NR 566 ADVANCED PHARMACOLOGY FOR CARE OF THE
FAMILY MIDTERM EXAM | ACTUAL TEST BANK |
CURRENTLY TESTING QUESTIONS AND ANSWERS WITH
RATIONALES | LATEST UPDATE
1. Which statement about carbapenems is correct?
A. Imipenem is preferred in epilepsy managed with valproate
B. Ertapenem increases valproate levels
C. Avoid imipenem in patients taking valproate for seizures ✅
D. Carbapenems have no relevant drug–drug interactions
Rationale: Carbapenems (esp. imipenem) can lower valproate levels → loss of seizure control.
2. Vancomycin should be used with particular caution in:
A. Hepatic failure only
B. Pregnancy only
C. Penicillin allergy
D. Renal impairment ✅
Rationale: Vanco is renally cleared and nephrotoxic; monitor closely in renal disease.
3. Cephalosporins are contraindicated in patients with:
A. Seasonal allergies
B. Mild childhood rash to amoxicillin only
C. History of cephalosporin anaphylaxis or severe penicillin reactions ✅
D. Any prior antibiotic exposure
Rationale: True β-lactam anaphylaxis (ceph or severe pen) is a contraindication.
,4. Tetracyclines are contraindicated in:
A. Adults with acne
B. Pregnant patients and children <8 years ✅
C. Patients with hypertension
D. Patients on PPIs
Rationale: Risk of fetal harm and permanent tooth discoloration in young children.
5. When prescribing macrolides, use caution in patients with:
A. GERD
B. QT prolongation ✅
C. Iron deficiency
D. Hypothyroidism
Rationale: Macrolides can prolong QT and precipitate torsades.
6. Aminoglycosides require caution in patients with:
A. Asthma
B. Renal impairment or pre-existing hearing loss ✅
C. IBS
D. Allergic rhinitis
Rationale: Nephrotoxicity and ototoxicity risks; also caution with other neuro/cytotoxic agents.
7. Trimethoprim–sulfamethoxazole (TMP-SMX) is contraindicated in:
A. Men with BPH
B. Nursing mothers, 1st trimester & near-term pregnancy, infants <2 months ✅
,C. Asthma
D. Adults with lactose intolerance
Rationale: Risk of kernicterus in neonates/young infants; pregnancy safety concerns.
8. Patients at higher risk of penicillin toxicity include:
A. Healthy young adults
B. Renal impairment, acutely ill, very young, very old ✅
C. Those with GERD
D. Hepatitis B carriers
Rationale: Altered pharmacokinetics and reduced clearance raise toxicity risk.
9. Use penicillins with extreme caution in patients with:
A. Sulfonamide allergy
B. Severe prior reactions to cephalosporins or carbapenems
C. Seasonal allergies
D. Lactose intolerance
Rationale: Cross-reactivity among β-lactams in severe immediate reactions.
10. Cephalosporins and pregnancy:
A. Contraindicated
B. Appear safe for use
C. Only 3rd-gen allowed
D. Only 1st-gen allowed
Rationale: Cephalosporins are generally considered safe in pregnancy.
, 11. Penicillins and pregnancy:
A. Proven teratogens
B. No evidence of 2nd/3rd-trimester fetal risk
C. Only penicillin V is safe
D. Avoid in all trimesters
Rationale: Available evidence suggests no fetal risk in later trimesters.
12. Tetracyclines in pregnancy:
A. Safe after 20 weeks
B. Safe if taken with calcium
C. Animal data show fetal harm → avoid
D. Only minocycline is safe
Rationale: Fetal toxicity; avoid throughout pregnancy.
13. Aminoglycosides in pregnancy:
A. Safe in 3rd trimester
B. Associated with fetal harm → avoid
C. Recommended for UTIs
D. Only tobramycin is safe
Rationale: Potential ototoxicity/nephrotoxicity to fetus.
