NURS 711 Pharmacotherapies - Practice Exam 4 (2026 Edition)
NURS 711 Pharmacotherapies
Practice Exam 4 (2026\2027 update)
70 Questions and answers | Total: 70 Points |
Suggested Time: 105 Minutes
Instructions
This examination contains 70 multiple-choice questions. Select the single best answer for each item and mark one
option (A through D) per question.
Each question is worth 1 point. There is no penalty for guessing; unanswered items are scored as incorrect.
Questions test graduate-level prescribing knowledge: drug selection, dosing and renal or hepatic adjustment,
monitoring parameters, interactions, pharmacogenomics, and special-population safety.
The complete answer key with detailed rationales begins on a separate page after Question 70. Do not consult the
key until you have finished the exam.
answer key at the end
1. A 34-year-old woman with major depressive disorder has had an inadequate
response to fluoxetine 40 mg daily after a full 12-week trial. The psychiatric-mental
health nurse practitioner plans to transition her to phenelzine, a monoamine oxidase
inhibitor. Which statement best reflects the appropriate switching strategy?
A. Begin phenelzine immediately while tapering fluoxetine over one week.
B. Discontinue fluoxetine and wait at least 5 weeks before starting phenelzine.
C. Discontinue fluoxetine and start phenelzine after a 2-week washout period.
D. Overlap fluoxetine and phenelzine for 3 days to prevent symptom relapse.
2. A 58-year-old man with type 2 diabetes, stage 3 chronic kidney disease (eGFR 48
mL/min/1.73 m2), and significant albuminuria (urine albumin-to-creatinine ratio
350 mg/g) has a blood pressure of 152/94 mm Hg despite 3 months of lifestyle
modification. Which antihypertensive agent is the most appropriate choice for
initial drug therapy?
A. Amlodipine
B. Hydrochlorothiazide
C. Lisinopril
D. Doxazosin
NURS 711 Pharmacotherapies Practice Exam 1
,NURS 711 Pharmacotherapies - Practice Exam 4 (2026 Edition)
3. A 62-year-old woman with type 2 diabetes has a stable eGFR of 40
mL/min/1.73 m2 and has tolerated metformin 1000 mg twice daily for years. At
today's visit the nurse practitioner reviews her renal dosing. What is the most
appropriate action?
A. Continue the current dose of 2000 mg daily without change.
B. Reduce metformin to a maximum of 1000 mg per day.
C. Discontinue metformin immediately and start insulin.
D. Switch metformin to glyburide for safer renal dosing.
4. A 45-year-old man with a remote history of a non-severe, delayed maculopapular
rash to amoxicillin in childhood now presents with uncomplicated cellulitis that is
best treated with an oral antistaphylococcal beta-lactam. The adult-gerontology
nurse practitioner considers cephalexin. What is the most accurate guidance?
A. All beta-lactam antibiotics must be avoided permanently after any penicillin
reaction.
B. Cephalexin is a reasonable option in a delayed, non-severe penicillin
reaction, with counseling and first-dose observation.
C. Aztreonam is the only beta-lactam antibiotic that is safe in any patient
with penicillin allergy.
D. Vancomycin is the only acceptable alternative and beta-lactams should never be
used.
5. A 22-year-old non-smoker with asthma uses albuterol 4 or more times per week,
awakens from sleep wheezing about 3 times per month, and takes no controller
medication. Spirometry is consistent with mild persistent asthma. According to
current asthma guidelines, what is the most appropriate management step?
A. Continue albuterol as needed without controller therapy because symptoms are
mild.
B. Start a daily low-dose inhaled corticosteroid, or an ICS-formoterol
combination used for both maintenance and relief.
C. Begin daily oral prednisone to achieve rapid control.
D. Prescribe montelukast as sole long-term controller therapy.
6. A 78-year-old man with severe osteoarthritis pain, eGFR of 55 mL/min/1.73 m2,
and no prior opioid exposure requires initiation of systemic opioid therapy after
NURS 711 Pharmacotherapies Practice Exam 2
,NURS 711 Pharmacotherapies - Practice Exam 4 (2026 Edition)
non-opioid options fail. Which prescribing approach is most appropriate?
