NR566 | NR566 Advanced Pharmacology for Care
of the Family Wk 3 Final Exam v1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A 24-year-old patient with asthma is prescribed a short-acting beta-2 agonist (SABA)
for rescue use. Which of the following best describes the mechanism of action of this
medication?
A. Inhibition of leukotriene receptors in the airway
B. Suppression of inflammatory mediators like cytokines
C. Relaxation of bronchial smooth muscle through stimulation of adenyl cyclase
D. Antagonism of muscarinic receptors to prevent bronchoconstriction
Correct Answer: C
Expert Explanation: Short-acting beta-2 agonists like albuterol work by binding to
beta-2 adrenergic receptors on airway smooth muscle. This activation stimulates
adenyl cyclase, increasing cyclic AMP levels and leading to rapid bronchodilation. It
is the primary treatment for acute bronchospasm but does not address underlying
inflammation.
2. When prescribing an inhaled corticosteroid (ICS) for long-term asthma
management, which education point is most critical for preventing local side effects?
A. Rinse the mouth with water and spit after each use
,B. Take the medication only when feeling short of breath
C. Avoid drinking water for 30 minutes after inhalation
D. Use a spacer only if the patient is elderly
Correct Answer: A
Expert Explanation: Rinsing the mouth after using an inhaled corticosteroid is
essential to reduce the risk of oropharyngeal candidiasis (thrush). This practice
helps remove residual drug particles deposited in the mouth and throat. Consistent
use of this technique significantly lowers the incidence of local fungal infections and
hoarseness.
3. A patient with a history of severe asthma requires treatment for hypertension.
Which class of antihypertensives should be used with extreme caution?
A. ACE Inhibitors
B. Calcium Channel Blockers
C. Non-selective Beta-blockers
D. Thiazide Diuretics
Correct Answer: C
Expert Explanation: Non-selective beta-blockers, such as propranolol, can block
beta-2 receptors in the lungs, leading to potentially fatal bronchoconstriction in
,asthma patients. While cardioselective beta-blockers are safer, they can still lose
selectivity at higher doses. Always assess the respiratory status of the patient before
initiating any beta-adrenergic antagonist.
4. A patient reporting a ‘Type I’ hypersensitivity reaction to Penicillin G needs
treatment for a skin infection. Which of the following is the safest alternative?
A. Cephalexin
B. Amoxicillin/Clavulanate
C. Azithromycin
D. Cefazolin
Correct Answer: C
Expert Explanation: Patients with a true Type I (IgE-mediated) penicillin allergy
have an increased risk of cross-reactivity with cephalosporins, particularly first-
generation ones like Cephalexin. Azithromycin, a macrolide, is chemically unrelated
to penicillins and is a safe alternative for most soft tissue infections. Clinicians must
distinguish between a mild rash and true anaphylaxis when choosing alternative
therapy.
5. A 7-year-old child presents with a suspected Mycoplasma pneumoniae infection.
Why is Doxycycline typically avoided in this age group unless no other options exist?
A. Risk of acute renal failure
, B. Risk of Reye syndrome
C. High incidence of ototoxicity in children
D. Potential for permanent tooth discoloration and enamel hypoplasia
Correct Answer: D
Expert Explanation: Tetracyclines like doxycycline bind to calcium in developing
teeth and bones, which can lead to permanent brownish discoloration. This effect is
most prominent in children under the age of 8 during the period of tooth
calcification. While short courses of doxycycline are now considered safer than
older tetracyclines, it remains a secondary choice in pediatric populations for many
infections.
6. A patient is prescribed Ciprofloxacin for a complicated urinary tract infection. Which
black box warning should the provider discuss with the patient?
A. Risk of Stevens-Johnson Syndrome
B. Risk of profound neutropenia
C. Risk of drug-induced lupus erythematosus
D. Risk of tendon rupture and tendinitis
Correct Answer: D
of the Family Wk 3 Final Exam v1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A 24-year-old patient with asthma is prescribed a short-acting beta-2 agonist (SABA)
for rescue use. Which of the following best describes the mechanism of action of this
medication?
A. Inhibition of leukotriene receptors in the airway
B. Suppression of inflammatory mediators like cytokines
C. Relaxation of bronchial smooth muscle through stimulation of adenyl cyclase
D. Antagonism of muscarinic receptors to prevent bronchoconstriction
Correct Answer: C
Expert Explanation: Short-acting beta-2 agonists like albuterol work by binding to
beta-2 adrenergic receptors on airway smooth muscle. This activation stimulates
adenyl cyclase, increasing cyclic AMP levels and leading to rapid bronchodilation. It
is the primary treatment for acute bronchospasm but does not address underlying
inflammation.
2. When prescribing an inhaled corticosteroid (ICS) for long-term asthma
management, which education point is most critical for preventing local side effects?
A. Rinse the mouth with water and spit after each use
,B. Take the medication only when feeling short of breath
C. Avoid drinking water for 30 minutes after inhalation
D. Use a spacer only if the patient is elderly
Correct Answer: A
Expert Explanation: Rinsing the mouth after using an inhaled corticosteroid is
essential to reduce the risk of oropharyngeal candidiasis (thrush). This practice
helps remove residual drug particles deposited in the mouth and throat. Consistent
use of this technique significantly lowers the incidence of local fungal infections and
hoarseness.
3. A patient with a history of severe asthma requires treatment for hypertension.
Which class of antihypertensives should be used with extreme caution?
A. ACE Inhibitors
B. Calcium Channel Blockers
C. Non-selective Beta-blockers
D. Thiazide Diuretics
Correct Answer: C
Expert Explanation: Non-selective beta-blockers, such as propranolol, can block
beta-2 receptors in the lungs, leading to potentially fatal bronchoconstriction in
,asthma patients. While cardioselective beta-blockers are safer, they can still lose
selectivity at higher doses. Always assess the respiratory status of the patient before
initiating any beta-adrenergic antagonist.
4. A patient reporting a ‘Type I’ hypersensitivity reaction to Penicillin G needs
treatment for a skin infection. Which of the following is the safest alternative?
A. Cephalexin
B. Amoxicillin/Clavulanate
C. Azithromycin
D. Cefazolin
Correct Answer: C
Expert Explanation: Patients with a true Type I (IgE-mediated) penicillin allergy
have an increased risk of cross-reactivity with cephalosporins, particularly first-
generation ones like Cephalexin. Azithromycin, a macrolide, is chemically unrelated
to penicillins and is a safe alternative for most soft tissue infections. Clinicians must
distinguish between a mild rash and true anaphylaxis when choosing alternative
therapy.
5. A 7-year-old child presents with a suspected Mycoplasma pneumoniae infection.
Why is Doxycycline typically avoided in this age group unless no other options exist?
A. Risk of acute renal failure
, B. Risk of Reye syndrome
C. High incidence of ototoxicity in children
D. Potential for permanent tooth discoloration and enamel hypoplasia
Correct Answer: D
Expert Explanation: Tetracyclines like doxycycline bind to calcium in developing
teeth and bones, which can lead to permanent brownish discoloration. This effect is
most prominent in children under the age of 8 during the period of tooth
calcification. While short courses of doxycycline are now considered safer than
older tetracyclines, it remains a secondary choice in pediatric populations for many
infections.
6. A patient is prescribed Ciprofloxacin for a complicated urinary tract infection. Which
black box warning should the provider discuss with the patient?
A. Risk of Stevens-Johnson Syndrome
B. Risk of profound neutropenia
C. Risk of drug-induced lupus erythematosus
D. Risk of tendon rupture and tendinitis
Correct Answer: D
