NR 566 FINAL EXAM NEWEST 2025/2026 ACTUAL
EXAM TEST BANK | NR566 ADVANCED
PHARMACOLOGY FOR CARE OF THE FAMILY
FINAL EXAM REVIEW WITH COMPLETE REAL
EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+ (BRAND NEW!!)
1. A patient with epilepsy is started on phenytoin. How should the nurse
monitor for effectiveness? - ANSWER✔ - Plasma drug level and absence
of seizure during trial period while finding right medication
Rationale:- Phenytoin has a narrow therapeutic index; therapeutic levels
(10-20 mcg/mL) correlate with seizure control. Clinical monitoring for
seizure frequency is essential.
2. Which anticonvulsant is appropriate as adjunctive therapy for partial
seizures with or without secondary generalization in a patient with epilepsy?
- ANSWER✔ - Lamotrigine
Rationale:- Lamotrigine is effective as adjunctive or monotherapy for partial
seizures and generalized seizures including tonic-clonic.
3. What is the first-line preventive therapy for migraine headaches? -
ANSWER✔ - Metoprolol/propranolol (Beta-blockers are often used as
preventive therapy)
Rationale:- Beta-blockers reduce migraine frequency by blocking
vasodilation and stabilizing neuronal excitability.
4. What is abortive therapy for migraine headache and when should it be used?
- ANSWER✔ - Abortive medications stop a migraine when patient feels
one coming or once it has begun. NSAIDs, opioids, and migraine-
specific meds (triptans and ergot alkaloids) used at first sign of attack
Rationale:- Early administration at aura or mild pain phase maximizes
efficacy and prevents progression to severe pain.
,5. What are contraindications to triptans? - ANSWER✔ - Ischemic heart
disease, HTN, CV disease, pregnancy, basilar or hemiplegic migraine,
use of an ergot alkaloid within 24 hours
Rationale:- Triptans cause vasoconstriction; contraindicated in coronary
artery disease, uncontrolled hypertension, and hemiplegic/basilar migraine
due to risk of cerebral vasospasm.
6. What is rivastigmine (Exelon) used for? - ANSWER✔ - Combat symptoms
of Alzheimer's disease. Slows progression of disease – not a cure
Rationale:- Rivastigmine is a cholinesterase inhibitor that increases
acetylcholine levels, temporarily improving cognitive function.
7. What are patient teachings for rivastigmine (Exelon)? - ANSWER✔
- Bradycardia, fainting, falls risk, falls-related fractures
Rationale:- Cholinesterase inhibitors can cause symptomatic bradycardia
and syncope, increasing fall risk especially in elderly.
8. What is donepezil (Aricept) used to treat? - ANSWER✔ - Symptoms of
Alzheimer's disease
Rationale:- Donepezil is a reversible acetylcholinesterase inhibitor approved
for mild to severe Alzheimer's dementia.
9. When would it be appropriate to increase the patient's dose of donepezil
(Aricept)? - ANSWER✔ - When the patient is stable on the initial dose
for at least 1-3 months
Rationale:- Dose escalation should be gradual (5 mg to 10 mg after 4-6
weeks, then to 23 mg after another 6 weeks) to minimize GI side effects.
10.Cholinesterase inhibitor side effects are usually related to what? -
ANSWER✔ - Dosing. Dosing should start low and titrate up.
Rationale:- Cholinergic side effects (nausea, diarrhea, insomnia) are dose-
dependent; slow titration improves tolerability.
11.Common dose-related side effects of cholinesterase inhibitors include: -
ANSWER✔ - Nausea, diarrhea, insomnia
Rationale:- These reflect peripheral and central cholinergic excess.
12.What is most likely to happen as a result of the cardiac side effects of
cholinesterase inhibitors? - ANSWER✔ - Falls due to bradycardia
, Rationale:- Bradycardia and heart block reduce cardiac output, causing
syncope and falls.
