NR566
OBJECTIVE ASSESSMENT - EXAM
NR 566 / NR566 Final Exam
Study Guide Qs & Ans
(Latest 2026/2027):
Advanced Pharmacology for
Care of the Family
Verified Answers | Advanced Pharmacology for Care of the Family
50 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Genitourinary & Men's Health Infectious Disease & Antimicrobials
Dermatology & Ophthalmology Women's Health & Endocrine
Psychopharmacology & Neurology Pharmacology Case Applications
COVER PAGE - 1
, SECTION 1 | Genitourinary & Men's Health Pharmacology | Q1-Q10 | NR566 2026/2027
Q1 Question 1 of 50
Q1. A 62-year-old male presents with urinary hesitancy, weak stream, and nocturia three times
nightly. DRE reveals a moderately enlarged prostate. He has hypertension controlled with
lisinopril. The provider plans to start tamsulosin (Flomax). What is the most important
counseling point regarding this medication?
A. Take the medication with food to enhance absorption and reduce gastrointestinal upset.
B. Rise slowly from sitting or lying positions to prevent orthostatic hypotension and dizziness.
C. Expect improvement in urinary symptoms within 24 hours of the first dose.
D. Discontinue the medication immediately if nasal congestion develops, as this indicates an allergic
reaction.
Correct Answer: B
Rationale:
Tamsulosin is an alpha-1A selective blocker that relaxes prostatic smooth muscle but can cause significant orthostatic
hypotension, especially in patients on antihypertensives. Patients must be counseled to rise slowly. While nasal
congestion is a common side effect, it is not an allergic reaction. Symptom improvement typically takes several days, not
hours.
Q2 Question 2 of 50
Q2. A 58-year-old man with BPH has been taking finasteride (Proscar) 5 mg daily for six months.
He reports minimal improvement in urinary symptoms. His PSA was 2.8 ng/mL at baseline and
is now 1.5 ng/mL. What is the most appropriate next step?
A. Increase the finasteride dose to 10 mg daily to achieve better symptom control.
B. Continue the current dose, as finasteride requires 6 to 12 months for full therapeutic effect.
C. Switch to dutasteride (Avodart) immediately, as it has a faster onset of action.
D. Discontinue finasteride and refer the patient for transurethral resection of the prostate (TURP).
Correct Answer: B
Rationale:
Finasteride is a 5-alpha reductase inhibitor that reduces prostate volume by blocking conversion of testosterone to DHT.
Clinical improvement typically requires 6 to 12 months of continuous therapy. The PSA reduction is expected and reflects
the medication's mechanism. Increasing the dose or switching agents prematurely is not indicated.
Q3 Question 3 of 50
Q3. A 45-year-old male is diagnosed with erectile dysfunction. He has stable coronary artery
NR566 - 2026/2027 | Passing Score: 80% | Page 2 of 27
, SECTION 1 | Genitourinary & Men's Health Pharmacology | Q1-Q10 | NR566 2026/2027
Q3 Question 3 of 50
Q3. A 45-year-old male is diagnosed with erectile dysfunction. He has stable coronary artery
disease and takes atorvastatin and low-dose aspirin. The provider considers prescribing
sildenafil (Viagra). Which medication represents the most significant contraindication to
sildenafil use?
A. Atorvastatin, due to increased risk of rhabdomyolysis when combined with PDE5 inhibitors.
B. Low-dose aspirin, due to additive antiplatelet effects increasing bleeding risk.
C. There is no significant contraindication; sildenafil is safe with both medications.
D. Nitroglycerin, if prescribed for acute angina, due to profound hypotension from combined
vasodilation.
Correct Answer: D
Rationale:
Sildenafil is a PDE5 inhibitor that potentiates nitric oxide-mediated vasodilation. When combined with nitrates such as
nitroglycerin, it can cause severe, potentially fatal hypotension. This is an absolute contraindication. Atorvastatin and
aspirin do not have clinically significant interactions with PDE5 inhibitors.
Q4 Question 4 of 50
Q4. A 70-year-old man with BPH is started on doxazosin (Cardura) 1 mg at bedtime. At two-week
follow-up, he reports lightheadedness when standing. BP is 118/72 mmHg supine and 94/60
mmHg standing. What is the best management strategy?
A. Discontinue doxazosin and switch to a 5-alpha reductase inhibitor instead.
B. Continue the current dose and instruct the patient to take the medication in the morning instead.
C. Reduce the dose to 0.5 mg daily and reassess symptoms in two weeks.
D. Add midodrine to counteract the orthostatic hypotension caused by doxazosin.
Correct Answer: A
Rationale:
If orthostatic hypotension is significant and dose reduction does not resolve symptoms within two weeks, switching to a
5-alpha reductase inhibitor such as finasteride is appropriate. These agents do not cause vasodilation and are better
tolerated in patients with cardiovascular comorbidities. Alpha blockers may need to be discontinued if hypotension
persists.
