2026/2027 Pharmacology Board Exam
Prep: 150 High-Yield Questions on First-
Line Drugs, Dosing, & Clinical Guidelines
for NP, PA, & Medical Students
Description:
Master pharmacology for 2026/2027 with 150 exam-style Q&A covering infectious
disease, psychiatry, neurology, and CAM. Includes updated CDC guidelines, black box
warnings, and clinical pearls.
Download now to pass your boards with confidence and ace your clinical rotations!
, 2026 Pharmacology Exam: 150 Q&A for NP & Med Students
Instructions
This examination consists of multiple-choice questions covering key pharmacological
concepts, treatment guidelines, and clinical decision-making. Select the single best answer for
each question. All questions are based on current 2026/2027 clinical guidelines and evidence-
based practice standards.
SECTION A: INFECTIOUS DISEASE PHARMACOTHERAPY
Chlamydia Trachomatis Infections
Question 1
A 22-year-old sexually active female presents with dysuria and vaginal discharge. Testing
confirms Chlamydia trachomatis infection. Which of the following represents the
recommended first-line treatment regimen?
A. Azithromycin 1 g orally as a single dose
B. Doxycycline 100 mg orally twice daily for 5 days
C. Azithromycin 500 mg orally once daily for 3 days
D. Doxycycline 100 mg orally twice daily for 7 days
Answer: D
Explanation: The current CDC guidelines recommend doxycycline 100 mg orally twice
daily for 7 days as the first-line treatment for Chlamydia trachomatis. While azithromycin 1 g
as a single dose remains an alternative, doxycycline demonstrates superior efficacy,
particularly in rectal infections. The 7-day course ensures adequate tissue penetration and
bacterial eradication.
Question 2
A 19-year-old male is diagnosed with Chlamydia. He reports difficulty swallowing pills and
prefers a single-dose treatment. Which alternative regimen would be most appropriate?
A. Doxycycline 100 mg twice daily for 5 days
B. Azithromycin 1 g orally as a single dose
C. Erythromycin 500 mg four times daily for 7 days
D. Ofloxacin 300 mg twice daily for 7 days
,Answer: B
Explanation: For patients who cannot adhere to a 7-day doxycycline regimen, azithromycin
1 g as a single oral dose provides an effective alternative. This regimen is particularly useful
for patients with adherence concerns or those who prefer single-dose therapy. Azithromycin
achieves high intracellular concentrations and requires only one administration.
Uncomplicated Gonorrhea
Question 3
A 25-year-old male presents with purulent urethral discharge. Gram stain reveals intracellular
gram-negative diplococci. What is the recommended first-line treatment for uncomplicated
gonococcal urethritis?
A. Ceftriaxone 250 mg IM single dose
B. Ceftriaxone 500 mg IM single dose plus doxycycline 100 mg twice daily for 7 days
C. Azithromycin 2 g orally single dose
D. Ciprofloxacin 500 mg orally single dose
Answer: B
Explanation: Current guidelines recommend ceftriaxone 500 mg IM as a single dose for
uncomplicated gonococcal urethritis. Due to high rates of co-infection with Chlamydia,
concurrent treatment with doxycycline 100 mg twice daily for 7 days is recommended unless
chlamydial infection has been definitively excluded. This dual therapy approach addresses
the common occurrence of co-infection and emerging antibiotic resistance.
Question 4
Which of the following factors would necessitate an alternative treatment approach for
gonococcal infection?
A. Patient reports penicillin allergy with anaphylactic reaction
B. Patient weighs less than 150 kg
C. Infection is limited to the urethra
D. Patient has no known drug allergies
Answer: A
Explanation: Patients with a history of severe penicillin allergy (anaphylaxis) require
alternative treatment for gonorrhea. Options include ceftriaxone desensitization or alternative
, agents such as gentamicin plus azithromycin. Weight, infection site, and absence of allergies
do not typically necessitate alternative regimens with the standard protocol.
Bacterial Vaginosis
Question 5
A 32-year-old non-pregnant female presents with vaginal discharge and a fishy odor.
Microscopy reveals clue cells. What is the first-line treatment for bacterial vaginosis in this
patient?
A. Metronidazole 500 mg orally twice daily for 7 days
B. Metronidazole 2 g orally as a single dose
C. Clindamycin 2% vaginal cream for 5 days
D. Metronidazole 0.75% vaginal gel once daily for 5 days
Answer: A
Explanation: For non-pregnant women with bacterial vaginosis, metronidazole 500 mg
orally twice daily for 7 days is the first-line treatment. This regimen provides excellent
efficacy and addresses the polymicrobial nature of the infection. The single-dose oral regimen
and topical alternatives demonstrate lower cure rates compared to the 7-day oral course.
Question 6
A 28-year-old pregnant woman at 20 weeks gestation is diagnosed with bacterial vaginosis.
Which treatment option is most appropriate?
A. Metronidazole 500 mg orally twice daily for 7 days
B. Metronidazole 2 g orally as a single dose
C. Metronidazole vaginal gel 0.75% once daily for 7 days
D. Clindamycin 2% vaginal cream once daily for 7 days
Answer: D
Explanation: In pregnant patients, topical vaginal therapy is preferred to minimize systemic
absorption. Clindamycin 2% vaginal cream once daily for 7 days is recommended. While oral
metronidazole may be used if topical therapy is not feasible, the vaginal route is preferred
during pregnancy. Both metronidazole vaginal gel and clindamycin cream are appropriate
options, with clindamycin being commonly recommended.