A. Morphine extended-release 30 mg every 12 hours.
B. Meperidine 50 mg every 4 hours as needed.
C. A low dose of an immediate-release opioid such as hydromorphone or
reduced-dose morphine, titrated cautiously with a bowel regimen.
D. Fentanyl transdermal patch 100 mcg/hour.
NURS 711 Pharmacotherapies Practice Exam 3
, NURS 711 Pharmacotherapies - Practice Exam 4 (2026 Edition)
7. A 47-year-old woman with hypertension and moderate persistent asthma (using
fluticasone daily and albuterol as needed) requires initiation of antihypertensive
therapy. Which agent should the nurse practitioner avoid in this patient?
A. Amlodipine
B. Lisinopril
C. Propranolol
D. Chlorthalidone
8. A 29-year-old man with bipolar I disorder has been stable on lithium 900 mg
daily. He reports 3 days of coarse hand tremor, nausea, and feeling unsteady when
walking. A serum level drawn 12 hours after his last dose is 1.6 mEq/L. What is the
most appropriate next step?
A. Continue the current dose and recheck the level in 3 months.
B. Hold lithium, evaluate for volume depletion and interacting drugs, and
reduce the dose once toxicity resolves.
C. Increase the lithium dose to suppress the tremor.
D. Stop lithium and restart immediately at half the dose without further evaluation.
9. A 54-year-old woman with type 2 diabetes (A1c 8.4 percent on maximally
tolerated metformin) and a BMI of 34 will start subcutaneous semaglutide. Which
counseling and monitoring plan is most appropriate?
A. Start the target dose immediately so glycemic control is achieved without
titration.
B. Titrate gradually to improve gastrointestinal tolerability; counsel to report
severe persistent abdominal pain; and confirm no personal or family history of
medullary thyroid carcinoma or MEN2.
C. The drug is safe to use in a patient with a personal history of medullary
thyroid carcinoma because the warning applies only to animals.
D. Hypoglycemia is the most common adverse effect when semaglutide is
combined with metformin alone.
NURS 711 Pharmacotherapies Practice Exam 4
NURS 711 Pharmacotherapies
Practice Exam 4 (2026\2027 update)
70 Questions and answers | Total: 70 Points |
Suggested Time: 105 Minutes
Instructions
This examination contains 70 multiple-choice questions. Select the single best answer for each item and mark one
option (A through D) per question.
Each question is worth 1 point. There is no penalty for guessing; unanswered items are scored as incorrect.
Questions test graduate-level prescribing knowledge: drug selection, dosing and renal or hepatic adjustment,
monitoring parameters, interactions, pharmacogenomics, and special-population safety.
The complete answer key with detailed rationales begins on a separate page after Question 70. Do not consult the
key until you have finished the exam.
answer key at the end
1. A 34-year-old woman with major depressive disorder has had an inadequate
response to fluoxetine 40 mg daily after a full 12-week trial. The psychiatric-mental
health nurse practitioner plans to transition her to phenelzine, a monoamine oxidase
inhibitor. Which statement best reflects the appropriate switching strategy?
A. Begin phenelzine immediately while tapering fluoxetine over one week.
B. Discontinue fluoxetine and wait at least 5 weeks before starting phenelzine.
C. Discontinue fluoxetine and start phenelzine after a 2-week washout period.
D. Overlap fluoxetine and phenelzine for 3 days to prevent symptom relapse.
2. A 58-year-old man with type 2 diabetes, stage 3 chronic kidney disease (eGFR 48
mL/min/1.73 m2), and significant albuminuria (urine albumin-to-creatinine ratio
350 mg/g) has a blood pressure of 152/94 mm Hg despite 3 months of lifestyle
modification. Which antihypertensive agent is the most appropriate choice for
initial drug therapy?
A. Amlodipine
B. Hydrochlorothiazide
C. Lisinopril
D. Doxazosin
NURS 711 Pharmacotherapies Practice Exam 1
,NURS 711 Pharmacotherapies - Practice Exam 4 (2026 Edition)
3. A 62-year-old woman with type 2 diabetes has a stable eGFR of 40
mL/min/1.73 m2 and has tolerated metformin 1000 mg twice daily for years. At
today's visit the nurse practitioner reviews her renal dosing. What is the most
appropriate action?
