NR565 / NR 565 MIDTERM EXAM STUDY GUIDE (LATEST 2026
UPDATED): ADVANCED PHARMACOLOGY FUNDAMENTALS -
CHAMBERLAIN QUESTIONS WITH ACCURATE ANSWERS
1st line treatment of osteoporosis correct answer alendronate
12 CDC guidelines for prescribing opioids correct answer Opioids are not first line
therapy
establish goals for pain and function
Discuss risks and benefits
Use immediate release opioids when starting
Use the lowest effective dose
Prescribe short durations for acute pain
Evaluate benefits and harms frequently
Use strategies to migrate risk
Review PDMP data
Use urine drug testing
Avoid concurrent opioid and benzo prescribing
Offer treatment for opioid use disorder
A 41 year old patient comes into the clinic complaining of increased heart rate
after starting nitro patches for stable angina. What would an appropriate
response be?
1. lets lower the dose and frequency of use
2. I will prescribe a BB to help with this
3. Next time this happens, lie down and practice deep breathing, this will bring
your heart rate down correct answer 2- I will prescribe a BB to help with this
,A 55 year old male comes into the clinic with a gouty arthritis. He states that he
has one flareup a year. Your response is:
1. I will prescribe you glucocorticoids to help with inflammation
2. Lets start you on prophylactic therapy colchicine.
3. It will be helpful to take an NSAID to start with to help relive some
inflammation. I'll prescribe naproxen. correct answer 3- in patients with
infrequent flareups, being less than three per year, treatment of symptoms is all
thats needed. NSAIDS are the first line agent for relieving pain of an acute gout
attack.
A patient comes in stating that he tried NSAIDS to relieve a gouty attack but it
hasnt helped. He asks, "what are my options?" He further states that he has
attacks every few years but when he does NSAIDS do not help. Your response is:
1. I can prescribe a glucocorticoid (prednisone) and that will bring down the
inflammation and pain.
2. Have your tried increasing your dosage of NSAIDS and drink plenty of water?
3. Lets start by making some changes in your diet, can you tell me what you eat
regularly? correct answer 1
3- can also be correct but BEST answer
A patient with HF develops fibrotic changes, what should the provider do next?
correct answer ensure that a patient is on an ARB (valsartan) as this inhibits
fibrosis (aldosterone antagonist)
A person who is depend on a pure opioid agonist should NEVER receive an opioid
agonist antagonist correct answer true
,ACE inhibitors MOA correct answer Angiotensin Converting Enzyme Inhibitors
(ACE-I) prevent the conversion of angiotensin I to angiotensin II, which disrupts
the renin-angiotensin-aldosterone system (RAAS).
1. reduce levels of angiotensin II (through inhibition of ACE)
2. increasing levels of bradykinin (through inhibition of kinase 11)
End in -pril
ACEI correct answer
Acute Pain Management correct answer
adverse effects for bisphosphonates correct answer osteonecrosis of the jaw and
hip fracture, Esophagitis
adverse effects of CCBs in elderly patients correct answer gingival hyperplasia
(overgrowth of gum tissue) and chronic eczematous rash
adverse effects of colchicine correct answer nausea, vomiting, diarrhea,
myelosuppression, myopathy, rhabdomyolysis
adverse effects of digoxin correct answer GI- anorexia, nausea, vomiting
CNS- fatigue
Visual disturbances **(appearance of halos around dark objects)
dysrhythmias
, Adverse effects of lasix (flurosemide) correct answer ototoxicity
adverse effects of nitro correct answer headache, hypotension, and tachycardia
(secondary to vasodilation)
Adverse effects of opioids correct answer constipation
urinary retention
orthostatic hypotension
emesis
neurotoxicity (delirium, agitation)
tolerance and physical dependence
respiratory depression
adverse effects of pregabalin correct answer Sedation/drowsy, dizziness, and
ataxia, blurred vision, difficulty thinking
adverse effects of statins correct answer rhabdomyolysis, hepatoxicity, new-onset
diabetes
After age one what happens to pharmacokinetic parameters, including drug
sensitivity? correct answer mirror adult parameters
Agonist correct answer A drug that binds to and activates a receptor. Can be full,
partial or inverse. A full agonist has high efficacy, producing a full response while
occupying a relatively low proportion of receptors. A partial agonist has lower
efficacy than a full agonist. It produces sub-maximal activation even when
occupying the total receptor population, therefore cannot produce the maximal
UPDATED): ADVANCED PHARMACOLOGY FUNDAMENTALS -
CHAMBERLAIN QUESTIONS WITH ACCURATE ANSWERS
1st line treatment of osteoporosis correct answer alendronate
12 CDC guidelines for prescribing opioids correct answer Opioids are not first line
therapy
establish goals for pain and function
Discuss risks and benefits
Use immediate release opioids when starting
Use the lowest effective dose
Prescribe short durations for acute pain
Evaluate benefits and harms frequently
Use strategies to migrate risk
Review PDMP data
Use urine drug testing
Avoid concurrent opioid and benzo prescribing
Offer treatment for opioid use disorder
A 41 year old patient comes into the clinic complaining of increased heart rate
after starting nitro patches for stable angina. What would an appropriate
response be?
