WGU D116 ADVANCED PHARMACOLOGY
OBJECTIVE ASSESSMENT EXAM ACTUAL
QUESTIONS AND ANSWERS 2026-27
1. A 14-year-old male with short stature and virilization is evaluated. The NP
suspects anabolic steroid use. What should be ordered?
A) Serum cortisol
B) Liver function tests and serum cholesterol
C) Testosterone only
D) Bone density
Answer: B
Rationale: Androgen use in adolescents can accelerate epiphyseal closure and
cause hepatotoxicity and dyslipidemia (↓ HDL, ↑ LDL), so liver panels and
cholesterol are appropriate.
2. A patient on tadalafil for ED should NOT be prescribed which medication due to
severe hypotension risk?
A) Aspirin
B) Nitro-tab (nitroglycerin)
C) Acetaminophen
D) Amoxicillin
Answer: B
Rationale: PDE-5 inhibitors and nitrates both cause vasodilation → severe
hypotension when combined.
3. What contraceptive is not appropriate for a breastfeeding patient at 6 weeks
postpartum?
A) Progestin-only pill
B) IUD
,C) Combination oral contraceptive
D) Barrier method
Answer: C
Rationale: Estrogen-containing combined oral contraceptives can reduce milk
supply and are contraindicated early in breastfeeding.
4. How do combination oral contraceptives primarily prevent pregnancy?
A) Thickening cervical mucus
B) Suppressing ovulation
C) Increasing basal body temperature
D) Increasing progesterone only
Answer: B
Rationale: They mainly inhibit ovulation through feedback on the hypothalamus
and pituitary.
5. A common side effect of tamsulosin in a 56-year-old man is:
A) Hypertension
B) Decreased ejaculate and libido
C) Increased appetite
D) Weight gain
Answer: B
Rationale: Alpha-blockers like tamsulosin can cause sexual dysfunction including
reduced ejaculate and libido.
6. Saw palmetto is thought to contain which active component?
A) Stigmasterol
B) Beta-sitosterol
C) Flavonoid alpha
D) Omega-3 fatty acids
,Answer: B
Rationale: Saw palmetto contains beta-sitosterol, believed to help benign prostatic
hyperplasia symptoms.
7. Patients taking garlic supplements have the highest risk of herb-drug interaction
with:
A) ACE inhibitors
B) Anticoagulants
C) Antibiotics
D) Beta-blockers
Answer: B
Rationale: Garlic has antiplatelet effects and can potentiate bleeding with
anticoagulants.
8. Best food sources of folate include:
A) Red meat and eggs
B) Green leafy vegetables, beans, lentils
C) Cheese and milk
D) White rice
Answer: B
Rationale: Folate is high in greens, legumes, and some fruits/vegetables.
9. A patient with benign prostatic hyperplasia is prescribed finasteride. What is the
most important teaching point?
A) Improvement in symptoms occurs within 48 hours
B) May take 6 months to see maximum benefit
C) Causes immediate increase in urine flow
D) No effect on prostate size
Answer: B
Rationale: Finasteride is a 5-alpha-reductase inhibitor that reduces prostate size
slowly; maximum symptom relief may take 6 months or longer.
, 10. Which medication is most appropriate for acute treatment of a migraine in a
patient with hypertension?
A) Sumatriptan
B) Rizatriptan (both triptans are generally safe, but if severe hypertension avoid
all triptans; however, among options, triptans are used but caution) – Actually
triptans are contraindicated in uncontrolled hypertension. The question may have
different options; I'll adjust:
Correction: Which medication is most appropriate for acute migraine in a patient
with well-controlled hypertension?
A) Ergotamine
B) Sumatriptan
C) Metoclopramide
D) Butalbital
Answer: B
Rationale: Triptans are first-line for acute migraine. Ergotamine has more
vasoconstrictive effects. Metoclopramide is an antiemetic. Butalbital has high risk
of rebound.
11. A patient taking warfarin has an INR of 4.5 without bleeding. What is the
appropriate management?
A) Hold warfarin and give vitamin K 10 mg IM
B) Hold warfarin and give vitamin K 1-2.5 mg orally
C) Continue warfarin at same dose
D) Increase warfarin dose
Answer: B
Rationale: For INR 4.5 without bleeding, hold warfarin and give low-dose oral
vitamin K (1-2.5 mg). High-dose vitamin K is for bleeding.
12. A patient with type 2 diabetes and heart failure is started on a new medication
that reduces cardiovascular mortality. Which drug is this?
