PASSPOINT PRO • CHAMBERLAIN
NR565
NR565 Prescribing &
Medication Safety Practice
Exam
100 Questions | Contraindications, Interactions, Monitoring,
Adverse Effects & Teaching
Original A-D multiple-choice practice • Compact PassPoint Pro layout • Detailed medication-safety
rationales
100 SAFETY KEY
Questions Focused At End
Original study and revision material • Clean print-ready format
,PASSPOINT PRO | NR565 ADVANCED PHARMACOLOGY FUNDAMENTALS
NR565 Prescribing & Medication Safety Practice Exam
100 Questions | Contraindications, Interactions, Monitoring, Adverse Effects & Teaching
Directions: Select the single best answer. Focus on the safest prescribing decision for the individual patient. Unless a question
states otherwise, assume standard adult dosing principles and that all relevant clinical information has been provided.
1. Which patient-teaching statement is most appropriate for a new prescription of fluticasone/salmeterol?
A. use on schedule, rinse the mouth after use, and keep a separate rescue inhaler if prescribed
B. report significant weight loss or mood changes; it is not a rescue bronchodilator
C. actuate one puff at a time into the chamber and inhale according to device instructions; clean as recommended
D. use regularly for maintenance, not as a rescue inhaler; avoid spraying mist into the eyes
2. A 35-year-old patient is being managed in primary care. which situation should make the prescriber avoid
or use particular caution with prednisone burst for exacerbation?
A. repeated unnecessary courses without reassessing controller therapy
B. moderate-to-severe liver impairment
C. treating sudden severe bronchospasm with this maintenance product
D. LABA monotherapy in asthma
3. Which interaction or coadministration issue is most relevant to metoclopramide?
A. antipsychotics and other dopamine-blocking drugs increase extrapyramidal risk
B. binds many oral medications, including some antibiotics and levothyroxine
C. minimal systemic drug interactions because absorption is negligible
D. other QT-prolonging drugs can increase arrhythmia risk
4. A 62-year-old adult is being managed in primary care. at a follow-up visit after starting St. John's wort,
which information should receive the highest priority when evaluating efficacy and safety?
A. allergic symptoms, especially in people with plant-family allergies
B. mood symptoms and a complete medication-interaction review
C. liver-related symptoms and CNS depression
D. bleeding/bruising and perioperative use
5. A 35-year-old patient is being managed in primary care. a patient taking black cohosh calls the clinic.
Which possible medication-related problem is most consistent with this therapy?
A. allergic reactions and GI upset
B. GI upset, headache, and rare reports of liver injury
C. photosensitivity, GI symptoms, insomnia, and serotonin toxicity when combined with serotonergic drugs
D. sedation, dizziness, and next-day impairment
6. A 48-year-old adult is being managed in primary care. the NP is completing medication reconciliation for a
patient using glipizide. Which counseling point should be reinforced?
A. follow prescribed fluid guidance and report headache, confusion, or sudden weight gain
B. take in relation to meals as prescribed and do not skip meals after dosing
C. maintain hydration and report nausea, abdominal pain, or rapid breathing; follow sick-day/perioperative holding instructions
D. stop the drug and seek prompt evaluation for fever or sore throat because a CBC may be needed
7. A patient is being evaluated for medication therapy. Which clinical use best matches prednisone?
A. selected ulcer disease when a protective barrier is desired
B. short-term treatment of significant inflammatory or autoimmune conditions and selected exacerbations
C. first-line pharmacotherapy for many adults with type 2 diabetes when tolerated
D. hypothyroidism requiring T4 replacement
8. Which statement best describes the primary pharmacologic action of budesonide inhaled?
A. blocks cysteinyl leukotriene receptors, reducing leukotriene-mediated inflammation and bronchoconstriction
B. reduces airway inflammation and hyperresponsiveness through local glucocorticoid effects
C. inhibits phosphodiesterase-4, decreasing inflammatory activity in the lungs
D. blocks muscarinic receptors to reduce vagally mediated bronchoconstriction
9. Which adverse-effect profile is most important for the prescriber to recognize with roflumilast?
A. tremor, tachycardia, and hypokalemia at high doses
B. neuropsychiatric reactions can occur, including mood or behavior changes
C. weight loss, diarrhea, insomnia, and neuropsychiatric symptoms
D. tremor, tachycardia, and paradoxical bronchospasm
10. A patient seen in primary care is being managed in primary care. a patient starts ondansetron. Which
monitoring plan is most appropriate for safe follow-up?
