NU 578 PHARMACOLOGY EXAM 5:
2026/2027 QUESTIONS AND VERIFIED
ANSWERS 100% PASS
OVERVIEW:
NU 578 PHARMACOLOGY EXAM 5 covers antimicrobial stewardship, bacterial
resistance, aminoglycosides, tetracyclines, fluoroquinolones, penicillins,
cephalosporins, azole antifungals, and metronidazole-alcohol interactions, plus
antiviral agents for influenza, herpes transmission, and HIV CCR5 tropism,
bioterrorism agents including anthrax and plague, C. difficile superinfection,
chemotherapy principles, P-glycoprotein multidrug resistance, antidotes like
deferoxamine and fomepizole, and ophthalmic/dermatologic therapies.
Correct answer highlighted in bold Green + rationales.
Question 1: With the drug combination of Metronidazole, certain cephalosporins, and
alcohol you might see which reaction:
A. Anaphylactic reaction
B. Cardiac arrhythmias
C. Antabuse reaction
D. Enhanced anti-coagulant effect
Rationale: Metronidazole and some cephalosporins (e.g., cefotetan) inhibit aldehyde
dehydrogenase, causing disulfiram-like (Antabuse) reaction when taken with alcohol
- nausea, vomiting, flushing, tachycardia, hypotension.
Question 2: The most common adverse reactions to azoles are:
A. GI symptoms
B. Neuro symptoms
C. Integumentary symptoms
,D. Hematologic symptoms
Rationale: Azole antifungals (fluconazole, ketoconazole etc.) most commonly cause GI
upset - nausea, vomiting, abdominal pain, diarrhea. Hepatotoxicity is more serious
but less common.
Question 3: A female patient who takes soy for its estrogenic effect is being treated
for sinusitis and experiencing hot flashes. The APN will consider what data regarding
soy?
A. Estrogenic effects on healing
B. Antibiotic antagonism of soy
C. Patient's sinusitis is misdiagnosed
D. Soy is not indicated for estrogen replacement
E. All the above are accurate
Rationale: Soy isoflavones require gut flora for activation. Antibiotics disrupt gut
flora, reducing conversion of soy to its active estrogenic form, leading to decreased
efficacy and return of menopausal symptoms like hot flashes.
Question 4: Aminoglycosides are usually given to treat:
A. gram negative infections
B. gram positive infections
C. both a and b are correct since aminoglycosides are broad spectrum
Rationale: Aminoglycosides are predominantly active against aerobic gram-negative
bacilli. While they have some gram-positive synergy (e.g., with beta-lactams), they
are primarily used for gram-negative infections.
Question 5: Which of the following tests run in an HIV-positive patient will give the
NP information about whether the drug Maraviroc will be effective?
A. CD4 T-cell counts
B. HLA-B*5701 Screening
C. Viral Load
, D. CCR5 Tropism
Rationale: Maraviroc is a CCR5 antagonist. It is only effective if the patient's HIV uses
CCR5 co-receptor (R5-tropic virus). Tropism testing is required before prescribing.
Question 6: Post-exposure prophylaxis for B. anthracis may involve which agent(s)?
A. Amoxicillin (Amoxil)
B. Ciprofloxacin (Cipro)
C. Cephalexin (Keflex)
D. Doxycycline (Vibramycin)
E. All but C
Rationale: First-line PEP for anthrax is ciprofloxacin or doxycycline. Amoxicillin can
be used if strain is susceptible. Cephalexin is not effective against B. anthracis.
Question 7: A patient takes Ginkgo for her 'well-being'. The practitioner knows that
this herbal may interact with:
A. Trimethoprim
B. Propranolol
C. Aspirin
D. Estrogen
E. Tamoxifen
Rationale: Ginkgo has antiplatelet properties and increases bleeding risk, especially
when combined with antiplatelet agents like aspirin, NSAIDs, or anticoagulants.
Question 8: Leucovorin rescue is used to enhance the effect of which anticancer drug?
