NR 568 Advanced Pharmacology for the
Adult-Gerontology Primary Care Nurse
Practitioner Final Exam Guide |
Chamberlain College | Latest 2026–2027
Update | Weeks 5–8 Covered | Questions
and Verified Answers | Grade A | 100%
Correct
Instructions: This final exam contains 50 multiple-choice questions covering advanced
pharmacology for adult-gerontology primary care (Weeks 5–8), including therapeutic
management, drug interactions, adverse effects, special populations (geriatric, renal/hepatic
impairment), and evidence-based prescribing across conditions like cardiovascular, endocrine,
psychiatric, and infectious diseases. 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 72-year-old patient with heart failure and CKD stage 4 is prescribed a loop diuretic. Which
medication is most appropriate?
A. Furosemide
B. Hydrochlorothiazide
C. Spironolactone
D. Chlorthalidone
Correct Answer: A
Rationale: Furosemide is effective in CKD stage 4 due to high potency and urinary excretion,
per ACC/AHA guidelines. Why correct: Maintains diuresis in low GFR. Why other options are
incorrect: Hydrochlorothiazide (B) and chlorthalidone (D) are less effective in advanced CKD;
spironolactone (C) risks hyperkalemia.
,Question 2
What is the mechanism of action of empagliflozin in type 2 diabetes?
A. Inhibits SGLT2 in kidneys
B. Stimulates insulin release
C. Inhibits DPP-4 enzyme
D. Enhances GLP-1 activity
Correct Answer: A
Rationale: Empagliflozin, an SGLT2 inhibitor, reduces renal glucose reabsorption, per ADA. Why
correct: Promotes glycosuria. Why other options are incorrect: Insulin release (B) is
sulfonylureas; DPP-4 inhibition (C) is sitagliptin; GLP-1 (D) is liraglutide.
Question 3
A 68-year-old with atrial fibrillation is prescribed apixaban. What is a key monitoring parameter?
A. Bleeding risk
B. INR
C. Platelet count
D. Blood pressure
Correct Answer: A
Rationale: Apixaban, a DOAC, requires monitoring for bleeding, per ACC guidelines. Why
correct: Primary adverse effect. Why other options are incorrect: INR (B) is for warfarin;
platelets (C) for heparin; blood pressure (D) is secondary.
Question 4
Which antibiotic is first-line for community-acquired pneumonia in a healthy adult?
A. Azithromycin
B. Levofloxacin
C. Ceftriaxone
D. Doxycycline
Correct Answer: A
Rationale: Azithromycin covers typical and atypical pathogens in outpatient CAP, per ATS/IDSA
guidelines. Why correct: Effective and safe. Why other options are incorrect: Levofloxacin (B)
for comorbidities; ceftriaxone (C) for inpatient; doxycycline (D) is alternative.
, Question 5
A 65-year-old with insomnia is prescribed a non-benzodiazepine hypnotic. Which is most
appropriate?
A. Zolpidem
B. Lorazepam
C. Alprazolam
D. Diazepam
Correct Answer: A
Rationale: Zolpidem has a shorter half-life, reducing fall risk in older adults, per Beers Criteria.
Why correct: Safer for geriatrics. Why other options are incorrect: Lorazepam (B),
alprazolam (C), and diazepam (D) are benzodiazepines with higher risks.
Question 6
What is the primary adverse effect of long-term PPI use in older adults?
A. Increased fracture risk
B. Hepatotoxicity
C. Hypokalemia
D. Hyperglycemia
Correct Answer: A
Rationale: PPIs like omeprazole reduce calcium absorption, increasing fracture risk, per ACG.
Why correct: Common in geriatrics. Why other options are incorrect: Hepatotoxicity (B) for
other drugs; hypokalemia (C) for diuretics; hyperglycemia (D) for steroids.
Question 7
A patient with rheumatoid arthritis is prescribed adalimumab. What is its mechanism?
A. TNF-alpha inhibitor
B. IL-6 receptor antagonist
C. JAK inhibitor
D. B-cell depleter
Correct Answer: A
Rationale: Adalimumab blocks TNF-alpha, reducing inflammation, per ACR. Why correct:
Targets RA pathology. Why other options are incorrect: IL-6 (B) is tocilizumab; JAK (C) is
tofacitinib; B-cell (D) is rituximab.
