NR566 | NR566 Advanced Pharmacology for Care
of the Family Exam 4 Version 2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A 54-year-old patient with Type 2 Diabetes is starting Metformin. Which lab value
should the nurse practitioner prioritize before initiating this medication?
A. Liver Enzymes (ALT/AST)
B. Thyroid Stimulating Hormone (TSH)
C. Serum Potassium
D. Glomerular Filtration Rate (eGFR)
Correct Answer: D
Expert Explanation: Metformin is primarily excreted by the kidneys and carries a
risk of lactic acidosis in patients with renal impairment. The manufacturer
recommends checking the eGFR before starting the drug and monitoring it annually.
Metformin is contraindicated in patients with an eGFR less than 30 mL/min/1.73m².
2. Which of the following instructions is most critical for a patient taking
Levothyroxine for hypothyroidism?
A. Take the medication on an empty stomach, 30-60 minutes before breakfast.
B. Take the medication at bedtime with a glass of milk.
,C. Take the medication with a full meal to avoid GI upset.
D. Take the medication only when feeling symptoms of fatigue.
Correct Answer: A
Expert Explanation: Levothyroxine absorption is significantly impacted by food
and certain minerals like calcium and iron. To ensure consistent therapeutic levels,
it should be taken on an empty stomach with water only. Patients should wait at
least 30 to 60 minutes before eating breakfast or drinking coffee.
3. A patient with hyperthyroidism is prescribed Propylthiouracil (PTU). What boxed
warning should the provider discuss with the patient?
A. Acute Renal Failure
B. Severe Liver Injury
C. Tendon Rupture
D. Prolonged QT Interval
Correct Answer: B
Expert Explanation: Propylthiouracil (PTU) carries a black box warning for severe
liver injury and acute liver failure, which can be fatal. Methimazole is generally
preferred unless the patient is in the first trimester of pregnancy or cannot tolerate
,Methimazole. Patients must be educated to report yellowing of the skin or eyes
immediately.
4. Which medication for Type 2 Diabetes is associated with a specific risk for
necrotizing fasciitis of the perineum (Fournier’s gangrene)?
A. Sitagliptin
B. Pioglitazone
C. Glipizide
D. Empagliflozin
Correct Answer: D
Expert Explanation: SGLT2 inhibitors like Empagliflozin have been linked to rare
but serious cases of Fournier’s gangrene. This condition is a life-threatening
bacterial infection of the tissue under the skin in the genital area. Patients should be
warned to seek medical attention for pain, tenderness, or redness in the genital or
perianal area.
5. Which patient would have a contraindication for the use of Combined Oral
Contraceptives (COCs)?
A. A 22-year-old with a history of dysmenorrhea
B. A 28-year-old with a Body Mass Index (BMI) of 30
, C. A 36-year-old woman who smokes 15 cigarettes per day
D. A 40-year-old with controlled hypothyroidism
Correct Answer: C
Expert Explanation: Women over 35 who smoke have a significantly increased risk
of serious cardiovascular events, such as myocardial infarction or stroke, while on
COCs. The CDC Medical Eligibility Criteria lists this as a Category 4 (unacceptable
health risk). For these patients, progestin-only options or non-hormonal methods
are recommended.
6. A patient is taking Omeprazole daily for GERD. What is a potential long-term risk of
Proton Pump Inhibitor (PPI) use?
A. Osteoporosis-related fractures
B. Hyperkalemia
C. Iron toxicity
D. Tachycardia
Correct Answer: A
Expert Explanation: Long-term use of PPIs like Omeprazole is associated with an
increased risk of hip, wrist, and spine fractures. This may be due to reduced calcium
of the Family Exam 4 Version 2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A 54-year-old patient with Type 2 Diabetes is starting Metformin. Which lab value
should the nurse practitioner prioritize before initiating this medication?
A. Liver Enzymes (ALT/AST)
B. Thyroid Stimulating Hormone (TSH)
C. Serum Potassium
D. Glomerular Filtration Rate (eGFR)
Correct Answer: D
Expert Explanation: Metformin is primarily excreted by the kidneys and carries a
risk of lactic acidosis in patients with renal impairment. The manufacturer
recommends checking the eGFR before starting the drug and monitoring it annually.
Metformin is contraindicated in patients with an eGFR less than 30 mL/min/1.73m².
2. Which of the following instructions is most critical for a patient taking
Levothyroxine for hypothyroidism?
A. Take the medication on an empty stomach, 30-60 minutes before breakfast.
B. Take the medication at bedtime with a glass of milk.
,C. Take the medication with a full meal to avoid GI upset.
D. Take the medication only when feeling symptoms of fatigue.
Correct Answer: A
Expert Explanation: Levothyroxine absorption is significantly impacted by food
and certain minerals like calcium and iron. To ensure consistent therapeutic levels,
it should be taken on an empty stomach with water only. Patients should wait at
least 30 to 60 minutes before eating breakfast or drinking coffee.
3. A patient with hyperthyroidism is prescribed Propylthiouracil (PTU). What boxed
warning should the provider discuss with the patient?
A. Acute Renal Failure
B. Severe Liver Injury
C. Tendon Rupture
D. Prolonged QT Interval
Correct Answer: B
Expert Explanation: Propylthiouracil (PTU) carries a black box warning for severe
liver injury and acute liver failure, which can be fatal. Methimazole is generally
preferred unless the patient is in the first trimester of pregnancy or cannot tolerate
,Methimazole. Patients must be educated to report yellowing of the skin or eyes
immediately.
4. Which medication for Type 2 Diabetes is associated with a specific risk for
necrotizing fasciitis of the perineum (Fournier’s gangrene)?
A. Sitagliptin
B. Pioglitazone
C. Glipizide
D. Empagliflozin
Correct Answer: D
Expert Explanation: SGLT2 inhibitors like Empagliflozin have been linked to rare
but serious cases of Fournier’s gangrene. This condition is a life-threatening
bacterial infection of the tissue under the skin in the genital area. Patients should be
warned to seek medical attention for pain, tenderness, or redness in the genital or
perianal area.
5. Which patient would have a contraindication for the use of Combined Oral
Contraceptives (COCs)?
A. A 22-year-old with a history of dysmenorrhea
B. A 28-year-old with a Body Mass Index (BMI) of 30
, C. A 36-year-old woman who smokes 15 cigarettes per day
D. A 40-year-old with controlled hypothyroidism
Correct Answer: C
Expert Explanation: Women over 35 who smoke have a significantly increased risk
of serious cardiovascular events, such as myocardial infarction or stroke, while on
COCs. The CDC Medical Eligibility Criteria lists this as a Category 4 (unacceptable
health risk). For these patients, progestin-only options or non-hormonal methods
are recommended.
6. A patient is taking Omeprazole daily for GERD. What is a potential long-term risk of
Proton Pump Inhibitor (PPI) use?
A. Osteoporosis-related fractures
B. Hyperkalemia
C. Iron toxicity
D. Tachycardia
Correct Answer: A
Expert Explanation: Long-term use of PPIs like Omeprazole is associated with an
increased risk of hip, wrist, and spine fractures. This may be due to reduced calcium
