Final Exam: NR 566 / NR566 (Latest
Update ) Advanced
Pharmacology for Care of the Family |
Questions & Answers | Grade A | 100%
Correct – Chamberlain
1. A 22-year-old female presents with lower abdominal pain, fever, and
cervical motion tenderness. She is diagnosed with Pelvic Inflammatory
Disease (PID). According to CDC guidelines, which outpatient regimen is
appropriate?
A) Azithromycin 1 gram PO once + Metronidazole 2 grams PO once
B) Ciprofloxacin 500 mg BID for 14 days
C) Doxycycline 100 mg BID for 7 days alone
D) Ceftriaxone 500 mg IM once + Doxycycline 100 mg BID for 14 days ±
Metronidazole 500 mg BID for 14 days
Rationale: The recommended outpatient regimen for PID is a single IM dose of
ceftriaxone plus oral doxycycline for 14 days. The addition of metronidazole is
recommended to cover anaerobic organisms.
2. A patient has just been diagnosed with uncomplicated gonorrhea. Which
intramuscular (IM) antibiotic is the recommended first-line treatment?
A) Penicillin G 2.4 million units IM
B) Ceftriaxone 500 mg IM
,C) Gentamicin 240 mg IM
D) Spectinomycin 2 grams IM
Rationale: Due to rising resistance, a single 500 mg IM dose of ceftriaxone is the
standard of care for uncomplicated gonorrhea.
3. In addition to IM ceftriaxone for gonorrhea, why is it recommended to also
treat the patient with oral doxycycline 100mg BID for 7 days?
A) To prevent the development of fungal superinfections
B) To treat possible coexisting chlamydial infection
C) To reduce the pain of the IM injection
D) To enhance the efficacy of the ceftriaxone against gonorrhea
Rationale: Co-infection with Chlamydia trachomatis is common. Doxycycline is
the recommended treatment for chlamydia, so dual therapy covers both infections
empirically.
4. A 26-year-old patient has been prescribed Phenytoin (Dilantin) for tonic-
colonic seizures. She asks about contraception. What is the most important
interaction to counsel her about?
A) Phenytoin increases the risk of blood clots from OCPs
B) Phenytoin reduces oral contraceptive effectiveness by accelerating
hormone metabolism
C) OCPs increase the seizure threshold, requiring higher Phenytoin doses
D) There is no significant interaction between Phenytoin and OCPs
,Rationale: Phenytoin is a potent CYP450 enzyme inducer (CYP3A4), accelerating
estrogen and progestin metabolism and reducing OCP efficacy.
5. A patient is treated for trichomoniasis with a 2-gram single dose of
metronidazole. What is essential teaching for this patient?
A) She may experience joint pain for a few days
B) She should avoid sexual intercourse for 3 months
C) She must avoid alcohol for at least 24 hours (up to 48-72 hours) due to a
disulfiram-like reaction
D) She needs to return for a follow-up urine test in one week
Rationale: Metronidazole causes a severe disulfiram-like reaction (nausea,
vomiting, flushing, headache) when combined with alcohol.
6. A patient presents with a painless chancre on the genitals, and serology
confirms primary syphilis. The patient reports a severe penicillin allergy.
What is the appropriate management?
A) Prescribe doxycycline 100 mg BID for 14 days
B) Prescribe azithromycin 2 grams PO once
C) Desensitize the patient to penicillin and then treat with penicillin G
benzathine
D) Prescribe cephalexin 500 mg QID for 14 days
Rationale: Penicillin is the only recommended treatment for syphilis during
pregnancy and is preferred for all patients. For severe allergy, desensitization is
required.
, 7. Which patient teaching point is most critical when prescribing tetracyclines
(e.g., doxycycline)?
A) Take with a full glass of milk to prevent stomach upset
B) Avoid taking with calcium supplements, antacids, or iron products
C) Take the medication only when symptoms flare up
D) Sun exposure is encouraged to help skin lesions heal faster
Rationale: Tetracyclines chelate divalent/trivalent cations, forming insoluble
complexes that are not absorbed.
8. A 58-year-old patient asks why long-term hormone therapy (HT) is not
usually the first choice for osteoporosis prevention. Which response is BEST?
A) HT prevents bone loss permanently even after it is stopped
B) Bone mass rapidly decreases after stopping HT, so ongoing lifelong use
would increase harm risk
C) HT only works if started before the first missed menstrual cycle
D) HT prevents fractures only when combined with calcium supplementation
Rationale: Bone mass rapidly declines after HT discontinuation, so lifelong
therapy would be needed, increasing risks like breast cancer and
thromboembolism.