13.What can be done to prevent weight loss associated with cholinesterase
inhibitors? - ANSWER✔ - Nutritional shakes, encourage snacks between
meals, meet with a dietician
Rationale:- Anorexia and weight loss are common; high-calorie
supplements and frequent small meals help maintain weight.
14.When taking medications for Alzheimer's disease, what medication should
be added before herbals, supplements, or NSAIDs? - ANSWER✔
- Memantine – dementia medication that decreases abnormal brain
activity
Rationale:- Memantine is an NMDA antagonist; it may be added to
cholinesterase inhibitors for moderate to severe Alzheimer's.
15.What should be considered in the renally impaired when prescribing
memantine? - ANSWER✔ - Dosage adjustment, especially in patients
with a creatinine clearance of less than 30 mL/min
Rationale:- Memantine is renally excreted; severe impairment (CrCl <30)
requires dose reduction to 5 mg BID or 10 mg daily.
16.What medication is the first-line treatment for panic disorder? - ANSWER✔
- SSRIs
Rationale:- SSRIs (e.g., sertraline, paroxetine, fluoxetine) have first-line
FDA approval for panic disorder with fewer side effects than TCAs or
benzodiazepines.
17.What are examples of SSRIs? - ANSWER✔ - Fluoxetine (Prozac),
sertraline (Zoloft), paroxetine (Paxil)
Rationale:- These are commonly used SSRIs; others include citalopram
(Celexa) and escitalopram (Lexapro).
18.What is the first-line treatment for performance anxiety? - ANSWER✔
- Beta blockers such as propranolol (Inderal)
Rationale:- Propranolol reduces autonomic symptoms (tachycardia, tremor)
without sedation, ideal for situational performance anxiety.
19.First-line treatment for acute mild to moderate migraine without nausea or
vomiting: - ANSWER✔ - NSAID: Naproxen and aspirin
, Rationale:- NSAIDs are effective for mild to moderate migraine;
combination with aspirin or caffeine may enhance efficacy.
20.What is the first-line treatment for Chlamydia that only needs to be taken
orally once? - ANSWER✔ - Azithromycin 1000 mg
Rationale:- Single 1g dose of azithromycin provides equivalent efficacy to
7-day doxycycline with improved adherence.
21.What is the first-line treatment for Chlamydia that is taken BID for 7 days? -
ANSWER✔ - Doxycycline 100 mg
Rationale:- Doxycycline 100 mg BID for 7 days is preferred by CDC
guidelines due to higher efficacy (97%) than azithromycin.
22.What is the IM treatment for uncomplicated gonorrhea? - ANSWER✔
- Ceftriaxone 500 mg
Rationale:- CDC recommends ceftriaxone 500 mg IM (1 g if weight >150
kg) for uncomplicated gonorrhea.
23.IM ceftriaxone can be given with or without this medication to treat
gonorrhea: - ANSWER✔ - Doxycycline 100 mg BID
Rationale:- Dual therapy with doxycycline covers co-infection with
Chlamydia, which occurs in ~20% of gonorrhea cases.
24.Treatment for bacterial vaginosis in a non-pregnant patient: - ANSWER✔
- Metronidazole 500 mg BID for 7 days
Rationale:- Oral metronidazole (500 mg BID x7 days) is first-line;
alternatives include intravaginal metronidazole gel or clindamycin cream.
25.What are two treatments for bacterial vaginosis in a pregnant patient? -
ANSWER✔ - Vaginal metronidazole 2% for 7 days; clindamycin 1% for
7 days
Rationale:- Intravaginal therapy minimizes systemic absorption; oral
metronidazole is also safe but topical preferred in first trimester.
26.A patient with generalized anxiety disorder has failed first-line SSRI
therapy. Which medication is next-line? - ANSWER✔ - SNRI (venlafaxine
or duloxetine)
Rationale:- SNRIs are effective for GAD and may work when SSRIs are
inadequate; buspirone or pregabalin are alternatives.
