NR 566 FINAL EXAM / NR566 FINAL
Page | 1 EXAM 200+ QUESTIONS & ANSWERS /
ADVANCED PHARMACOLOGY FOR CARE
OF FAMILY|AGRADE LATEST )
✅ 1. A patient taking lisinopril for hypertension reports a persistent dry cough.
What is the best action by the nurse practitioner?
A. Reassure the patient this is normal and will resolve
B. Discontinue lisinopril and initiate losartan
C. Add an over-the-counter cough suppressant
D. Refer the patient to pulmonology
✅ Correct Answer: B
Rationale: ACE inhibitors like lisinopril can cause a persistent dry cough due to bradykinin
buildup. Switching to an ARB like losartan avoids this side effect.
✅ 2. Which laboratory value should be monitored most closely in a patient
taking spironolactone?
A. Sodium
B. Potassium
C. Magnesium
D. Glucose
✅ Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic, which may cause hyperkalemia.
✅ 3. A pregnant woman with a history of epilepsy is prescribed valproic acid.
What is the most appropriate action?
, A. Reassure that it's safe in pregnancy
B. Decrease the dose
C. Discontinue and consult neurology for safer alternatives
D. Continue therapy with folic acid supplementation
✅ Correct Answer: C
Page | 2 Rationale: Valproic acid is teratogenic, especially in the first trimester. Alternatives like
lamotrigine are safer.
✅ 4. What is the most appropriate initial therapy for a healthy adult with newly
diagnosed hypertension?
A. Beta-blocker
B. Thiazide diuretic
C. Loop diuretic
D. Central alpha agonist
✅ Correct Answer: B
Rationale: Thiazide diuretics are first-line agents for managing uncomplicated hypertension
in most patients.
✅ 5. Which medication is contraindicated in children under 8 due to risk of
permanent tooth discoloration?
A. Amoxicillin
B. Azithromycin
C. Doxycycline
D. Cefdinir
✅ Correct Answer: C
Rationale: Tetracyclines like doxycycline deposit in bones and teeth, leading to discoloration
and growth suppression.
✅ 6. Which of the following is the antidote for benzodiazepine overdose?
A. Flumazenil
B. Naloxone
C. Acetylcysteine
D. Atropine
✅ Correct Answer: A
Rationale: Flumazenil is a benzodiazepine receptor antagonist used to reverse effects of
drugs like diazepam or lorazepam.
, ✅ 7. Which class of medications is best for treating generalized anxiety disorder
(GAD) long-term?
Page | 3 A. Benzodiazepines
B. SSRIs
C. Beta-blockers
D. Antipsychotics
✅ Correct Answer: B
Rationale: SSRIs are first-line treatment for chronic anxiety due to efficacy and safety for
long-term use.
✅ 8. Which patient should avoid pseudoephedrine?
A. One with a common cold
B. One with uncontrolled hypertension
C. One with seasonal allergies
D. One with nasal congestion
✅ Correct Answer: B
Rationale: Pseudoephedrine is a sympathomimetic, and can raise blood pressure dangerously
in hypertensive patients.
✅ 9. A patient starting metformin should be advised to report which symptom
immediately?
A. Muscle pain and fatigue
B. Frequent urination
C. Increased appetite
D. Drowsiness
✅ Correct Answer: A
Rationale: Muscle pain and fatigue could indicate lactic acidosis, a rare but serious side
effect of metformin.
✅ 10. Which antibiotic is most appropriate for treating acute otitis media in a
child with no allergies?
A. Cefdinir
B. Amoxicillin
, C. Azithromycin
D. Ciprofloxacin
✅ Correct Answer: B
Rationale: Amoxicillin remains first-line therapy for most uncomplicated cases of otitis
media.
Page | 4
✅ 11. Which medication can cause gingival hyperplasia as a side effect?
A. Carbamazepine
B. Valproic acid
C. Phenytoin
D. Topiramate
✅ Correct Answer: C
Rationale: Phenytoin commonly causes gingival overgrowth, especially with poor dental
hygiene.
✅ 12. Which class of antihypertensives is most associated with first-dose
orthostatic hypotension?
A. Calcium channel blockers
B. Alpha-blockers
C. Beta-blockers
D. Diuretics
✅ Correct Answer: B
Rationale: Alpha-blockers (e.g., prazosin) may cause a significant drop in BP after the first
dose.
✅ 13. Which lipid-lowering agent may cause flushing and pruritus?
A. Atorvastatin
B. Ezetimibe
C. Niacin (vitamin B3)
D. Fenofibrate
✅ Correct Answer: C
Rationale: Niacin causes histamine release, leading to uncomfortable skin flushing.
✅ 14. Which adverse effect is most commonly associated with statin therapy?