A. TB/hepatitis screening before therapy and ongoing infection surveillance
B. symptom control and ECG/electrolytes when significant QT risk is present
C. new involuntary movements, restlessness, and treatment duration
Original practice material for study and review Page75
Page 2
, PASSPOINT PRO | NR565 ADVANCED PHARMACOLOGY FUNDAMENTALS
D. bowel frequency and cramping
11. Which patient-teaching statement is most appropriate for a new prescription of Panax ginseng?
A. avoid late-day dosing if it causes insomnia and discuss use if taking diabetes or anticoagulant medications
B. avoid driving until effects are known and do not combine casually with alcohol or other sedatives
C. tell every prescriber/pharmacist before use because it can reduce effectiveness of many prescription drugs
D. do not assume it replaces vaccination or evidence-based treatment and disclose use with immunosuppressive therapy
12. A patient preparing for discharge is being managed in primary care. which situation should make the
prescriber avoid or use particular caution with metformin?
A. unnecessary prolonged exposure when lower-risk alternatives are available
B. severe renal impairment or acute conditions associated with hypoxia/poor perfusion
C. patients with recurrent severe hypoglycemia or inability to maintain regular food intake
D. preexisting hypercalcemia
13. Which interaction or coadministration issue is most relevant to pioglitazone?
A. changes in thyroid status can alter response to warfarin and other drugs
B. insulin can increase edema/heart-failure risk when used with pioglitazone
C. heavy alcohol use can increase lactic acidosis risk
D. thiazide diuretics can increase hypercalcemia risk
14. A 54-year-old adult is being managed in primary care. at a follow-up visit after starting desmopressin,
which information should receive the highest priority when evaluating efficacy and safety?
A. TSH (and free T4 when indicated) after dose changes and periodically once stable
B. serum sodium, fluid balance, and neurologic symptoms when risk is significant
C. renal function for dose adjustment and glycemic response
D. clinical response and repeat glucose after administration
15. A 48-year-old adult is being managed in primary care. a patient taking tiotropium calls the clinic. Which
possible medication-related problem is most consistent with this therapy?
A. dry mouth, urinary retention, and possible worsening of narrow-angle glaucoma symptoms
B. injection-site reactions and rare anaphylaxis
C. oral candidiasis, dysphonia, tremor, and tachycardia
D. weight loss, diarrhea, insomnia, and neuropsychiatric symptoms
16. A 71-year-old patient is being managed in primary care. the NP is completing medication reconciliation
for a patient using spacer/valved holding chamber with MDI. Which counseling point should be reinforced?
A. use for quick relief; frequent need signals poor control and should prompt reassessment
B. actuate one puff at a time into the chamber and inhale according to device instructions; clean as recommended
C. rinse the mouth and spit after each dose; use consistently even when asymptomatic
D. report significant weight loss or mood changes; it is not a rescue bronchodilator
17. A patient is being evaluated for medication therapy. Which clinical use best matches loperamide?
A. adrenal insufficiency requiring physiologic glucocorticoid replacement
B. short-term symptomatic treatment of uncomplicated acute diarrhea in appropriate patients
C. maintenance bronchodilation in COPD and selected patients with asthma
D. type 2 diabetes, especially when cardiovascular or kidney benefits are desirable in an appropriate patient
18. Which statement best describes the primary pharmacologic action of ginkgo biloba?
A. contains compounds that may influence immune signaling
B. activates melatonin receptors involved in circadian rhythm signaling
C. contains flavonoids/terpenoids with antioxidant and platelet-activating-factor effects
D. may modulate GABA-related CNS activity
19. Which adverse-effect profile is most important for the prescriber to recognize with melatonin?
A. serious hepatotoxicity and sedation
B. daytime drowsiness, dizziness, and vivid dreams
C. GI upset, headache, and rare reports of liver injury
D. photosensitivity, GI symptoms, insomnia, and serotonin toxicity when combined with serotonergic drugs
20. A 48-year-old adult is being managed in primary care. a patient starts sitagliptin. Which monitoring plan
is most appropriate for safe follow-up?
