NR566 Advanced Pharmacology for Care of
the Family Final Exam Review (Weeks 5-8)
100 Practice Questions with Correct
Answers & Rationales
This comprehensive review guide contains 100 exam-style questions with
verified answers and detailed rationales for the NR566 Advanced Pharmacology
Final Exam (Weeks 5-8). Based on exam blueprints
covering Eyes/Ears/Nose/Throat, Dermatology, Psychiatry, Neurology, and
Infectious Disease .
SECTION 1: EYES, EARS, NOSE & THROAT (Questions 1-25)
Question 1
A 68-year-old man with primary open-angle glaucoma is started on latanoprost
ophthalmic drops. Which finding should the prescriber include as a common, non-
dangerous long-term effect of this medication?
A. Permanent clouding of the cornea
B. Heightened brown pigmentation of the iris
C. Progressive constriction of the visual field
D. Accelerated formation of cataracts
Answer: B. Heightened brown pigmentation of the iris
Rationale: Prostaglandin analogs such as latanoprost lower intraocular pressure
by increasing aqueous humor outflow and often cause gradual darkening of the
iris and eyelid; this cosmetic change is common but not harmful .
Question 2
,A patient with COPD and primary open-angle glaucoma needs an ophthalmic β-
blocker. Which agent is the safest choice?
A. Timolol eye drops
B. Levobunolol eye drops
C. Betaxolol eye drops
D. Carteolol eye drops
Answer: C. Betaxolol eye drops
Rationale: Betaxolol is a selective β1-blocker and is preferred in patients with
asthma or COPD because it is less likely to cause bronchospasm than nonselective
ophthalmic β-blockers .
Question 3
A 55-year-old woman with seasonal allergic rhinitis has persistent nasal
congestion despite using an intranasal glucocorticoid correctly for one week.
Which action is most appropriate?
A. Discontinue the steroid and start an oral antihistamine
B. Continue the steroid daily and consider adding a second agent
C. Switch to an oral decongestant alone
D. Recommend surgery for turbinate reduction
Answer: B. Continue the steroid daily and consider adding a second agent
Rationale: Intranasal glucocorticoids require regular daily use, with maximal
benefit developing over about a week; adherence is essential even if immediate
relief is not complete .
Question 4
A patient is prescribed intranasal fluticasone for allergic rhinitis. Which instruction
is most appropriate?
A. "Use these only when you feel symptoms coming on."
B. "You will feel complete relief within 30 minutes."
,C. "Full benefit may take about a week, so use them every day as prescribed."
D. "Stop the spray if you experience mild nasal dryness."
Answer: C. "Full benefit may take about a week, so use them every day as
prescribed."
Rationale: Intranasal glucocorticoids require regular daily use, with maximal
benefit developing over about a week; adherence is essential even if immediate
relief is not complete .
Question 5
A 5-year-old child with acute otitis externa and a perforated tympanic membrane
needs treatment. Which otic regimen is most appropriate?
A. Neomycin/polymyxin B/hydrocortisone drops
B. Ofloxacin 0.3% otic solution, 5 drops twice daily
C. Acetic acid 2% otic solution, 3 drops three times daily
D. Carbamide peroxide otic drops
Answer: B. Ofloxacin 0.3% otic solution, 5 drops twice daily
Rationale: Fluoroquinolone otic solutions such as ofloxacin are recommended
and safe in the presence of TM perforation, whereas aminoglycoside
combinations like neomycin/polymyxin B/hydrocortisone should be avoided due
to ototoxicity risk .
Question 6
A 9-month-old infant is diagnosed with otitis externa. The tympanic membrane
cannot be fully visualized but perforation is suspected. Which prescription is most
appropriate?
A. Ciprofloxacin 0.3% plus dexamethasone 0.1%, four drops every 12 hours
B. Ofloxacin 0.3% otic, five drops twice daily
C. Carbamide peroxide 5–10 drops twice daily
D. Oral amoxicillin for 10 days
, Answer: A. Ciprofloxacin 0.3% plus dexamethasone 0.1%, four drops every 12
hours
Rationale: For children 6–12 months old with otitis externa, ciprofloxacin with a
corticosteroid is recommended and can be used whether or not TM perforation is
present, providing both antimicrobial and anti-inflammatory effects .
Question 7
Which patient should avoid ocular decongestant eye drops such as naphazoline?
A. A patient with mild dry eye syndrome
B. A patient with controlled hypothyroidism
C. A patient with open-angle glaucoma and hypertension
D. A patient wearing soft contact lenses
Answer: C. A patient with open-angle glaucoma and hypertension
Rationale: Ocular decongestants are topical adrenergic agonists that can
exacerbate hypertension, thyrotoxicosis, and glaucomatous eye conditions; they
are contraindicated in such patients .
Question 8
A teenager with mild inflammatory acne is starting benzoyl peroxide gel. Which
explanation best describes how this agent works?
A. It suppresses sebum production from sebaceous glands
B. It kills Cutibacterium acnes and promotes shedding of the outer epidermis
C. It acts as a systemic antibiotic after absorption
D. It directly blocks androgen receptors in the skin
Answer: B. It kills Cutibacterium acnes and promotes shedding of the outer
epidermis
Rationale: Benzoyl peroxide is both an antibacterial and a keratolytic, releasing
active oxygen to suppress P. acnes while promoting desquamation of the stratum
corneum .
the Family Final Exam Review (Weeks 5-8)
100 Practice Questions with Correct
Answers & Rationales
This comprehensive review guide contains 100 exam-style questions with
verified answers and detailed rationales for the NR566 Advanced Pharmacology
Final Exam (Weeks 5-8). Based on exam blueprints
covering Eyes/Ears/Nose/Throat, Dermatology, Psychiatry, Neurology, and
Infectious Disease .