Update ) Advanced
Pharmacology for Care of the Family |
Questions & Answers | Grade A | 100%
Correct – Chamberlain
1. A 22-year-old female presents with lower abdominal pain, fever, and
cervical motion tenderness. She is diagnosed with Pelvic Inflammatory
Disease (PID). According to CDC guidelines, which outpatient regimen is
appropriate?
A) Azithromycin 1 gram PO once + Metronidazole 2 grams PO once
B) Ciprofloxacin 500 mg BID for 14 days
C) Doxycycline 100 mg BID for 7 days alone
D) Ceftriaxone 500 mg IM once + Doxycycline 100 mg BID for 14 days ±
Metronidazole 500 mg BID for 14 days
Rationale: The recommended outpatient regimen for PID is a single IM dose of
ceftriaxone plus oral doxycycline for 14 days. The addition of metronidazole is
recommended to cover anaerobic organisms.
2. A patient has just been diagnosed with uncomplicated gonorrhea. Which
intramuscular (IM) antibiotic is the recommended first-line treatment?
A) Penicillin G 2.4 million units IM
B) Ceftriaxone 500 mg IM
,C) Gentamicin 240 mg IM
D) Spectinomycin 2 grams IM
Rationale: Due to rising resistance, a single 500 mg IM dose of ceftriaxone is the
standard of care for uncomplicated gonorrhea.
3. In addition to IM ceftriaxone for gonorrhea, why is it recommended to also
treat the patient with oral doxycycline 100mg BID for 7 days?
A) To prevent the development of fungal superinfections
B) To treat possible coexisting chlamydial infection
C) To reduce the pain of the IM injection
D) To enhance the efficacy of the ceftriaxone against gonorrhea
Rationale: Co-infection with Chlamydia trachomatis is common. Doxycycline is
the recommended treatment for chlamydia, so dual therapy covers both infections
empirically.
4. A 26-year-old patient has been prescribed Phenytoin (Dilantin) for tonic-
colonic seizures. She asks about contraception. What is the most important
interaction to counsel her about?
A) Phenytoin increases the risk of blood clots from OCPs
B) Phenytoin reduces oral contraceptive effectiveness by accelerating
hormone metabolism
C) OCPs increase the seizure threshold, requiring higher Phenytoin doses
D) There is no significant interaction between Phenytoin and OCPs
,Rationale: Phenytoin is a potent CYP450 enzyme inducer (CYP3A4), accelerating
estrogen and progestin metabolism and reducing OCP efficacy.
5. A patient is treated for trichomoniasis with a 2-gram single dose of
metronidazole. What is essential teaching for this patient?
A) She may experience joint pain for a few days
B) She should avoid sexual intercourse for 3 months
C) She must avoid alcohol for at least 24 hours (up to 48-72 hours) due to a
disulfiram-like reaction
D) She needs to return for a follow-up urine test in one week
Rationale: Metronidazole causes a severe disulfiram-like reaction (nausea,
vomiting, flushing, headache) when combined with alcohol.
6. A patient presents with a painless chancre on the genitals, and serology
confirms primary syphilis. The patient reports a severe penicillin allergy.
What is the appropriate management?
A) Prescribe doxycycline 100 mg BID for 14 days
B) Prescribe azithromycin 2 grams PO once
C) Desensitize the patient to penicillin and then treat with penicillin G
benzathine
D) Prescribe cephalexin 500 mg QID for 14 days
Rationale: Penicillin is the only recommended treatment for syphilis during
pregnancy and is preferred for all patients. For severe allergy, desensitization is
required.
, 7. Which patient teaching point is most critical when prescribing tetracyclines
(e.g., doxycycline)?
A) Take with a full glass of milk to prevent stomach upset
B) Avoid taking with calcium supplements, antacids, or iron products
C) Take the medication only when symptoms flare up
D) Sun exposure is encouraged to help skin lesions heal faster
Rationale: Tetracyclines chelate divalent/trivalent cations, forming insoluble
complexes that are not absorbed.
8. A 58-year-old patient asks why long-term hormone therapy (HT) is not
usually the first choice for osteoporosis prevention. Which response is BEST?
A) HT prevents bone loss permanently even after it is stopped
B) Bone mass rapidly decreases after stopping HT, so ongoing lifelong use
would increase harm risk
C) HT only works if started before the first missed menstrual cycle
D) HT prevents fractures only when combined with calcium supplementation
Rationale: Bone mass rapidly declines after HT discontinuation, so lifelong
therapy would be needed, increasing risks like breast cancer and
thromboembolism.