A. premeal/postmeal glucose and symptoms of hypoglycemia
B. thyroid function plus symptoms/signs of liver injury or infection
C. renal function for dose adjustment and glycemic response
D. fasting glucose trends and episodes of hypoglycemia
21. Which patient-teaching statement is most appropriate for a new prescription of glucagon?
A. eat smaller meals during titration and seek care for persistent severe abdominal pain
B. take consistently on an empty stomach and separate from calcium or iron supplements by several hours
Original practice material for study and review Page76
Page 3
NR565
NR565 Prescribing &
Medication Safety Practice
Exam
100 Questions | Contraindications, Interactions, Monitoring,
Adverse Effects & Teaching
Original A-D multiple-choice practice • Compact PassPoint Pro layout • Detailed medication-safety
rationales
100 SAFETY KEY
Questions Focused At End
Original study and revision material • Clean print-ready format
,PASSPOINT PRO | NR565 ADVANCED PHARMACOLOGY FUNDAMENTALS
NR565 Prescribing & Medication Safety Practice Exam
100 Questions | Contraindications, Interactions, Monitoring, Adverse Effects & Teaching
Directions: Select the single best answer. Focus on the safest prescribing decision for the individual patient. Unless a question
states otherwise, assume standard adult dosing principles and that all relevant clinical information has been provided.
1. Which patient-teaching statement is most appropriate for a new prescription of fluticasone/salmeterol?
A. use on schedule, rinse the mouth after use, and keep a separate rescue inhaler if prescribed
B. report significant weight loss or mood changes; it is not a rescue bronchodilator
C. actuate one puff at a time into the chamber and inhale according to device instructions; clean as recommended
D. use regularly for maintenance, not as a rescue inhaler; avoid spraying mist into the eyes
2. A 35-year-old patient is being managed in primary care. which situation should make the prescriber avoid
or use particular caution with prednisone burst for exacerbation?
A. repeated unnecessary courses without reassessing controller therapy
B. moderate-to-severe liver impairment
C. treating sudden severe bronchospasm with this maintenance product
D. LABA monotherapy in asthma
3. Which interaction or coadministration issue is most relevant to metoclopramide?
A. antipsychotics and other dopamine-blocking drugs increase extrapyramidal risk
B. binds many oral medications, including some antibiotics and levothyroxine
C. minimal systemic drug interactions because absorption is negligible
D. other QT-prolonging drugs can increase arrhythmia risk
4. A 62-year-old adult is being managed in primary care. at a follow-up visit after starting St. John's wort,
which information should receive the highest priority when evaluating efficacy and safety?
A. allergic symptoms, especially in people with plant-family allergies
B. mood symptoms and a complete medication-interaction review
C. liver-related symptoms and CNS depression
D. bleeding/bruising and perioperative use
5. A 35-year-old patient is being managed in primary care. a patient taking black cohosh calls the clinic.
Which possible medication-related problem is most consistent with this therapy?
A. allergic reactions and GI upset
B. GI upset, headache, and rare reports of liver injury
C. photosensitivity, GI symptoms, insomnia, and serotonin toxicity when combined with serotonergic drugs
D. sedation, dizziness, and next-day impairment
6. A 48-year-old adult is being managed in primary care. the NP is completing medication reconciliation for a
patient using glipizide. Which counseling point should be reinforced?
A. follow prescribed fluid guidance and report headache, confusion, or sudden weight gain
B. take in relation to meals as prescribed and do not skip meals after dosing
C. maintain hydration and report nausea, abdominal pain, or rapid breathing; follow sick-day/perioperative holding instructions
D. stop the drug and seek prompt evaluation for fever or sore throat because a CBC may be needed
7. A patient is being evaluated for medication therapy. Which clinical use best matches prednisone?
A. selected ulcer disease when a protective barrier is desired
B. short-term treatment of significant inflammatory or autoimmune conditions and selected exacerbations
C. first-line pharmacotherapy for many adults with type 2 diabetes when tolerated
D. hypothyroidism requiring T4 replacement
8. Which statement best describes the primary pharmacologic action of budesonide inhaled?
A. blocks cysteinyl leukotriene receptors, reducing leukotriene-mediated inflammation and bronchoconstriction
B. reduces airway inflammation and hyperresponsiveness through local glucocorticoid effects
C. inhibits phosphodiesterase-4, decreasing inflammatory activity in the lungs
D. blocks muscarinic receptors to reduce vagally mediated bronchoconstriction
9. Which adverse-effect profile is most important for the prescriber to recognize with roflumilast?
A. tremor, tachycardia, and hypokalemia at high doses
B. neuropsychiatric reactions can occur, including mood or behavior changes
C. weight loss, diarrhea, insomnia, and neuropsychiatric symptoms
D. tremor, tachycardia, and paradoxical bronchospasm
10. A patient seen in primary care is being managed in primary care. a patient starts ondansetron. Which
monitoring plan is most appropriate for safe follow-up?