EXAM TEST BANK | NR566 ADVANCED
PHARMACOLOGY FOR CARE OF THE FAMILY
FINAL EXAM REVIEW WITH COMPLETE REAL
EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+ (BRAND NEW!!)
1. A patient with epilepsy is started on phenytoin. How should the nurse
monitor for effectiveness? - ANSWER✔ - Plasma drug level and absence
of seizure during trial period while finding right medication
Rationale:- Phenytoin has a narrow therapeutic index; therapeutic levels
(10-20 mcg/mL) correlate with seizure control. Clinical monitoring for
seizure frequency is essential.
2. Which anticonvulsant is appropriate as adjunctive therapy for partial
seizures with or without secondary generalization in a patient with epilepsy?
- ANSWER✔ - Lamotrigine
Rationale:- Lamotrigine is effective as adjunctive or monotherapy for partial
seizures and generalized seizures including tonic-clonic.
3. What is the first-line preventive therapy for migraine headaches? -
ANSWER✔ - Metoprolol/propranolol (Beta-blockers are often used as
preventive therapy)
Rationale:- Beta-blockers reduce migraine frequency by blocking
vasodilation and stabilizing neuronal excitability.
4. What is abortive therapy for migraine headache and when should it be used?
- ANSWER✔ - Abortive medications stop a migraine when patient feels
one coming or once it has begun. NSAIDs, opioids, and migraine-
specific meds (triptans and ergot alkaloids) used at first sign of attack
Rationale:- Early administration at aura or mild pain phase maximizes
efficacy and prevents progression to severe pain.
,5. What are contraindications to triptans? - ANSWER✔ - Ischemic heart
disease, HTN, CV disease, pregnancy, basilar or hemiplegic migraine,
use of an ergot alkaloid within 24 hours
Rationale:- Triptans cause vasoconstriction; contraindicated in coronary
artery disease, uncontrolled hypertension, and hemiplegic/basilar migraine
due to risk of cerebral vasospasm.
6. What is rivastigmine (Exelon) used for? - ANSWER✔ - Combat symptoms
of Alzheimer's disease. Slows progression of disease – not a cure
Rationale:- Rivastigmine is a cholinesterase inhibitor that increases
acetylcholine levels, temporarily improving cognitive function.
7. What are patient teachings for rivastigmine (Exelon)? - ANSWER✔
- Bradycardia, fainting, falls risk, falls-related fractures
Rationale:- Cholinesterase inhibitors can cause symptomatic bradycardia
and syncope, increasing fall risk especially in elderly.
8. What is donepezil (Aricept) used to treat? - ANSWER✔ - Symptoms of
Alzheimer's disease
Rationale:- Donepezil is a reversible acetylcholinesterase inhibitor approved
for mild to severe Alzheimer's dementia.
9. When would it be appropriate to increase the patient's dose of donepezil
(Aricept)? - ANSWER✔ - When the patient is stable on the initial dose
for at least 1-3 months
Rationale:- Dose escalation should be gradual (5 mg to 10 mg after 4-6
weeks, then to 23 mg after another 6 weeks) to minimize GI side effects.
10.Cholinesterase inhibitor side effects are usually related to what? -
ANSWER✔ - Dosing. Dosing should start low and titrate up.
Rationale:- Cholinergic side effects (nausea, diarrhea, insomnia) are dose-
dependent; slow titration improves tolerability.
11.Common dose-related side effects of cholinesterase inhibitors include: -
ANSWER✔ - Nausea, diarrhea, insomnia
Rationale:- These reflect peripheral and central cholinergic excess.
12.What is most likely to happen as a result of the cardiac side effects of
cholinesterase inhibitors? - ANSWER✔ - Falls due to bradycardia
, Rationale:- Bradycardia and heart block reduce cardiac output, causing
syncope and falls.
