NUR 521
Exam 4 Blueprint
High-Yield Qs & Answers with
Rationales
University of Alabama
This Exam Description:
High-Yield Qs
Answers with Rationales
100% Guaranteed Pass
Multiple –Choices (A-D)
1
,Section 1: Antifungal Pharmacology (Clinical Depth)
Question 1
A patient with HIV presents with cryptococcal meningitis. Which initial therapy is most
appropriate?
A) Fluconazole monotherapy
B) Amphotericin B + Flucytosine
C) Itraconazole
D) Caspofungin
Answer: B
Rationale:
In UAB-style exams, this is testing stepwise therapy and severity-based treatment.
Cryptococcal meningitis requires induction therapy with Amphotericin B + flucytosine
due to synergistic fungicidal activity. Fluconazole alone is insufficient for initial
management but is used in maintenance phases. The key concept is disease severity
dictates drug selection, not just organism.
Question 2
A patient receiving amphotericin B develops muscle weakness and ECG changes. Which
electrolyte imbalance is most likely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Answer: B
Rationale:
Amphotericin B causes renal tubular damage, leading to potassium and magnesium
wasting. Hypokalemia increases risk of cardiac arrhythmias, which is why electrolyte
monitoring is a priority. UAB questions often link drug toxicity → lab abnormality →
clinical manifestation.
Section 2: Endocrine Pharmacology (Integrated
Prescribing)
Question 3
2
,A patient on levothyroxine starts warfarin therapy. What is the priority concern?
A) Reduced anticoagulation
B) Increased bleeding risk
C) Decreased thyroid function
D) Hyperglycemia
Answer: B
Rationale:
Levothyroxine increases metabolism of clotting factors, thereby enhancing warfarin’s
anticoagulant effect. This leads to elevated INR and bleeding risk. This question
reflects UAB emphasis on drug-drug interactions and prescribing safety, not just
mechanism.
Question 4
Which finding indicates metformin should be discontinued immediately?
A) Mild diarrhea
B) Elevated fasting glucose
C) Elevated creatinine
D) Weight loss
Answer: C
Rationale:
Metformin is contraindicated in renal impairment due to risk of lactic acidosis, a life-
threatening condition. UAB exams emphasize contraindications + risk stratification,
especially with renal function.
Section 3: Pain Management (High-Risk Medications)
Question 5
A patient receiving morphine becomes difficult to arouse with a respiratory rate of
8/min. What is the priority action?
A) Administer naloxone
B) Reduce morphine dose
C) Administer oxygen
D) Monitor closely
Answer: A
3
, Rationale:
This is a priority/next-step question, common in UAB exams. Respiratory depression
(<12/min) is a life-threatening opioid adverse effect. Naloxone must be given
immediately. Oxygen alone does not reverse CNS depression.
Question 6
Which statement about naloxone is correct?
A) It has a longer half-life than opioids
B) It prevents opioid withdrawal
C) It may require repeated dosing
D) It enhances analgesia
Answer: C
Rationale:
Naloxone has a shorter half-life than most opioids, so repeated dosing is often
necessary. Patients can relapse into respiratory depression after initial reversal. This
reflects UAB’s focus on pharmacokinetics and clinical monitoring.
Section 4: Cardiovascular Pharmacology (Clinical
Recognition)
Question 7
A patient taking digoxin presents with nausea, anorexia, and yellow vision. What is the
priority action?
A) Administer potassium
B) Hold digoxin and check level
C) Increase dose
D) Administer atropine
Answer: B
Rationale:
Classic digoxin toxicity includes GI symptoms and visual disturbances. The priority is
to hold the drug and assess serum levels. UAB questions often test recognition of
toxicity patterns.
Question 8
4
Exam 4 Blueprint
High-Yield Qs & Answers with
Rationales
University of Alabama
This Exam Description:
High-Yield Qs
Answers with Rationales
100% Guaranteed Pass
Multiple –Choices (A-D)
1
,Section 1: Antifungal Pharmacology (Clinical Depth)
Question 1
A patient with HIV presents with cryptococcal meningitis. Which initial therapy is most
appropriate?
A) Fluconazole monotherapy
B) Amphotericin B + Flucytosine
C) Itraconazole
D) Caspofungin
Answer: B
Rationale:
In UAB-style exams, this is testing stepwise therapy and severity-based treatment.
Cryptococcal meningitis requires induction therapy with Amphotericin B + flucytosine
due to synergistic fungicidal activity. Fluconazole alone is insufficient for initial
management but is used in maintenance phases. The key concept is disease severity
dictates drug selection, not just organism.
Question 2
A patient receiving amphotericin B develops muscle weakness and ECG changes. Which
electrolyte imbalance is most likely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
Answer: B
Rationale:
Amphotericin B causes renal tubular damage, leading to potassium and magnesium
wasting. Hypokalemia increases risk of cardiac arrhythmias, which is why electrolyte
monitoring is a priority. UAB questions often link drug toxicity → lab abnormality →
clinical manifestation.
Section 2: Endocrine Pharmacology (Integrated
Prescribing)
Question 3
2
,A patient on levothyroxine starts warfarin therapy. What is the priority concern?
A) Reduced anticoagulation
B) Increased bleeding risk
C) Decreased thyroid function
D) Hyperglycemia
Answer: B
Rationale:
Levothyroxine increases metabolism of clotting factors, thereby enhancing warfarin’s
anticoagulant effect. This leads to elevated INR and bleeding risk. This question
reflects UAB emphasis on drug-drug interactions and prescribing safety, not just
mechanism.
Question 4
Which finding indicates metformin should be discontinued immediately?
A) Mild diarrhea
B) Elevated fasting glucose
C) Elevated creatinine
D) Weight loss
Answer: C
Rationale:
Metformin is contraindicated in renal impairment due to risk of lactic acidosis, a life-
threatening condition. UAB exams emphasize contraindications + risk stratification,
especially with renal function.
Section 3: Pain Management (High-Risk Medications)
Question 5
A patient receiving morphine becomes difficult to arouse with a respiratory rate of
8/min. What is the priority action?
A) Administer naloxone
B) Reduce morphine dose
C) Administer oxygen
D) Monitor closely
Answer: A
3
, Rationale:
This is a priority/next-step question, common in UAB exams. Respiratory depression
(<12/min) is a life-threatening opioid adverse effect. Naloxone must be given
immediately. Oxygen alone does not reverse CNS depression.
Question 6
Which statement about naloxone is correct?
A) It has a longer half-life than opioids
B) It prevents opioid withdrawal
C) It may require repeated dosing
D) It enhances analgesia
Answer: C
Rationale:
Naloxone has a shorter half-life than most opioids, so repeated dosing is often
necessary. Patients can relapse into respiratory depression after initial reversal. This
reflects UAB’s focus on pharmacokinetics and clinical monitoring.
Section 4: Cardiovascular Pharmacology (Clinical
Recognition)
Question 7
A patient taking digoxin presents with nausea, anorexia, and yellow vision. What is the
priority action?
A) Administer potassium
B) Hold digoxin and check level
C) Increase dose
D) Administer atropine
Answer: B
Rationale:
Classic digoxin toxicity includes GI symptoms and visual disturbances. The priority is
to hold the drug and assess serum levels. UAB questions often test recognition of
toxicity patterns.
Question 8
4
