NUR 521 ADV PHARM EXAM 4
NUR 521 ADV PHARM EXAM 4 NEWEST 2025 COMPLETE
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW!!
What patient education is needed when beginning Tofacitinib? - ANSWER-* Monitor CBC, LFTs,
lipids regularly
* Report signs of infection immediately
* Do not take live vaccines
* Risk of thrombosis and cancer (BBW)
* Screen for TB before starting.
Pathology of Gout - ANSWER-Excess uric acid --> Crystal deposits in joints --> Inflammation
Diagnosis of gout: - ANSWER-* Serum uric acid > 6.8 mg/dL
* Joint aspiration may show crystals
Medications to treat acute gout: - ANSWER-* NSAIDs
* Glucocorticoids
* Colchicine
Medications to prevent gout: - ANSWER-* Allopurinol
* Probenecid
What to start gout medications: - ANSWER-* 2 or more attacks per year
* Trophaceous gout
* Not during acute flare
1|Page
, NUR 521 ADV PHARM EXAM 4
Serious AEs of Allopurinol: - ANSWER-* SJS/TENS (especially in Asian patients with HLA-B*5801)
Serious AEs of Colchicine: - ANSWER-* Myopathy
* Bone marrow suppression with chronic use
Drug interactions with Methotrexate: - ANSWER-* NSAIDs
* Sulfonamides
* Alcohol (increased toxicity)
Drug interactions with Allopurinol: - ANSWER-* Inhibits xanthine oxidase --> Increases effects of
Azathioprine and Mercaptopurine
Drug interactions with Probenecid: - ANSWER-Inhibits renal excretion of Penicillin and
Methotrexate
Drug interactions with Colchicine: - ANSWER-Avoid with macrolide antibiotics (Erythromycin,
Clarithromycin) due to increased toxicity
What medications inhibit hepatic metabolism? - ANSWER-CYP inhibitors (e.g., Allopurinol) may
increase toxicity of liver-metabolized medications
What medications treat Osteoporosis? - ANSWER-* Bisphosphonate: Alendronate (Fosamax)
* Non-bisphosphonate: Denosumab (Prolia), Calcitonin (nasal spray)
* Bone-forming agent: Teriparatide (Forteo)
* Vitamin D replacement: Vitamin D3
2|Page
, NUR 521 ADV PHARM EXAM 4
What patient history and diseases should be considered before starting osteoporosis
treatment? - ANSWER-* Esophageal disorders or inability to sit upright: Avoid bisphosphonates
* Renal impairment: Avoid bisphosphonates and denosumab
* Hypocalcemia: Correct before starting teriparatide or denosumab
* Hypercalcemia, digoxin use: Caution with vitamin D.
Patient education for Alendronate: - ANSWER-* Take on empty stomach with full glass of water
* Sit upright 30 minutes post-dos
Patient education for Denosumab: - ANSWER-* SubQ every 6 months
* May cause hypocalcemia—ensure calcium/vitamin D intake
Patient education for nasal Calcitonin: - ANSWER-* Alternate nostrils daily
* Store in refrigerator before opening.
Patient education for Teriparatide: - ANSWER-* Daily SubQ
* Limit to 2 years due to osteosarcoma risk (BBW)
Patient education for Vitamin D: - ANSWER-* Take with calcium
* Monitor for hypercalcemia
* Avoid in patients on digoxin
How is Prolia (Denosumab) administered? - ANSWER-Administered as a subcutaneous injection
every 6 months
When is Prolia stopped? - ANSWER-Stopped if patient develops hypocalcemia or serious
adverse reactions
3|Page
, NUR 521 ADV PHARM EXAM 4
How is Fosamax (Alendronate) administered? - ANSWER-* Oral tablet taken weekly
* Must be taken with full glass of water on an empty stomach
* Patient must sit upright for 30 minutes
When is Fosamax stopped? - ANSWER-Stopped after 3-5 years to reduce risk of atypical femur
fractures and osteonecrosis of the jaw
Medications used to treat Paget's disease - ANSWER-* Biphosphonates (ex: Alendronate)
* Calcitonin (Miacalcin)
Common SE of Miacalcin: - ANSWER-* Nasal irritation
* Rhinitis
* Epistaxis (if nasal spray)
* Nausea
CI of Miacalcin: - ANSWER-* Hypersensitivity to salmon protein
* Hypocalcemia
Treatment of Acute Otitis Media (AOM): - ANSWER-* High dose Amoxicillin
* Alternatives include Augmentin or Cephalosporins
Treatment of Acute Otitis Externa (AOE): - ANSWER-* Topical ciprofloxacin + hydrocortisone
(Cipro HC), Ciprodex, or Orfloxacin
Treatment of Otomycosis: - ANSWER-Antifungal ear drops like Clotrimazole or Acetic acid
solution
4|Page
NUR 521 ADV PHARM EXAM 4 NEWEST 2025 COMPLETE
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW!!
