NU 578
OBJECTIVE ASSESSMENT - EXAM
NU 578 Units 1-5 Exam
(2026/2027) | Advanced Nursing
University of South Alabama | Advanced Pharmacology for Practice Nurses
50 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
o Pharmacokinetics & Drug Safety o Endocrine & Immune Modulators
o CNS Pharmacology & Analgesics o Antimicrobials & Anti-Infectives
o Cardiovascular & Hematologic Agents o Clinical Prescribing & Monitoring
COVER PAGE - 1
NU 578 - 2026/2027 | Passing Score: 80% | Page 1 of Y
,SECTION 1 | Pharmacokinetics, Pharmacodynamics & Drug Safety | Q1-Q10 | NU 578 2026/2027
Q1 Question 1 of 50
A 72-year-old male with a creatinine clearance of 28 mL/min is prescribed a renally
eliminated antibiotic. The standard dose is 500 mg every 8 hours. Which adjustment should
the advanced practice nurse recommend to ensure safe and effective therapy?
A. Reduce the dose to 250 mg every 8 hours and monitor serum drug levels.
B. Maintain the standard dose but extend the interval to every 12 hours.
C. Reduce the dose to 250 mg every 12 hours and monitor renal function weekly.
D. Discontinue the antibiotic and select an agent that is primarily hepatically metabolized.
Correct Answer: A
Rationale:
With a creatinine clearance below 30 mL/min, dose reduction is the preferred strategy for renally eliminated
drugs. Reducing the dose to 250 mg every 8 hours while maintaining the same interval allows more
consistent plasma levels compared to interval extension. Monitoring serum drug levels ensures therapeutic
concentrations are maintained without accumulation. Extending the interval (Option B) may create
subtherapeutic troughs. Reducing dose and interval (Option C) may be excessive. Discontinuing (Option D)
is unnecessary when dose adjustment is feasible.
Q2 Question 2 of 50
A 34-year-old pregnant patient at 16 weeks gestation presents with hypertension. The
advanced practice nurse knows that which antihypertensive agent is preferred during
pregnancy due to its established safety profile and mechanism of action?
A. Lisinopril
B. Methyldopa
C. Atenolol
D. Valsartan
Correct Answer: B
Rationale:
Methyldopa is the preferred antihypertensive during pregnancy because it has the longest safety record and
does not adversely affect uteroplacental blood flow. ACE inhibitors (lisinopril) and ARBs (valsartan) are
contraindicated in pregnancy due to teratogenic effects on fetal renal development. Atenolol is associated
with intrauterine growth restriction and is generally avoided in pregnancy.
NU 578 - 2026/2027 | Passing Score: 80% | Page 2 of 27
, SECTION 1 | Pharmacokinetics, Pharmacodynamics & Drug Safety | Q1-Q10 | NU 578 2026/2027
Q3 Question 3 of 50
A 68-year-old patient with atrial fibrillation is prescribed warfarin 5 mg daily. The advanced
practice nurse reviews the medication list and notes the patient also takes clopidogrel 75 mg
daily for coronary artery disease. Which action is most appropriate to prevent adverse
outcomes?
A. Discontinue clopidogrel immediately because the combination increases bleeding risk
excessively.
B. Continue both agents and monitor INR weekly, educating the patient on bleeding precautions.
C. Switch the patient to aspirin 81 mg daily instead of clopidogrel to reduce bleeding risk.
D. Reduce the warfarin dose by 50 percent to compensate for the clopidogrel interaction.
Correct Answer: C
Rationale:
Switching to aspirin 81 mg daily provides antiplatelet protection for coronary artery disease while significantly
reducing bleeding risk compared to the triple combination or dual therapy with warfarin and clopidogrel.
Aspirin is the preferred antiplatelet agent when combined with warfarin. Discontinuing clopidogrel (Option A)
without substitution leaves the patient unprotected. Continuing both (Option B) carries excessive bleeding
risk. Reducing warfarin by 50 percent (Option D) is an arbitrary adjustment not supported by guidelines.
Q4 Question 4 of 50
A 45-year-old patient with benign prostatic hyperplasia is prescribed tamsulosin 0.4 mg
daily. The patient also has seasonal allergic rhinitis and asks about taking an
over-the-counter decongestant. Which response by the advanced practice nurse is most
appropriate?
A. Pseudoephedrine is safe to use because it selectively targets nasal congestion without
systemic effects.
B. Pseudoephedrine should be avoided because it can cause urinary retention and worsen BPH
symptoms.
C. Pseudoephedrine is preferred over phenylephrine because it has fewer cardiovascular side
effects.
D. Either pseudoephedrine or phenylephrine may be used at half the standard dose.
Correct Answer: D
Rationale:
Either pseudoephedrine or phenylephrine may be used at half the standard dose with careful monitoring for
urinary symptoms. While systemic decongestants can worsen BPH, low-dose therapy with patient education
and monitoring is often acceptable. Complete avoidance (Option B) is overly restrictive. Pseudoephedrine
does have systemic effects (Option A is incorrect). Phenylephrine has similar concerns to pseudoephedrine
(Option C is incorrect).
