WGU D116 Advanced Pharmacology Final Exam
MASTERY GUIDE 2025-2026: 61 Expert-Curated Q&A
with Detailed Rationales, System-Based
Pharmacotherapeutics, and Clinical Case Applications
A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially?
d. Arrange to schedule an appointment with the patient.
Feedback: Schedule II medications are not eligible for refills, and prescriptions must be
handwritten. It is important to verify the patient’s adherence to the drug regimen and determine
the current dosage of medication and pain level; however, this can be accomplished by
scheduling an appointment and evaluating the patient in person.
A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding
would be most concerning to the provider?
b. The patient drinks two glasses of wine every night.
Feedback: Patients taking metronidazole should be educated not to drink alcohol to prevent a
disulfiram-like reaction. It would be concerning that the patient drinks wine daily. History of a
yeast infection may indicate increased risk for recurrence with administration of an
antimicrobial. A family history of cervical cancer is not related to administration of
metronidazole. Unemployment can indicate lack of insurance coverage, which may limit the
patient’s ability to purchase medications; however, generic metronidazole is one of the less
expensive medications.
The provider prepares a patient with newly diagnosed type 1 diabetes for hospital
discharge. Which action by the provider will best support the patient's ability to effectively
manage medication therapy?
c. Asking the patient to demonstrate how to measure and administer insulin
Feedback: Because insulin must be given correctly to control symptoms and prevent an
overdose, it is most important for the patient to know how to measure and administer it. Asking
for a demonstration of technique is the best way to determine whether the patient has understood
the teaching. The other teaching points are important as well, but they are not as critical.
A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber's priority when addressing the patient's concern?
, b. Ask the patient about the number and frequency of tablets taken.
Feedback: When evaluating the effectiveness of a drug, it is important to determine how often
the patient is using the drug. Asking the patient to identify how many tablets are taken and how
often helps the provider determine effective dosages and adherence to the medication regimen.
The patient has already stated that the medication is not working; the actual level of pain may
determine the degree to which it is not working, but it does not help the provider to determine
why it is not working. The assessment process should gather as much information about
compliance, symptoms, and drug effectiveness as possible before enacting a change in treatment.
Biofeedback may be an effective adjunct to treatment, but it should not be recommended without
complete information about drug effectiveness.
The drug manual states that older adult patients are at increased risk for hepatotoxicity.
Which action is most important when prescribing this medication to an 80-year-old
patient?
d. Obtaining baseline liver function studies
Feedback: The drug manual indicates that this drug increases risk of hepatotoxicity for elderly
patients. Getting information about liver function before giving the drug establishes baseline data
that can be compared with posttreatment data to determine whether the drug is affecting the liver.
Taking the correct dose at the correct interval may minimize risk, but without baseline
information, the effects cannot be determined. Drugs are not routinely contraindicated for an
increased risk of adverse effects
A patient with bipolar disorder is prescribed daily lithium. Which action is most important
for the provider to take in order to determine if the therapeutic level is maintained?
. Order periodic laboratory testing
Feedback: Therapeutic serum levels are determined through periodic laboratory testing.
Preadministration blood work may be necessary to obtain baseline status prior to initiating
treatment, but it will not determine therapeutic levels. Scheduling medication administration at
regular intervals will help to ensure medication is absorbed and metabolized predictably, but it
will not determine therapeutic blood levels. Assessing the patient for signs and symptoms of
toxicity will help to determine if the therapeutic level has been exceeded, not maintained.
When prescribing lovastatin, what will a provider advise to decrease the risk of developing
muscle toxicity?
B. Substitute grapefruit juice with orange juice.
Feedback: Grapefruit juice can inhibit the metabolism of certain drugs including statins like
lovastatin. The juice raises drug levels decreasing the intestinal metabolism of the drug resulting
in increased drug levels which increases the risk for adverse effects such as muscle toxicity.