A. TB/hepatitis screening before therapy and ongoing infection surveillance
B. symptom control and ECG/electrolytes when significant QT risk is present
C. new involuntary movements, restlessness, and treatment duration
Original practice material for study and review Page75
Page 2
, PASSPOINT PRO | NR565 ADVANCED PHARMACOLOGY FUNDAMENTALS
D. bowel frequency and cramping
11. Which patient-teaching statement is most appropriate for a new prescription of Panax ginseng?
A. avoid late-day dosing if it causes insomnia and discuss use if taking diabetes or anticoagulant medications
B. avoid driving until effects are known and do not combine casually with alcohol or other sedatives
C. tell every prescriber/pharmacist before use because it can reduce effectiveness of many prescription drugs
D. do not assume it replaces vaccination or evidence-based treatment and disclose use with immunosuppressive therapy
12. A patient preparing for discharge is being managed in primary care. which situation should make the
prescriber avoid or use particular caution with metformin?
A. unnecessary prolonged exposure when lower-risk alternatives are available
B. severe renal impairment or acute conditions associated with hypoxia/poor perfusion
C. patients with recurrent severe hypoglycemia or inability to maintain regular food intake
D. preexisting hypercalcemia
13. Which interaction or coadministration issue is most relevant to pioglitazone?
A. changes in thyroid status can alter response to warfarin and other drugs
B. insulin can increase edema/heart-failure risk when used with pioglitazone
C. heavy alcohol use can increase lactic acidosis risk
D. thiazide diuretics can increase hypercalcemia risk
14. A 54-year-old adult is being managed in primary care. at a follow-up visit after starting desmopressin,
which information should receive the highest priority when evaluating efficacy and safety?
A. TSH (and free T4 when indicated) after dose changes and periodically once stable
B. serum sodium, fluid balance, and neurologic symptoms when risk is significant
C. renal function for dose adjustment and glycemic response
D. clinical response and repeat glucose after administration
15. A 48-year-old adult is being managed in primary care. a patient taking tiotropium calls the clinic. Which
possible medication-related problem is most consistent with this therapy?
A. dry mouth, urinary retention, and possible worsening of narrow-angle glaucoma symptoms
B. injection-site reactions and rare anaphylaxis
C. oral candidiasis, dysphonia, tremor, and tachycardia
D. weight loss, diarrhea, insomnia, and neuropsychiatric symptoms
16. A 71-year-old patient is being managed in primary care. the NP is completing medication reconciliation
for a patient using spacer/valved holding chamber with MDI. Which counseling point should be reinforced?
A. use for quick relief; frequent need signals poor control and should prompt reassessment
B. actuate one puff at a time into the chamber and inhale according to device instructions; clean as recommended
C. rinse the mouth and spit after each dose; use consistently even when asymptomatic
D. report significant weight loss or mood changes; it is not a rescue bronchodilator
17. A patient is being evaluated for medication therapy. Which clinical use best matches loperamide?
A. adrenal insufficiency requiring physiologic glucocorticoid replacement
B. short-term symptomatic treatment of uncomplicated acute diarrhea in appropriate patients
C. maintenance bronchodilation in COPD and selected patients with asthma
D. type 2 diabetes, especially when cardiovascular or kidney benefits are desirable in an appropriate patient
18. Which statement best describes the primary pharmacologic action of ginkgo biloba?
A. contains compounds that may influence immune signaling
B. activates melatonin receptors involved in circadian rhythm signaling
C. contains flavonoids/terpenoids with antioxidant and platelet-activating-factor effects
D. may modulate GABA-related CNS activity
19. Which adverse-effect profile is most important for the prescriber to recognize with melatonin?
A. serious hepatotoxicity and sedation
B. daytime drowsiness, dizziness, and vivid dreams
C. GI upset, headache, and rare reports of liver injury
D. photosensitivity, GI symptoms, insomnia, and serotonin toxicity when combined with serotonergic drugs
20. A 48-year-old adult is being managed in primary care. a patient starts sitagliptin. Which monitoring plan
is most appropriate for safe follow-up?
A. premeal/postmeal glucose and symptoms of hypoglycemia
B. thyroid function plus symptoms/signs of liver injury or infection
C. renal function for dose adjustment and glycemic response
D. fasting glucose trends and episodes of hypoglycemia
21. Which patient-teaching statement is most appropriate for a new prescription of glucagon?
A. eat smaller meals during titration and seek care for persistent severe abdominal pain
B. take consistently on an empty stomach and separate from calcium or iron supplements by several hours
Original practice material for study and review Page76
Page 3
