NURSl 5334/l NURS5334l Examl 2l (NEWl
2026l Update)l –l Advancedl
Pharmacologyl Reviewl |l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l UTA
QUESTION
Al patientl withl al historyl ofl ulcerativel colitisl welll controlledl onl mesalaminel (Apriso)l
presentsl withl epigastricl painl andl darkl tarryl stools.l Hel isl foundl tol havel al duodenall
ulcerl andl isl prescribedl esomeprazolel forl 8l weeks.l Atl follow-upl 2l weeksl later,l hisl
epigastricl painl andl darkl tarryl stoolsl arel resolved.l However,l hel reportsl havingl increasedl
lowerl abdominall painl andl increasedl stooll frequency.l Whichl changel inl drugl therapyl isl
appropriatel atl thisl time?
Changel mesalaminel (Apriso)l tol mesalaminel (Asacoll HD).
Discontinuel esomeprazole.
Changel esomeprazolel tol omeprazolel duel tol interactionl withl mesalaminel (Apriso).
Changel mesalaminel (Apriso)l tol olsalazinel (Dipentum).
Answer:
Changel mesalaminel (Apriso)l tol olsalazinel (Dipentum).
Thel patientl seemsl tol bel havingl increasedl symptomsl ofl ulcerativel colitisl afterl startingl
thel PPI,l esomeprazole.l Thel pH-dependentl releasel formulationsl ofl mesalaminel havel al
significantl interactionl withl thel PPIs,l whichl mayl leadl tol earlyl releasel andl lossl ofl
efficacy.l Al isl incorrectl becausel omeprazolel isl expectedl tol havel thel samel interaction.l Bl
isl incorrectl becausel thisl patientl stilll requiresl therapyl withl al PPI.l Cl isl incorrectl becausel
Asacoll HDl isl alsol pH-dependentl releasel andl isl likelyl tol bel affected.l Dl isl correctl
becausel olsalazinel isl notl pHl dependentl andl releasel reliesl onl cleavagel byl colonicl
bacteria.
QUESTION
Al patientl withl significantl vomitingl presentsl tol thel emergencyl departmentl secondaryl tol
al virall infection.l Thel patientl statesl hel hasl beenl unablel tol eatl orl drinkl forl 6l hoursl
,secondaryl tol thel vomiting.l Whichl medicationl wouldl bel thel bestl optionl forl treatingl thisl
patient?
Scopolaminel TD
Prochlorperazinel suppository
Bisacodyll suppository
Meclizinel tablets
Answer:
Prochlorperazinel suppository
Prochlorperazinel actsl byl blockingl dopaminel receptorsl inl thel CTZ.l Itl isl alsol usefull tol
givel thel medicationl inl al suppository,l sincel thel patientl isl vomting.l Meclizinel tabletsl
mayl bel usefull inl somel formsl ofl nausea,l butl withl severel vomitingl thel patientl wouldl
havel difficultyl takingl thel medicationl andl al non-orall formulationl wouldl bel thel bestl
treatmentl optionl forl thisl patient.l Scopolaminel doesl helpl withl nausea,l butl thel
transdermall formulationl isl slowl tol workl andl wouldl notl bel beneficiall inl al patientl
needingl al quickerl actingl medication.l Bisacodyll wouldl notl bel recommended,l asl itl isl al
stimulantl usedl tol treatl constipation.
QUESTION
Al 25-year-oldl manl withl al pastl medicall historyl ofl alcoholl usel disorderl presentsl withl
IBS-D.l Hel hasl triedl variousl nonpharmacologicall approachesl andl continuesl tol havel
bothersomel cramping,l especiallyl duringl stressfull situations.l Whichl ofl thel followingl mayl
bel consideredl asl al treatmentl optionl forl thisl patient?
Linaclotide
Eluxadoline
Dicyclomine
Alosetron
Answer:
Dicyclomine
Dicyclominel isl usedl inl IBS-Dl andl isl particularlyl usefull inl decreasingl GIl spasmsl andl
motility.l Alosetronl isl currentlyl onlyl approvedl forl usel inl women.l Eluxadolinel shouldl bel
excluded,l givenl thel historyl ofl alcoholl usel disorder.l Linaclotidel isl usedl inl IBS-C.
