NSG 5240 ADVANCED PHARMACOLOGY
FINAL EXAM REVIEW | SOUTH COLLEGE |
COMPREHENSIVE STUDY GUIDE WITH
EXAM-FOCUSED QUESTIONS & VERIFIED
ANSWERS 2026
• This comprehensive 200-question exam review for NSG 5240 Advanced
Pharmacology is designed to mirror the rigor and format of your South College final
exam — each question includes five options, a clearly highlighted correct answer,
and a concise EXPERT RATIONALE to reinforce understanding.
• Study tip: Work through each question independently before checking the answer,
use the EXPERT RATIONALE to solidify your reasoning, and revisit any topic where
you select a wrong option — pattern recognition across questions will sharpen your
exam performance.
NSG 5240 ADVANCED PHARMACOLOGY FINAL EXAM REVIEW SOUTH COLLEGE |
2026 | 200 QUESTIONS
1. A patient taking warfarin is prescribed trimethoprim-sulfamethoxazole.
The nurse practitioner should anticipate which effect?
A. Decreased anticoagulation effect
B. No significant drug interaction
C. Increased risk of bleeding due to enhanced anticoagulation
D. Increased warfarin metabolism
E. Decreased absorption of warfarin
C. Increased risk of bleeding due to enhanced anticoagulation
EXPERT RATIONALE: TMP-SMX inhibits CYP2C9, the enzyme responsible for warfarin
metabolism, leading to elevated warfarin levels and increased bleeding risk. INR should
be closely monitored.
,2. Which mechanism of action best describes beta-lactam antibiotics?
A. Inhibition of DNA gyrase
B. Disruption of cell membrane integrity
C. Inhibition of 30S ribosomal subunit
D. Inhibition of cell wall synthesis by binding penicillin-binding proteins
E. Blockade of RNA polymerase
D. Inhibition of cell wall synthesis by binding penicillin-binding proteins
EXPERT RATIONALE: Beta-lactams bind to penicillin-binding proteins (PBPs) and inhibit
transpeptidation, a key step in peptidoglycan cross-linking, weakening the bacterial cell
wall and causing lysis.
3. A patient with a penicillin allergy describes anaphylaxis. Which antibiotic
class should be used with the most caution?
A. Macrolides
B. Fluoroquinolones
C. Cephalosporins
D. Tetracyclines
E. Aminoglycosides
C. Cephalosporins
EXPERT RATIONALE: Cephalosporins share a beta-lactam ring structure with penicillins.
In patients with a history of anaphylaxis to penicillin, cross-reactivity risk exists,
particularly with first-generation cephalosporins.
4. Which drug is a first-line agent for Helicobacter pylori eradication?
A. Ciprofloxacin
, B. Vancomycin
C. Clarithromycin
D. Doxycycline
E. Linezolid
C. Clarithromycin
EXPERT RATIONALE: Standard triple therapy for H. pylori includes clarithromycin,
amoxicillin, and a proton pump inhibitor. Clarithromycin is the macrolide backbone of
most first-line regimens.
5. A patient is started on metformin. Which condition is an absolute
contraindication?
A. Obesity
B. Hypertension
C. Stage 4 chronic kidney disease (eGFR < 30)
D. Hyperlipidemia
E. Type 1 diabetes
C. Stage 4 chronic kidney disease (eGFR < 30)
EXPERT RATIONALE: Metformin is contraindicated in severe renal impairment due to
the risk of lactic acidosis from drug accumulation. FDA recommends avoiding use when
eGFR falls below 30 mL/min/1.73m².
6. Which class of antihypertensives is the preferred first-line treatment in a
diabetic patient with proteinuria?
A. Beta-blockers
B. Calcium channel blockers
C. Thiazide diuretics
, D. ACE inhibitors
E. Alpha-1 blockers
D. ACE inhibitors EXPERT RATIONALE:
ACE inhibitors reduce intraglomerular pressure and proteinuria, providing
nephroprotection in diabetic nephropathy. They are the first-line antihypertensive choice
in diabetic patients with kidney involvement.
7. A patient on isoniazid (INH) therapy should receive which supplement to
prevent peripheral neuropathy?
A. Vitamin C
B. Folate
C. Vitamin B6 (pyridoxine)
D. Vitamin D
E. Zinc
C. Vitamin B6 (pyridoxine)
EXPERT RATIONALE: INH interferes with pyridoxine metabolism, causing peripheral
neuropathy. Supplementation with Vitamin B6 prevents this adverse effect, especially in
high-risk patients.
8. Which opioid analgesic has an active metabolite that can accumulate in
renal failure, causing CNS toxicity?