Prep: 150 High-Yield Questions on First-
Line Drugs, Dosing, & Clinical Guidelines
for NP, PA, & Medical Students
Description:
Master pharmacology for 2026/2027 with 150 exam-style Q&A covering infectious
disease, psychiatry, neurology, and CAM. Includes updated CDC guidelines, black box
warnings, and clinical pearls.
Download now to pass your boards with confidence and ace your clinical rotations!
, 2026 Pharmacology Exam: 150 Q&A for NP & Med Students
Instructions
This examination consists of multiple-choice questions covering key pharmacological
concepts, treatment guidelines, and clinical decision-making. Select the single best answer for
each question. All questions are based on current 2026/2027 clinical guidelines and evidence-
based practice standards.
SECTION A: INFECTIOUS DISEASE PHARMACOTHERAPY
Chlamydia Trachomatis Infections
Question 1
A 22-year-old sexually active female presents with dysuria and vaginal discharge. Testing
confirms Chlamydia trachomatis infection. Which of the following represents the
recommended first-line treatment regimen?
A. Azithromycin 1 g orally as a single dose
B. Doxycycline 100 mg orally twice daily for 5 days
C. Azithromycin 500 mg orally once daily for 3 days
D. Doxycycline 100 mg orally twice daily for 7 days
Answer: D
Explanation: The current CDC guidelines recommend doxycycline 100 mg orally twice
daily for 7 days as the first-line treatment for Chlamydia trachomatis. While azithromycin 1 g
as a single dose remains an alternative, doxycycline demonstrates superior efficacy,
particularly in rectal infections. The 7-day course ensures adequate tissue penetration and
bacterial eradication.
Question 2
A 19-year-old male is diagnosed with Chlamydia. He reports difficulty swallowing pills and
prefers a single-dose treatment. Which alternative regimen would be most appropriate?
A. Doxycycline 100 mg twice daily for 5 days
B. Azithromycin 1 g orally as a single dose
C. Erythromycin 500 mg four times daily for 7 days
D. Ofloxacin 300 mg twice daily for 7 days
,Answer: B
Explanation: For patients who cannot adhere to a 7-day doxycycline regimen, azithromycin
1 g as a single oral dose provides an effective alternative. This regimen is particularly useful
for patients with adherence concerns or those who prefer single-dose therapy. Azithromycin
achieves high intracellular concentrations and requires only one administration.
Uncomplicated Gonorrhea
Question 3
A 25-year-old male presents with purulent urethral discharge. Gram stain reveals intracellular
gram-negative diplococci. What is the recommended first-line treatment for uncomplicated
gonococcal urethritis?
A. Ceftriaxone 250 mg IM single dose
B. Ceftriaxone 500 mg IM single dose plus doxycycline 100 mg twice daily for 7 days
C. Azithromycin 2 g orally single dose
D. Ciprofloxacin 500 mg orally single dose
Answer: B
Explanation: Current guidelines recommend ceftriaxone 500 mg IM as a single dose for
uncomplicated gonococcal urethritis. Due to high rates of co-infection with Chlamydia,
concurrent treatment with doxycycline 100 mg twice daily for 7 days is recommended unless
chlamydial infection has been definitively excluded. This dual therapy approach addresses
the common occurrence of co-infection and emerging antibiotic resistance.
Question 4
Which of the following factors would necessitate an alternative treatment approach for
gonococcal infection?
A. Patient reports penicillin allergy with anaphylactic reaction
B. Patient weighs less than 150 kg
C. Infection is limited to the urethra
D. Patient has no known drug allergies
Answer: A
Explanation: Patients with a history of severe penicillin allergy (anaphylaxis) require
alternative treatment for gonorrhea. Options include ceftriaxone desensitization or alternative
, agents such as gentamicin plus azithromycin. Weight, infection site, and absence of allergies
do not typically necessitate alternative regimens with the standard protocol.
Bacterial Vaginosis
Question 5
A 32-year-old non-pregnant female presents with vaginal discharge and a fishy odor.
Microscopy reveals clue cells. What is the first-line treatment for bacterial vaginosis in this
patient?
A. Metronidazole 500 mg orally twice daily for 7 days
B. Metronidazole 2 g orally as a single dose
C. Clindamycin 2% vaginal cream for 5 days
D. Metronidazole 0.75% vaginal gel once daily for 5 days
Answer: A
Explanation: For non-pregnant women with bacterial vaginosis, metronidazole 500 mg
orally twice daily for 7 days is the first-line treatment. This regimen provides excellent
efficacy and addresses the polymicrobial nature of the infection. The single-dose oral regimen
and topical alternatives demonstrate lower cure rates compared to the 7-day oral course.
Question 6
A 28-year-old pregnant woman at 20 weeks gestation is diagnosed with bacterial vaginosis.
Which treatment option is most appropriate?
A. Metronidazole 500 mg orally twice daily for 7 days
B. Metronidazole 2 g orally as a single dose
C. Metronidazole vaginal gel 0.75% once daily for 7 days
D. Clindamycin 2% vaginal cream once daily for 7 days
Answer: D
Explanation: In pregnant patients, topical vaginal therapy is preferred to minimize systemic
absorption. Clindamycin 2% vaginal cream once daily for 7 days is recommended. While oral
metronidazole may be used if topical therapy is not feasible, the vaginal route is preferred
during pregnancy. Both metronidazole vaginal gel and clindamycin cream are appropriate
options, with clindamycin being commonly recommended.
