NURS 5334 Advanced Pharmacology Final Real
Exam 2026 –2027 Full Practice Exam with
Answers and Rationales
Overview
This comprehensive practice exam is designed to simulate the actual NURS 5334 Advanced
Pharmacology Final Exam. It contains 100 multiple-choice questions, covering all key areas
of advanced pharmacology relevant to Nurse Practitioner practice.
Topics Included:
Psychiatric Pharmacology: SSRIs, SNRIs, TCAs, MAOIs, antipsychotics, mood
stabilizers, benzodiazepines
Neurological Agents: Antiepileptics, Parkinson’s medications, migraine therapies
Cardiovascular Pharmacology: Antihypertensives, antiarrhythmics, antianginals,
anticoagulants, antiplatelets, lipid-lowering agents
Endocrine Drugs: Diabetes medications, insulin, thyroid medications, corticosteroids
Respiratory Pharmacology: Asthma and COPD therapies, leukotriene inhibitors,
bronchodilators, inhaled steroids
Infectious Disease Pharmacology: Antibiotics, antivirals, antifungals, HIV therapies
Pain Management: Opioids, NSAIDs, local anesthetics, adjuvants
Geriatric & Pediatric Pharmacology: Age-related changes, dosing adjustments, Beers
list, neonatal and pediatric considerations
Chemotherapy and Antiemetics: Cytotoxic drugs, supportive therapy, antiemetic
strategies
1. SSRIs and Sexual Dysfunction
A 32-year-old male is starting paroxetine for depression. He complains of erectile
dysfunction. What can the NP do to help?
A. Change SSRIs
B. Decrease the dose of paroxetine
C. Add bupropion
D. Add another SSRI
Rationale: Bupropion does not commonly cause sexual dysfunction and can
counteract SSRI-induced sexual side effects.
,2. Ethosuximide Monitoring
A six-year-old is being treated with ethosuximide. She should be monitored for:
A. Increased seizure activity
B. Renal dysfunction
C. Blood dyscrasias
D. Hepatotoxicity
Rationale: Rare hematologic effects can occur; routine monitoring of CBC is
recommended.
3. Lamotrigine and Oral Contraceptives
Sandy takes lamotrigine for seizures and wants an OCP prescription. Which
interaction is relevant?
A. Contraceptive failure
B. Weight gain
C. Reduced lamotrigine levels
D. Increased estrogen metabolism
Rationale: Estrogen-containing OCPs can induce glucuronidation of lamotrigine,
reducing its effectiveness.
4. Tricyclic Antidepressants
TCAs should be prescribed cautiously in patients with:
A. CAD
B. Eczema
C. Asthma
D. Diabetes
Rationale: TCAs can cause arrhythmias and orthostatic hypotension; CAD
patients are at higher risk.
,5. SSRI Onset Symptoms
Which onset-of-action symptoms should be reviewed with newly prescribed
SSRIs?
A. Insomnia for a week
B. Mild nausea resolving in ~1 week
C. Huge increase in appetite
D. No dreaming
Rationale: Common transient side effects include mild GI upset.
6. Pediatric Drug Labeling
Why do many medications lack pediatric dosing info?
A. Not used in children
B. Lack of evidence-based literature
C. FDA restriction
D. Only liquid meds require pediatric info
Rationale: Many drugs are not formally studied in children due to ethical and
practical limitations.
7. Neonatal Toxicity
Why are neonates at greater risk for toxicity from highly protein-bound drugs?
A. Decreased protein binding
B. Poor elimination
C. Unable to metabolize
D. Increased protein binding
Rationale: Less albumin leads to more free (active) drug in circulation.
8. Renal Maturity
, At what age are adult renal function levels reached?
A. 6 months
B. 12 months
C. 24 months
D. 3 years
Rationale: Renal clearance matures within the first year of life.
9. High-Risk Drugs in Elderly
What identifies drugs with a high likelihood of adverse effects in older adults?
A. No use list
B. Beers list
C. Pharmacists list
D. Adverse drug list
Rationale: The Beers criteria guide safer prescribing in geriatrics.
10. Pediatric Gastric Acidity
In pediatric patients, gastric acidity reaches adult levels by:
2 years
Rationale: Acid production matures gradually; neonates have higher gastric pH.
11. Complications in Elderly Pharmacotherapy
Principles underlying drug therapy complications in the elderly:
Altered pharmacokinetics, multiple/severe illnesses, polypharmacy, poor
adherence
Rationale: All increase risk of adverse reactions.
