ADVANCED PHARMACOLOGY FOR NP 2
CERTIFICATION SCRIPT 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◍ NTI.
Answer: Narrow therapeutic index (difference between effective dose and
lethal dose is SMALL)
◍ Common SEs of DPP-4 inhibitors.
Answer: Generally well tolerated; possible mild nasopharyngitis, joint pain
(rare severe arthralgia), and possible HF signal with saxagliptin in some
studies.
◍ Medication education.
Answer: Main influencer of medication compliance
◍ UTI treatment.
Answer: TMP/SMX if local resistance low and not contraindicated;
fosfomycin single dose is an option.
◍ Narrow-spectrum antibiotics.
Answer: Target a limited range of organisms; preferred when pathogen
known to reduce collateral damage and resistance selection (e.g., penicillin
V for strep throat).
◍ Metformin.
Answer: First-line diabetes medication, contraindicated in renal impairment
and should be held for contrast/acute illness.
◍ MOA of SGLT2 inhibitors.
Answer: Inhibit SGLT2 in proximal tubule → increased urinary glucose
excretion → lower plasma glucose, mild diuresis.
,◍ Fentanyl (renal dosing).
Answer: Does not require a dose reduction in patients with renal impairment
◍ NTI drug examples.
Answer: Carbamazepine, digoxin, lithium, phenytoin, and theophylline
◍ Fluconazole 150mg PO x1 dose.
Answer: Initial treatment for vaginal yeast infection; can be extended for up
to 3 days for persistent infections.
◍ Rx elements.
Answer: Prescriber name, lic, and info, DEA number, Pt name/DOB,
allergies medication, indication for use, dose, strength, amount and refills
◍ Cephalosporins safety.
Answer: Generally safe; allergic cross-reactivity with penicillin is low but
consider history.
◍ Correctional insulin.
Answer: Sliding-scale used as supplement (not monotherapy) in hospital
settings.
◍ Meglitinides Agents.
Answer: Includes repaglinide, nateglinide.
◍ Fosfomycin.
Answer: An antibiotic that inhibits bacterial cell wall synthesis, used for
uncomplicated cystitis.
◍ Antibiotics to avoid in pregnancy.
Answer: Avoid/Use with caution: tetracyclines (tooth discoloration),
fluoroquinolones (cartilage concerns — generally avoided),
aminoglycosides (ototoxicity/nephrotoxicity risk),
trimethoprim/sulfamethoxazole (TMX/SMX — folate antagonist; avoid in
first trimester and near term), sulfonamides caution near term.
◍ Common SEs of Metformin.
Answer: GI upset (nausea/diarrhea), metallic taste, B12 deficiency with
, long-term use.
◍ When used: GIP-GLP-1 agonists.
Answer: T2DM with need for weight loss and/or A1c reduction; used
increasingly per guidelines for CV/weight/renal benefits.
◍ Ensuring positive outcomes.
Answer: Establishing a medication education plan, monitoring +/- patient
responses, identifying and addressing issues of nonadherence, managing the
patient's complete medication regimen
◍ Reasons for drug monitoring.
Answer: 1. Determining therapeutic dosage 2. Evaluating adequacy 3.
Identifying adverse effects
◍ Ceftriaxone 250mg IM + azithromycin 1g.
Answer: ASAP therapy for gonorrhea with multiple partners, no allergies;
treat all sexual partners and cross-cover for chlamydia.
◍ Vaginal metronidazole.
Answer: Treatment for bacterial vaginosis in pregnant patients with no other
contraindications.
◍ Immediate management of hypoglycemia (conscious).
Answer: 15-20 g fast-acting carbohydrate; recheck in 15 min.
◍ Special Population.
Answer: Include pregnant or nursing mothers and older adults
◍ First step in providing safe and competent medication.
Answer: Selecting and prescribing the most appropriate drug
◍ Common SEs of Insulins.
Answer: Hypoglycemia (most important), weight gain, injection-site
reactions; rare allergy.
◍ Amoxicillin.
Answer: Recommended for uncomplicated urinary tract infections in
pregnant females without history or allergies.