Q5 Question 5 of 50
Q5. A 55-year-old male with recurrent kidney stones is prescribed potassium citrate (Urocit-K)
NR566 - 2026/2027 | Passing Score: 80% | Page 3 of 27
OBJECTIVE ASSESSMENT - EXAM
NR 566 / NR566 Final Exam
Study Guide Qs & Ans
(Latest 2026/2027):
Advanced Pharmacology for
Care of the Family
Verified Answers | Advanced Pharmacology for Care of the Family
50 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Genitourinary & Men's Health Infectious Disease & Antimicrobials
Dermatology & Ophthalmology Women's Health & Endocrine
Psychopharmacology & Neurology Pharmacology Case Applications
COVER PAGE - 1
, SECTION 1 | Genitourinary & Men's Health Pharmacology | Q1-Q10 | NR566 2026/2027
Q1 Question 1 of 50
Q1. A 62-year-old male presents with urinary hesitancy, weak stream, and nocturia three times
nightly. DRE reveals a moderately enlarged prostate. He has hypertension controlled with
lisinopril. The provider plans to start tamsulosin (Flomax). What is the most important
counseling point regarding this medication?
A. Take the medication with food to enhance absorption and reduce gastrointestinal upset.
B. Rise slowly from sitting or lying positions to prevent orthostatic hypotension and dizziness.
C. Expect improvement in urinary symptoms within 24 hours of the first dose.
D. Discontinue the medication immediately if nasal congestion develops, as this indicates an allergic
reaction.
Correct Answer: B
Rationale:
Tamsulosin is an alpha-1A selective blocker that relaxes prostatic smooth muscle but can cause significant orthostatic
hypotension, especially in patients on antihypertensives. Patients must be counseled to rise slowly. While nasal
congestion is a common side effect, it is not an allergic reaction. Symptom improvement typically takes several days, not
hours.
Q2 Question 2 of 50
Q2. A 58-year-old man with BPH has been taking finasteride (Proscar) 5 mg daily for six months.
He reports minimal improvement in urinary symptoms. His PSA was 2.8 ng/mL at baseline and
is now 1.5 ng/mL. What is the most appropriate next step?
A. Increase the finasteride dose to 10 mg daily to achieve better symptom control.
B. Continue the current dose, as finasteride requires 6 to 12 months for full therapeutic effect.
C. Switch to dutasteride (Avodart) immediately, as it has a faster onset of action.
D. Discontinue finasteride and refer the patient for transurethral resection of the prostate (TURP).
Correct Answer: B
Rationale:
Finasteride is a 5-alpha reductase inhibitor that reduces prostate volume by blocking conversion of testosterone to DHT.
Clinical improvement typically requires 6 to 12 months of continuous therapy. The PSA reduction is expected and reflects
the medication's mechanism. Increasing the dose or switching agents prematurely is not indicated.
Q3 Question 3 of 50
Q3. A 45-year-old male is diagnosed with erectile dysfunction. He has stable coronary artery
NR566 - 2026/2027 | Passing Score: 80% | Page 2 of 27
, SECTION 1 | Genitourinary & Men's Health Pharmacology | Q1-Q10 | NR566 2026/2027
Q3 Question 3 of 50
Q3. A 45-year-old male is diagnosed with erectile dysfunction. He has stable coronary artery
disease and takes atorvastatin and low-dose aspirin. The provider considers prescribing
sildenafil (Viagra). Which medication represents the most significant contraindication to
sildenafil use?
A. Atorvastatin, due to increased risk of rhabdomyolysis when combined with PDE5 inhibitors.
B. Low-dose aspirin, due to additive antiplatelet effects increasing bleeding risk.
C. There is no significant contraindication; sildenafil is safe with both medications.
D. Nitroglycerin, if prescribed for acute angina, due to profound hypotension from combined
vasodilation.
Correct Answer: D
Rationale:
Sildenafil is a PDE5 inhibitor that potentiates nitric oxide-mediated vasodilation. When combined with nitrates such as
nitroglycerin, it can cause severe, potentially fatal hypotension. This is an absolute contraindication. Atorvastatin and
aspirin do not have clinically significant interactions with PDE5 inhibitors.
Q4 Question 4 of 50
Q4. A 70-year-old man with BPH is started on doxazosin (Cardura) 1 mg at bedtime. At two-week
follow-up, he reports lightheadedness when standing. BP is 118/72 mmHg supine and 94/60
mmHg standing. What is the best management strategy?
A. Discontinue doxazosin and switch to a 5-alpha reductase inhibitor instead.
B. Continue the current dose and instruct the patient to take the medication in the morning instead.
C. Reduce the dose to 0.5 mg daily and reassess symptoms in two weeks.
D. Add midodrine to counteract the orthostatic hypotension caused by doxazosin.
Correct Answer: A
Rationale:
If orthostatic hypotension is significant and dose reduction does not resolve symptoms within two weeks, switching to a
5-alpha reductase inhibitor such as finasteride is appropriate. These agents do not cause vasodilation and are better
tolerated in patients with cardiovascular comorbidities. Alpha blockers may need to be discontinued if hypotension
persists.
Q5 Question 5 of 50
Q5. A 55-year-old male with recurrent kidney stones is prescribed potassium citrate (Urocit-K)
NR566 - 2026/2027 | Passing Score: 80% | Page 3 of 27
