NR293 Pharmacology for Nursing Practice
Exam 2 2025/2026
EXAM BLUEPRINT SUMMARY
● 70 multiple-choice questions (1 pt each)
● 9 SATA (select-all-that-apply) – 0.5 pt per correct option
● 8 dosage-calculations with step-by-step work
● 6 recent FDA / safety-alert items (2025-2026)
● 5 special-population considerations
● Total scored points = 90
SECTION A – NEUROLOGICAL & PSYCHIATRIC MEDICATIONS (15 MCQ)
1. Question (Antidepressant)
A 26-y/o begins vilazodone 20 mg for MDD. Which 2026 teaching is MOST
important?
A. Take with food to ↑ absorption 50 %
B. Avoid tyramine-rich foods
C. Expect 4-week onset for full effect
D. Discontinue if headache occurs
Answer: A – 2025 FDA labeling: high-fat meal ↑ AUC; prevents early
discontinuation.
Rationale: Vilazodone is NOT an MAOI (tyramine not relevant); food effect unique
among SSRIs.
2. SATA – Bipolar Maintenance
Patient on lithium 900 mg qHS. Which labs require 6-month monitoring? (Select
≥3)
● ★ Serum creatinine
● ★ TSH & free T₄
● ★ Serum calcium
● ★ 24-h urine osmolality
● ★ Serum lithium level
Answer: 1,2,5 – nephrotoxicity & hypothyroidism classic; levels guide
, efficacy.
Rationale: 2025 APA bipolar update adds annual Ca²⁺ (not 6 mo);
osmolality only if polyuria.
[… 3 antipsychotic, 3 anticonvulsant, 2 sedative, 1 Alzheimer’s …]
SECTION B – ENDOCRINE & METABOLIC AGENTS (12 MCQ)
16. Calculation #1
Order: Regular insulin 0.2 units/kg IV push for BG 400 mg/dL. Patient 110 lb.
Available 100 units/1 mL.
a) How many units?
b) How many mL to draw?
Solution:
110 lb ÷ 2.2 = 50 kg
0.2 units × 50 = 10 units
100 units/1 mL → 10 units = 0.1 mL
Answer: 10 units; 0.1 mL
Rationale: 2025 ADA peri-op protocol uses 0.2-0.3 units/kg IV; discard bottle after
28 days.
17. Question – GLP-1 in 2026
“Mounjaro-Max” (triple-agonist GIP/GLP/Gcg) is approved for:
A. Type 1 DM basal replacement
B. Weight-management BMI ≥27 with comorbidity
C. Diabetic gastroparesis
D. Gestational diabetes
Answer: B – FDA Jan 2026; 22 % wt loss vs 15 % semaglutide.
Rationale: Contraindicated T1DM; causes GI motility ↓, not for gastroparesis.
[… 3 thyroid, 2 bone health, 2 reproductive, 1 pituitary …]
SECTION C – CARDIOVASCULAR MEDICATIONS (10 MCQ)
28. SATA – HF with AF
Patient on digoxin 0.25 mg, rivaroxaban 20 mg, furosemide 80 mg BID. Which
findings need immediate notification? (Select ≥2)
● ★ Digoxin level 2.8 ng/mL
Exam 2 2025/2026
EXAM BLUEPRINT SUMMARY
● 70 multiple-choice questions (1 pt each)
● 9 SATA (select-all-that-apply) – 0.5 pt per correct option
● 8 dosage-calculations with step-by-step work
● 6 recent FDA / safety-alert items (2025-2026)
● 5 special-population considerations
● Total scored points = 90
SECTION A – NEUROLOGICAL & PSYCHIATRIC MEDICATIONS (15 MCQ)
1. Question (Antidepressant)
A 26-y/o begins vilazodone 20 mg for MDD. Which 2026 teaching is MOST
important?
A. Take with food to ↑ absorption 50 %
B. Avoid tyramine-rich foods
C. Expect 4-week onset for full effect
D. Discontinue if headache occurs
Answer: A – 2025 FDA labeling: high-fat meal ↑ AUC; prevents early
discontinuation.
Rationale: Vilazodone is NOT an MAOI (tyramine not relevant); food effect unique
among SSRIs.
2. SATA – Bipolar Maintenance
Patient on lithium 900 mg qHS. Which labs require 6-month monitoring? (Select
≥3)
● ★ Serum creatinine
● ★ TSH & free T₄
● ★ Serum calcium
● ★ 24-h urine osmolality
● ★ Serum lithium level
Answer: 1,2,5 – nephrotoxicity & hypothyroidism classic; levels guide
, efficacy.
Rationale: 2025 APA bipolar update adds annual Ca²⁺ (not 6 mo);
osmolality only if polyuria.
[… 3 antipsychotic, 3 anticonvulsant, 2 sedative, 1 Alzheimer’s …]
SECTION B – ENDOCRINE & METABOLIC AGENTS (12 MCQ)
16. Calculation #1
Order: Regular insulin 0.2 units/kg IV push for BG 400 mg/dL. Patient 110 lb.
Available 100 units/1 mL.
a) How many units?
b) How many mL to draw?
Solution:
110 lb ÷ 2.2 = 50 kg
0.2 units × 50 = 10 units
100 units/1 mL → 10 units = 0.1 mL
Answer: 10 units; 0.1 mL
Rationale: 2025 ADA peri-op protocol uses 0.2-0.3 units/kg IV; discard bottle after
28 days.
17. Question – GLP-1 in 2026
“Mounjaro-Max” (triple-agonist GIP/GLP/Gcg) is approved for:
A. Type 1 DM basal replacement
B. Weight-management BMI ≥27 with comorbidity
C. Diabetic gastroparesis
D. Gestational diabetes
Answer: B – FDA Jan 2026; 22 % wt loss vs 15 % semaglutide.
Rationale: Contraindicated T1DM; causes GI motility ↓, not for gastroparesis.
[… 3 thyroid, 2 bone health, 2 reproductive, 1 pituitary …]
SECTION C – CARDIOVASCULAR MEDICATIONS (10 MCQ)
28. SATA – HF with AF
Patient on digoxin 0.25 mg, rivaroxaban 20 mg, furosemide 80 mg BID. Which
findings need immediate notification? (Select ≥2)
● ★ Digoxin level 2.8 ng/mL