12. Altered Absorption in Elderly
Exam 2026 –2027 Full Practice Exam with
Answers and Rationales
Overview
This comprehensive practice exam is designed to simulate the actual NURS 5334 Advanced
Pharmacology Final Exam. It contains 100 multiple-choice questions, covering all key areas
of advanced pharmacology relevant to Nurse Practitioner practice.
Topics Included:
Psychiatric Pharmacology: SSRIs, SNRIs, TCAs, MAOIs, antipsychotics, mood
stabilizers, benzodiazepines
Neurological Agents: Antiepileptics, Parkinson’s medications, migraine therapies
Cardiovascular Pharmacology: Antihypertensives, antiarrhythmics, antianginals,
anticoagulants, antiplatelets, lipid-lowering agents
Endocrine Drugs: Diabetes medications, insulin, thyroid medications, corticosteroids
Respiratory Pharmacology: Asthma and COPD therapies, leukotriene inhibitors,
bronchodilators, inhaled steroids
Infectious Disease Pharmacology: Antibiotics, antivirals, antifungals, HIV therapies
Pain Management: Opioids, NSAIDs, local anesthetics, adjuvants
Geriatric & Pediatric Pharmacology: Age-related changes, dosing adjustments, Beers
list, neonatal and pediatric considerations
Chemotherapy and Antiemetics: Cytotoxic drugs, supportive therapy, antiemetic
strategies
1. SSRIs and Sexual Dysfunction
A 32-year-old male is starting paroxetine for depression. He complains of erectile
dysfunction. What can the NP do to help?
A. Change SSRIs
B. Decrease the dose of paroxetine
C. Add bupropion
D. Add another SSRI
Rationale: Bupropion does not commonly cause sexual dysfunction and can
counteract SSRI-induced sexual side effects.
,2. Ethosuximide Monitoring
A six-year-old is being treated with ethosuximide. She should be monitored for:
A. Increased seizure activity
B. Renal dysfunction
C. Blood dyscrasias
D. Hepatotoxicity
Rationale: Rare hematologic effects can occur; routine monitoring of CBC is
recommended.
3. Lamotrigine and Oral Contraceptives
Sandy takes lamotrigine for seizures and wants an OCP prescription. Which
interaction is relevant?
A. Contraceptive failure
B. Weight gain
C. Reduced lamotrigine levels
D. Increased estrogen metabolism
Rationale: Estrogen-containing OCPs can induce glucuronidation of lamotrigine,
reducing its effectiveness.
4. Tricyclic Antidepressants
TCAs should be prescribed cautiously in patients with:
A. CAD
B. Eczema
C. Asthma
D. Diabetes
Rationale: TCAs can cause arrhythmias and orthostatic hypotension; CAD
patients are at higher risk.
,5. SSRI Onset Symptoms
Which onset-of-action symptoms should be reviewed with newly prescribed
SSRIs?
A. Insomnia for a week
B. Mild nausea resolving in ~1 week
C. Huge increase in appetite
D. No dreaming
Rationale: Common transient side effects include mild GI upset.
6. Pediatric Drug Labeling
Why do many medications lack pediatric dosing info?
A. Not used in children
B. Lack of evidence-based literature
C. FDA restriction
D. Only liquid meds require pediatric info
Rationale: Many drugs are not formally studied in children due to ethical and
practical limitations.
7. Neonatal Toxicity
Why are neonates at greater risk for toxicity from highly protein-bound drugs?
A. Decreased protein binding
B. Poor elimination
C. Unable to metabolize
D. Increased protein binding
Rationale: Less albumin leads to more free (active) drug in circulation.
8. Renal Maturity
, At what age are adult renal function levels reached?
A. 6 months
B. 12 months
C. 24 months
D. 3 years
Rationale: Renal clearance matures within the first year of life.
9. High-Risk Drugs in Elderly
What identifies drugs with a high likelihood of adverse effects in older adults?
A. No use list
B. Beers list
C. Pharmacists list
D. Adverse drug list
Rationale: The Beers criteria guide safer prescribing in geriatrics.
10. Pediatric Gastric Acidity
In pediatric patients, gastric acidity reaches adult levels by:
2 years
Rationale: Acid production matures gradually; neonates have higher gastric pH.
11. Complications in Elderly Pharmacotherapy
Principles underlying drug therapy complications in the elderly:
Altered pharmacokinetics, multiple/severe illnesses, polypharmacy, poor
adherence
Rationale: All increase risk of adverse reactions.
12. Altered Absorption in Elderly