QUESTION
Al 68-year-oldl patientl withl cardiacl failurel isl diagnosedl withl ovarianl cancer.l Shel beginsl
usingl cisplatinl butl becomesl nauseousl andl suffersl froml severel vomiting.l Whichl ofl thel
,followingl drugsl wouldl bel mostl effectivel tol counteractl thel emesisl inl thisl patientl
withoutl exacerbatingl herl cardiacl problem?
Dolasetron
Palonosetron
Prochlorperazine
Droperidol
Answer:
Palonosetron
Palonosetronl isl al 5-HT3l antagonistl thatl isl effectivel againstl drugsl withl highl emetogenicl
activity,l suchl asl cisplatin.l Althoughl dolasetronl isl alsol inl thisl category,l itsl propensityl tol
affectl thel heartl makesl itl al poorl choicel forl thisl patient.l Droperidoll hasl thel potentiall tol
prolongl thel QTcl intervall andl isl onlyl recommendedl forl thel treatmentl ofl postoperativel
nauseal andl vomiting.l Thel antiemeticl effectl ofl prochlorperazine,l al phenothiazine,l isl mostl
beneficiall againstl anticancerl drugsl withl moderatel tol lowl emetogenicl properties.
QUESTION
Whichl ofl thel followingl agentsl forl gastrointestinall problemsl isl contraindicatedl inl
pregnancy?
Calciuml carbonate
Misoprostol
Lansoprazole
Famotidine
Answer:
Misoprostol,l al syntheticl prostaglandinl analog,l isl contraindicatedl inl pregnancyl becausel itl
mayl stimulatel uterinel contractions.l Thel otherl medicationsl mayl bel usedl duringl
pregnancyl forl thel treatmentl ofl heartburnl (commonl inl pregnancy)l orl pepticl ulcerl disease.
QUESTION
Whichl ofl thel followingl classesl ofl antimicrobialsl hasl al mechanisml ofl actionl tol inhibitl
celll walll synthesis?
Tetracyclines
Aminoglycosides
β-Lactams
Macrolides
, Answer:
β-Lactams:
Thel β-lactaml antimicrobialsl suchl asl penicillinsl andl cephalosporinsl actl byl inhibitingl
synthesisl ofl thel bacteriall celll wall.l Thel otherl drugl categoriesl workl byl inhibitingl
targetingl bacteriall ribosomesl andl inhibitingl bacteriall proteinl synthesisl (Figurel 28.10).
QUESTION
Whichl ofl thel followingl isl thel primaryl methodl ofl β-lactaml resistancel withl Streptococcusl
pneumoniae?
Decreasedl drugl levelsl duel tol anl effluxl pump
Decreasedl drugl levelsl duel tol changesl inl permeability
Enzymaticl inactivation
Modificationl ofl al targetl site
Answer:
Modificationl ofl al targetl site
Streptococcusl pneumoniael resistancel tol beta-lactaml antimicrobialsl involvesl alterationl inl
onel orl morel ofl thel majorl penicillin-bindingl proteins.
QUESTION
Whichl ofl thel followingl antimicrobialsl mayl causel directl toxicityl suchl asl photosensitivityl
inl patientsl thatl mayl havel highl seruml concentrations?
Gentamicin
Doxycycline
Azithromycin
Ceftriaxone
Answer:
Doxycycline
Doxycyclinel isl anl antimicrobiall thatl belongsl tol thel tetracyclinel class.l Tetracyclinesl arel
associatedl withl photosensitivity.l Azithromycinl isl al macrolidel thatl isl correlatedl withl
gastrointestinall toxicity.l Ceftriaxonel isl al β-lactam,l specificallyl al cephalosporin,l andl isl
relativelyl safel withl minimall toxicities.l Gentamicinl isl anl aminoglycosidel andl isl
associatedl withl nephrotoxicity.