A. Methotrexate
B. Cytarabine
C. Cisplatin
D. Fluorouracil
2026/2027 QUESTIONS AND VERIFIED
ANSWERS 100% PASS
OVERVIEW:
NU 578 PHARMACOLOGY EXAM 5 covers antimicrobial stewardship, bacterial
resistance, aminoglycosides, tetracyclines, fluoroquinolones, penicillins,
cephalosporins, azole antifungals, and metronidazole-alcohol interactions, plus
antiviral agents for influenza, herpes transmission, and HIV CCR5 tropism,
bioterrorism agents including anthrax and plague, C. difficile superinfection,
chemotherapy principles, P-glycoprotein multidrug resistance, antidotes like
deferoxamine and fomepizole, and ophthalmic/dermatologic therapies.
Correct answer highlighted in bold Green + rationales.
Question 1: With the drug combination of Metronidazole, certain cephalosporins, and
alcohol you might see which reaction:
A. Anaphylactic reaction
B. Cardiac arrhythmias
C. Antabuse reaction
D. Enhanced anti-coagulant effect
Rationale: Metronidazole and some cephalosporins (e.g., cefotetan) inhibit aldehyde
dehydrogenase, causing disulfiram-like (Antabuse) reaction when taken with alcohol
- nausea, vomiting, flushing, tachycardia, hypotension.
Question 2: The most common adverse reactions to azoles are:
A. GI symptoms
B. Neuro symptoms
C. Integumentary symptoms
,D. Hematologic symptoms
Rationale: Azole antifungals (fluconazole, ketoconazole etc.) most commonly cause GI
upset - nausea, vomiting, abdominal pain, diarrhea. Hepatotoxicity is more serious
but less common.
Question 3: A female patient who takes soy for its estrogenic effect is being treated
for sinusitis and experiencing hot flashes. The APN will consider what data regarding
soy?
A. Estrogenic effects on healing
B. Antibiotic antagonism of soy
C. Patient's sinusitis is misdiagnosed
D. Soy is not indicated for estrogen replacement
E. All the above are accurate
Rationale: Soy isoflavones require gut flora for activation. Antibiotics disrupt gut
flora, reducing conversion of soy to its active estrogenic form, leading to decreased
efficacy and return of menopausal symptoms like hot flashes.
Question 4: Aminoglycosides are usually given to treat:
A. gram negative infections
B. gram positive infections
C. both a and b are correct since aminoglycosides are broad spectrum
Rationale: Aminoglycosides are predominantly active against aerobic gram-negative
bacilli. While they have some gram-positive synergy (e.g., with beta-lactams), they
are primarily used for gram-negative infections.
Question 5: Which of the following tests run in an HIV-positive patient will give the
NP information about whether the drug Maraviroc will be effective?
A. CD4 T-cell counts
B. HLA-B*5701 Screening
C. Viral Load
, D. CCR5 Tropism
Rationale: Maraviroc is a CCR5 antagonist. It is only effective if the patient's HIV uses
CCR5 co-receptor (R5-tropic virus). Tropism testing is required before prescribing.
Question 6: Post-exposure prophylaxis for B. anthracis may involve which agent(s)?
A. Amoxicillin (Amoxil)
B. Ciprofloxacin (Cipro)
C. Cephalexin (Keflex)
D. Doxycycline (Vibramycin)
E. All but C
Rationale: First-line PEP for anthrax is ciprofloxacin or doxycycline. Amoxicillin can
be used if strain is susceptible. Cephalexin is not effective against B. anthracis.
Question 7: A patient takes Ginkgo for her 'well-being'. The practitioner knows that
this herbal may interact with:
A. Trimethoprim
B. Propranolol
C. Aspirin
D. Estrogen
E. Tamoxifen
Rationale: Ginkgo has antiplatelet properties and increases bleeding risk, especially
when combined with antiplatelet agents like aspirin, NSAIDs, or anticoagulants.
Question 8: Leucovorin rescue is used to enhance the effect of which anticancer drug?
A. Methotrexate
B. Cytarabine
C. Cisplatin
D. Fluorouracil