NU 578 - 2026/2027 | Passing Score: 80% | Page 3 of 27
OBJECTIVE ASSESSMENT - EXAM
NU 578 Units 1-5 Exam
(2026/2027) | Advanced Nursing
University of South Alabama | Advanced Pharmacology for Practice Nurses
50 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
o Pharmacokinetics & Drug Safety o Endocrine & Immune Modulators
o CNS Pharmacology & Analgesics o Antimicrobials & Anti-Infectives
o Cardiovascular & Hematologic Agents o Clinical Prescribing & Monitoring
COVER PAGE - 1
NU 578 - 2026/2027 | Passing Score: 80% | Page 1 of Y
,SECTION 1 | Pharmacokinetics, Pharmacodynamics & Drug Safety | Q1-Q10 | NU 578 2026/2027
Q1 Question 1 of 50
A 72-year-old male with a creatinine clearance of 28 mL/min is prescribed a renally
eliminated antibiotic. The standard dose is 500 mg every 8 hours. Which adjustment should
the advanced practice nurse recommend to ensure safe and effective therapy?
A. Reduce the dose to 250 mg every 8 hours and monitor serum drug levels.
B. Maintain the standard dose but extend the interval to every 12 hours.
C. Reduce the dose to 250 mg every 12 hours and monitor renal function weekly.
D. Discontinue the antibiotic and select an agent that is primarily hepatically metabolized.
Correct Answer: A
Rationale:
With a creatinine clearance below 30 mL/min, dose reduction is the preferred strategy for renally eliminated
drugs. Reducing the dose to 250 mg every 8 hours while maintaining the same interval allows more
consistent plasma levels compared to interval extension. Monitoring serum drug levels ensures therapeutic
concentrations are maintained without accumulation. Extending the interval (Option B) may create
subtherapeutic troughs. Reducing dose and interval (Option C) may be excessive. Discontinuing (Option D)
is unnecessary when dose adjustment is feasible.
Q2 Question 2 of 50
A 34-year-old pregnant patient at 16 weeks gestation presents with hypertension. The
advanced practice nurse knows that which antihypertensive agent is preferred during
pregnancy due to its established safety profile and mechanism of action?
A. Lisinopril
B. Methyldopa
C. Atenolol
D. Valsartan
Correct Answer: B
Rationale:
Methyldopa is the preferred antihypertensive during pregnancy because it has the longest safety record and
does not adversely affect uteroplacental blood flow. ACE inhibitors (lisinopril) and ARBs (valsartan) are
contraindicated in pregnancy due to teratogenic effects on fetal renal development. Atenolol is associated
with intrauterine growth restriction and is generally avoided in pregnancy.
NU 578 - 2026/2027 | Passing Score: 80% | Page 2 of 27
, SECTION 1 | Pharmacokinetics, Pharmacodynamics & Drug Safety | Q1-Q10 | NU 578 2026/2027
Q3 Question 3 of 50
A 68-year-old patient with atrial fibrillation is prescribed warfarin 5 mg daily. The advanced
practice nurse reviews the medication list and notes the patient also takes clopidogrel 75 mg
daily for coronary artery disease. Which action is most appropriate to prevent adverse
outcomes?
A. Discontinue clopidogrel immediately because the combination increases bleeding risk
excessively.
B. Continue both agents and monitor INR weekly, educating the patient on bleeding precautions.
C. Switch the patient to aspirin 81 mg daily instead of clopidogrel to reduce bleeding risk.
D. Reduce the warfarin dose by 50 percent to compensate for the clopidogrel interaction.
Correct Answer: C
Rationale:
Switching to aspirin 81 mg daily provides antiplatelet protection for coronary artery disease while significantly
reducing bleeding risk compared to the triple combination or dual therapy with warfarin and clopidogrel.
Aspirin is the preferred antiplatelet agent when combined with warfarin. Discontinuing clopidogrel (Option A)
without substitution leaves the patient unprotected. Continuing both (Option B) carries excessive bleeding
risk. Reducing warfarin by 50 percent (Option D) is an arbitrary adjustment not supported by guidelines.
Q4 Question 4 of 50
A 45-year-old patient with benign prostatic hyperplasia is prescribed tamsulosin 0.4 mg
daily. The patient also has seasonal allergic rhinitis and asks about taking an
over-the-counter decongestant. Which response by the advanced practice nurse is most
appropriate?
A. Pseudoephedrine is safe to use because it selectively targets nasal congestion without
systemic effects.
B. Pseudoephedrine should be avoided because it can cause urinary retention and worsen BPH
symptoms.
C. Pseudoephedrine is preferred over phenylephrine because it has fewer cardiovascular side
effects.
D. Either pseudoephedrine or phenylephrine may be used at half the standard dose.
Correct Answer: D
Rationale:
Either pseudoephedrine or phenylephrine may be used at half the standard dose with careful monitoring for
urinary symptoms. While systemic decongestants can worsen BPH, low-dose therapy with patient education
and monitoring is often acceptable. Complete avoidance (Option B) is overly restrictive. Pseudoephedrine
does have systemic effects (Option A is incorrect). Phenylephrine has similar concerns to pseudoephedrine
(Option C is incorrect).
NU 578 - 2026/2027 | Passing Score: 80% | Page 3 of 27