SECTION 1: EYES, EARS, NOSE & THROAT (Questions 1-25)
Question 1
A 68-year-old man with primary open-angle glaucoma is started on latanoprost
ophthalmic drops. Which finding should the prescriber include as a common, non-
dangerous long-term effect of this medication?
A. Permanent clouding of the cornea
B. Heightened brown pigmentation of the iris
C. Progressive constriction of the visual field
D. Accelerated formation of cataracts
Answer: B. Heightened brown pigmentation of the iris
Rationale: Prostaglandin analogs such as latanoprost lower intraocular pressure
by increasing aqueous humor outflow and often cause gradual darkening of the
iris and eyelid; this cosmetic change is common but not harmful .
Question 2
,A patient with COPD and primary open-angle glaucoma needs an ophthalmic β-
blocker. Which agent is the safest choice?
A. Timolol eye drops
B. Levobunolol eye drops
C. Betaxolol eye drops
D. Carteolol eye drops
Answer: C. Betaxolol eye drops
Rationale: Betaxolol is a selective β1-blocker and is preferred in patients with
asthma or COPD because it is less likely to cause bronchospasm than nonselective
ophthalmic β-blockers .
Question 3
A 55-year-old woman with seasonal allergic rhinitis has persistent nasal
congestion despite using an intranasal glucocorticoid correctly for one week.
Which action is most appropriate?
A. Discontinue the steroid and start an oral antihistamine
B. Continue the steroid daily and consider adding a second agent
C. Switch to an oral decongestant alone
D. Recommend surgery for turbinate reduction
Answer: B. Continue the steroid daily and consider adding a second agent
Rationale: Intranasal glucocorticoids require regular daily use, with maximal
benefit developing over about a week; adherence is essential even if immediate
relief is not complete .
Question 4
A patient is prescribed intranasal fluticasone for allergic rhinitis. Which instruction
is most appropriate?
A. "Use these only when you feel symptoms coming on."
B. "You will feel complete relief within 30 minutes."
,C. "Full benefit may take about a week, so use them every day as prescribed."
D. "Stop the spray if you experience mild nasal dryness."
Answer: C. "Full benefit may take about a week, so use them every day as
prescribed."
Rationale: Intranasal glucocorticoids require regular daily use, with maximal
benefit developing over about a week; adherence is essential even if immediate
relief is not complete .
Question 5
A 5-year-old child with acute otitis externa and a perforated tympanic membrane
needs treatment. Which otic regimen is most appropriate?
A. Neomycin/polymyxin B/hydrocortisone drops
B. Ofloxacin 0.3% otic solution, 5 drops twice daily
C. Acetic acid 2% otic solution, 3 drops three times daily
D. Carbamide peroxide otic drops
Answer: B. Ofloxacin 0.3% otic solution, 5 drops twice daily
Rationale: Fluoroquinolone otic solutions such as ofloxacin are recommended
and safe in the presence of TM perforation, whereas aminoglycoside
combinations like neomycin/polymyxin B/hydrocortisone should be avoided due
to ototoxicity risk .
Question 6
A 9-month-old infant is diagnosed with otitis externa. The tympanic membrane
cannot be fully visualized but perforation is suspected. Which prescription is most
appropriate?
A. Ciprofloxacin 0.3% plus dexamethasone 0.1%, four drops every 12 hours
B. Ofloxacin 0.3% otic, five drops twice daily
C. Carbamide peroxide 5–10 drops twice daily
D. Oral amoxicillin for 10 days
, Answer: A. Ciprofloxacin 0.3% plus dexamethasone 0.1%, four drops every 12
hours
Rationale: For children 6–12 months old with otitis externa, ciprofloxacin with a
corticosteroid is recommended and can be used whether or not TM perforation is
present, providing both antimicrobial and anti-inflammatory effects .
Question 7
Which patient should avoid ocular decongestant eye drops such as naphazoline?
A. A patient with mild dry eye syndrome
B. A patient with controlled hypothyroidism
C. A patient with open-angle glaucoma and hypertension
D. A patient wearing soft contact lenses
Answer: C. A patient with open-angle glaucoma and hypertension
Rationale: Ocular decongestants are topical adrenergic agonists that can
exacerbate hypertension, thyrotoxicosis, and glaucomatous eye conditions; they
are contraindicated in such patients .
Question 8
A teenager with mild inflammatory acne is starting benzoyl peroxide gel. Which
explanation best describes how this agent works?
A. It suppresses sebum production from sebaceous glands
B. It kills Cutibacterium acnes and promotes shedding of the outer epidermis
C. It acts as a systemic antibiotic after absorption
D. It directly blocks androgen receptors in the skin
Answer: B. It kills Cutibacterium acnes and promotes shedding of the outer
epidermis
Rationale: Benzoyl peroxide is both an antibacterial and a keratolytic, releasing
active oxygen to suppress P. acnes while promoting desquamation of the stratum
corneum .