A. Continue the current dose of 2000 mg daily without change.
B. Reduce metformin to a maximum of 1000 mg per day.
C. Discontinue metformin immediately and start insulin.
D. Switch metformin to glyburide for safer renal dosing.
4. A 45-year-old man with a remote history of a non-severe, delayed maculopapular
rash to amoxicillin in childhood now presents with uncomplicated cellulitis that is
best treated with an oral antistaphylococcal beta-lactam. The adult-gerontology
nurse practitioner considers cephalexin. What is the most accurate guidance?
A. All beta-lactam antibiotics must be avoided permanently after any penicillin
reaction.
B. Cephalexin is a reasonable option in a delayed, non-severe penicillin
reaction, with counseling and first-dose observation.
C. Aztreonam is the only beta-lactam antibiotic that is safe in any patient
with penicillin allergy.
D. Vancomycin is the only acceptable alternative and beta-lactams should never be
used.
5. A 22-year-old non-smoker with asthma uses albuterol 4 or more times per week,
awakens from sleep wheezing about 3 times per month, and takes no controller
medication. Spirometry is consistent with mild persistent asthma. According to
current asthma guidelines, what is the most appropriate management step?
A. Continue albuterol as needed without controller therapy because symptoms are
mild.
B. Start a daily low-dose inhaled corticosteroid, or an ICS-formoterol
combination used for both maintenance and relief.
C. Begin daily oral prednisone to achieve rapid control.
D. Prescribe montelukast as sole long-term controller therapy.
6. A 78-year-old man with severe osteoarthritis pain, eGFR of 55 mL/min/1.73 m2,
and no prior opioid exposure requires initiation of systemic opioid therapy after
NURS 711 Pharmacotherapies Practice Exam 2
,NURS 711 Pharmacotherapies - Practice Exam 4 (2026 Edition)
non-opioid options fail. Which prescribing approach is most appropriate?
A. Morphine extended-release 30 mg every 12 hours.
B. Meperidine 50 mg every 4 hours as needed.
C. A low dose of an immediate-release opioid such as hydromorphone or
reduced-dose morphine, titrated cautiously with a bowel regimen.
D. Fentanyl transdermal patch 100 mcg/hour.
NURS 711 Pharmacotherapies Practice Exam 3
, NURS 711 Pharmacotherapies - Practice Exam 4 (2026 Edition)
7. A 47-year-old woman with hypertension and moderate persistent asthma (using
fluticasone daily and albuterol as needed) requires initiation of antihypertensive
therapy. Which agent should the nurse practitioner avoid in this patient?
A. Amlodipine
B. Lisinopril
C. Propranolol
D. Chlorthalidone
8. A 29-year-old man with bipolar I disorder has been stable on lithium 900 mg
daily. He reports 3 days of coarse hand tremor, nausea, and feeling unsteady when
walking. A serum level drawn 12 hours after his last dose is 1.6 mEq/L. What is the
most appropriate next step?
A. Continue the current dose and recheck the level in 3 months.
B. Hold lithium, evaluate for volume depletion and interacting drugs, and
reduce the dose once toxicity resolves.
C. Increase the lithium dose to suppress the tremor.
D. Stop lithium and restart immediately at half the dose without further evaluation.
9. A 54-year-old woman with type 2 diabetes (A1c 8.4 percent on maximally
tolerated metformin) and a BMI of 34 will start subcutaneous semaglutide. Which
counseling and monitoring plan is most appropriate?
A. Start the target dose immediately so glycemic control is achieved without
titration.
B. Titrate gradually to improve gastrointestinal tolerability; counsel to report
severe persistent abdominal pain; and confirm no personal or family history of
medullary thyroid carcinoma or MEN2.
C. The drug is safe to use in a patient with a personal history of medullary
thyroid carcinoma because the warning applies only to animals.
D. Hypoglycemia is the most common adverse effect when semaglutide is
combined with metformin alone.
NURS 711 Pharmacotherapies Practice Exam 4
