NUR 521 Advanced Pharmacology –
complete Exam 4 Blueprint TEST
BANK Practice Questions with correct
answers and Rationale 2026 University
of Alabama
Insulin and drug interactions with nonselective beta-blocker and alcohol - answer- Beta-
blockers mask hypotension and hyperglycemia. Alcohol can cause hypoglycemia.
Why is metformin a popular selection for DM - answer- Does not cause hypoglycemia
Precaution when sprinkling pancreatic enzymes in food - answer- Do not inhale.
If on skin or oral mucousa can cause ulcers wash immediately after contact.
Use 10 mL or less on cold food or can inactivate enzymes.
Inactivated by ph less than 4.
Do not crush or chew. enteric coated not taken with alkaline foods.
Antacids reduce effectiveness and decreased iron absorption.
Antidiuretic hormone - why does it cause water balance issues post-op - answer- Stress
from surgery causes increase in ADH which causes water retention and decreased
urinary output
Why do steroids need to be tapered - answer- to allow adrenal glands to catch up on
production of cortisol on their own
What should a provider order before prescribing metformin - answer- serum creatinine,
A1c, kidney function, GFR
Why have sulfonylurreas moved to step 2 therapy - answer- Hypoglycemia risk and
many drug interactions
What meds are used for DM who have high cholesterol - answer- Statins then PCSK9
inhibitors
Why use ACE and ARB in DM - answer- Protects kidneys
Treatment for DM neuropathy - answer- Lyrica, Gabapentin, Cymbalta, Effexor
, Treatment for pregnant women with hyperthyroidism - answer- PTU (Propylthiourazil)
Patient education when starting medications for hypothryoidism - answer- Take on
empty stomach at least 1 hour before meal
Monitor HR
Avoid OTC cold medicine
Decrease dietary intake of iodine
Do not miss doses
Hormone replacement dosage when a women becomes pregnant - answer- Increase
dosing hypothyroid can cause severe fetal issues
Precautions with radioactive iodine - answer- No kissing, wash clothing separately,
sleep alone for 7 days, not for pregnant or breast feeding
Mechanism of action for bisphosphonates - answer- Inhibits osteoclast activity and
increases bone density
Reduce bone reabsorption by inhibiting osteoclast activity
Calcium supplements and bisphosphonates - answer- Calcium decreases absorption of
bisphosphonates - DO not take calcium supplements for at least an hour after taking
bisphosphonates
SERM's and treatment of osteoporosis - answer- Raloxifene: Prescribed for post-
menopausal women with osteoporosis to mimic estrogen effects, lipid metabolism and
blood clotting on bone but not on breast and endometrium.
Safest formulation for mild to moderate iron deficiency anemia - answer- Ferrous sulfate
Foods and substances that increase dietary absorption of plant-based iron - answer-
Vitamin C
Most likely cause of macrocytic anemia - answer- B12 or folate defienciency
Advantage of combination chemotherapy - answer- Decreased chance the tumor will
become resistant to therapy
Instructions for starting ortho evra patch - answer- Patch on for 7 days, change on day 8
to clean and dry skin, ensure edged are intact, change site with new patches, sites
include outer arm, lower abdomen, upper body or buttocks
NuvaRing advantages - answer- Regular menses, less blood loss, decreased risk for
iron deficiency anemia, decreases cramping, decreased ovarian and endometrial CA
risk, decreased ovarian cysts, decreased ectopic pregnancy, decreased benign breast
tissue
complete Exam 4 Blueprint TEST
BANK Practice Questions with correct
answers and Rationale 2026 University
of Alabama
Insulin and drug interactions with nonselective beta-blocker and alcohol - answer- Beta-
blockers mask hypotension and hyperglycemia. Alcohol can cause hypoglycemia.
Why is metformin a popular selection for DM - answer- Does not cause hypoglycemia
Precaution when sprinkling pancreatic enzymes in food - answer- Do not inhale.
If on skin or oral mucousa can cause ulcers wash immediately after contact.
Use 10 mL or less on cold food or can inactivate enzymes.
Inactivated by ph less than 4.
Do not crush or chew. enteric coated not taken with alkaline foods.
Antacids reduce effectiveness and decreased iron absorption.
Antidiuretic hormone - why does it cause water balance issues post-op - answer- Stress
from surgery causes increase in ADH which causes water retention and decreased
urinary output
Why do steroids need to be tapered - answer- to allow adrenal glands to catch up on
production of cortisol on their own
What should a provider order before prescribing metformin - answer- serum creatinine,
A1c, kidney function, GFR
Why have sulfonylurreas moved to step 2 therapy - answer- Hypoglycemia risk and
many drug interactions
What meds are used for DM who have high cholesterol - answer- Statins then PCSK9
inhibitors
Why use ACE and ARB in DM - answer- Protects kidneys
Treatment for DM neuropathy - answer- Lyrica, Gabapentin, Cymbalta, Effexor
, Treatment for pregnant women with hyperthyroidism - answer- PTU (Propylthiourazil)
Patient education when starting medications for hypothryoidism - answer- Take on
empty stomach at least 1 hour before meal
Monitor HR
Avoid OTC cold medicine
Decrease dietary intake of iodine
Do not miss doses
Hormone replacement dosage when a women becomes pregnant - answer- Increase
dosing hypothyroid can cause severe fetal issues
Precautions with radioactive iodine - answer- No kissing, wash clothing separately,
sleep alone for 7 days, not for pregnant or breast feeding
Mechanism of action for bisphosphonates - answer- Inhibits osteoclast activity and
increases bone density
Reduce bone reabsorption by inhibiting osteoclast activity
Calcium supplements and bisphosphonates - answer- Calcium decreases absorption of
bisphosphonates - DO not take calcium supplements for at least an hour after taking
bisphosphonates
SERM's and treatment of osteoporosis - answer- Raloxifene: Prescribed for post-
menopausal women with osteoporosis to mimic estrogen effects, lipid metabolism and
blood clotting on bone but not on breast and endometrium.
Safest formulation for mild to moderate iron deficiency anemia - answer- Ferrous sulfate
Foods and substances that increase dietary absorption of plant-based iron - answer-
Vitamin C
Most likely cause of macrocytic anemia - answer- B12 or folate defienciency
Advantage of combination chemotherapy - answer- Decreased chance the tumor will
become resistant to therapy
Instructions for starting ortho evra patch - answer- Patch on for 7 days, change on day 8
to clean and dry skin, ensure edged are intact, change site with new patches, sites
include outer arm, lower abdomen, upper body or buttocks
NuvaRing advantages - answer- Regular menses, less blood loss, decreased risk for
iron deficiency anemia, decreases cramping, decreased ovarian and endometrial CA
risk, decreased ovarian cysts, decreased ectopic pregnancy, decreased benign breast
tissue
