1
260 VERIFIED QUESTIONS FROM PHARMACOTHERAPEUTICS FOR
ADVANCED PRACTICE NURSE PRESCRIBERS, 6TH EDITION BY TERI
MOSER TEST BANK 2026 EDITION ALL CHAPTERS COMPLETE
ANSWERS/ SOLUTIONS. 100 % CORRECT ALREADY GRADED A+
1. A 42-year-old woman with hypertension begins hydrochlorothiazide therapy.
Which laboratory test should be monitored most closely during the first few
weeks?
A. Serum calcium
B. Serum potassium
C. Serum uric acid
D. Serum sodium
Answer: B. Serum potassium
Rationale: Thiazide diuretics cause potassium loss through increased renal
excretion; hypokalemia is a common adverse effect.
2. Which pharmacokinetic phase primarily determines the duration of a drug’s
effect?
A. Absorption
B. Distribution
C. Metabolism
D. Elimination
Answer: D. Elimination
Rationale: Duration depends on how long it takes to clear the active compound
from systemic circulation.
3. A drug with a high first-pass effect is best administered by which route to
maximize bioavailability?
A. Oral
B. Intramuscular
C. Sublingual
D. Rectal
Answer: C. Sublingual
Rationale: Sublingual drugs bypass hepatic first-pass metabolism via direct
absorption into systemic circulation.
4. An NP prescribes lisinopril for a patient with diabetes. The patient asks why this
drug was chosen. The best explanation is:
, 2
A. It reduces insulin resistance
B. It prevents diabetic neuropathy
C. It protects renal function by reducing intraglomerular pressure
D. It directly lowers blood glucose
Answer: C
Rationale: ACE inhibitors slow progression of diabetic nephropathy by decreasing
efferent arteriolar resistance.
5. When prescribing a fluoroquinolone, which adverse effect should be discussed
with patients over 60 years of age?
A. Photosensitivity
B. Achilles tendon rupture
C. Ototoxicity
D. Hypoglycemia
Answer: B
Rationale: Fluoroquinolones increase risk of tendonitis and tendon rupture,
particularly in older adults.
6. The nurse practitioner is evaluating drug therapy effectiveness for a patient
taking an SSRI for depression. When should therapeutic effects generally be
expected?
A. 24–48 hours
B. 3–5 days
C. 2–4 weeks
D. Immediately
Answer: C
Rationale: SSRIs require 2–4 weeks for sufficient synaptic serotonin accumulation
and clinical improvement.
7. Which of the following is an example of pharmacodynamic tolerance?
A. Reduced absorption after chronic use
B. Enzyme induction leading to faster metabolism
C. Receptor down-regulation with chronic agonist exposure
D. Impaired renal elimination
Answer: C
Rationale: Pharmacodynamic tolerance results from decreased receptor sensitivity
or number.
, 3
8. Which of these antibiotics is contraindicated in pregnancy due to effects on fetal
teeth and bone?
A. Penicillin
B. Erythromycin
C. Tetracycline
D. Cephalexin
Answer: C
Rationale: Tetracyclines chelate calcium, causing discoloration of teeth and
inhibition of bone growth in the fetus.
9. A 70-year-old male with heart failure is prescribed digoxin. Which concurrent
condition most increases risk for toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Answer: B
Rationale: Low serum potassium enhances digoxin binding to myocardial
receptors, predisposing to toxicity.
10. A patient on warfarin reports starting St. John’s wort for mood. The NP should
expect:
A. Increased INR
B. Decreased INR
C. No change in INR
D. Unpredictable INR
Answer: B
Rationale: St. John’s wort induces CYP450 enzymes, increasing warfarin
metabolism and reducing anticoagulant effect.
11. Which of the following represents an appropriate antibiotic stewardship
principle?
A. Start broad-spectrum therapy and continue for at least 14 days
B. Use antibiotics prophylactically for all viral infections
C. Select the narrowest effective agent once culture results are known
D. Rotate antibiotics weekly to prevent resistance
Answer: C
Rationale: Narrow-spectrum selection minimizes resistance and preserves
microbiota.
, 4
12. Which pharmacologic property is most influenced by plasma protein binding?
A. Drug distribution
B. Absorption rate
C. Renal filtration rate
D. Bioavailability
Answer: A
Rationale: Only unbound (free) drug crosses membranes and acts
pharmacologically.
13. A 35-year-old woman develops a dry, persistent cough after starting an
antihypertensive medication. Which drug class is most likely responsible?
A. Beta blocker
B. Calcium channel blocker
C. ACE inhibitor
D. ARB
Answer: C
Rationale: ACE inhibitors increase bradykinin levels, causing cough in 5–20% of
patients.
14. A patient with peptic ulcer disease is prescribed omeprazole. Which statement
reflects proper administration?
A. Take with antacids for faster effect
B. Take 30–60 minutes before meals
C. Take only when symptoms occur
D. Stop if symptoms improve in 2 days
Answer: B
Rationale: Proton pump inhibitors work best before meals to block active proton
pumps in parietal cells.
15. Which factor most decreases hepatic drug metabolism in elderly patients?
A. Increased gastric pH
B. Decreased hepatic blood flow
C. Enhanced enzyme activity
D. Increased plasma protein binding
Answer: B
Rationale: Aging reduces liver perfusion and enzymatic capacity, prolonging drug
half-life.
16. The NP prescribes metformin to a new patient with type 2 diabetes. Which
baseline laboratory test is essential before starting therapy?
