CHAMBERLAIN UNIVERSITY
NR 601: ADVANCED PHARMACOTHERAPEUTICS
FINAL EXAMINATION – LATEST VERSION
2026/2027 SPRING
20 CASE STUDIES WITH COMPLETE
PRESCRIPTIONS & RATIONALES
INSTRUCTIONS
For each case, you will write an appropriate prescription including:
Item Description P
1. Name of medication, dose and Plausible medication choice, dose, and route for
1
route working diagnosis
2. Instructions ("sig.") how to
Correct instructions in clear language 1
take medication - frequency
3. Special instructions regarding
Correct instructions in clear language 1
medication
Plausible working diagnosis based on case
4. Indication 1
presentation
Reasonable quantities and refills based on likely
5. Dispensing number and refills 1
time until next patient evaluation needed
TOTAL 5
,CASE 1
Patient: Ten-year-old Hispanic male accompanied by his father
HPI/ROS: Father reports that the child has complained of sore throat × 48
hours. Associated symptoms: fever, chills, lethargy, "sandpapery" rash × 24
hours. Child denies vomiting, diarrhea or abdominal pain. Oral intake limited to
liquids. Last void 3 hours ago.
PMH/PSH: Negative. Immunizations up to date.
Social History/Substances: No smoke exposure.
Current Medications: Ibuprofen 400 mg every 6 hours for pain, PRN.
Allergies: Amoxicillin (rash).
Vital Signs: T: 101.2°F; P: 90; R: 18; BP: 100/60; Height: 125 cm; Weight: 25 kg.
Exam/Lab Findings: General: fatigued appearing, awake, alert, in no acute
distress. HEENT: conjunctiva clear, TMs clear bilaterally, pharynx is injected,
tonsils enlarged with patchy white exudate. No drooling. Heart: regular rate
and rhythm, S1, S2, no S3, S4, no murmur. Lungs: clear to auscultation
bilaterally. Abdomen: bowel sounds present four quadrants, soft, non-tender.
Skin: fine palpable, rough feeling macular/papular rash over trunk and
extremities. Rapid strep screen positive.
PRESCRIPTION
Component Answer
1. Medication, Dose,
Cephalexin 500 mg PO
Route
2. Instructions (Sig.) Take one tablet by mouth twice daily for 10 days
, Component Answer
3. Special Complete full course even if symptoms improve. May take with foo
Instructions reduce GI upset. Report any difficulty breathing, swelling, or severe
4. Indication Streptococcal pharyngitis (Group A Strep) – Scarlet Fever
5. Dispense/Refills Dispense 20 tablets. Refills: 0
Rationale: Patient has positive rapid strep screen with classic findings
(exudative pharyngitis, fever, sandpapery rash) consistent with Group A
Streptococcus with scarlet fever. Patient has amoxicillin allergy (rash), so
cephalexin (first-generation cephalosporin) is appropriate for penicillin-allergic
patients without anaphylactic reaction. Weight-based dosing: 25-50 mg/kg/day
divided BID. At 25 kg, 500 mg BID is appropriate.
CASE 2
Patient: 43-year-old African American female school nurse
HPI/ROS: Gradual onset 3-5 days ago. Patient complains of non-productive
cough × 2-3 days, mild fever, headache, muscle aches and fatigue. Denies
shortness of breath, chest pain. Denies nausea, vomiting or diarrhea.
PMH/PSH: GERD.
Social History/Substances: Tobacco: smokes ½ pack per day × 20 years. Rare
alcohol.
Current Medications: Pantoprazole 40 mg QD PRN.
Allergies: Azithromycin (hives).
Vital Signs: T: 100.2°F; P: 88; R: 18; BP: 130/80.
Exam/Lab Findings: General: awake and alert oriented ×3, in no acute distress.
HEENT: conjunctiva clear, TMs clear bilaterally, pharynx non-injected, neck
nodes negative. Heart: regular rate and rhythm, S1, S2, no S3, S4, no murmur.
