Questions 1-100 Actual Exam Examplify
Online Proctored Exam NR566 Advanced
Pharmacology For Care Of The Family
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Section I: Reproductive & Hormonal Pharmacology (Questions 1-25)
Question 1: Raloxifene (Evista) and bisphosphonates (alendronate, calcitonin) are
used as:
A. First-line treatment for breast cancer
B. Alternatives for hormone replacement therapy
C. Treatment for endometriosis
D. Contraceptive agents
,,answer,,,,: B. Alternatives for hormone replacement therapy
Rationale: Raloxifene and bisphosphonates are used as alternatives to hormone
replacement therapy for managing postmenopausal osteoporosis and reducing
fracture risk without estrogen-related side effects . Raloxifene is a SERM that
provides estrogen's beneficial effects on bone without stimulating breast or
endometrial tissue.
Question 2: Which medications are classified as Selective Estrogen Receptor
Modulators (SERMs)?
A. Estradiol and progesterone
B. Tamoxifen, toremifene, raloxifene
,C. Medroxyprogesterone and norethindrone
D. Clomiphene and letrozole
,,answer,,,,: B. Tamoxifen, toremifene, raloxifene
Rationale: SERMs provide estrogen benefits while avoiding its drawbacks. They
are used for breast cancer treatment/prevention (tamoxifen) and osteoporosis
(raloxifene). Unlike estrogen, SERMs have tissue-specific effects .
Question 3: Dysfunctional uterine bleeding is treated with:
A. 5-7 day course of estrogen
B. 10-14 day course of progestin
C. Single dose of medroxyprogesterone
D. Continuous combined oral contraceptive
,,answer,,,,: B. 10-14 day course of progestin
*Rationale: A 10-14 day course of progestin helps regulate the endometrial lining
and control bleeding in dysfunctional uterine bleeding. Progestin stabilizes the
endometrium and induces withdrawal bleeding when discontinued .*
Question 4: For a patient with amenorrhea and low estrogen levels, the appropriate
treatment is:
A. Estrogen therapy alone for 21 days
B. Progestin for 5-10 days to induce menstrual flow
C. Combined oral contraceptive continuously
D. Gonadotropin-releasing hormone agonist
,,answer,,,,: B. Progestin for 5-10 days to induce menstrual flow
*Rationale: When estrogen levels are adequate, progestin alone for 5-10 days can
induce withdrawal bleeding. When estrogen levels are low, combined estrogen-
progestin therapy is needed to first build the endometrial lining .*
,Question 5: What is the advantage of the estrogen transdermal patch over oral
estrogen?
A. Higher total estrogen dose
B. Lower risk of DVT, PE, and stroke
C. More fluctuation of estrogen blood levels
D. Increased first-pass metabolism
,,answer,,,,: B. Lower risk of DVT, PE, and stroke
Rationale: Transdermal estrogen bypasses first-pass hepatic metabolism, resulting
in lower total estrogen dose, less nausea/vomiting, less fluctuation of blood levels,
and lower risk of DVT, PE, and stroke compared to oral formulations .
Question 6: Finasteride (Propecia, Proscar) works by:
A. Blocking alpha-adrenergic receptors
B. Inhibiting 5-alpha reductase, blocking conversion of testosterone to
dihydrotestosterone (DHT)
C. Relaxing smooth muscle in the prostate
D. Increasing testosterone production
,,answer,,,,: B. Inhibiting 5-alpha reductase, blocking conversion of
testosterone to dihydrotestosterone (DHT)
Rationale: Finasteride blocks conversion of testosterone to dihydrotestosterone.
Used to treat BPH and male pattern baldness. Benefits take 3 months of therapy to
see, and stopping reverses effect within 12 months. Adverse effects include
decreased libido and impotence .
Question 7: Dutasteride (Avodart) differs from finasteride in that:
A. It is a 5-alpha reductase inhibitor that can stay in serum up to 6 months after
discontinuing
B. It has no adverse effects
C. It works immediately
D. It is only used for baldness
, ,,answer,,,,: A. It is a 5-alpha reductase inhibitor that can stay in serum up to 6
months after discontinuing
*Rationale: Dutasteride is a 5-alpha reductase inhibitor used to treat BPH. It can
stay in serum up to 6 months after discontinuing. Pregnant women should not
handle capsules (risk of fetal anomaly in male fetus). Adverse effects include
decreased libido and impotence .*
Question 8: Leuprolide Acetate (Lupron) is a luteinizing hormone-releasing
agonist that creates a reversible:
A. Orchiectomy or oophorectomy state
B. Pregnancy state
C. Hyperthyroid state
D. Adrenal crisis
,,answer,,,,: A. Orchiectomy or oophorectomy state
Rationale: Leuprolide creates reversible orchiectomy (male) or oophorectomy
(female) state. Used to treat advanced prostate cancer, management of
endometriosis, uterine fibroids, polycystic ovarian disease, and central precocious
puberty in pediatrics .
Question 9: Spironolactone (Aldactone) is used in women for:
A. Treatment of hypertension only
B. Female hirsutism, acne, and relief of PMS/PMDD symptoms (25-50 mg/day)
C. Weight loss
D. Infertility treatment
,,answer,,,,: B. Female hirsutism, acne, and relief of PMS/PMDD symptoms
(25-50 mg/day)
*Rationale: Spironolactone is an aldosterone antagonist and potassium-sparing
diuretic used for female hirsutism (abnormal growth of hair), acne, and relief of
PMS/PMDD symptoms (25-50 mg/day). Adverse reactions are dose-related and
reversible upon discontinuation; may cause GI upset .*