1. lets lower the dose and frequency of use
2. I will prescribe a BB to help with this
3. Next time this happens, lie down and practice deep breathing, this will bring
your heart rate down correct answer 2- I will prescribe a BB to help with this
,A 55 year old male comes into the clinic with a gouty arthritis. He states that he
has one flareup a year. Your response is:
1. I will prescribe you glucocorticoids to help with inflammation
2. Lets start you on prophylactic therapy colchicine.
3. It will be helpful to take an NSAID to start with to help relive some
inflammation. I'll prescribe naproxen. correct answer 3- in patients with
infrequent flareups, being less than three per year, treatment of symptoms is all
thats needed. NSAIDS are the first line agent for relieving pain of an acute gout
attack.
A patient comes in stating that he tried NSAIDS to relieve a gouty attack but it
hasnt helped. He asks, "what are my options?" He further states that he has
attacks every few years but when he does NSAIDS do not help. Your response is:
1. I can prescribe a glucocorticoid (prednisone) and that will bring down the
inflammation and pain.
2. Have your tried increasing your dosage of NSAIDS and drink plenty of water?
3. Lets start by making some changes in your diet, can you tell me what you eat
regularly? correct answer 1
3- can also be correct but BEST answer
A patient with HF develops fibrotic changes, what should the provider do next?
correct answer ensure that a patient is on an ARB (valsartan) as this inhibits
fibrosis (aldosterone antagonist)
A person who is depend on a pure opioid agonist should NEVER receive an opioid
agonist antagonist correct answer true
,ACE inhibitors MOA correct answer Angiotensin Converting Enzyme Inhibitors
(ACE-I) prevent the conversion of angiotensin I to angiotensin II, which disrupts
the renin-angiotensin-aldosterone system (RAAS).
1. reduce levels of angiotensin II (through inhibition of ACE)
2. increasing levels of bradykinin (through inhibition of kinase 11)
End in -pril
ACEI correct answer
Acute Pain Management correct answer
adverse effects for bisphosphonates correct answer osteonecrosis of the jaw and
hip fracture, Esophagitis
adverse effects of CCBs in elderly patients correct answer gingival hyperplasia
(overgrowth of gum tissue) and chronic eczematous rash
adverse effects of colchicine correct answer nausea, vomiting, diarrhea,
myelosuppression, myopathy, rhabdomyolysis
adverse effects of digoxin correct answer GI- anorexia, nausea, vomiting
CNS- fatigue
Visual disturbances **(appearance of halos around dark objects)
dysrhythmias
, Adverse effects of lasix (flurosemide) correct answer ototoxicity
adverse effects of nitro correct answer headache, hypotension, and tachycardia
(secondary to vasodilation)
Adverse effects of opioids correct answer constipation
urinary retention
orthostatic hypotension
emesis
neurotoxicity (delirium, agitation)
tolerance and physical dependence
respiratory depression
adverse effects of pregabalin correct answer Sedation/drowsy, dizziness, and
ataxia, blurred vision, difficulty thinking
adverse effects of statins correct answer rhabdomyolysis, hepatoxicity, new-onset
diabetes
After age one what happens to pharmacokinetic parameters, including drug
sensitivity? correct answer mirror adult parameters
Agonist correct answer A drug that binds to and activates a receptor. Can be full,
partial or inverse. A full agonist has high efficacy, producing a full response while
occupying a relatively low proportion of receptors. A partial agonist has lower
efficacy than a full agonist. It produces sub-maximal activation even when
occupying the total receptor population, therefore cannot produce the maximal