NR 601: ADVANCED PHARMACOTHERAPEUTICS
FINAL EXAMINATION – LATEST VERSION
2026/2027 SPRING
20 CASE STUDIES WITH COMPLETE
PRESCRIPTIONS & RATIONALES
INSTRUCTIONS
For each case, you will write an appropriate prescription including:
Item Description P
1. Name of medication, dose and Plausible medication choice, dose, and route for
1
route working diagnosis
2. Instructions ("sig.") how to
Correct instructions in clear language 1
take medication - frequency
3. Special instructions regarding
Correct instructions in clear language 1
medication
Plausible working diagnosis based on case
4. Indication 1
presentation
Reasonable quantities and refills based on likely
5. Dispensing number and refills 1
time until next patient evaluation needed
TOTAL 5
,CASE 1
Patient: Ten-year-old Hispanic male accompanied by his father
HPI/ROS: Father reports that the child has complained of sore throat × 48
hours. Associated symptoms: fever, chills, lethargy, "sandpapery" rash × 24
hours. Child denies vomiting, diarrhea or abdominal pain. Oral intake limited to
liquids. Last void 3 hours ago.
PMH/PSH: Negative. Immunizations up to date.
Social History/Substances: No smoke exposure.
Current Medications: Ibuprofen 400 mg every 6 hours for pain, PRN.
Allergies: Amoxicillin (rash).
Vital Signs: T: 101.2°F; P: 90; R: 18; BP: 100/60; Height: 125 cm; Weight: 25 kg.
Exam/Lab Findings: General: fatigued appearing, awake, alert, in no acute
distress. HEENT: conjunctiva clear, TMs clear bilaterally, pharynx is injected,
tonsils enlarged with patchy white exudate. No drooling. Heart: regular rate
and rhythm, S1, S2, no S3, S4, no murmur. Lungs: clear to auscultation
bilaterally. Abdomen: bowel sounds present four quadrants, soft, non-tender.
Skin: fine palpable, rough feeling macular/papular rash over trunk and
extremities. Rapid strep screen positive.
PRESCRIPTION
Component Answer
1. Medication, Dose,
Cephalexin 500 mg PO
Route
2. Instructions (Sig.) Take one tablet by mouth twice daily for 10 days
, Component Answer
3. Special Complete full course even if symptoms improve. May take with foo
Instructions reduce GI upset. Report any difficulty breathing, swelling, or severe
4. Indication Streptococcal pharyngitis (Group A Strep) – Scarlet Fever
5. Dispense/Refills Dispense 20 tablets. Refills: 0
Rationale: Patient has positive rapid strep screen with classic findings
(exudative pharyngitis, fever, sandpapery rash) consistent with Group A
Streptococcus with scarlet fever. Patient has amoxicillin allergy (rash), so
cephalexin (first-generation cephalosporin) is appropriate for penicillin-allergic
patients without anaphylactic reaction. Weight-based dosing: 25-50 mg/kg/day
divided BID. At 25 kg, 500 mg BID is appropriate.
CASE 2
Patient: 43-year-old African American female school nurse
HPI/ROS: Gradual onset 3-5 days ago. Patient complains of non-productive
cough × 2-3 days, mild fever, headache, muscle aches and fatigue. Denies
shortness of breath, chest pain. Denies nausea, vomiting or diarrhea.
PMH/PSH: GERD.
Social History/Substances: Tobacco: smokes ½ pack per day × 20 years. Rare
alcohol.
Current Medications: Pantoprazole 40 mg QD PRN.
Allergies: Azithromycin (hives).
Vital Signs: T: 100.2°F; P: 88; R: 18; BP: 130/80.
Exam/Lab Findings: General: awake and alert oriented ×3, in no acute distress.
HEENT: conjunctiva clear, TMs clear bilaterally, pharynx non-injected, neck
nodes negative. Heart: regular rate and rhythm, S1, S2, no S3, S4, no murmur.