Page | 1 EXAM 200+ QUESTIONS & ANSWERS /
ADVANCED PHARMACOLOGY FOR CARE
OF FAMILY|AGRADE LATEST )
✅ 1. A patient taking lisinopril for hypertension reports a persistent dry cough.
What is the best action by the nurse practitioner?
A. Reassure the patient this is normal and will resolve
B. Discontinue lisinopril and initiate losartan
C. Add an over-the-counter cough suppressant
D. Refer the patient to pulmonology
✅ Correct Answer: B
Rationale: ACE inhibitors like lisinopril can cause a persistent dry cough due to bradykinin
buildup. Switching to an ARB like losartan avoids this side effect.
✅ 2. Which laboratory value should be monitored most closely in a patient
taking spironolactone?
A. Sodium
B. Potassium
C. Magnesium
D. Glucose
✅ Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic, which may cause hyperkalemia.
✅ 3. A pregnant woman with a history of epilepsy is prescribed valproic acid.
What is the most appropriate action?
, A. Reassure that it's safe in pregnancy
B. Decrease the dose
C. Discontinue and consult neurology for safer alternatives
D. Continue therapy with folic acid supplementation
✅ Correct Answer: C
Page | 2 Rationale: Valproic acid is teratogenic, especially in the first trimester. Alternatives like
lamotrigine are safer.
✅ 4. What is the most appropriate initial therapy for a healthy adult with newly
diagnosed hypertension?
A. Beta-blocker
B. Thiazide diuretic
C. Loop diuretic
D. Central alpha agonist
✅ Correct Answer: B
Rationale: Thiazide diuretics are first-line agents for managing uncomplicated hypertension
in most patients.
✅ 5. Which medication is contraindicated in children under 8 due to risk of
permanent tooth discoloration?
A. Amoxicillin
B. Azithromycin
C. Doxycycline
D. Cefdinir
✅ Correct Answer: C
Rationale: Tetracyclines like doxycycline deposit in bones and teeth, leading to discoloration
and growth suppression.
✅ 6. Which of the following is the antidote for benzodiazepine overdose?
A. Flumazenil
B. Naloxone
C. Acetylcysteine
D. Atropine
✅ Correct Answer: A
Rationale: Flumazenil is a benzodiazepine receptor antagonist used to reverse effects of
drugs like diazepam or lorazepam.
, ✅ 7. Which class of medications is best for treating generalized anxiety disorder
(GAD) long-term?
Page | 3 A. Benzodiazepines
B. SSRIs
C. Beta-blockers
D. Antipsychotics
✅ Correct Answer: B
Rationale: SSRIs are first-line treatment for chronic anxiety due to efficacy and safety for
long-term use.
✅ 8. Which patient should avoid pseudoephedrine?
A. One with a common cold
B. One with uncontrolled hypertension
C. One with seasonal allergies
D. One with nasal congestion
✅ Correct Answer: B
Rationale: Pseudoephedrine is a sympathomimetic, and can raise blood pressure dangerously
in hypertensive patients.
✅ 9. A patient starting metformin should be advised to report which symptom
immediately?
A. Muscle pain and fatigue
B. Frequent urination
C. Increased appetite
D. Drowsiness
✅ Correct Answer: A
Rationale: Muscle pain and fatigue could indicate lactic acidosis, a rare but serious side
effect of metformin.
✅ 10. Which antibiotic is most appropriate for treating acute otitis media in a
child with no allergies?
A. Cefdinir
B. Amoxicillin
, C. Azithromycin
D. Ciprofloxacin
✅ Correct Answer: B
Rationale: Amoxicillin remains first-line therapy for most uncomplicated cases of otitis
media.
Page | 4
✅ 11. Which medication can cause gingival hyperplasia as a side effect?
A. Carbamazepine
B. Valproic acid
C. Phenytoin
D. Topiramate
✅ Correct Answer: C
Rationale: Phenytoin commonly causes gingival overgrowth, especially with poor dental
hygiene.
✅ 12. Which class of antihypertensives is most associated with first-dose
orthostatic hypotension?
A. Calcium channel blockers
B. Alpha-blockers
C. Beta-blockers
D. Diuretics
✅ Correct Answer: B
Rationale: Alpha-blockers (e.g., prazosin) may cause a significant drop in BP after the first
dose.
✅ 13. Which lipid-lowering agent may cause flushing and pruritus?
A. Atorvastatin
B. Ezetimibe
C. Niacin (vitamin B3)
D. Fenofibrate
✅ Correct Answer: C
Rationale: Niacin causes histamine release, leading to uncomfortable skin flushing.
✅ 14. Which adverse effect is most commonly associated with statin therapy?
