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NURS 6521 Advanced Pharmacology Midterm Exam
Version 1 2026/2027 | Questions with Verified Answers
& Detailed Rationales | Grade A Study Guide
1. A nurse practitioner explains to a patient that nitroglycerin patches should be applied
in the morning and removed in the evening. This medication schedule reduces the
potential for:
A. Medication tolerance
B. Nitrate tolerance
C. Rebound hypertension
D. Withdrawal symptoms
Correct Answer: B
Rationale: Nitrate tolerance develops with continuous exposure to nitrates. A nitrate-
free interval of 10-12 hours daily, typically achieved by removing the patch at night,
prevents tolerance and maintains therapeutic efficacy.
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2. Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful
coronary artery bypass graft (CABG). During patient education about his drug regimen,
Mr. Nguyen's nurse should prioritize teaching about:
A. The names and purposes of all his medications
B. Potential adverse effects of the drugs that Mr. Nguyen will be taking
C. The mechanisms of action of his new medications
D. The financial cost of his new medications
Correct Answer: B
Rationale: Understanding potential adverse effects is essential for patient safety and
early recognition of complications. This knowledge enables the patient to identify
concerning symptoms and seek timely medical intervention.
3. The most effective therapy for a patient who is H. pylori positive with a gastric ulcer
is:
A. Amoxicillin, clarithromycin, and omeprazole
B. Bismuth, metronidazole, omeprazole, and tetracycline
C. Metronidazole, clarithromycin, and lansoprazole
D. Amoxicillin, metronidazole, and famotidine
Correct Answer: B
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Rationale: Quadruple therapy with bismuth, metronidazole, omeprazole, and
tetracycline is a first-line regimen for H. pylori eradication, particularly in areas with high
clarithromycin resistance or when penicillin allergy is present.
4. A 60-year-old African-American man lives with a number of chronic health problems.
Genetic factors are likely to influence his etiology and/or treatment of:
A. Diabetes mellitus
B. Hypertension
C. Chronic obstructive pulmonary disease
D. Osteoarthritis
Correct Answer: B
Rationale: African-American patients have a higher prevalence of hypertension and
often respond differently to antihypertensive medications. Genetic factors influence
both the development of hypertension and the response to certain drug classes such as
ACE inhibitors and beta-blockers.
5. A female patient has been taking prednisone for her asthma for 1 month. The nurse
will teach her to gradually decrease her dose of prednisone to avoid:
A. Adrenal insufficiency
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B. Rebound asthma symptoms
C. Cushing's syndrome
D. Hyperglycemia
Correct Answer: A
Rationale: Abrupt withdrawal of corticosteroids after prolonged use can cause adrenal
insufficiency because the body's hypothalamic-pituitary-adrenal axis is suppressed.
Gradual tapering allows adrenal function to recover.
6. A nurse practitioner is caring for a 70-year-old patient who is taking desmopressin
(DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the
assessment of which of the following?
A. Electrolyte levels
B. Blood glucose levels
C. Cardiac enzymes
D. Liver function tests
Correct Answer: A
Rationale: Desmopressin can cause fluid retention and hyponatremia, particularly in
older adults and those with cardiovascular disease. Electrolyte monitoring, especially
sodium levels, is essential to prevent complications.
NURS 6521 Advanced Pharmacology Midterm Exam
Version 1 2026/2027 | Questions with Verified Answers
& Detailed Rationales | Grade A Study Guide
1. A nurse practitioner explains to a patient that nitroglycerin patches should be applied
in the morning and removed in the evening. This medication schedule reduces the
potential for:
A. Medication tolerance
B. Nitrate tolerance
C. Rebound hypertension
D. Withdrawal symptoms
Correct Answer: B
Rationale: Nitrate tolerance develops with continuous exposure to nitrates. A nitrate-
free interval of 10-12 hours daily, typically achieved by removing the patch at night,
prevents tolerance and maintains therapeutic efficacy.
,2|Page
2. Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful
coronary artery bypass graft (CABG). During patient education about his drug regimen,
Mr. Nguyen's nurse should prioritize teaching about:
A. The names and purposes of all his medications
B. Potential adverse effects of the drugs that Mr. Nguyen will be taking
C. The mechanisms of action of his new medications
D. The financial cost of his new medications
Correct Answer: B
Rationale: Understanding potential adverse effects is essential for patient safety and
early recognition of complications. This knowledge enables the patient to identify
concerning symptoms and seek timely medical intervention.
3. The most effective therapy for a patient who is H. pylori positive with a gastric ulcer
is:
A. Amoxicillin, clarithromycin, and omeprazole
B. Bismuth, metronidazole, omeprazole, and tetracycline
C. Metronidazole, clarithromycin, and lansoprazole
D. Amoxicillin, metronidazole, and famotidine
Correct Answer: B
,3|Page
Rationale: Quadruple therapy with bismuth, metronidazole, omeprazole, and
tetracycline is a first-line regimen for H. pylori eradication, particularly in areas with high
clarithromycin resistance or when penicillin allergy is present.
4. A 60-year-old African-American man lives with a number of chronic health problems.
Genetic factors are likely to influence his etiology and/or treatment of:
A. Diabetes mellitus
B. Hypertension
C. Chronic obstructive pulmonary disease
D. Osteoarthritis
Correct Answer: B
Rationale: African-American patients have a higher prevalence of hypertension and
often respond differently to antihypertensive medications. Genetic factors influence
both the development of hypertension and the response to certain drug classes such as
ACE inhibitors and beta-blockers.
5. A female patient has been taking prednisone for her asthma for 1 month. The nurse
will teach her to gradually decrease her dose of prednisone to avoid:
A. Adrenal insufficiency
, 4|Page
B. Rebound asthma symptoms
C. Cushing's syndrome
D. Hyperglycemia
Correct Answer: A
Rationale: Abrupt withdrawal of corticosteroids after prolonged use can cause adrenal
insufficiency because the body's hypothalamic-pituitary-adrenal axis is suppressed.
Gradual tapering allows adrenal function to recover.
6. A nurse practitioner is caring for a 70-year-old patient who is taking desmopressin
(DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the
assessment of which of the following?
A. Electrolyte levels
B. Blood glucose levels
C. Cardiac enzymes
D. Liver function tests
Correct Answer: A
Rationale: Desmopressin can cause fluid retention and hyponatremia, particularly in
older adults and those with cardiovascular disease. Electrolyte monitoring, especially
sodium levels, is essential to prevent complications.
