider. Which
statement by the patient indicates an understanding of the use of nutrition and
supplements during pregnancy correct answer
D. “Excessive amounts of vitamin A can cause birth defects in my baby.”
Feedback: Vitamin A in high doses can cause birth defects, so pregnant women should
be cautioned about exceeding the UL and probably the RDA for vitamin A while
pregnant. Pregnant women need to take 400 to 800 mg of supplemental folic acid in
addition to that in food. Vitamin C deficiency, not excess, can lead to bleeding disorders.
Maternal intake of vitamin K will not prevent infants from being born vitamin K deficient.
A patient who is malnourished reports difficulty seeing at night. The provider will order a
laboratory test that checks for a deficiency of which fat-soluble vitamin correct answer
B. Vitamin A (retinol)
Feedback: Vitamin A is needed for dark adaptation; night blindness often is the first
indication of deficiency. Night blindness is not a sign of deficiency of vitamins D, E, or K.
A patient with stable COPD is prescribed a bronchodilator by the provider. Which type of
bronchodilator is preferred for this patient correct answer
D. A long-acting inhaled β2 agonist (LABA)
Feedback: LABAs are preferred over SABAs for COPD. Oral β2 agonists are not first-
line therapy. Although theophylline, a methylxanthine, was once standard therapy in
COPD, it is no longer recommended. It is used only if β2 agonists are not available.
, A patient who uses nutritional therapy to manage an elevated cholesterol level reports
experiencing flushing after taking these supplements. The provider will question the
patient concerning intake of which vitamin correct answer
C. Niacin
Feedback: High-dose niacin is used to reduce cholesterol levels. When taken in large
doses, nicotinic acid can cause vasodilation, with resultant flushing, dizziness, and
nausea. Flushing is not a side effect of thiamine, riboflavin, or pyridoxine.
The provider prescribes iron supplements to treat a patient's anemia. The provider
advises the patient to take the iron with which food to facilitate absorption correct
answer
C. Orange juice
Feedback: Orange juice is a good source of vitamin C, and vitamin C facilitates the
absorption of iron. Cereals often are fortified with iron but do not facilitate its absorption.
Calcium interferes with the absorption of iron. Red meats are a natural source of iron
but do improve absorption of iron supplements.
A patient who recently immigrated from a third world country is thin and malnourished.
The provider notes that the patient has loose and missing teeth, gingivitis, and bleeding
gums as well as multiple sores and ecchymoses. What vitamin deficiency does the
provider suspect correct answer
D. Ascorbic acid (Vitamin C)
Feedback: This patient likely has scurvy, a vitamin C deficiency, with acute, severe
symptoms. Laboratory testing will confirm the diagnosis. The patient does not have
signs of vitamin B12 deficiency, niacin deficiency, or thiamine deficiency.
Questions and complete solution Guaranteed Success
2025/2026
A patient develops an asthma exacerbation. The patient's medication history lists an
inhaled glucocorticoid, montelukast, and a short acting β2 agonist as needed via
metered-dose inhaler (MDI). The patient's respiratory rate is 18 breaths/minute, heart
rate is 96 beats/minute, and an oxygen saturation is 95%. The provider auscultates mild
expiratory wheezes bilaterally. What action will the provider take first correct answer
C. Question the patient about how much albuterol has been used.
Feedback: To determine the next course of action, it is important to assess the drugs
given before these symptoms were observed. Patients who continue to wheeze after
using a SABA need systemic glucocorticoids and nebulized albuterol. If a SABA has not
been used, that will be the first intervention. LABAs are not used for exacerbations. If a
patient reports using a SABA without good results, evaluating the MDI technique may
be warranted.
A patient with asthma reports daily symptoms requiring a short-acting β2-agonist for
relief. The patient has used oral glucocorticoids three times in the past 3 months and
reports awakening at night with symptoms about once a week. The patient's forced
expiratory volume in 1 second (FEV1) is 75% of predicted values. Which regimen does
the provider determine is best for this patient correct answer
B. Daily low-dose inhaled glucocorticoid/LABA with a SABA as needed
Feedback: This patient has moderate persistent asthma, which requires step 3
management for initial treatment. Step 3 includes daily inhalation of a low-dose
glucocorticoid/LABA combination supplemented with a SABA as needed. A daily low-
dose glucocorticoid with an as-needed SABA is used for step 2 management. A daily
medium-dose glucocorticoid/LABA is used for step 4 management. Patients requiring
step 1 management do not need daily medications.
,A pregnant patient discusses nutrition and vitamin supplements with her provider. Which
statement by the patient indicates an understanding of the use of nutrition and
supplements during pregnancy correct answer
D. “Excessive amounts of vitamin A can cause birth defects in my baby.”
Feedback: Vitamin A in high doses can cause birth defects, so pregnant women should
be cautioned about exceeding the UL and probably the RDA for vitamin A while
pregnant. Pregnant women need to take 400 to 800 mg of supplemental folic acid in
addition to that in food. Vitamin C deficiency, not excess, can lead to bleeding disorders.
Maternal intake of vitamin K will not prevent infants from being born vitamin K deficient.
A patient who is malnourished reports difficulty seeing at night. The provider will order a
laboratory test that checks for a deficiency of which fat-soluble vitamin correct answer
B. Vitamin A (retinol)
Feedback: Vitamin A is needed for dark adaptation; night blindness often is the first
indication of deficiency. Night blindness is not a sign of deficiency of vitamins D, E, or K.
A patient with stable COPD is prescribed a bronchodilator by the provider. Which type of
bronchodilator is preferred for this patient correct answer
D. A long-acting inhaled β2 agonist (LABA)
Feedback: LABAs are preferred over SABAs for COPD. Oral β2 agonists are not first-
line therapy. Although theophylline, a methylxanthine, was once standard therapy in
COPD, it is no longer recommended. It is used only if β2 agonists are not available.
, A patient who uses nutritional therapy to manage an elevated cholesterol level reports
experiencing flushing after taking these supplements. The provider will question the
patient concerning intake of which vitamin correct answer
C. Niacin
Feedback: High-dose niacin is used to reduce cholesterol levels. When taken in large
doses, nicotinic acid can cause vasodilation, with resultant flushing, dizziness, and
nausea. Flushing is not a side effect of thiamine, riboflavin, or pyridoxine.
The provider prescribes iron supplements to treat a patient's anemia. The provider
advises the patient to take the iron with which food to facilitate absorption correct
answer
C. Orange juice
Feedback: Orange juice is a good source of vitamin C, and vitamin C facilitates the
absorption of iron. Cereals often are fortified with iron but do not facilitate its absorption.
Calcium interferes with the absorption of iron. Red meats are a natural source of iron
but do improve absorption of iron supplements.
A patient who recently immigrated from a third world country is thin and malnourished.
The provider notes that the patient has loose and missing teeth, gingivitis, and bleeding
gums as well as multiple sores and ecchymoses. What vitamin deficiency does the
provider suspect correct answer
D. Ascorbic acid (Vitamin C)
Feedback: This patient likely has scurvy, a vitamin C deficiency, with acute, severe
symptoms. Laboratory testing will confirm the diagnosis. The patient does not have
signs of vitamin B12 deficiency, niacin deficiency, or thiamine deficiency.
