Page |1
NUR 521 ADV PHARM EXAM 4 NEWEST 2025/2026 NEWEST
ACTUAL EXAM WITH COMPLETE QUESTIONS AND
VERIFIED ANSWERS |ALREADY GRADED A+|
Calcitonin - salmon nasal spray Indications: - ANSWER-*
Postmenopausal osteoporosis
* Injection form indicated for rapid relief of pain caused by Paget's
disease and hypercalcemia
Calcitonin - salmon nasal spray CI: - ANSWER-* Hypersensitivity
to drug or ingredient, uncorrected hypocalcemia
* Allergy to fish
Calcitonin - salmon nasal spray Precautions: - ANSWER-* Use
caution in elderly pts or at risk for hypocalcemia
Calcitonin - salmon nasal spray Patient education: - ANSWER-*
Delivery: Nasal spray; 200 units per actuation, 1 spray in one
nostril daily. Alternate nostrils with each spray
* Monitor Ca, alkaline phosphatase and Vit D levels and DXA
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Calcitonin - salmon nasal spray evaluation: - ANSWER-* Side
Effects: hypocalcemia, rhinitis, nasal sx, back pain, epistaxis,
headache
Denosumab (Prolia) MOA: - ANSWER-* Binds to receptor
activator of nuclear factor kappa-B ligand (RANKL), inhibiting
osteoclast formation, maintenance, and survival and reducing
bone resorption and turnover (RANKL inhibitor)
* Antirestorative agent: Non-bisphosphonate
Prolia Safety: - ANSWER-* Cr
* Oral exam
* Pregnancy test at baseline
* Ca at baseline
* Ca, Mg, PO4 w/in 14 days of administration
Prolia Pharmacokinetics: - ANSWER-* Metabolism unknown,
excretion unknown
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* Drug Interactions: Denosumab is a RANKL inhibitor and cause
hypocalcemia and hyporphosphatemia
Prolia Indications: - ANSWER-* Osteoporosis in men and
postmenopausal women
* Bone loss when receiving certain Cancer tx;
Prolia CI: - ANSWER-* Hypersensitivity to drug or ingredient
* Pregnancy
* Pts <4 yo
* Hypocalcemia
Prolia Precautions: - ANSWER-* Hypocalcemia risk
* CrCL<30
* Corticosteroids, chemotherapy
* Infection
* Avoid dental procedures
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Prolia Patient Education: - ANSWER-* Delivery: injected SubQ
every 6 months
* Monitor:
-- Calcium, magnesium and phosphorous levels
-- Monitor for jawbone osteonecrosis
Prolia Evaluation: - ANSWER-* Side Effects:
-- Back pain
-- Pain in extremities
-- MSK pain
-- Hypercholesterolemia and bladder infections
-- Skin reactions
Alendronate (Fosamax) MOA: - ANSWER-* Inhibits osteoclast
activity, reducing bone resorption and turnover
* Antiresorptive agent: Bisphosphonates
Fosamax Safety: - ANSWER-* Confused with Flomax, Fosamax
Plus D, Zithromax
NUR 521 ADV PHARM EXAM 4 NEWEST 2025/2026 NEWEST
ACTUAL EXAM WITH COMPLETE QUESTIONS AND
VERIFIED ANSWERS |ALREADY GRADED A+|
Calcitonin - salmon nasal spray Indications: - ANSWER-*
Postmenopausal osteoporosis
* Injection form indicated for rapid relief of pain caused by Paget's
disease and hypercalcemia
Calcitonin - salmon nasal spray CI: - ANSWER-* Hypersensitivity
to drug or ingredient, uncorrected hypocalcemia
* Allergy to fish
Calcitonin - salmon nasal spray Precautions: - ANSWER-* Use
caution in elderly pts or at risk for hypocalcemia
Calcitonin - salmon nasal spray Patient education: - ANSWER-*
Delivery: Nasal spray; 200 units per actuation, 1 spray in one
nostril daily. Alternate nostrils with each spray
* Monitor Ca, alkaline phosphatase and Vit D levels and DXA
, Page |2
Calcitonin - salmon nasal spray evaluation: - ANSWER-* Side
Effects: hypocalcemia, rhinitis, nasal sx, back pain, epistaxis,
headache
Denosumab (Prolia) MOA: - ANSWER-* Binds to receptor
activator of nuclear factor kappa-B ligand (RANKL), inhibiting
osteoclast formation, maintenance, and survival and reducing
bone resorption and turnover (RANKL inhibitor)
* Antirestorative agent: Non-bisphosphonate
Prolia Safety: - ANSWER-* Cr
* Oral exam
* Pregnancy test at baseline
* Ca at baseline
* Ca, Mg, PO4 w/in 14 days of administration
Prolia Pharmacokinetics: - ANSWER-* Metabolism unknown,
excretion unknown
, Page |3
* Drug Interactions: Denosumab is a RANKL inhibitor and cause
hypocalcemia and hyporphosphatemia
Prolia Indications: - ANSWER-* Osteoporosis in men and
postmenopausal women
* Bone loss when receiving certain Cancer tx;
Prolia CI: - ANSWER-* Hypersensitivity to drug or ingredient
* Pregnancy
* Pts <4 yo
* Hypocalcemia
Prolia Precautions: - ANSWER-* Hypocalcemia risk
* CrCL<30
* Corticosteroids, chemotherapy
* Infection
* Avoid dental procedures
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Prolia Patient Education: - ANSWER-* Delivery: injected SubQ
every 6 months
* Monitor:
-- Calcium, magnesium and phosphorous levels
-- Monitor for jawbone osteonecrosis
Prolia Evaluation: - ANSWER-* Side Effects:
-- Back pain
-- Pain in extremities
-- MSK pain
-- Hypercholesterolemia and bladder infections
-- Skin reactions
Alendronate (Fosamax) MOA: - ANSWER-* Inhibits osteoclast
activity, reducing bone resorption and turnover
* Antiresorptive agent: Bisphosphonates
Fosamax Safety: - ANSWER-* Confused with Flomax, Fosamax
Plus D, Zithromax