260 VERIFIED QUESTIONS FROM PHARMACOTHERAPEUTICS FOR
ADVANCED PRACTICE NURSE PRESCRIBERS, 6TH EDITION BY TERI
MOSER TEST BANK 2026 EDITION ALL CHAPTERS COMPLETE
ANSWERS/ SOLUTIONS. 100 % CORRECT ALREADY GRADED A+
1. A 42-year-old woman with hypertension begins hydrochlorothiazide therapy.
Which laboratory test should be monitored most closely during the first few
weeks?
A. Serum calcium
B. Serum potassium
C. Serum uric acid
D. Serum sodium
Answer: B. Serum potassium
Rationale: Thiazide diuretics cause potassium loss through increased renal
excretion; hypokalemia is a common adverse effect.
2. Which pharmacokinetic phase primarily determines the duration of a drug’s
effect?
A. Absorption
B. Distribution
C. Metabolism
D. Elimination
Answer: D. Elimination
Rationale: Duration depends on how long it takes to clear the active compound
from systemic circulation.
3. A drug with a high first-pass effect is best administered by which route to
maximize bioavailability?
A. Oral
B. Intramuscular
C. Sublingual
D. Rectal
Answer: C. Sublingual
Rationale: Sublingual drugs bypass hepatic first-pass metabolism via direct
absorption into systemic circulation.
4. An NP prescribes lisinopril for a patient with diabetes. The patient asks why this
drug was chosen. The best explanation is:
, 2
A. It reduces insulin resistance
B. It prevents diabetic neuropathy
C. It protects renal function by reducing intraglomerular pressure
D. It directly lowers blood glucose
Answer: C
Rationale: ACE inhibitors slow progression of diabetic nephropathy by decreasing
efferent arteriolar resistance.
5. When prescribing a fluoroquinolone, which adverse effect should be discussed
with patients over 60 years of age?
A. Photosensitivity
B. Achilles tendon rupture
C. Ototoxicity
D. Hypoglycemia
Answer: B
Rationale: Fluoroquinolones increase risk of tendonitis and tendon rupture,
particularly in older adults.
6. The nurse practitioner is evaluating drug therapy effectiveness for a patient
taking an SSRI for depression. When should therapeutic effects generally be
expected?
A. 24–48 hours
B. 3–5 days
C. 2–4 weeks
D. Immediately
Answer: C
Rationale: SSRIs require 2–4 weeks for sufficient synaptic serotonin accumulation
and clinical improvement.
7. Which of the following is an example of pharmacodynamic tolerance?
A. Reduced absorption after chronic use
B. Enzyme induction leading to faster metabolism
C. Receptor down-regulation with chronic agonist exposure
D. Impaired renal elimination
Answer: C
Rationale: Pharmacodynamic tolerance results from decreased receptor sensitivity
or number.
, 3
8. Which of these antibiotics is contraindicated in pregnancy due to effects on fetal
teeth and bone?
A. Penicillin
B. Erythromycin
C. Tetracycline
D. Cephalexin
Answer: C
Rationale: Tetracyclines chelate calcium, causing discoloration of teeth and
inhibition of bone growth in the fetus.
9. A 70-year-old male with heart failure is prescribed digoxin. Which concurrent
condition most increases risk for toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Answer: B
Rationale: Low serum potassium enhances digoxin binding to myocardial
receptors, predisposing to toxicity.
10. A patient on warfarin reports starting St. John’s wort for mood. The NP should
expect:
A. Increased INR
B. Decreased INR
C. No change in INR
D. Unpredictable INR
Answer: B
Rationale: St. John’s wort induces CYP450 enzymes, increasing warfarin
metabolism and reducing anticoagulant effect.
11. Which of the following represents an appropriate antibiotic stewardship
principle?
A. Start broad-spectrum therapy and continue for at least 14 days
B. Use antibiotics prophylactically for all viral infections
C. Select the narrowest effective agent once culture results are known
D. Rotate antibiotics weekly to prevent resistance
Answer: C
Rationale: Narrow-spectrum selection minimizes resistance and preserves
microbiota.
, 4
12. Which pharmacologic property is most influenced by plasma protein binding?
A. Drug distribution
B. Absorption rate
C. Renal filtration rate
D. Bioavailability
Answer: A
Rationale: Only unbound (free) drug crosses membranes and acts
pharmacologically.
13. A 35-year-old woman develops a dry, persistent cough after starting an
antihypertensive medication. Which drug class is most likely responsible?
A. Beta blocker
B. Calcium channel blocker
C. ACE inhibitor
D. ARB
Answer: C
Rationale: ACE inhibitors increase bradykinin levels, causing cough in 5–20% of
patients.
14. A patient with peptic ulcer disease is prescribed omeprazole. Which statement
reflects proper administration?
A. Take with antacids for faster effect
B. Take 30–60 minutes before meals
C. Take only when symptoms occur
D. Stop if symptoms improve in 2 days
Answer: B
Rationale: Proton pump inhibitors work best before meals to block active proton
pumps in parietal cells.
15. Which factor most decreases hepatic drug metabolism in elderly patients?
A. Increased gastric pH
B. Decreased hepatic blood flow
C. Enhanced enzyme activity
D. Increased plasma protein binding
Answer: B
Rationale: Aging reduces liver perfusion and enzymatic capacity, prolonging drug
half-life.
16. The NP prescribes metformin to a new patient with type 2 diabetes. Which
baseline laboratory test is essential before starting therapy?
