NR566 ADVANCED PHARMACOLOGY
MIDTERM EXAM PREP QUESTIONS
WITH 100% CORRECT ANSWERS
1. A patient with Parkinson’s disease is prescribed levodopa/carbidopa. The patient asks why
the carbidopa is necessary. What is the most accurate response by the NP?
A. Carbidopa crosses the blood-brain barrier to increase dopamine synthesis.
B. Carbidopa decreases the peripheral conversion of levodopa to dopamine.
C. Carbidopa acts as a dopamine agonist in the basal ganglia.
D. Carbidopa reduces the incidence of dyskinesias associated with levodopa.
Answer: B
Conceptual Explanation: Carbidopa inhibits the decarboxylation of levodopa in the
periphery, making more levodopa available to cross the blood-brain barrier and reducing
systemic side effects like nausea.
2. Which laboratory value must be monitored closely in a patient taking Valproic acid for
seizure management due to the risk of life-threatening toxicity?
A. Serum creatinine
B. Creatine kinase
C. Thyroid stimulating hormone (TSH)
,D. Serum amylase and lipase
Answer: D
Conceptual Explanation: Valproic acid is associated with a risk of life-threatening
pancreatitis, making monitoring of amylase and lipase essential if symptoms occur.
3. An elderly patient with Alzheimer’s disease is started on Donepezil (Aricept). What is the
primary mechanism of action for this drug?
A. Reversible inhibition of acetylcholinesterase
B. Dopamine reuptake inhibition
C. NMDA receptor antagonism
D. GABA receptor modulation
Answer: A
Conceptual Explanation: Donepezil is a cholinesterase inhibitor that increases the
concentration of acetylcholine available at the synapse.
4. A patient taking Lithium for Bipolar Disorder presents with coarse hand tremors, ataxia,
and confusion. What is the most likely serum lithium level?
A. 0.6 mEq/L
B. 1.0 mEq/L
C. 1.4 mEq/L
D. 2.5 mEq/L
, Answer: D
Conceptual Explanation: Symptoms like coarse tremors, ataxia, and confusion are signs of
severe lithium toxicity, typically occurring at levels above 2.0-2.5 mEq/L.
5. Which antidepressant is most likely to cause a hypertensive crisis if the patient consumes
foods high in tyramine?
A. Sertraline
B. Venlafaxine
C. Phenelzine
D. Bupropion
Answer: C
Conceptual Explanation: Phenelzine is an MAOI. Inhibiting MAO allows dietary tyramine
to trigger massive norepinephrine release, leading to hypertensive crisis.
6. A 24-year-old female patient is being treated for a urinary tract infection. Which antibiotic
should be avoided if she is in her first trimester of pregnancy?
A. Amoxicillin
B. Nitrofurantoin
C. Cephalexin
D. Trimethoprim/Sulfamethoxazole
Answer: D
MIDTERM EXAM PREP QUESTIONS
WITH 100% CORRECT ANSWERS
1. A patient with Parkinson’s disease is prescribed levodopa/carbidopa. The patient asks why
the carbidopa is necessary. What is the most accurate response by the NP?
A. Carbidopa crosses the blood-brain barrier to increase dopamine synthesis.
B. Carbidopa decreases the peripheral conversion of levodopa to dopamine.
C. Carbidopa acts as a dopamine agonist in the basal ganglia.
D. Carbidopa reduces the incidence of dyskinesias associated with levodopa.
Answer: B
Conceptual Explanation: Carbidopa inhibits the decarboxylation of levodopa in the
periphery, making more levodopa available to cross the blood-brain barrier and reducing
systemic side effects like nausea.
2. Which laboratory value must be monitored closely in a patient taking Valproic acid for
seizure management due to the risk of life-threatening toxicity?
A. Serum creatinine
B. Creatine kinase
C. Thyroid stimulating hormone (TSH)
,D. Serum amylase and lipase
Answer: D
Conceptual Explanation: Valproic acid is associated with a risk of life-threatening
pancreatitis, making monitoring of amylase and lipase essential if symptoms occur.
3. An elderly patient with Alzheimer’s disease is started on Donepezil (Aricept). What is the
primary mechanism of action for this drug?
A. Reversible inhibition of acetylcholinesterase
B. Dopamine reuptake inhibition
C. NMDA receptor antagonism
D. GABA receptor modulation
Answer: A
Conceptual Explanation: Donepezil is a cholinesterase inhibitor that increases the
concentration of acetylcholine available at the synapse.
4. A patient taking Lithium for Bipolar Disorder presents with coarse hand tremors, ataxia,
and confusion. What is the most likely serum lithium level?
A. 0.6 mEq/L
B. 1.0 mEq/L
C. 1.4 mEq/L
D. 2.5 mEq/L
, Answer: D
Conceptual Explanation: Symptoms like coarse tremors, ataxia, and confusion are signs of
severe lithium toxicity, typically occurring at levels above 2.0-2.5 mEq/L.
5. Which antidepressant is most likely to cause a hypertensive crisis if the patient consumes
foods high in tyramine?
A. Sertraline
B. Venlafaxine
C. Phenelzine
D. Bupropion
Answer: C
Conceptual Explanation: Phenelzine is an MAOI. Inhibiting MAO allows dietary tyramine
to trigger massive norepinephrine release, leading to hypertensive crisis.
6. A 24-year-old female patient is being treated for a urinary tract infection. Which antibiotic
should be avoided if she is in her first trimester of pregnancy?
A. Amoxicillin
B. Nitrofurantoin
C. Cephalexin
D. Trimethoprim/Sulfamethoxazole
Answer: D