14. Sulfonamides in pregnancy:
A. Always safe
B. Birth-defect risk esp. 1st trimester; near term risk of neonatal kernicterus
FAMILY MIDTERM EXAM | ACTUAL TEST BANK |
CURRENTLY TESTING QUESTIONS AND ANSWERS WITH
RATIONALES | LATEST UPDATE
1. Which statement about carbapenems is correct?
A. Imipenem is preferred in epilepsy managed with valproate
B. Ertapenem increases valproate levels
C. Avoid imipenem in patients taking valproate for seizures ✅
D. Carbapenems have no relevant drug–drug interactions
Rationale: Carbapenems (esp. imipenem) can lower valproate levels → loss of seizure control.
2. Vancomycin should be used with particular caution in:
A. Hepatic failure only
B. Pregnancy only
C. Penicillin allergy
D. Renal impairment ✅
Rationale: Vanco is renally cleared and nephrotoxic; monitor closely in renal disease.
3. Cephalosporins are contraindicated in patients with:
A. Seasonal allergies
B. Mild childhood rash to amoxicillin only
C. History of cephalosporin anaphylaxis or severe penicillin reactions ✅
D. Any prior antibiotic exposure
Rationale: True β-lactam anaphylaxis (ceph or severe pen) is a contraindication.
,4. Tetracyclines are contraindicated in:
A. Adults with acne
B. Pregnant patients and children <8 years ✅
C. Patients with hypertension
D. Patients on PPIs
Rationale: Risk of fetal harm and permanent tooth discoloration in young children.
5. When prescribing macrolides, use caution in patients with:
A. GERD
B. QT prolongation ✅
C. Iron deficiency
D. Hypothyroidism
Rationale: Macrolides can prolong QT and precipitate torsades.
6. Aminoglycosides require caution in patients with:
A. Asthma
B. Renal impairment or pre-existing hearing loss ✅
C. IBS
D. Allergic rhinitis
Rationale: Nephrotoxicity and ototoxicity risks; also caution with other neuro/cytotoxic agents.
7. Trimethoprim–sulfamethoxazole (TMP-SMX) is contraindicated in:
A. Men with BPH
B. Nursing mothers, 1st trimester & near-term pregnancy, infants <2 months ✅
,C. Asthma
D. Adults with lactose intolerance
Rationale: Risk of kernicterus in neonates/young infants; pregnancy safety concerns.
8. Patients at higher risk of penicillin toxicity include:
A. Healthy young adults
B. Renal impairment, acutely ill, very young, very old ✅
C. Those with GERD
D. Hepatitis B carriers
Rationale: Altered pharmacokinetics and reduced clearance raise toxicity risk.
9. Use penicillins with extreme caution in patients with:
A. Sulfonamide allergy
B. Severe prior reactions to cephalosporins or carbapenems
C. Seasonal allergies
D. Lactose intolerance
Rationale: Cross-reactivity among β-lactams in severe immediate reactions.
10. Cephalosporins and pregnancy:
A. Contraindicated
B. Appear safe for use
C. Only 3rd-gen allowed
D. Only 1st-gen allowed
Rationale: Cephalosporins are generally considered safe in pregnancy.
, 11. Penicillins and pregnancy:
A. Proven teratogens
B. No evidence of 2nd/3rd-trimester fetal risk
C. Only penicillin V is safe
D. Avoid in all trimesters
Rationale: Available evidence suggests no fetal risk in later trimesters.
12. Tetracyclines in pregnancy:
A. Safe after 20 weeks
B. Safe if taken with calcium
C. Animal data show fetal harm → avoid
D. Only minocycline is safe
Rationale: Fetal toxicity; avoid throughout pregnancy.
13. Aminoglycosides in pregnancy:
A. Safe in 3rd trimester
B. Associated with fetal harm → avoid
C. Recommended for UTIs
D. Only tobramycin is safe
Rationale: Potential ototoxicity/nephrotoxicity to fetus.
14. Sulfonamides in pregnancy:
A. Always safe
B. Birth-defect risk esp. 1st trimester; near term risk of neonatal kernicterus
