NR 508 Week 8 Advanced Pharmacology
Final Exam 2025| Chamberlain University|
Actual Exam Questions and Correct Answers
A 55-year-old patient develops Parkinson’s disease characterized by unilateral tremors only. The
primary care NP will refer the patient to a neurologist and should expect initial treatment to be:
A) Levodopa/carbidopa
B) Pramipexole
C) Benztropine
D) Amantadine
Correct Answer: B) Pramipexole
Explanation: For early-stage Parkinson’s disease with unilateral tremors, dopamine agonists like
pramipexole are often used as initial treatment, especially in younger patients, to delay the use of
levodopa and minimize long-term side effects.
A 70-year-old patient with osteoarthritis in fingers, thumbs, hips, and knees, currently taking
high-dose acetaminophen, reports moderate to severe pain. The patient has a strong family
history of cardiovascular disease and hypertension. The primary care NP prescribes a
nonselective NSAID. At a follow-up visit, the patient reports mild GI side effects. The NP
should:
A) Discontinue the NSAID and prescribe a COX-2 selective inhibitor
B) Add a proton pump inhibitor to the regimen
C) Switch to a topical NSAID
D) Increase the acetaminophen dose
Correct Answer: B) Add a proton pump inhibitor to the regimen
Explanation: Mild GI side effects from a nonselective NSAID can be managed by adding a
proton pump inhibitor (PPI) to reduce the risk of GI complications, especially in a patient with
cardiovascular risk factors where COX-2 inhibitors may pose additional risks.
A child is diagnosed with AD/HD after being suspended from school for disruptive behaviors.
The child’s parents are reluctant to start medication due to stigma. The primary care NP should
suggest:
, A) Starting methylphenidate immediately
B) Behavioral therapy as an initial approach
C) Delaying any intervention for 6 months
D) Atomoxetine as a non-stimulant alternative
Correct Answer: B) Behavioral therapy as an initial approach
Explanation: For parents reluctant to use medication, behavioral therapy is a recommended
first-line approach for AD/HD, especially in younger children, to address symptoms and support
the family’s concerns.
A child taking methylphenidate (Ritalin) for AD/HD has a parent report increased behavior
problems and delusional thinking. The primary care NP should:
A) Increase the methylphenidate dose
B) Discontinue methylphenidate and consult a psychiatrist
C) Add a mood stabilizer to the regimen
D) Switch to a long-acting methylphenidate formulation
Correct Answer: B) Discontinue methylphenidate and consult a psychiatrist
Explanation: Delusional thinking and increased behavior problems may indicate serious side
effects of methylphenidate, such as psychosis. Discontinuing the medication and consulting a
psychiatrist for further evaluation is the safest approach.
A patient exhibits keratin deposits around hair follicles and has hardened pigmented “goose
bump” lesions on all extremities. The primary care NP should consider prescribing:
A) Topical corticosteroids
B) Oral isotretinoin
C) Topical retinoids
D) Oral antibiotics
Correct Answer: C) Topical retinoids
Explanation: The description suggests keratosis pilaris, characterized by keratin plugs and
“goose bump” lesions. Topical retinoids are effective in promoting cell turnover and reducing
keratin buildup.
A patient with Rocky Mountain spotted fever, treated with doxycycline 100 mg orally for 7 days,
reports persistent fever, headache, and myalgia at the end of therapy. The primary care NP will
consult with the infectious disease specialist and order:
Final Exam 2025| Chamberlain University|
Actual Exam Questions and Correct Answers
A 55-year-old patient develops Parkinson’s disease characterized by unilateral tremors only. The
primary care NP will refer the patient to a neurologist and should expect initial treatment to be:
A) Levodopa/carbidopa
B) Pramipexole
C) Benztropine
D) Amantadine
Correct Answer: B) Pramipexole
Explanation: For early-stage Parkinson’s disease with unilateral tremors, dopamine agonists like
pramipexole are often used as initial treatment, especially in younger patients, to delay the use of
levodopa and minimize long-term side effects.
A 70-year-old patient with osteoarthritis in fingers, thumbs, hips, and knees, currently taking
high-dose acetaminophen, reports moderate to severe pain. The patient has a strong family
history of cardiovascular disease and hypertension. The primary care NP prescribes a
nonselective NSAID. At a follow-up visit, the patient reports mild GI side effects. The NP
should:
A) Discontinue the NSAID and prescribe a COX-2 selective inhibitor
B) Add a proton pump inhibitor to the regimen
C) Switch to a topical NSAID
D) Increase the acetaminophen dose
Correct Answer: B) Add a proton pump inhibitor to the regimen
Explanation: Mild GI side effects from a nonselective NSAID can be managed by adding a
proton pump inhibitor (PPI) to reduce the risk of GI complications, especially in a patient with
cardiovascular risk factors where COX-2 inhibitors may pose additional risks.
A child is diagnosed with AD/HD after being suspended from school for disruptive behaviors.
The child’s parents are reluctant to start medication due to stigma. The primary care NP should
suggest:
, A) Starting methylphenidate immediately
B) Behavioral therapy as an initial approach
C) Delaying any intervention for 6 months
D) Atomoxetine as a non-stimulant alternative
Correct Answer: B) Behavioral therapy as an initial approach
Explanation: For parents reluctant to use medication, behavioral therapy is a recommended
first-line approach for AD/HD, especially in younger children, to address symptoms and support
the family’s concerns.
A child taking methylphenidate (Ritalin) for AD/HD has a parent report increased behavior
problems and delusional thinking. The primary care NP should:
A) Increase the methylphenidate dose
B) Discontinue methylphenidate and consult a psychiatrist
C) Add a mood stabilizer to the regimen
D) Switch to a long-acting methylphenidate formulation
Correct Answer: B) Discontinue methylphenidate and consult a psychiatrist
Explanation: Delusional thinking and increased behavior problems may indicate serious side
effects of methylphenidate, such as psychosis. Discontinuing the medication and consulting a
psychiatrist for further evaluation is the safest approach.
A patient exhibits keratin deposits around hair follicles and has hardened pigmented “goose
bump” lesions on all extremities. The primary care NP should consider prescribing:
A) Topical corticosteroids
B) Oral isotretinoin
C) Topical retinoids
D) Oral antibiotics
Correct Answer: C) Topical retinoids
Explanation: The description suggests keratosis pilaris, characterized by keratin plugs and
“goose bump” lesions. Topical retinoids are effective in promoting cell turnover and reducing
keratin buildup.
A patient with Rocky Mountain spotted fever, treated with doxycycline 100 mg orally for 7 days,
reports persistent fever, headache, and myalgia at the end of therapy. The primary care NP will
consult with the infectious disease specialist and order:
