NR 568 Advanced Pharmacology for the
Adult-Gerontology Primary Care Nurse
Practitioner Midterm Exam Review |
Chamberlain College | Latest 2026–2027
Update | Questions and Verified
Answers | Grade A | 100% Correct
Instructions: This midterm exam consists of 50 multiple-choice questions covering advanced
pharmacology principles for adult-gerontology primary care, including drug mechanisms,
interactions, adverse effects, prescribing considerations across the lifespan, and
evidence-based therapeutic management. Select the best answer (A–D) for each question.
Each question is worth 2 points (total 100 points). Use this for study and review. Good luck!
Question 1
A 65-year-old patient with hypertension and chronic kidney disease (CKD stage 3) is prescribed
an antihypertensive. Which medication is most appropriate as first-line therapy?
A. Lisinopril
B. Hydrochlorothiazide
C. Amlodipine
D. Metoprolol
Correct Answer: C
Rationale: Amlodipine, a calcium channel blocker, is preferred in CKD due to its efficacy in
reducing blood pressure without worsening renal function, per JNC 8 guidelines. Why correct: It
provides vasodilation with minimal impact on glomerular filtration rate (GFR). Why other
options are incorrect: Lisinopril (A), an ACE inhibitor, can cause hyperkalemia and GFR
decline in CKD; hydrochlorothiazide (B) is less effective in low GFR; metoprolol (D) is
second-line and may mask hypoglycemia in diabetics.
,Question 2
What is the primary mechanism of action of metformin in managing type 2 diabetes?
A. Stimulates insulin secretion from pancreatic beta cells
B. Inhibits alpha-glucosidase in the intestine
C. Decreases hepatic glucose production and improves insulin sensitivity
D. Blocks sodium-glucose cotransporter 2 in the kidneys
Correct Answer: C
Rationale: Metformin reduces hepatic gluconeogenesis and enhances peripheral insulin
sensitivity, leading to decreased blood glucose without hypoglycemia risk, per ADA guidelines.
Why correct: It targets the core defects in type 2 diabetes. Why other options are incorrect:
Insulin secretion (A) is sulfonylureas; alpha-glucosidase inhibition (B) is acarbose; SGLT2
inhibition (D) is canagliflozin.
Question 3
A 70-year-old patient with osteoarthritis is prescribed ibuprofen for pain. What is the most
important monitoring parameter?
A. Blood glucose
B. Renal function
C. Liver enzymes
D. Thyroid function
Correct Answer: B
Rationale: NSAIDs like ibuprofen can cause acute kidney injury, especially in older adults with
reduced renal reserve, per ACR guidelines. Why correct: Renal function (e.g., creatinine) must
be monitored to prevent NSAID nephropathy. Why other options are incorrect: Blood glucose
(A) is unrelated; liver enzymes (C) are for acetaminophen; thyroid function (D) is irrelevant to
NSAID use.
Question 4
Which antibiotic is first-line for uncomplicated urinary tract infection (UTI) in a non-pregnant adult
female?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Doxycycline
Correct Answer: B
Rationale: Nitrofurantoin is first-line for uncomplicated UTI due to high urinary concentration and
, low resistance rates, per IDSA guidelines. Why correct: Effective against common
uropathogens like E. coli. Why other options are incorrect: Ciprofloxacin (A) is reserved for
complicated UTI; amoxicillin (C) has high resistance; doxycycline (D) is for atypical infections.
Question 5
A patient with atrial fibrillation is prescribed warfarin. What is the target INR range?
A. 1.0–2.0
B. 2.0–3.0
C. 3.0–4.0
D. >4.0
Correct Answer: B
Rationale: INR 2.0–3.0 balances anticoagulation benefits and bleeding risks in non-valvular AF,
per ACC/AHA guidelines. Why correct: Optimal for stroke prevention. Why other options are
incorrect: 1.0–2.0 (A) is subtherapeutic; 3.0–4.0 (C) is for mechanical valves; >4.0 (D) risks
bleeding.
Question 6
What is the primary concern when prescribing statins to a 75-year-old patient?
A. Myopathy and rhabdomyolysis
B. Hyperglycemia
C. Hepatotoxicity
D. All of the above
Correct Answer: D
Rationale: Statins increase risk of myopathy, new-onset diabetes, and elevated liver enzymes in
older adults, per ACC/AHA. Why correct: Comprehensive monitoring is needed. Why other
options are incorrect: Each (A, B, C) is a valid concern, so D is best.
Question 7
A 50-year-old with gastroesophageal reflux disease (GERD) is prescribed omeprazole. What is
the duration for initial therapy?