13.What can be done to prevent weight loss associated with cholinesterase
inhibitors? - ANSWER✔ - Nutritional shakes, encourage snacks between
meals, meet with a dietician
Rationale:- Anorexia and weight loss are common; high-calorie
supplements and frequent small meals help maintain weight.
14.When taking medications for Alzheimer's disease, what medication should
be added before herbals, supplements, or NSAIDs? - ANSWER✔
- Memantine – dementia medication that decreases abnormal brain
activity
Rationale:- Memantine is an NMDA antagonist; it may be added to
cholinesterase inhibitors for moderate to severe Alzheimer's.
15.What should be considered in the renally impaired when prescribing
memantine? - ANSWER✔ - Dosage adjustment, especially in patients
with a creatinine clearance of less than 30 mL/min
Rationale:- Memantine is renally excreted; severe impairment (CrCl <30)
requires dose reduction to 5 mg BID or 10 mg daily.
16.What medication is the first-line treatment for panic disorder? - ANSWER✔
- SSRIs
Rationale:- SSRIs (e.g., sertraline, paroxetine, fluoxetine) have first-line
FDA approval for panic disorder with fewer side effects than TCAs or
benzodiazepines.
17.What are examples of SSRIs? - ANSWER✔ - Fluoxetine (Prozac),
sertraline (Zoloft), paroxetine (Paxil)
Rationale:- These are commonly used SSRIs; others include citalopram
(Celexa) and escitalopram (Lexapro).
18.What is the first-line treatment for performance anxiety? - ANSWER✔
- Beta blockers such as propranolol (Inderal)
Rationale:- Propranolol reduces autonomic symptoms (tachycardia, tremor)
without sedation, ideal for situational performance anxiety.
19.First-line treatment for acute mild to moderate migraine without nausea or
vomiting: - ANSWER✔ - NSAID: Naproxen and aspirin
, Rationale:- NSAIDs are effective for mild to moderate migraine;
combination with aspirin or caffeine may enhance efficacy.
20.What is the first-line treatment for Chlamydia that only needs to be taken
orally once? - ANSWER✔ - Azithromycin 1000 mg
Rationale:- Single 1g dose of azithromycin provides equivalent efficacy to
7-day doxycycline with improved adherence.
21.What is the first-line treatment for Chlamydia that is taken BID for 7 days? -
ANSWER✔ - Doxycycline 100 mg
Rationale:- Doxycycline 100 mg BID for 7 days is preferred by CDC
guidelines due to higher efficacy (97%) than azithromycin.
22.What is the IM treatment for uncomplicated gonorrhea? - ANSWER✔
- Ceftriaxone 500 mg
Rationale:- CDC recommends ceftriaxone 500 mg IM (1 g if weight >150
kg) for uncomplicated gonorrhea.
23.IM ceftriaxone can be given with or without this medication to treat
gonorrhea: - ANSWER✔ - Doxycycline 100 mg BID
Rationale:- Dual therapy with doxycycline covers co-infection with
Chlamydia, which occurs in ~20% of gonorrhea cases.
24.Treatment for bacterial vaginosis in a non-pregnant patient: - ANSWER✔
- Metronidazole 500 mg BID for 7 days
Rationale:- Oral metronidazole (500 mg BID x7 days) is first-line;
alternatives include intravaginal metronidazole gel or clindamycin cream.
25.What are two treatments for bacterial vaginosis in a pregnant patient? -
ANSWER✔ - Vaginal metronidazole 2% for 7 days; clindamycin 1% for
7 days
Rationale:- Intravaginal therapy minimizes systemic absorption; oral
metronidazole is also safe but topical preferred in first trimester.
26.A patient with generalized anxiety disorder has failed first-line SSRI
therapy. Which medication is next-line? - ANSWER✔ - SNRI (venlafaxine
or duloxetine)
Rationale:- SNRIs are effective for GAD and may work when SSRIs are
inadequate; buspirone or pregabalin are alternatives.