CERTIFICATION SCRIPT 2026 QUESTIONS
WITH SOLUTIONS GRADED A+
◍ NTI.
Answer: Narrow therapeutic index (difference between effective dose and
lethal dose is SMALL)
◍ Common SEs of DPP-4 inhibitors.
Answer: Generally well tolerated; possible mild nasopharyngitis, joint pain
(rare severe arthralgia), and possible HF signal with saxagliptin in some
studies.
◍ Medication education.
Answer: Main influencer of medication compliance
◍ UTI treatment.
Answer: TMP/SMX if local resistance low and not contraindicated;
fosfomycin single dose is an option.
◍ Narrow-spectrum antibiotics.
Answer: Target a limited range of organisms; preferred when pathogen
known to reduce collateral damage and resistance selection (e.g., penicillin
V for strep throat).
◍ Metformin.
Answer: First-line diabetes medication, contraindicated in renal impairment
and should be held for contrast/acute illness.
◍ MOA of SGLT2 inhibitors.
Answer: Inhibit SGLT2 in proximal tubule → increased urinary glucose
excretion → lower plasma glucose, mild diuresis.
,◍ Fentanyl (renal dosing).
Answer: Does not require a dose reduction in patients with renal impairment
◍ NTI drug examples.
Answer: Carbamazepine, digoxin, lithium, phenytoin, and theophylline
◍ Fluconazole 150mg PO x1 dose.
Answer: Initial treatment for vaginal yeast infection; can be extended for up
to 3 days for persistent infections.
◍ Rx elements.
Answer: Prescriber name, lic, and info, DEA number, Pt name/DOB,
allergies medication, indication for use, dose, strength, amount and refills
◍ Cephalosporins safety.
Answer: Generally safe; allergic cross-reactivity with penicillin is low but
consider history.
◍ Correctional insulin.
Answer: Sliding-scale used as supplement (not monotherapy) in hospital
settings.
◍ Meglitinides Agents.
Answer: Includes repaglinide, nateglinide.
◍ Fosfomycin.
Answer: An antibiotic that inhibits bacterial cell wall synthesis, used for
uncomplicated cystitis.
◍ Antibiotics to avoid in pregnancy.
Answer: Avoid/Use with caution: tetracyclines (tooth discoloration),
fluoroquinolones (cartilage concerns — generally avoided),
aminoglycosides (ototoxicity/nephrotoxicity risk),
trimethoprim/sulfamethoxazole (TMX/SMX — folate antagonist; avoid in
first trimester and near term), sulfonamides caution near term.
◍ Common SEs of Metformin.
Answer: GI upset (nausea/diarrhea), metallic taste, B12 deficiency with
, long-term use.
◍ When used: GIP-GLP-1 agonists.
Answer: T2DM with need for weight loss and/or A1c reduction; used
increasingly per guidelines for CV/weight/renal benefits.
◍ Ensuring positive outcomes.
Answer: Establishing a medication education plan, monitoring +/- patient
responses, identifying and addressing issues of nonadherence, managing the
patient's complete medication regimen
◍ Reasons for drug monitoring.
Answer: 1. Determining therapeutic dosage 2. Evaluating adequacy 3.
Identifying adverse effects
◍ Ceftriaxone 250mg IM + azithromycin 1g.
Answer: ASAP therapy for gonorrhea with multiple partners, no allergies;
treat all sexual partners and cross-cover for chlamydia.
◍ Vaginal metronidazole.
Answer: Treatment for bacterial vaginosis in pregnant patients with no other
contraindications.
◍ Immediate management of hypoglycemia (conscious).
Answer: 15-20 g fast-acting carbohydrate; recheck in 15 min.
◍ Special Population.
Answer: Include pregnant or nursing mothers and older adults
◍ First step in providing safe and competent medication.
Answer: Selecting and prescribing the most appropriate drug
◍ Common SEs of Insulins.
Answer: Hypoglycemia (most important), weight gain, injection-site
reactions; rare allergy.
◍ Amoxicillin.
Answer: Recommended for uncomplicated urinary tract infections in
pregnant females without history or allergies.
