NR 568 FINAL EXAM 2026/2027 | Advanced Pharmacology
for AGPCNP | Practice Questions &Answers Graded A
with Rationales | Chamberlain University | Complete
Study Guide
NR 568 FINAL EXAM 2026 - 200 practice questions with detailed Rationales, updated for
2026/2027. Covers HRT, Alzheimer's, Parkinson's, heart failure, BPH, and antibiotics. Based
on Chamberlain's AGPCNP curriculum. Includes high-yield topics like HRT estrogen-progestin
protocols, tamsulosin side effects, and warfarin-amiodarone interactions. Verified answers
with Rationales explain the "why" behind each choice. Perfect for last-minute review or
comprehensive study. 100% pass guarantee!
,1. A 67-year-old postmenopausal woman with an intact uterus asks about hormone
therapy for severe hot flashes. What is the most important addition to her estrogen
regimen?
a) Testosterone gel
b) Bazedoxifene
c) Progestin
d) Calcium citrate
Rationale: In women with an intact uterus, unopposed estrogen significantly increases
the risk of endometrial hyperplasia and cancer. Adding a progestin counteracts this effect
by inducing endometrial shedding.
2. A patient on warfarin is started on amiodarone for atrial fibrillation. What action should
the provider take regarding the warfarin dose?
a) Increase the warfarin dose by 50%
b) Maintain the current warfarin dose
c) Reduce the warfarin dose by 33-50%
d) Discontinue warfarin and start aspirin
Rationale: Amiodarone inhibits CYP2C9, the enzyme responsible for metabolizing
warfarin. This leads to elevated INR levels and bleeding risk, so the warfarin dose must
be significantly reduced.
3. A 72-year-old male with benign prostatic hyperplasia is started on tamsulosin. What
adverse effect is most specific to this medication class that the provider must warn the
patient about?
a) Gynecomastia
b) Intraoperative floppy-iris syndrome
c) Severe hepatotoxicity
d) Hyperkalemia
Rationale: Tamsulosin is an alpha-1 blocker that can cause intraoperative floppy-iris
syndrome during cataract surgery. Patients must inform their ophthalmologist about this
medication.
4. A 55-year-old female with moderate Alzheimer's disease is prescribed rivastigmine.
What is a distinct advantage of rivastigmine over other cholinesterase inhibitors?
a) It has a once-daily dosing schedule
b) It is not metabolized by the CYP450 system
c) It has no gastrointestinal side effects
d) It is effective for severe Alzheimer's only
, Rationale: Rivastigmine is unique among cholinesterase inhibitors because it is not
metabolized by the CYP450 system, resulting in fewer drug-drug interactions.
5. A 48-year-old male with hypogonadism is started on transdermal testosterone gel. What
is the most important education point regarding this route?
a) Apply the gel to the scrotum for best absorption
b) Wash hands thoroughly after application and cover the site with clothing
c) Apply the gel immediately after showering while skin is still damp
d) Monitor blood pressure daily for the first month
Rationale: Transdermal testosterone can be transferred to women and children through
skin contact, causing virilization or premature puberty. Hand washing and covering the
application site are essential precautions.
6. A 60-year-old female presents with medication overuse headache. She has been using
sumatriptan for her migraines. What is the maximum number of days per week she
should limit her abortive medication to prevent this?
a) 1 day per week
b) 2-3 days per week
c) 5 days per week
d) Every day as needed
Rationale: Medication overuse headache (MOH) is prevented by limiting abortive
medications, including triptans, to no more than 2-3 days per week. Overuse leads to
rebound headaches.
7. A patient with heart failure with reduced ejection fraction is already on an ACE inhibitor
and a beta-blocker. Which medication should be added next to reduce mortality based
on current guidelines?
a) Digoxin
b) Spironolactone
c) Hydralazine
d) Diltiazem
Rationale: Spironolactone, an aldosterone antagonist, has been shown to reduce
mortality in HFrEF patients already on ACE inhibitors and beta-blockers as part of
guideline-directed medical therapy.