2026l Update)l –l Advancedl
Pharmacologyl Reviewl |l Questionsl &l
Answersl |l Gradel A|l 100%l Correctl
(Verifiedl Solutions)-l UTA
QUESTION
Al patientl withl al historyl ofl ulcerativel colitisl welll controlledl onl mesalaminel (Apriso)l
presentsl withl epigastricl painl andl darkl tarryl stools.l Hel isl foundl tol havel al duodenall
ulcerl andl isl prescribedl esomeprazolel forl 8l weeks.l Atl follow-upl 2l weeksl later,l hisl
epigastricl painl andl darkl tarryl stoolsl arel resolved.l However,l hel reportsl havingl increasedl
lowerl abdominall painl andl increasedl stooll frequency.l Whichl changel inl drugl therapyl isl
appropriatel atl thisl time?
Changel mesalaminel (Apriso)l tol mesalaminel (Asacoll HD).
Discontinuel esomeprazole.
Changel esomeprazolel tol omeprazolel duel tol interactionl withl mesalaminel (Apriso).
Changel mesalaminel (Apriso)l tol olsalazinel (Dipentum).
Answer:
Changel mesalaminel (Apriso)l tol olsalazinel (Dipentum).
Thel patientl seemsl tol bel havingl increasedl symptomsl ofl ulcerativel colitisl afterl startingl
thel PPI,l esomeprazole.l Thel pH-dependentl releasel formulationsl ofl mesalaminel havel al
significantl interactionl withl thel PPIs,l whichl mayl leadl tol earlyl releasel andl lossl ofl
efficacy.l Al isl incorrectl becausel omeprazolel isl expectedl tol havel thel samel interaction.l Bl
isl incorrectl becausel thisl patientl stilll requiresl therapyl withl al PPI.l Cl isl incorrectl becausel
Asacoll HDl isl alsol pH-dependentl releasel andl isl likelyl tol bel affected.l Dl isl correctl
becausel olsalazinel isl notl pHl dependentl andl releasel reliesl onl cleavagel byl colonicl
bacteria.
QUESTION
Al patientl withl significantl vomitingl presentsl tol thel emergencyl departmentl secondaryl tol
al virall infection.l Thel patientl statesl hel hasl beenl unablel tol eatl orl drinkl forl 6l hoursl
,secondaryl tol thel vomiting.l Whichl medicationl wouldl bel thel bestl optionl forl treatingl thisl
patient?
Scopolaminel TD
Prochlorperazinel suppository
Bisacodyll suppository
Meclizinel tablets
Answer:
Prochlorperazinel suppository
Prochlorperazinel actsl byl blockingl dopaminel receptorsl inl thel CTZ.l Itl isl alsol usefull tol
givel thel medicationl inl al suppository,l sincel thel patientl isl vomting.l Meclizinel tabletsl
mayl bel usefull inl somel formsl ofl nausea,l butl withl severel vomitingl thel patientl wouldl
havel difficultyl takingl thel medicationl andl al non-orall formulationl wouldl bel thel bestl
treatmentl optionl forl thisl patient.l Scopolaminel doesl helpl withl nausea,l butl thel
transdermall formulationl isl slowl tol workl andl wouldl notl bel beneficiall inl al patientl
needingl al quickerl actingl medication.l Bisacodyll wouldl notl bel recommended,l asl itl isl al
stimulantl usedl tol treatl constipation.
QUESTION
Al 25-year-oldl manl withl al pastl medicall historyl ofl alcoholl usel disorderl presentsl withl
IBS-D.l Hel hasl triedl variousl nonpharmacologicall approachesl andl continuesl tol havel
bothersomel cramping,l especiallyl duringl stressfull situations.l Whichl ofl thel followingl mayl
bel consideredl asl al treatmentl optionl forl thisl patient?
Linaclotide
Eluxadoline
Dicyclomine
Alosetron
Answer:
Dicyclomine
Dicyclominel isl usedl inl IBS-Dl andl isl particularlyl usefull inl decreasingl GIl spasmsl andl
motility.l Alosetronl isl currentlyl onlyl approvedl forl usel inl women.l Eluxadolinel shouldl bel
excluded,l givenl thel historyl ofl alcoholl usel disorder.l Linaclotidel isl usedl inl IBS-C.