Adult-Gerontology Primary Care Nurse
Practitioner Final Exam Guide |
Chamberlain College | Latest 2026–2027
Update | Weeks 5–8 Covered | Questions
and Verified Answers | Grade A | 100%
Correct
Instructions: This final exam contains 50 multiple-choice questions covering advanced
pharmacology for adult-gerontology primary care (Weeks 5–8), including therapeutic
management, drug interactions, adverse effects, special populations (geriatric, renal/hepatic
impairment), and evidence-based prescribing across conditions like cardiovascular, endocrine,
psychiatric, and infectious diseases. 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 72-year-old patient with heart failure and CKD stage 4 is prescribed a loop diuretic. Which
medication is most appropriate?
A. Furosemide
B. Hydrochlorothiazide
C. Spironolactone
D. Chlorthalidone
Correct Answer: A
Rationale: Furosemide is effective in CKD stage 4 due to high potency and urinary excretion,
per ACC/AHA guidelines. Why correct: Maintains diuresis in low GFR. Why other options are
incorrect: Hydrochlorothiazide (B) and chlorthalidone (D) are less effective in advanced CKD;
spironolactone (C) risks hyperkalemia.
,Question 2
What is the mechanism of action of empagliflozin in type 2 diabetes?
A. Inhibits SGLT2 in kidneys
B. Stimulates insulin release
C. Inhibits DPP-4 enzyme
D. Enhances GLP-1 activity
Correct Answer: A
Rationale: Empagliflozin, an SGLT2 inhibitor, reduces renal glucose reabsorption, per ADA. Why
correct: Promotes glycosuria. Why other options are incorrect: Insulin release (B) is
sulfonylureas; DPP-4 inhibition (C) is sitagliptin; GLP-1 (D) is liraglutide.
Question 3
A 68-year-old with atrial fibrillation is prescribed apixaban. What is a key monitoring parameter?
A. Bleeding risk
B. INR
C. Platelet count
D. Blood pressure
Correct Answer: A
Rationale: Apixaban, a DOAC, requires monitoring for bleeding, per ACC guidelines. Why
correct: Primary adverse effect. Why other options are incorrect: INR (B) is for warfarin;
platelets (C) for heparin; blood pressure (D) is secondary.
Question 4
Which antibiotic is first-line for community-acquired pneumonia in a healthy adult?
A. Azithromycin
B. Levofloxacin
C. Ceftriaxone
D. Doxycycline
Correct Answer: A
Rationale: Azithromycin covers typical and atypical pathogens in outpatient CAP, per ATS/IDSA
guidelines. Why correct: Effective and safe. Why other options are incorrect: Levofloxacin (B)
for comorbidities; ceftriaxone (C) for inpatient; doxycycline (D) is alternative.
, Question 5
A 65-year-old with insomnia is prescribed a non-benzodiazepine hypnotic. Which is most
appropriate?
A. Zolpidem
B. Lorazepam
C. Alprazolam
D. Diazepam
Correct Answer: A
Rationale: Zolpidem has a shorter half-life, reducing fall risk in older adults, per Beers Criteria.
Why correct: Safer for geriatrics. Why other options are incorrect: Lorazepam (B),
alprazolam (C), and diazepam (D) are benzodiazepines with higher risks.
Question 6
What is the primary adverse effect of long-term PPI use in older adults?
A. Increased fracture risk
B. Hepatotoxicity
C. Hypokalemia
D. Hyperglycemia
Correct Answer: A
Rationale: PPIs like omeprazole reduce calcium absorption, increasing fracture risk, per ACG.
Why correct: Common in geriatrics. Why other options are incorrect: Hepatotoxicity (B) for
other drugs; hypokalemia (C) for diuretics; hyperglycemia (D) for steroids.
Question 7
A patient with rheumatoid arthritis is prescribed adalimumab. What is its mechanism?
A. TNF-alpha inhibitor
B. IL-6 receptor antagonist
C. JAK inhibitor
D. B-cell depleter
Correct Answer: A
Rationale: Adalimumab blocks TNF-alpha, reducing inflammation, per ACR. Why correct:
Targets RA pathology. Why other options are incorrect: IL-6 (B) is tocilizumab; JAK (C) is
tofacitinib; B-cell (D) is rituximab.