8. A 45-year-old female is prescribed combined oral contraceptives. Which of the following
medical histories would be an absolute contraindication to this therapy?
a) Migraine without aura
b) Factor V Leiden mutation
c) Mild hypertension controlled with diet
, d) Previous cholecystectomy
Rationale: Combined oral contraceptives are contraindicated in patients with hereditary
thrombophilias like Factor V Leiden due to a significantly increased risk of venous
thromboembolism.
9. A patient with Parkinson's disease is experiencing "wearing-off" phenomena between
doses of carbidopa-levodopa. Which medication can be added to prolong the half-life of
levodopa?
a) Pramipexole
b) Entacapone
c) Rotigotine
d) Amantadine
Rationale: Entacapone is a COMT inhibitor that blocks the metabolism of levodopa,
thereby prolonging its half-life and reducing "wearing-off" episodes.
10. A 70-year-old male with severe renal impairment (eGFR 28 mL/min) is being evaluated
for type 2 diabetes management. Which GLP-1 receptor agonist is contraindicated in this
patient?
a) Semaglutide
b) Dulaglutide
c) Exenatide
d) Liraglutide
Rationale: Exenatide is primarily renally cleared and is contraindicated in patients with
severe renal impairment (eGFR <30 mL/min) due to the risk of acute kidney injury.
11. A 52-year-old female is started on bazedoxifene for osteoporosis prevention. Which
additional benefit is associated with this medication?
a) Reduction in hot flashes
b) Protection against breast cancer
c) Improved lipid profile
d) Weight loss
Rationale: Bazedoxifene is a selective estrogen receptor modulator (SERM) that treats
osteoporosis while also providing protective effects against breast cancer.
12. A 65-year-old male with erectile dysfunction did not respond to sildenafil. What is the
next-line alternative medication that can be administered via intracavernosal injection?
a) Tadalafil
b) Vardenafil
c) Alprostadil
d) Yohimbine
for AGPCNP | Practice Questions &Answers Graded A
with Rationales | Chamberlain University | Complete
Study Guide
NR 568 FINAL EXAM 2026 - 200 practice questions with detailed Rationales, updated for
2026/2027. Covers HRT, Alzheimer's, Parkinson's, heart failure, BPH, and antibiotics. Based
on Chamberlain's AGPCNP curriculum. Includes high-yield topics like HRT estrogen-progestin
protocols, tamsulosin side effects, and warfarin-amiodarone interactions. Verified answers
with Rationales explain the "why" behind each choice. Perfect for last-minute review or
comprehensive study. 100% pass guarantee!
,1. A 67-year-old postmenopausal woman with an intact uterus asks about hormone
therapy for severe hot flashes. What is the most important addition to her estrogen
regimen?
a) Testosterone gel
b) Bazedoxifene
c) Progestin
d) Calcium citrate
Rationale: In women with an intact uterus, unopposed estrogen significantly increases
the risk of endometrial hyperplasia and cancer. Adding a progestin counteracts this effect
by inducing endometrial shedding.
2. A patient on warfarin is started on amiodarone for atrial fibrillation. What action should
the provider take regarding the warfarin dose?
a) Increase the warfarin dose by 50%
b) Maintain the current warfarin dose
c) Reduce the warfarin dose by 33-50%
d) Discontinue warfarin and start aspirin
Rationale: Amiodarone inhibits CYP2C9, the enzyme responsible for metabolizing
warfarin. This leads to elevated INR levels and bleeding risk, so the warfarin dose must
be significantly reduced.
3. A 72-year-old male with benign prostatic hyperplasia is started on tamsulosin. What
adverse effect is most specific to this medication class that the provider must warn the
patient about?
a) Gynecomastia
b) Intraoperative floppy-iris syndrome
c) Severe hepatotoxicity
d) Hyperkalemia
Rationale: Tamsulosin is an alpha-1 blocker that can cause intraoperative floppy-iris
syndrome during cataract surgery. Patients must inform their ophthalmologist about this
medication.