MASTERY GUIDE 2025-2026: 61 Expert-Curated Q&A
with Detailed Rationales, System-Based
Pharmacotherapeutics, and Clinical Case Applications
A patient diagnosed with chronic pain calls to request an oxycodone (Oxycontin) refill.
Which action should the prescriber take initially?
d. Arrange to schedule an appointment with the patient.
Feedback: Schedule II medications are not eligible for refills, and prescriptions must be
handwritten. It is important to verify the patient’s adherence to the drug regimen and determine
the current dosage of medication and pain level; however, this can be accomplished by
scheduling an appointment and evaluating the patient in person.
A patient is prescribed metronidazole for bacterial vaginosis. Which patient history finding
would be most concerning to the provider?
b. The patient drinks two glasses of wine every night.
Feedback: Patients taking metronidazole should be educated not to drink alcohol to prevent a
disulfiram-like reaction. It would be concerning that the patient drinks wine daily. History of a
yeast infection may indicate increased risk for recurrence with administration of an
antimicrobial. A family history of cervical cancer is not related to administration of
metronidazole. Unemployment can indicate lack of insurance coverage, which may limit the
patient’s ability to purchase medications; however, generic metronidazole is one of the less
expensive medications.
The provider prepares a patient with newly diagnosed type 1 diabetes for hospital
discharge. Which action by the provider will best support the patient's ability to effectively
manage medication therapy?
c. Asking the patient to demonstrate how to measure and administer insulin
Feedback: Because insulin must be given correctly to control symptoms and prevent an
overdose, it is most important for the patient to know how to measure and administer it. Asking
for a demonstration of technique is the best way to determine whether the patient has understood
the teaching. The other teaching points are important as well, but they are not as critical.
A patient reports that a medication prescribed for recurrent migraine headaches is not
working. Which action is the prescriber's priority when addressing the patient's concern?
, b. Ask the patient about the number and frequency of tablets taken.
Feedback: When evaluating the effectiveness of a drug, it is important to determine how often
the patient is using the drug. Asking the patient to identify how many tablets are taken and how
often helps the provider determine effective dosages and adherence to the medication regimen.
The patient has already stated that the medication is not working; the actual level of pain may
determine the degree to which it is not working, but it does not help the provider to determine
why it is not working. The assessment process should gather as much information about
compliance, symptoms, and drug effectiveness as possible before enacting a change in treatment.
Biofeedback may be an effective adjunct to treatment, but it should not be recommended without
complete information about drug effectiveness.
The drug manual states that older adult patients are at increased risk for hepatotoxicity.
Which action is most important when prescribing this medication to an 80-year-old
patient?
d. Obtaining baseline liver function studies
Feedback: The drug manual indicates that this drug increases risk of hepatotoxicity for elderly
patients. Getting information about liver function before giving the drug establishes baseline data
that can be compared with posttreatment data to determine whether the drug is affecting the liver.
Taking the correct dose at the correct interval may minimize risk, but without baseline
information, the effects cannot be determined. Drugs are not routinely contraindicated for an
increased risk of adverse effects
A patient with bipolar disorder is prescribed daily lithium. Which action is most important
for the provider to take in order to determine if the therapeutic level is maintained?
. Order periodic laboratory testing
Feedback: Therapeutic serum levels are determined through periodic laboratory testing.
Preadministration blood work may be necessary to obtain baseline status prior to initiating
treatment, but it will not determine therapeutic levels. Scheduling medication administration at
regular intervals will help to ensure medication is absorbed and metabolized predictably, but it
will not determine therapeutic blood levels. Assessing the patient for signs and symptoms of
toxicity will help to determine if the therapeutic level has been exceeded, not maintained.
When prescribing lovastatin, what will a provider advise to decrease the risk of developing
muscle toxicity?
B. Substitute grapefruit juice with orange juice.
Feedback: Grapefruit juice can inhibit the metabolism of certain drugs including statins like
lovastatin. The juice raises drug levels decreasing the intestinal metabolism of the drug resulting
in increased drug levels which increases the risk for adverse effects such as muscle toxicity.