A. Fentanyl
B. Buprenorphine
C. Morphine
D. Methadone
E. Tramadol
FINAL EXAM REVIEW | SOUTH COLLEGE |
COMPREHENSIVE STUDY GUIDE WITH
EXAM-FOCUSED QUESTIONS & VERIFIED
ANSWERS 2026
• This comprehensive 200-question exam review for NSG 5240 Advanced
Pharmacology is designed to mirror the rigor and format of your South College final
exam — each question includes five options, a clearly highlighted correct answer,
and a concise EXPERT RATIONALE to reinforce understanding.
• Study tip: Work through each question independently before checking the answer,
use the EXPERT RATIONALE to solidify your reasoning, and revisit any topic where
you select a wrong option — pattern recognition across questions will sharpen your
exam performance.
NSG 5240 ADVANCED PHARMACOLOGY FINAL EXAM REVIEW SOUTH COLLEGE |
2026 | 200 QUESTIONS
1. A patient taking warfarin is prescribed trimethoprim-sulfamethoxazole.
The nurse practitioner should anticipate which effect?
A. Decreased anticoagulation effect
B. No significant drug interaction
C. Increased risk of bleeding due to enhanced anticoagulation
D. Increased warfarin metabolism
E. Decreased absorption of warfarin
C. Increased risk of bleeding due to enhanced anticoagulation
EXPERT RATIONALE: TMP-SMX inhibits CYP2C9, the enzyme responsible for warfarin
metabolism, leading to elevated warfarin levels and increased bleeding risk. INR should
be closely monitored.
,2. Which mechanism of action best describes beta-lactam antibiotics?
A. Inhibition of DNA gyrase
B. Disruption of cell membrane integrity
C. Inhibition of 30S ribosomal subunit
D. Inhibition of cell wall synthesis by binding penicillin-binding proteins
E. Blockade of RNA polymerase
D. Inhibition of cell wall synthesis by binding penicillin-binding proteins
EXPERT RATIONALE: Beta-lactams bind to penicillin-binding proteins (PBPs) and inhibit
transpeptidation, a key step in peptidoglycan cross-linking, weakening the bacterial cell
wall and causing lysis.
3. A patient with a penicillin allergy describes anaphylaxis. Which antibiotic
class should be used with the most caution?
A. Macrolides
B. Fluoroquinolones
C. Cephalosporins
D. Tetracyclines
E. Aminoglycosides
C. Cephalosporins
EXPERT RATIONALE: Cephalosporins share a beta-lactam ring structure with penicillins.
In patients with a history of anaphylaxis to penicillin, cross-reactivity risk exists,
particularly with first-generation cephalosporins.
4. Which drug is a first-line agent for Helicobacter pylori eradication?
A. Ciprofloxacin
, B. Vancomycin
C. Clarithromycin
D. Doxycycline
E. Linezolid
C. Clarithromycin
EXPERT RATIONALE: Standard triple therapy for H. pylori includes clarithromycin,
amoxicillin, and a proton pump inhibitor. Clarithromycin is the macrolide backbone of
most first-line regimens.
5. A patient is started on metformin. Which condition is an absolute
contraindication?
A. Obesity
B. Hypertension
C. Stage 4 chronic kidney disease (eGFR < 30)
D. Hyperlipidemia
E. Type 1 diabetes
C. Stage 4 chronic kidney disease (eGFR < 30)
EXPERT RATIONALE: Metformin is contraindicated in severe renal impairment due to
the risk of lactic acidosis from drug accumulation. FDA recommends avoiding use when
eGFR falls below 30 mL/min/1.73m².
6. Which class of antihypertensives is the preferred first-line treatment in a
diabetic patient with proteinuria?
A. Beta-blockers
B. Calcium channel blockers
C. Thiazide diuretics
, D. ACE inhibitors
E. Alpha-1 blockers
D. ACE inhibitors EXPERT RATIONALE:
ACE inhibitors reduce intraglomerular pressure and proteinuria, providing
nephroprotection in diabetic nephropathy. They are the first-line antihypertensive choice
in diabetic patients with kidney involvement.
7. A patient on isoniazid (INH) therapy should receive which supplement to
prevent peripheral neuropathy?
A. Vitamin C
B. Folate
C. Vitamin B6 (pyridoxine)
D. Vitamin D
E. Zinc
C. Vitamin B6 (pyridoxine)
EXPERT RATIONALE: INH interferes with pyridoxine metabolism, causing peripheral
neuropathy. Supplementation with Vitamin B6 prevents this adverse effect, especially in
high-risk patients.
8. Which opioid analgesic has an active metabolite that can accumulate in
renal failure, causing CNS toxicity?
A. Fentanyl
B. Buprenorphine
C. Morphine
D. Methadone
E. Tramadol