4. A 55-year-old female with moderate Alzheimer's disease is prescribed rivastigmine.
What is a distinct advantage of rivastigmine over other cholinesterase inhibitors?
a) It has a once-daily dosing schedule
b) It is not metabolized by the CYP450 system
c) It has no gastrointestinal side effects
d) It is effective for severe Alzheimer's only
, Rationale: Rivastigmine is unique among cholinesterase inhibitors because it is not
metabolized by the CYP450 system, resulting in fewer drug-drug interactions.
5. A 48-year-old male with hypogonadism is started on transdermal testosterone gel. What
is the most important education point regarding this route?
a) Apply the gel to the scrotum for best absorption
b) Wash hands thoroughly after application and cover the site with clothing
c) Apply the gel immediately after showering while skin is still damp
d) Monitor blood pressure daily for the first month
Rationale: Transdermal testosterone can be transferred to women and children through
skin contact, causing virilization or premature puberty. Hand washing and covering the
application site are essential precautions.
6. A 60-year-old female presents with medication overuse headache. She has been using
sumatriptan for her migraines. What is the maximum number of days per week she
should limit her abortive medication to prevent this?
a) 1 day per week
b) 2-3 days per week
c) 5 days per week
d) Every day as needed
Rationale: Medication overuse headache (MOH) is prevented by limiting abortive
medications, including triptans, to no more than 2-3 days per week. Overuse leads to
rebound headaches.
7. A patient with heart failure with reduced ejection fraction is already on an ACE inhibitor
and a beta-blocker. Which medication should be added next to reduce mortality based
on current guidelines?
a) Digoxin
b) Spironolactone
c) Hydralazine
d) Diltiazem
Rationale: Spironolactone, an aldosterone antagonist, has been shown to reduce
mortality in HFrEF patients already on ACE inhibitors and beta-blockers as part of
guideline-directed medical therapy.
8. A 45-year-old female is prescribed combined oral contraceptives. Which of the following
medical histories would be an absolute contraindication to this therapy?
a) Migraine without aura
b) Factor V Leiden mutation
c) Mild hypertension controlled with diet
, d) Previous cholecystectomy
Rationale: Combined oral contraceptives are contraindicated in patients with hereditary
thrombophilias like Factor V Leiden due to a significantly increased risk of venous
thromboembolism.
9. A patient with Parkinson's disease is experiencing "wearing-off" phenomena between
doses of carbidopa-levodopa. Which medication can be added to prolong the half-life of
levodopa?
a) Pramipexole
b) Entacapone
c) Rotigotine
d) Amantadine
Rationale: Entacapone is a COMT inhibitor that blocks the metabolism of levodopa,
thereby prolonging its half-life and reducing "wearing-off" episodes.
10. A 70-year-old male with severe renal impairment (eGFR 28 mL/min) is being evaluated
for type 2 diabetes management. Which GLP-1 receptor agonist is contraindicated in this
patient?
a) Semaglutide
b) Dulaglutide
c) Exenatide
d) Liraglutide
Rationale: Exenatide is primarily renally cleared and is contraindicated in patients with
severe renal impairment (eGFR <30 mL/min) due to the risk of acute kidney injury.
11. A 52-year-old female is started on bazedoxifene for osteoporosis prevention. Which
additional benefit is associated with this medication?
a) Reduction in hot flashes
b) Protection against breast cancer
c) Improved lipid profile
d) Weight loss
Rationale: Bazedoxifene is a selective estrogen receptor modulator (SERM) that treats
osteoporosis while also providing protective effects against breast cancer.
12. A 65-year-old male with erectile dysfunction did not respond to sildenafil. What is the
next-line alternative medication that can be administered via intracavernosal injection?
a) Tadalafil
b) Vardenafil
c) Alprostadil
d) Yohimbine
