,Herzing NU 636 Quiz 6 | Advanced Pharmacology (2026)
Q&A
1. A 31-year-old male with allergic rhinitis is using intranasal antihistamines. Which of the
following adverse effects is NOT associated with intranasal antihistamine use?
A) Bitter taste
B) Dry mouth
C) Flatulence
D) Headache
Correct Answer: C) Flatulence
Rationale: Intranasal antihistamines like azelastine are associated with local and systemic
adverse effects including bitter taste, dry mouth, headache, and somnolence. Flatulence is a
gastrointestinal side effect associated with oral medications, not intranasal formulations.
2. A 9-year-old child presents with left ear pain and a "raging red," bulging tympanic
membrane. The child weighs 60 kg. The calculated amoxicillin dose is 90 mg/kg/day, totaling
5,400 mg/day. The maximum adult daily dose is 4,000 mg. What is the most appropriate
action?
A) Choose a different antibiotic since the calculated dose exceeds the maximum adult dose
B) Dose 5,400 mg divided into 3 doses daily of 1,800 mg each
C) Have the mother bring the child back for reassessment in 3 days
D) Dose 4,000 mg divided into 2 doses daily of 2,000 mg each
Correct Answer: D) Dose 4,000 mg divided into 2 doses daily of 2,000 mg each
Rationale: For acute otitis media, the recommended amoxicillin dose is 80-90 mg/kg/day.
The maximum adult daily dose is 4,000 mg. Dosing 4,000 mg/day (2,000 mg BID) is
appropriate for this child, as it provides adequate coverage without exceeding the maximum
adult limit.
,3. A patient reports using Afrin nasal spray 2 to 3 times daily without relief. What is the most
likely explanation for the lack of improvement?
A) He will need to increase his Zyrtec to twice daily dosing
B) He will need to change from Zyrtec to Allegra
C) His nasal congestion may be a rebound phenomenon from habitual Afrin use
D) His Afrin nasal spray is not potent enough and he needs Neo-Synephrine spray
Correct Answer: C) His nasal congestion may be a rebound phenomenon from habitual
Afrin use
Rationale: Rhinitis medicamentosa, or rebound congestion, is caused by prolonged use of
topical nasal decongestants like oxymetazoline (Afrin). This condition leads to worsening
nasal congestion despite continued use, and treatment involves discontinuing the medication.
4. Neo-Synephrine, an intranasal decongestant, is a sympathomimetic amine. What is its
primary mechanism of action?
A) Increase mast cell degranulation
B) Decrease the action of antihistamines
C) Blocks mast cell degranulation
D) Vasoconstricts nasal mucosa
Correct Answer: D) Vasoconstricts nasal mucosa
Rationale: Neo-Synephrine (phenylephrine) is an alpha-adrenergic agonist that causes
vasoconstriction of nasal mucosal blood vessels, reducing nasal congestion. It does not affect
mast cell degranulation.
5. A college student with Trichomoniasis is prescribed metronidazole. Which of the following
should NOT be included in patient education about this antibiotic?
A) Headache
B) Metallic taste in mouth
C) Major interactions with alcohol
, D) Increased appetite
Correct Answer: D) Increased appetite
Rationale: Metronidazole commonly causes headache and a metallic taste in the mouth. It
has a major interaction with alcohol, causing a disulfiram-like reaction. Increased appetite is
not a recognized side effect of metronidazole.
6. An eight-grade boy with suspected constitutional growth delay presents with erythema
migrans after a tick bite. Which antibiotic should be avoided for Lyme disease prophylaxis in
this patient?
A) Doxycycline
B) Amoxicillin
C) Bactrim
D) Augmentin
Correct Answer: A) Doxycycline
Rationale: Doxycycline is contraindicated in children under 8 years of age due to the risk of
permanent tooth discoloration and enamel hypoplasia. For Lyme disease prophylaxis in this
age group, amoxicillin is the preferred alternative.
7. Which of the following is the first-line treatment for acute bacterial sinusitis in adults with
no antibiotic allergies?