A. 4–8 weeks
B. 12 weeks
C. 6 months
D. Indefinite
Adult-Gerontology Primary Care Nurse
Practitioner Midterm Exam Review |
Chamberlain College | Latest 2026–2027
Update | Questions and Verified
Answers | Grade A | 100% Correct
Instructions: This midterm exam consists of 50 multiple-choice questions covering advanced
pharmacology principles for adult-gerontology primary care, including drug mechanisms,
interactions, adverse effects, prescribing considerations across the lifespan, and
evidence-based therapeutic management. Select the best answer (A–D) for each question.
Each question is worth 2 points (total 100 points). Use this for study and review. Good luck!
Question 1
A 65-year-old patient with hypertension and chronic kidney disease (CKD stage 3) is prescribed
an antihypertensive. Which medication is most appropriate as first-line therapy?
A. Lisinopril
B. Hydrochlorothiazide
C. Amlodipine
D. Metoprolol
Correct Answer: C
Rationale: Amlodipine, a calcium channel blocker, is preferred in CKD due to its efficacy in
reducing blood pressure without worsening renal function, per JNC 8 guidelines. Why correct: It
provides vasodilation with minimal impact on glomerular filtration rate (GFR). Why other
options are incorrect: Lisinopril (A), an ACE inhibitor, can cause hyperkalemia and GFR
decline in CKD; hydrochlorothiazide (B) is less effective in low GFR; metoprolol (D) is
second-line and may mask hypoglycemia in diabetics.
,Question 2
What is the primary mechanism of action of metformin in managing type 2 diabetes?
A. Stimulates insulin secretion from pancreatic beta cells
B. Inhibits alpha-glucosidase in the intestine
C. Decreases hepatic glucose production and improves insulin sensitivity
D. Blocks sodium-glucose cotransporter 2 in the kidneys
Correct Answer: C
Rationale: Metformin reduces hepatic gluconeogenesis and enhances peripheral insulin
sensitivity, leading to decreased blood glucose without hypoglycemia risk, per ADA guidelines.
Why correct: It targets the core defects in type 2 diabetes. Why other options are incorrect:
Insulin secretion (A) is sulfonylureas; alpha-glucosidase inhibition (B) is acarbose; SGLT2
inhibition (D) is canagliflozin.
Question 3
A 70-year-old patient with osteoarthritis is prescribed ibuprofen for pain. What is the most
important monitoring parameter?
A. Blood glucose
B. Renal function
C. Liver enzymes
D. Thyroid function
Correct Answer: B
Rationale: NSAIDs like ibuprofen can cause acute kidney injury, especially in older adults with
reduced renal reserve, per ACR guidelines. Why correct: Renal function (e.g., creatinine) must
be monitored to prevent NSAID nephropathy. Why other options are incorrect: Blood glucose
(A) is unrelated; liver enzymes (C) are for acetaminophen; thyroid function (D) is irrelevant to
NSAID use.
Question 4
Which antibiotic is first-line for uncomplicated urinary tract infection (UTI) in a non-pregnant adult
female?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Doxycycline
Correct Answer: B
Rationale: Nitrofurantoin is first-line for uncomplicated UTI due to high urinary concentration and
, low resistance rates, per IDSA guidelines. Why correct: Effective against common
uropathogens like E. coli. Why other options are incorrect: Ciprofloxacin (A) is reserved for
complicated UTI; amoxicillin (C) has high resistance; doxycycline (D) is for atypical infections.
Question 5
A patient with atrial fibrillation is prescribed warfarin. What is the target INR range?
A. 1.0–2.0
B. 2.0–3.0
C. 3.0–4.0
D. >4.0
Correct Answer: B
Rationale: INR 2.0–3.0 balances anticoagulation benefits and bleeding risks in non-valvular AF,
per ACC/AHA guidelines. Why correct: Optimal for stroke prevention. Why other options are
incorrect: 1.0–2.0 (A) is subtherapeutic; 3.0–4.0 (C) is for mechanical valves; >4.0 (D) risks
bleeding.
Question 6
What is the primary concern when prescribing statins to a 75-year-old patient?
A. Myopathy and rhabdomyolysis
B. Hyperglycemia
C. Hepatotoxicity
D. All of the above
Correct Answer: D
Rationale: Statins increase risk of myopathy, new-onset diabetes, and elevated liver enzymes in
older adults, per ACC/AHA. Why correct: Comprehensive monitoring is needed. Why other
options are incorrect: Each (A, B, C) is a valid concern, so D is best.
Question 7
A 50-year-old with gastroesophageal reflux disease (GERD) is prescribed omeprazole. What is
the duration for initial therapy?
A. 4–8 weeks
B. 12 weeks
C. 6 months
D. Indefinite
