NU 578 PHARMACOLOGY EXAM 4:
2026/2027 QUESTIONS AND VERIFIED
ANSWERS 100% PASS
OVERVIEW:
NU 578 PHARMACOLOGY EXAM 4 covers musculoskeletal and endocrine
pharmacology including gout agents, NSAIDs, bisphosphonates, raloxifene,
glucocorticoid-induced osteoporosis, diabetes management with metformin,
glitazones, DPP-4 inhibitors, GLP-1 agonists, and basal-bolus insulin, plus thyroid
disorders, contraception, hormone therapy, immunosuppressants like
cyclosporine and adalimumab, vaccines, acetaminophen toxicity, pregnancy
category X drugs, and GI agents.
Correct answer highlighted in bold Green + rationales.
Question 1: Which of the following is a uricosuric agent for the treatment of gout?
A. Probenecid (Benemid)
B. Allopurinol (Zyloprim)
C. Colchicine (Colbenemid)
D. Methylprednisolone
Rationale: Probenecid is uricosuric - increases uric acid excretion in urine.
Allopurinol is xanthine oxidase inhibitor, colchicine is anti-inflammatory for acute
gout.
Question 2: Cautions to the use of Adalimumab for musculoskeletal diseases include:
Select all that apply:
A. Heart failure
B. Use of oral contraceptives
C. Lymphoma
,D. Multiple sclerosis
Rationale: TNF inhibitors like adalimumab carry boxed warnings for serious
infections, lymphoma, worsening heart failure, and demyelinating disease like MS.
Oral contraceptives are not a caution.
Question 3: Raloxifene treatment is contraindicated in:
A. Postmenopausal osteoporosis
B. a history of venous thromboembolic events
C. Short-bowel syndrome
D. Breast cancer
Rationale: Raloxifene, a SERM, increases risk of VTE like DVT/PE. History of VTE is
contraindication. It is actually indicated for postmenopausal osteoporosis and
reduces breast cancer risk.
Question 4: Select the correct match of drug and side effect below:
A. Acetaminophen (Tylenol) - renal insufficiency and swelling
B. Ibuprofen (Motrin) - elevated liver enzymes and icterus
C. Celecoxib (Celebrex) - prolonged prothrombin time and occult bleeding
D. Indomethacin (Indocin) - GI bleeds and abdominal distress
Rationale: NSAIDs like indomethacin commonly cause GI irritation, ulceration and
bleeding. Acetaminophen causes hepatotoxicity, not renal swelling.
Question 5: A patient requests something for arthritic pain but tells you that she is
allergic to sulfa antibiotics. Given her history, you know that she also cannot take the
following:
A. Celecoxib (Celebrex)
B. Prednisone
C. Acetaminophen
D. Gold salts
, Rationale: Celecoxib contains a sulfonamide moiety and cross-reacts in sulfa-allergic
patients. Risk of allergic reaction.
Question 6: The patient taking Alendronate (Fosamax) for Paget's disease should be
monitored for:
A. Cardiac irregularities
B. Elevated creatinine
C. Heartburn, difficulty swallowing
D. Elevated liver enzymes
Rationale: Oral bisphosphonates cause esophagitis, esophageal ulceration. Must take
with full glass water, upright 30-60 min, monitor for dysphagia, heartburn.
Question 7: The APN will especially remind the patient about the hypoglycemic effect
of which of the following oral agents?
A. Metformin (Glucophage)
B. Pioglitazone (Actos)
C. Acarbose (Precose)
D. Sitagliptin (Januvia)
Rationale: Metformin, pioglitazone, acarbose, sitagliptin alone rarely cause
hypoglycemia, but risk increases with other agents, missed meals, alcohol.
Counseling on signs of hypoglycemia is still required. Sulfonylureas are classic hypo
agents.
Question 8: In the patient on cyclosporine, which of the following additional agents
can inhibit cyp 450 enzymes and lead to toxic levels?
