NR566 | NR566 Advanced Pharmacology for Care
of the Family Wk 6 Midterm v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient with a documented severe anaphylactic reaction to penicillin requires
treatment for a respiratory infection. Which of the following antibiotics should the
nurse practitioner avoid due to a potential cross-sensitivity?
A. Azithromycin
B. Levofloxacin
C. Doxycycline
D. Cephalexin
Correct Answer: D
Expert Explanation: Penicillins and cephalosporins share a common beta-lactam
ring structure which can lead to cross-reactivity. While the risk is generally low, it is
significantly higher in patients who have experienced a Type I hypersensitivity
reaction such as anaphylaxis. Providers should choose a different class of
medication like a macrolide or fluoroquinolone to ensure patient safety.
2. When prescribing an ACE inhibitor such as Lisinopril, the provider must warn the
patient about which common side effect caused by the accumulation of bradykinin?
A. Peripheral edema
,B. Dry, non-productive cough
C. Hypokalemia
D. Tachycardia
Correct Answer: B
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin in the
lungs, which leads to a persistent dry cough in up to 20% of patients. This side effect
is a common reason for patients to switch from an ACE inhibitor to an Angiotensin
Receptor Blocker (ARB). The cough typically resolves within a few weeks after the
medication is discontinued.
3. A patient is being started on Metformin for Type 2 Diabetes. Which lab value is the
most critical to monitor to prevent the risk of lactic acidosis?
A. Glomerular Filtration Rate (eGFR)
B. Serum Potassium
C. Liver enzymes (AST/ALT)
D. Glycated Hemoglobin (A1C)
Correct Answer: A
Expert Explanation: Metformin is primarily excreted by the kidneys and can
accumulate in the setting of renal impairment, increasing the risk of life-threatening
,lactic acidosis. Current guidelines recommend against initiating Metformin if the
eGFR is below 45 mL/min/1.73m2 and it is contraindicated below 30. Regular
monitoring of renal function is essential for all patients on long-term Metformin
therapy.
4. Which education point is most important for a patient newly prescribed an Inhaled
Corticosteroid (ICS) for asthma management?
A. Take the medication only when feeling short of breath.
B. Expect immediate relief of symptoms after the first dose.
C. Rinse the mouth with water and spit after each use.
D. Limit fluid intake to avoid systemic absorption.
Correct Answer: C
Expert Explanation: Inhaled corticosteroids can cause local immunosuppression in
the oral cavity, leading to the development of oropharyngeal candidiasis, also
known as thrush. Rinsing the mouth and spitting after administration significantly
reduces the amount of residual drug on the oral mucosa. This simple practice
improves patient adherence and prevents a common and uncomfortable side effect.
5. Long-term use of Proton Pump Inhibitors (PPIs) has been associated with an
increased risk of which of the following conditions?
A. Hip fractures and osteoporosis
, B. Vitamin C deficiency
C. Hypermagnesemia
D. Weight gain
Correct Answer: A
Expert Explanation: PPIs reduce gastric acid secretion, which is necessary for the
optimal absorption of calcium and other minerals. Chronic use of these medications
has been linked to decreased bone mineral density and an increased risk of
fractures, particularly in the hip and spine. Providers should encourage the lowest
effective dose for the shortest duration possible to mitigate these risks.
6. When should a patient be instructed to take their Levothyroxine for the treatment
of hypothyroidism to ensure maximum absorption?
A. In the morning on an empty stomach, 30-60 minutes before food
B. At bedtime with a glass of milk
C. With a high-fiber breakfast
D. Immediately following the largest meal of the day
Correct Answer: A
Expert Explanation: Levothyroxine absorption is highly sensitive to the presence
of food, minerals like calcium or iron, and coffee. To ensure consistent blood levels
of the Family Wk 6 Midterm v2 | Questions with
Correct Answers and Expert Explanation for Each
Question | Chamberlain
1. A patient with a documented severe anaphylactic reaction to penicillin requires
treatment for a respiratory infection. Which of the following antibiotics should the
nurse practitioner avoid due to a potential cross-sensitivity?
A. Azithromycin
B. Levofloxacin
C. Doxycycline
D. Cephalexin
Correct Answer: D
Expert Explanation: Penicillins and cephalosporins share a common beta-lactam
ring structure which can lead to cross-reactivity. While the risk is generally low, it is
significantly higher in patients who have experienced a Type I hypersensitivity
reaction such as anaphylaxis. Providers should choose a different class of
medication like a macrolide or fluoroquinolone to ensure patient safety.
2. When prescribing an ACE inhibitor such as Lisinopril, the provider must warn the
patient about which common side effect caused by the accumulation of bradykinin?
A. Peripheral edema
,B. Dry, non-productive cough
C. Hypokalemia
D. Tachycardia
Correct Answer: B
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin in the
lungs, which leads to a persistent dry cough in up to 20% of patients. This side effect
is a common reason for patients to switch from an ACE inhibitor to an Angiotensin
Receptor Blocker (ARB). The cough typically resolves within a few weeks after the
medication is discontinued.
3. A patient is being started on Metformin for Type 2 Diabetes. Which lab value is the
most critical to monitor to prevent the risk of lactic acidosis?
A. Glomerular Filtration Rate (eGFR)
B. Serum Potassium
C. Liver enzymes (AST/ALT)
D. Glycated Hemoglobin (A1C)
Correct Answer: A
Expert Explanation: Metformin is primarily excreted by the kidneys and can
accumulate in the setting of renal impairment, increasing the risk of life-threatening
,lactic acidosis. Current guidelines recommend against initiating Metformin if the
eGFR is below 45 mL/min/1.73m2 and it is contraindicated below 30. Regular
monitoring of renal function is essential for all patients on long-term Metformin
therapy.
4. Which education point is most important for a patient newly prescribed an Inhaled
Corticosteroid (ICS) for asthma management?
A. Take the medication only when feeling short of breath.
B. Expect immediate relief of symptoms after the first dose.
C. Rinse the mouth with water and spit after each use.
D. Limit fluid intake to avoid systemic absorption.
Correct Answer: C
Expert Explanation: Inhaled corticosteroids can cause local immunosuppression in
the oral cavity, leading to the development of oropharyngeal candidiasis, also
known as thrush. Rinsing the mouth and spitting after administration significantly
reduces the amount of residual drug on the oral mucosa. This simple practice
improves patient adherence and prevents a common and uncomfortable side effect.
5. Long-term use of Proton Pump Inhibitors (PPIs) has been associated with an
increased risk of which of the following conditions?
A. Hip fractures and osteoporosis
, B. Vitamin C deficiency
C. Hypermagnesemia
D. Weight gain
Correct Answer: A
Expert Explanation: PPIs reduce gastric acid secretion, which is necessary for the
optimal absorption of calcium and other minerals. Chronic use of these medications
has been linked to decreased bone mineral density and an increased risk of
fractures, particularly in the hip and spine. Providers should encourage the lowest
effective dose for the shortest duration possible to mitigate these risks.
6. When should a patient be instructed to take their Levothyroxine for the treatment
of hypothyroidism to ensure maximum absorption?
A. In the morning on an empty stomach, 30-60 minutes before food
B. At bedtime with a glass of milk
C. With a high-fiber breakfast
D. Immediately following the largest meal of the day
Correct Answer: A
Expert Explanation: Levothyroxine absorption is highly sensitive to the presence
of food, minerals like calcium or iron, and coffee. To ensure consistent blood levels