OBJECTIVE ASSESSMENT EXAM ACTUAL
QUESTIONS AND ANSWERS 2026-27
1. A 14-year-old male with short stature and virilization is evaluated. The NP
suspects anabolic steroid use. What should be ordered?
A) Serum cortisol
B) Liver function tests and serum cholesterol
C) Testosterone only
D) Bone density
Answer: B
Rationale: Androgen use in adolescents can accelerate epiphyseal closure and
cause hepatotoxicity and dyslipidemia (↓ HDL, ↑ LDL), so liver panels and
cholesterol are appropriate.
2. A patient on tadalafil for ED should NOT be prescribed which medication due to
severe hypotension risk?
A) Aspirin
B) Nitro-tab (nitroglycerin)
C) Acetaminophen
D) Amoxicillin
Answer: B
Rationale: PDE-5 inhibitors and nitrates both cause vasodilation → severe
hypotension when combined.
3. What contraceptive is not appropriate for a breastfeeding patient at 6 weeks
postpartum?
A) Progestin-only pill
B) IUD
,C) Combination oral contraceptive
D) Barrier method
Answer: C
Rationale: Estrogen-containing combined oral contraceptives can reduce milk
supply and are contraindicated early in breastfeeding.
4. How do combination oral contraceptives primarily prevent pregnancy?
A) Thickening cervical mucus
B) Suppressing ovulation
C) Increasing basal body temperature
D) Increasing progesterone only
Answer: B
Rationale: They mainly inhibit ovulation through feedback on the hypothalamus
and pituitary.
5. A common side effect of tamsulosin in a 56-year-old man is:
A) Hypertension
B) Decreased ejaculate and libido
C) Increased appetite
D) Weight gain
Answer: B
Rationale: Alpha-blockers like tamsulosin can cause sexual dysfunction including
reduced ejaculate and libido.
6. Saw palmetto is thought to contain which active component?
A) Stigmasterol
B) Beta-sitosterol
C) Flavonoid alpha
D) Omega-3 fatty acids
,Answer: B
Rationale: Saw palmetto contains beta-sitosterol, believed to help benign prostatic
hyperplasia symptoms.
7. Patients taking garlic supplements have the highest risk of herb-drug interaction
with:
A) ACE inhibitors
B) Anticoagulants
C) Antibiotics
D) Beta-blockers
Answer: B
Rationale: Garlic has antiplatelet effects and can potentiate bleeding with
anticoagulants.
8. Best food sources of folate include:
A) Red meat and eggs
B) Green leafy vegetables, beans, lentils
C) Cheese and milk
D) White rice
Answer: B
Rationale: Folate is high in greens, legumes, and some fruits/vegetables.
9. A patient with benign prostatic hyperplasia is prescribed finasteride. What is the
most important teaching point?
A) Improvement in symptoms occurs within 48 hours
B) May take 6 months to see maximum benefit
C) Causes immediate increase in urine flow
D) No effect on prostate size
Answer: B
Rationale: Finasteride is a 5-alpha-reductase inhibitor that reduces prostate size
slowly; maximum symptom relief may take 6 months or longer.
, 10. Which medication is most appropriate for acute treatment of a migraine in a
patient with hypertension?
A) Sumatriptan
B) Rizatriptan (both triptans are generally safe, but if severe hypertension avoid
all triptans; however, among options, triptans are used but caution) – Actually
triptans are contraindicated in uncontrolled hypertension. The question may have
different options; I'll adjust:
Correction: Which medication is most appropriate for acute migraine in a patient
with well-controlled hypertension?
A) Ergotamine
B) Sumatriptan
C) Metoclopramide
D) Butalbital
Answer: B
Rationale: Triptans are first-line for acute migraine. Ergotamine has more
vasoconstrictive effects. Metoclopramide is an antiemetic. Butalbital has high risk
of rebound.
11. A patient taking warfarin has an INR of 4.5 without bleeding. What is the
appropriate management?
A) Hold warfarin and give vitamin K 10 mg IM
B) Hold warfarin and give vitamin K 1-2.5 mg orally
C) Continue warfarin at same dose
D) Increase warfarin dose
Answer: B
Rationale: For INR 4.5 without bleeding, hold warfarin and give low-dose oral
vitamin K (1-2.5 mg). High-dose vitamin K is for bleeding.
12. A patient with type 2 diabetes and heart failure is started on a new medication
that reduces cardiovascular mortality. Which drug is this?
