1
NUR 635 FINAL REVIEW TYLER/SARHAN EXAM BANK AND A NEW
UPDATED STUDY GUIDE 2026/2027 ALL COMPLETE ACTUAL QUESTIONS
AND CORRECT VERIFIED ANSWERS (A NEW UPDATED VERSION)
|GUARANTEED PASS A+A
1. A 35-year-old patient with generalized anxiety disorder reports persistent
excessive worry, muscle tension, irritability, and difficulty sleeping for
several months. The patient has no history of substance use disorder and
wants a medication appropriate for long-term management rather than
rapid symptom relief. Which medication is most appropriate as a first-line
pharmacologic option?
A. Alprazolam
B. Sertraline
C. Buspirone
D. Phenobarbital
Answer: B
2. A patient taking sertraline for depression develops agitation, diaphoresis,
diarrhea, hyperreflexia, tremor, and a temperature of 39°C after starting
another serotonergic medication. Which adverse drug reaction should the
nurse practitioner suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Anticholinergic toxicity
D. Hypertensive emergency
Answer: A
3. A patient with epilepsy has been taking carbamazepine consistently, but a
serum drug level becomes lower than expected despite adherence and no
recent change in dose. Which pharmacokinetic phenomenon best explains
this finding?
,2
A. Renal failure causing decreased clearance
B. Protein-binding displacement
C. Carbamazepine-induced inhibition of metabolism
D. Autoinduction of hepatic metabolism
Answer: D
4. A patient recently started phenytoin and returns several weeks later with
fever, diffuse rash, facial edema, and generalized lymphadenopathy. Which
action is most appropriate?
A. Increase the phenytoin dose
B. Add a second anticonvulsant while continuing phenytoin
C. Discontinue phenytoin and evaluate for a serious hypersensitivity reaction
D. Reassure the patient that the symptoms are expected
Answer: C
5. A patient with moderate persistent asthma asks why a long-acting beta-2
agonist should not be prescribed as monotherapy. Which response is most
accurate?
A. LABA monotherapy can increase the risk of serious asthma-related outcomes
B. LABAs are contraindicated because they always cause severe bradycardia
C. LABAs permanently decrease pulmonary function
D. LABAs are ineffective in patients with persistent asthma
Answer: A
6. A patient with asthma uses an inhaled corticosteroid every day as
prescribed. Which instruction should the nurse practitioner emphasize to
reduce the risk of a common local adverse effect?
A. Take the medication only when experiencing acute wheezing
B. Rinse the mouth after inhalation
C. Stop the medication once symptoms improve
D. Use the medication immediately before every meal
, 3
Answer: B
7. A 68-year-old patient with COPD is prescribed tiotropium through a
HandiHaler. The patient asks about the purpose of the medication. Which
explanation is most appropriate?
A. It is a short-acting rescue medication for acute asthma attacks
B. It is an inhaled corticosteroid used to treat pneumonia
C. It is a long-acting antimuscarinic bronchodilator used for COPD maintenance
D. It is an oral leukotriene antagonist used for allergic rhinitis
Answer: C
8. A patient with COPD presents with increased dyspnea, increased sputum
production, and purulent sputum accompanied by fever. Which
management approach is most appropriate when bacterial infection is
suspected?
A. Stop all bronchodilators
B. Use an antibiotic when bacterial exacerbation criteria are met
C. Prescribe an inhaled corticosteroid alone
D. Treat exclusively with an antihistamine
Answer: B
9. A patient with allergic rhinitis has hypertension and benign prostatic
hyperplasia. The patient asks whether an older systemic antihistamine is
appropriate for daily use. Which concern is most important?
A. First-generation antihistamines can cause sedation and anticholinergic effects
B. First-generation antihistamines invariably cause severe hypoglycemia
C. They permanently suppress immune function
D. They are associated with severe renal failure in all older adults
Answer: A
10. A patient with asthma has been prescribed montelukast for maintenance
therapy. Which counseling point is especially important?