QUESTION
Al 68-year-oldl patientl withl cardiacl failurel isl diagnosedl withl ovarianl cancer.l Shel beginsl
usingl cisplatinl butl becomesl nauseousl andl suffersl froml severel vomiting.l Whichl ofl thel
,followingl drugsl wouldl bel mostl effectivel tol counteractl thel emesisl inl thisl patientl
withoutl exacerbatingl herl cardiacl problem?
Dolasetron
Palonosetron
Prochlorperazine
Droperidol
Answer:
Palonosetron
Palonosetronl isl al 5-HT3l antagonistl thatl isl effectivel againstl drugsl withl highl emetogenicl
activity,l suchl asl cisplatin.l Althoughl dolasetronl isl alsol inl thisl category,l itsl propensityl tol
affectl thel heartl makesl itl al poorl choicel forl thisl patient.l Droperidoll hasl thel potentiall tol
prolongl thel QTcl intervall andl isl onlyl recommendedl forl thel treatmentl ofl postoperativel
nauseal andl vomiting.l Thel antiemeticl effectl ofl prochlorperazine,l al phenothiazine,l isl mostl
beneficiall againstl anticancerl drugsl withl moderatel tol lowl emetogenicl properties.
QUESTION
Whichl ofl thel followingl agentsl forl gastrointestinall problemsl isl contraindicatedl inl
pregnancy?
Calciuml carbonate
Misoprostol
Lansoprazole
Famotidine
Answer:
Misoprostol,l al syntheticl prostaglandinl analog,l isl contraindicatedl inl pregnancyl becausel itl
mayl stimulatel uterinel contractions.l Thel otherl medicationsl mayl bel usedl duringl
pregnancyl forl thel treatmentl ofl heartburnl (commonl inl pregnancy)l orl pepticl ulcerl disease.
QUESTION
Whichl ofl thel followingl classesl ofl antimicrobialsl hasl al mechanisml ofl actionl tol inhibitl
celll walll synthesis?
Tetracyclines
Aminoglycosides
β-Lactams
Macrolides
, Answer:
β-Lactams:
Thel β-lactaml antimicrobialsl suchl asl penicillinsl andl cephalosporinsl actl byl inhibitingl
synthesisl ofl thel bacteriall celll wall.l Thel otherl drugl categoriesl workl byl inhibitingl
targetingl bacteriall ribosomesl andl inhibitingl bacteriall proteinl synthesisl (Figurel 28.10).
QUESTION
Whichl ofl thel followingl isl thel primaryl methodl ofl β-lactaml resistancel withl Streptococcusl
pneumoniae?
Decreasedl drugl levelsl duel tol anl effluxl pump
Decreasedl drugl levelsl duel tol changesl inl permeability
Enzymaticl inactivation
Modificationl ofl al targetl site
Answer:
Modificationl ofl al targetl site
Streptococcusl pneumoniael resistancel tol beta-lactaml antimicrobialsl involvesl alterationl inl
onel orl morel ofl thel majorl penicillin-bindingl proteins.
QUESTION
Whichl ofl thel followingl antimicrobialsl mayl causel directl toxicityl suchl asl photosensitivityl
inl patientsl thatl mayl havel highl seruml concentrations?
Gentamicin
Doxycycline
Azithromycin
Ceftriaxone
Answer:
Doxycycline
Doxycyclinel isl anl antimicrobiall thatl belongsl tol thel tetracyclinel class.l Tetracyclinesl arel
associatedl withl photosensitivity.l Azithromycinl isl al macrolidel thatl isl correlatedl withl
gastrointestinall toxicity.l Ceftriaxonel isl al β-lactam,l specificallyl al cephalosporin,l andl isl
relativelyl safel withl minimall toxicities.l Gentamicinl isl anl aminoglycosidel andl isl
associatedl withl nephrotoxicity.