What patient education is needed when beginning Tofacitinib? - ANSWER-* Monitor CBC, LFTs,
lipids regularly
* Report signs of infection immediately
* Do not take live vaccines
* Risk of thrombosis and cancer (BBW)
* Screen for TB before starting.
Pathology of Gout - ANSWER-Excess uric acid --> Crystal deposits in joints --> Inflammation
Diagnosis of gout: - ANSWER-* Serum uric acid > 6.8 mg/dL
* Joint aspiration may show crystals
Medications to treat acute gout: - ANSWER-* NSAIDs
* Glucocorticoids
* Colchicine
Medications to prevent gout: - ANSWER-* Allopurinol
* Probenecid
What to start gout medications: - ANSWER-* 2 or more attacks per year
* Trophaceous gout
* Not during acute flare
1|Page
, NUR 521 ADV PHARM EXAM 4
Serious AEs of Allopurinol: - ANSWER-* SJS/TENS (especially in Asian patients with HLA-B*5801)
Serious AEs of Colchicine: - ANSWER-* Myopathy
* Bone marrow suppression with chronic use
Drug interactions with Methotrexate: - ANSWER-* NSAIDs
* Sulfonamides
* Alcohol (increased toxicity)
Drug interactions with Allopurinol: - ANSWER-* Inhibits xanthine oxidase --> Increases effects of
Azathioprine and Mercaptopurine
Drug interactions with Probenecid: - ANSWER-Inhibits renal excretion of Penicillin and
Methotrexate
Drug interactions with Colchicine: - ANSWER-Avoid with macrolide antibiotics (Erythromycin,
Clarithromycin) due to increased toxicity
What medications inhibit hepatic metabolism? - ANSWER-CYP inhibitors (e.g., Allopurinol) may
increase toxicity of liver-metabolized medications
What medications treat Osteoporosis? - ANSWER-* Bisphosphonate: Alendronate (Fosamax)
* Non-bisphosphonate: Denosumab (Prolia), Calcitonin (nasal spray)
* Bone-forming agent: Teriparatide (Forteo)
* Vitamin D replacement: Vitamin D3
2|Page
, NUR 521 ADV PHARM EXAM 4
What patient history and diseases should be considered before starting osteoporosis
treatment? - ANSWER-* Esophageal disorders or inability to sit upright: Avoid bisphosphonates
* Renal impairment: Avoid bisphosphonates and denosumab
* Hypocalcemia: Correct before starting teriparatide or denosumab
* Hypercalcemia, digoxin use: Caution with vitamin D.
Patient education for Alendronate: - ANSWER-* Take on empty stomach with full glass of water
* Sit upright 30 minutes post-dos
Patient education for Denosumab: - ANSWER-* SubQ every 6 months
* May cause hypocalcemia—ensure calcium/vitamin D intake
Patient education for nasal Calcitonin: - ANSWER-* Alternate nostrils daily
* Store in refrigerator before opening.
Patient education for Teriparatide: - ANSWER-* Daily SubQ
* Limit to 2 years due to osteosarcoma risk (BBW)
Patient education for Vitamin D: - ANSWER-* Take with calcium
* Monitor for hypercalcemia
* Avoid in patients on digoxin
How is Prolia (Denosumab) administered? - ANSWER-Administered as a subcutaneous injection
every 6 months
When is Prolia stopped? - ANSWER-Stopped if patient develops hypocalcemia or serious
adverse reactions
3|Page
, NUR 521 ADV PHARM EXAM 4
How is Fosamax (Alendronate) administered? - ANSWER-* Oral tablet taken weekly
* Must be taken with full glass of water on an empty stomach
* Patient must sit upright for 30 minutes
When is Fosamax stopped? - ANSWER-Stopped after 3-5 years to reduce risk of atypical femur
fractures and osteonecrosis of the jaw
Medications used to treat Paget's disease - ANSWER-* Biphosphonates (ex: Alendronate)
* Calcitonin (Miacalcin)
Common SE of Miacalcin: - ANSWER-* Nasal irritation
* Rhinitis
* Epistaxis (if nasal spray)
* Nausea
CI of Miacalcin: - ANSWER-* Hypersensitivity to salmon protein
* Hypocalcemia
Treatment of Acute Otitis Media (AOM): - ANSWER-* High dose Amoxicillin
* Alternatives include Augmentin or Cephalosporins
Treatment of Acute Otitis Externa (AOE): - ANSWER-* Topical ciprofloxacin + hydrocortisone
(Cipro HC), Ciprodex, or Orfloxacin
Treatment of Otomycosis: - ANSWER-Antifungal ear drops like Clotrimazole or Acetic acid
solution
4|Page