A) Azithromycin
B) Amoxicillin-clavulanate
C) Doxycycline
D) Levofloxacin
Correct Answer: B) Amoxicillin-clavulanate
Q&A
1. A 31-year-old male with allergic rhinitis is using intranasal antihistamines. Which of the
following adverse effects is NOT associated with intranasal antihistamine use?
A) Bitter taste
B) Dry mouth
C) Flatulence
D) Headache
Correct Answer: C) Flatulence
Rationale: Intranasal antihistamines like azelastine are associated with local and systemic
adverse effects including bitter taste, dry mouth, headache, and somnolence. Flatulence is a
gastrointestinal side effect associated with oral medications, not intranasal formulations.
2. A 9-year-old child presents with left ear pain and a "raging red," bulging tympanic
membrane. The child weighs 60 kg. The calculated amoxicillin dose is 90 mg/kg/day, totaling
5,400 mg/day. The maximum adult daily dose is 4,000 mg. What is the most appropriate
action?
A) Choose a different antibiotic since the calculated dose exceeds the maximum adult dose
B) Dose 5,400 mg divided into 3 doses daily of 1,800 mg each
C) Have the mother bring the child back for reassessment in 3 days
D) Dose 4,000 mg divided into 2 doses daily of 2,000 mg each
Correct Answer: D) Dose 4,000 mg divided into 2 doses daily of 2,000 mg each
Rationale: For acute otitis media, the recommended amoxicillin dose is 80-90 mg/kg/day.
The maximum adult daily dose is 4,000 mg. Dosing 4,000 mg/day (2,000 mg BID) is
appropriate for this child, as it provides adequate coverage without exceeding the maximum
adult limit.
,3. A patient reports using Afrin nasal spray 2 to 3 times daily without relief. What is the most
likely explanation for the lack of improvement?
A) He will need to increase his Zyrtec to twice daily dosing
B) He will need to change from Zyrtec to Allegra
C) His nasal congestion may be a rebound phenomenon from habitual Afrin use
D) His Afrin nasal spray is not potent enough and he needs Neo-Synephrine spray
Correct Answer: C) His nasal congestion may be a rebound phenomenon from habitual
Afrin use
Rationale: Rhinitis medicamentosa, or rebound congestion, is caused by prolonged use of
topical nasal decongestants like oxymetazoline (Afrin). This condition leads to worsening
nasal congestion despite continued use, and treatment involves discontinuing the medication.
4. Neo-Synephrine, an intranasal decongestant, is a sympathomimetic amine. What is its
primary mechanism of action?
A) Increase mast cell degranulation
B) Decrease the action of antihistamines
C) Blocks mast cell degranulation
D) Vasoconstricts nasal mucosa
Correct Answer: D) Vasoconstricts nasal mucosa
Rationale: Neo-Synephrine (phenylephrine) is an alpha-adrenergic agonist that causes
vasoconstriction of nasal mucosal blood vessels, reducing nasal congestion. It does not affect
mast cell degranulation.
5. A college student with Trichomoniasis is prescribed metronidazole. Which of the following
should NOT be included in patient education about this antibiotic?
A) Headache
B) Metallic taste in mouth
C) Major interactions with alcohol
, D) Increased appetite
Correct Answer: D) Increased appetite
Rationale: Metronidazole commonly causes headache and a metallic taste in the mouth. It
has a major interaction with alcohol, causing a disulfiram-like reaction. Increased appetite is
not a recognized side effect of metronidazole.
6. An eight-grade boy with suspected constitutional growth delay presents with erythema
migrans after a tick bite. Which antibiotic should be avoided for Lyme disease prophylaxis in
this patient?
A) Doxycycline
B) Amoxicillin
C) Bactrim
D) Augmentin
Correct Answer: A) Doxycycline
Rationale: Doxycycline is contraindicated in children under 8 years of age due to the risk of
permanent tooth discoloration and enamel hypoplasia. For Lyme disease prophylaxis in this
age group, amoxicillin is the preferred alternative.
7. Which of the following is the first-line treatment for acute bacterial sinusitis in adults with
no antibiotic allergies?
A) Azithromycin
B) Amoxicillin-clavulanate
C) Doxycycline
D) Levofloxacin
Correct Answer: B) Amoxicillin-clavulanate