A. phenytoin (Dilantin)
B. Rifampin (Rifamate)
C. Erythromycin (ERY, PCE)
D. Amoxicillin (Amoxil)
2026/2027 QUESTIONS AND VERIFIED
ANSWERS 100% PASS
OVERVIEW:
NU 578 PHARMACOLOGY EXAM 4 covers musculoskeletal and endocrine
pharmacology including gout agents, NSAIDs, bisphosphonates, raloxifene,
glucocorticoid-induced osteoporosis, diabetes management with metformin,
glitazones, DPP-4 inhibitors, GLP-1 agonists, and basal-bolus insulin, plus thyroid
disorders, contraception, hormone therapy, immunosuppressants like
cyclosporine and adalimumab, vaccines, acetaminophen toxicity, pregnancy
category X drugs, and GI agents.
Correct answer highlighted in bold Green + rationales.
Question 1: Which of the following is a uricosuric agent for the treatment of gout?
A. Probenecid (Benemid)
B. Allopurinol (Zyloprim)
C. Colchicine (Colbenemid)
D. Methylprednisolone
Rationale: Probenecid is uricosuric - increases uric acid excretion in urine.
Allopurinol is xanthine oxidase inhibitor, colchicine is anti-inflammatory for acute
gout.
Question 2: Cautions to the use of Adalimumab for musculoskeletal diseases include:
Select all that apply:
A. Heart failure
B. Use of oral contraceptives
C. Lymphoma
,D. Multiple sclerosis
Rationale: TNF inhibitors like adalimumab carry boxed warnings for serious
infections, lymphoma, worsening heart failure, and demyelinating disease like MS.
Oral contraceptives are not a caution.
Question 3: Raloxifene treatment is contraindicated in:
A. Postmenopausal osteoporosis
B. a history of venous thromboembolic events
C. Short-bowel syndrome
D. Breast cancer
Rationale: Raloxifene, a SERM, increases risk of VTE like DVT/PE. History of VTE is
contraindication. It is actually indicated for postmenopausal osteoporosis and
reduces breast cancer risk.
Question 4: Select the correct match of drug and side effect below:
A. Acetaminophen (Tylenol) - renal insufficiency and swelling
B. Ibuprofen (Motrin) - elevated liver enzymes and icterus
C. Celecoxib (Celebrex) - prolonged prothrombin time and occult bleeding
D. Indomethacin (Indocin) - GI bleeds and abdominal distress
Rationale: NSAIDs like indomethacin commonly cause GI irritation, ulceration and
bleeding. Acetaminophen causes hepatotoxicity, not renal swelling.
Question 5: A patient requests something for arthritic pain but tells you that she is
allergic to sulfa antibiotics. Given her history, you know that she also cannot take the
following:
A. Celecoxib (Celebrex)
B. Prednisone
C. Acetaminophen
D. Gold salts
, Rationale: Celecoxib contains a sulfonamide moiety and cross-reacts in sulfa-allergic
patients. Risk of allergic reaction.
Question 6: The patient taking Alendronate (Fosamax) for Paget's disease should be
monitored for:
A. Cardiac irregularities
B. Elevated creatinine
C. Heartburn, difficulty swallowing
D. Elevated liver enzymes
Rationale: Oral bisphosphonates cause esophagitis, esophageal ulceration. Must take
with full glass water, upright 30-60 min, monitor for dysphagia, heartburn.
Question 7: The APN will especially remind the patient about the hypoglycemic effect
of which of the following oral agents?
A. Metformin (Glucophage)
B. Pioglitazone (Actos)
C. Acarbose (Precose)
D. Sitagliptin (Januvia)
Rationale: Metformin, pioglitazone, acarbose, sitagliptin alone rarely cause
hypoglycemia, but risk increases with other agents, missed meals, alcohol.
Counseling on signs of hypoglycemia is still required. Sulfonylureas are classic hypo
agents.
Question 8: In the patient on cyclosporine, which of the following additional agents
can inhibit cyp 450 enzymes and lead to toxic levels?
A. phenytoin (Dilantin)
B. Rifampin (Rifamate)
C. Erythromycin (ERY, PCE)
D. Amoxicillin (Amoxil)
