NSG 533 Advanced Pharmacology: Exam 2 Practice Question Bank – 250 High-Yield Questions with Answers (Wilkes University / AGPCNP Aligned)

NSG 533 Advanced Pharmacology: Exam 2 Practice Question Bank – 250 High-Yield Questions with Answers (Wilkes University / AGPCNP Aligned) 1. A 58-year-old male presents with acute onset of right great toe pain, swelling, and erythema lasting 48 hours. He has a history of hypertension and CKD stage 3 (eGFR 48 mL/min/1.73m²). He rates his pain as 9/10. Which of the following is the MOST appropriate initial pharmacotherapy for this acute pain? A. Naproxen 500 mg BID B. Acetaminophen 1000 mg q6h C. Colchicine 1.2 mg now, then 0.6 mg in 1 hour D. Tramadol 50 mg q6h PRN Answer: C. Colchicine 1.2 mg now, then 0.6 mg in 1 hour 2. A 72-year-old female with osteoarthritis of both knees requests medication for pain. She has a history of hypertension, GERD, and takes omeprazole 20 mg daily. Her BP is 128/74 mmHg. Which of the following is the MOST appropriate initial pharmacotherapy? A. Ibuprofen 600 mg TID B. Celecoxib 200 mg daily C. Acetaminophen 1000 mg q6h PRN D. Topical diclofenac gel 1% to both knees Answer: D. Topical diclofenac gel 1% to both knees 3. A patient with chronic low back pain is being started on ibuprofen 600 mg TID. Which of the following statements by the patient indicates an understanding of the medication teaching? A. "I should take this medication on an empty stomach for better absorption." B. "I will watch for dark, tarry stools and report them immediately." C. "This medication is safe to take with my daily low-dose aspirin." D. "I can increase the dose to 800 mg if my pain is not controlled." Answer: B. "I will watch for dark, tarry stools and report them immediately." 4. According to the WHO 3-step analgesic ladder, which of the following represents the correct stepwise approach for a patient with moderate cancer pain? A. Step 1: Non-opioid ± adjuvant → Step 2: Weak opioid + non-opioid ± adjuvant → Step 3: Strong opioid + non-opioid ± adjuvant B. Step 1: Weak opioid alone → Step 2: Strong opioid alone → Step 3: Strong opioid + adjuvant C. Step 1: Non-pharmacologic therapy → Step 2: NSAIDs → Step 3: Opioids D. Step 1: Acetaminophen → Step 2: Ibuprofen → Step 3: Morphine Answer: A. Step 1: Non-opioid ± adjuvant → Step 2: Weak opioid + non-opioid ± adjuvant → Step 3: Strong opioid + non-opioid ± adjuvant 5. A 45-year-old male with chronic pancreatitis reports constant epigastric pain radiating to the back. He describes the pain as deep, gnawing, and poorly localized. This type of pain is BEST classified as: A. Somatic nociceptive pain B. Visceral nociceptive pain C. Neuropathic pain D. Inflammatory pain Answer: B. Visceral nociceptive pain 6. A 68-year-old female with a history of peptic ulcer disease and atrial fibrillation on warfarin presents with acute osteoarthritis pain. Which of the following is the MOST appropriate initial pharmacotherapy? A. Naproxen 500 mg BID B. Ibuprofen 400 mg TID C. Acetaminophen 1000 mg q6h PRN D. Indomethacin 50 mg TID Answer: C. Acetaminophen 1000 mg q6h PRN 7. A 55-year-old male with a history of heart failure (EF 35%) and CKD stage 4 presents with chronic knee pain. Which of the following medications is CONTRAINDICATED? A. Acetaminophen B. Duloxetine C. Celecoxib D. Topical capsaicin Answer: C. Celecoxib 8. A patient is prescribed tramadol for moderate pain. Which of the following adverse effects should the NP warn the patient about? A. Hypertension and tachycardia B. Seizures and serotonin syndrome C. Hyperglycemia and weight gain D. Bradycardia and heart block Answer: B. Seizures and serotonin syndrome 9. A 62-year-old male with diabetic peripheral neuropathy reports burning pain in his feet. Which of the following is a first-line medication for this condition? A. Ibuprofen B. Gabapentin C. Tramadol D. Acetaminophen Answer: B. Gabapentin 10. A patient on chronic opioid therapy for cancer pain reports inadequate relief and is requesting an increase in dose. Which of the following is the MOST appropriate initial action by the NP? A. Immediately double the current dose B. Assess the patient for opioid-induced neurotoxicity and disease progression C. Add a benzodiazepine for anxiety D. Switch to a different opioid class Answer: B. Assess the patient for opioid-induced neurotoxicity and disease progression