NUR 635 FINAL REVIEW TYLER/SARHAN EXAM BANK AND A NEW
UPDATED STUDY GUIDE 2026/2027 ALL COMPLETE ACTUAL QUESTIONS
AND CORRECT VERIFIED ANSWERS (A NEW UPDATED VERSION)
|GUARANTEED PASS A+A
1. A 35-year-old patient with generalized anxiety disorder reports persistent
excessive worry, muscle tension, irritability, and difficulty sleeping for
several months. The patient has no history of substance use disorder and
wants a medication appropriate for long-term management rather than
rapid symptom relief. Which medication is most appropriate as a first-line
pharmacologic option?
A. Alprazolam
B. Sertraline
C. Buspirone
D. Phenobarbital
Answer: B
2. A patient taking sertraline for depression develops agitation, diaphoresis,
diarrhea, hyperreflexia, tremor, and a temperature of 39°C after starting
another serotonergic medication. Which adverse drug reaction should the
nurse practitioner suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Anticholinergic toxicity
D. Hypertensive emergency
Answer: A
3. A patient with epilepsy has been taking carbamazepine consistently, but a
serum drug level becomes lower than expected despite adherence and no
recent change in dose. Which pharmacokinetic phenomenon best explains
this finding?
,2
A. Renal failure causing decreased clearance
B. Protein-binding displacement
C. Carbamazepine-induced inhibition of metabolism
D. Autoinduction of hepatic metabolism
Answer: D
4. A patient recently started phenytoin and returns several weeks later with
fever, diffuse rash, facial edema, and generalized lymphadenopathy. Which
action is most appropriate?
A. Increase the phenytoin dose
B. Add a second anticonvulsant while continuing phenytoin
C. Discontinue phenytoin and evaluate for a serious hypersensitivity reaction
D. Reassure the patient that the symptoms are expected
Answer: C
5. A patient with moderate persistent asthma asks why a long-acting beta-2
agonist should not be prescribed as monotherapy. Which response is most
accurate?
A. LABA monotherapy can increase the risk of serious asthma-related outcomes
B. LABAs are contraindicated because they always cause severe bradycardia
C. LABAs permanently decrease pulmonary function
D. LABAs are ineffective in patients with persistent asthma
Answer: A
6. A patient with asthma uses an inhaled corticosteroid every day as
prescribed. Which instruction should the nurse practitioner emphasize to
reduce the risk of a common local adverse effect?
A. Take the medication only when experiencing acute wheezing
B. Rinse the mouth after inhalation
C. Stop the medication once symptoms improve
D. Use the medication immediately before every meal
, 3
Answer: B
7. A 68-year-old patient with COPD is prescribed tiotropium through a
HandiHaler. The patient asks about the purpose of the medication. Which
explanation is most appropriate?
A. It is a short-acting rescue medication for acute asthma attacks
B. It is an inhaled corticosteroid used to treat pneumonia
C. It is a long-acting antimuscarinic bronchodilator used for COPD maintenance
D. It is an oral leukotriene antagonist used for allergic rhinitis
Answer: C
8. A patient with COPD presents with increased dyspnea, increased sputum
production, and purulent sputum accompanied by fever. Which
management approach is most appropriate when bacterial infection is
suspected?
A. Stop all bronchodilators
B. Use an antibiotic when bacterial exacerbation criteria are met
C. Prescribe an inhaled corticosteroid alone
D. Treat exclusively with an antihistamine
Answer: B
9. A patient with allergic rhinitis has hypertension and benign prostatic
hyperplasia. The patient asks whether an older systemic antihistamine is
appropriate for daily use. Which concern is most important?
A. First-generation antihistamines can cause sedation and anticholinergic effects
B. First-generation antihistamines invariably cause severe hypoglycemia
C. They permanently suppress immune function
D. They are associated with severe renal failure in all older adults
Answer: A
10. A patient with asthma has been prescribed montelukast for maintenance
therapy. Which counseling point is especially important?
