,Herzing NU 636 Quiz 5 | Advanced Pharmacology (2026)
Q&A
1. A 62-year-old patient with Parkinson's disease is started on carbidopa-levodopa. Which
statement accurately describes the purpose of combining carbidopa with levodopa?
A) Carbidopa increases the central nervous system penetration of levodopa
B) Carbidopa prevents the peripheral conversion of levodopa to dopamine
C) Carbidopa enhances the renal excretion of levodopa metabolites
D) Carbidopa directly stimulates dopamine receptors in the brain
Correct Answer: B) Carbidopa prevents the peripheral conversion of levodopa to dopamine
Rationale: Carbidopa is a peripheral decarboxylase inhibitor that prevents the conversion of
levodopa to dopamine in the periphery, thereby increasing the amount of levodopa available
to cross the blood-brain barrier. This reduces peripheral side effects like nausea and allows
for a lower levodopa dose.
2. A patient on long-term corticosteroid therapy is at increased risk for which of the following
complications?
A) Hyperphosphatemia
B) Hyperglycemia
C) Hyperkalemia
D) Hyponatremia
Correct Answer: B) Hyperglycemia
Rationale: Corticosteroids can induce insulin resistance and stimulate gluconeogenesis,
leading to hyperglycemia. This is a common metabolic complication of chronic corticosteroid
use.
,3. A patient with generalized anxiety disorder is prescribed buspirone. What is the primary
advantage of buspirone over benzodiazepines?
A) It has a faster onset of action
B) It has less potential for dependence and sedation
C) It is more effective for acute panic attacks
D) It does not require dose adjustment in hepatic impairment
Correct Answer: B) It has less potential for dependence and sedation
Rationale: Buspirone is a non-benzodiazepine anxiolytic that acts on serotonin receptors. It
has a lower risk of dependence and sedation compared to benzodiazepines, making it a
preferred option for chronic anxiety.
4. A patient with major depressive disorder is started on fluoxetine (Prozac). What is the most
important teaching point regarding the onset of therapeutic action?
A) Therapeutic effects will be seen within 24 hours
B) Therapeutic effects may take 2 to 4 weeks to fully develop
C) The medication should be taken only during depressive episodes
D) The medication is safe to stop abruptly once mood improves
Correct Answer: B) Therapeutic effects may take 2 to 4 weeks to fully develop
Rationale: SSRIs like fluoxetine have a delayed onset of action, typically taking 2 to 4 weeks
to achieve full therapeutic effects. Patients should be counseled to continue the medication as
prescribed and not to expect immediate results.
5. A patient with chronic pain is prescribed duloxetine (Cymbalta). Which of the following
best describes the primary mechanism of action of this medication?
A) Inhibition of COX-1 and COX-2 enzymes
B) Inhibition of serotonin and norepinephrine reuptake
C) Activation of mu-opioid receptors in the brain
, D) Blockade of sodium channels in peripheral nerves
Correct Answer: B) Inhibition of serotonin and norepinephrine reuptake
Rationale: Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI). It increases
the levels of serotonin and norepinephrine in the synaptic cleft, which is thought to modulate
pain pathways.
6. A patient with bipolar disorder is prescribed lithium. What laboratory value must be
monitored closely during lithium therapy?
A) Serum creatinine and BUN
B) Serum potassium
C) Serum calcium
D) Liver function tests
Correct Answer: A) Serum creatinine and BUN
Rationale: Lithium has a narrow therapeutic index and is excreted by the kidneys. Renal
function (serum creatinine and BUN) must be monitored to prevent toxicity.
7. A 45-year-old male with schizophrenia is started on clozapine. Which of the following is a
significant adverse effect requiring regular monitoring?
A) Weight loss
B) Agranulocytosis
C) Hypernatremia
D) Tachyphylaxis
Correct Answer: B) Agranulocytosis
Rationale: Clozapine is associated with a risk of agranulocytosis, a potentially fatal drop in
white blood cell count. Regular monitoring of absolute neutrophil count (ANC) is required.
Q&A
1. A 62-year-old patient with Parkinson's disease is started on carbidopa-levodopa. Which
statement accurately describes the purpose of combining carbidopa with levodopa?
A) Carbidopa increases the central nervous system penetration of levodopa
B) Carbidopa prevents the peripheral conversion of levodopa to dopamine
C) Carbidopa enhances the renal excretion of levodopa metabolites
D) Carbidopa directly stimulates dopamine receptors in the brain
Correct Answer: B) Carbidopa prevents the peripheral conversion of levodopa to dopamine
Rationale: Carbidopa is a peripheral decarboxylase inhibitor that prevents the conversion of
levodopa to dopamine in the periphery, thereby increasing the amount of levodopa available
to cross the blood-brain barrier. This reduces peripheral side effects like nausea and allows
for a lower levodopa dose.
2. A patient on long-term corticosteroid therapy is at increased risk for which of the following
complications?
A) Hyperphosphatemia
B) Hyperglycemia
C) Hyperkalemia
D) Hyponatremia
Correct Answer: B) Hyperglycemia
Rationale: Corticosteroids can induce insulin resistance and stimulate gluconeogenesis,
leading to hyperglycemia. This is a common metabolic complication of chronic corticosteroid
use.
,3. A patient with generalized anxiety disorder is prescribed buspirone. What is the primary
advantage of buspirone over benzodiazepines?
A) It has a faster onset of action
B) It has less potential for dependence and sedation
C) It is more effective for acute panic attacks
D) It does not require dose adjustment in hepatic impairment
Correct Answer: B) It has less potential for dependence and sedation
Rationale: Buspirone is a non-benzodiazepine anxiolytic that acts on serotonin receptors. It
has a lower risk of dependence and sedation compared to benzodiazepines, making it a
preferred option for chronic anxiety.
4. A patient with major depressive disorder is started on fluoxetine (Prozac). What is the most
important teaching point regarding the onset of therapeutic action?
A) Therapeutic effects will be seen within 24 hours
B) Therapeutic effects may take 2 to 4 weeks to fully develop
C) The medication should be taken only during depressive episodes
D) The medication is safe to stop abruptly once mood improves
Correct Answer: B) Therapeutic effects may take 2 to 4 weeks to fully develop
Rationale: SSRIs like fluoxetine have a delayed onset of action, typically taking 2 to 4 weeks
to achieve full therapeutic effects. Patients should be counseled to continue the medication as
prescribed and not to expect immediate results.
5. A patient with chronic pain is prescribed duloxetine (Cymbalta). Which of the following
best describes the primary mechanism of action of this medication?
A) Inhibition of COX-1 and COX-2 enzymes
B) Inhibition of serotonin and norepinephrine reuptake
C) Activation of mu-opioid receptors in the brain
, D) Blockade of sodium channels in peripheral nerves
Correct Answer: B) Inhibition of serotonin and norepinephrine reuptake
Rationale: Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI). It increases
the levels of serotonin and norepinephrine in the synaptic cleft, which is thought to modulate
pain pathways.
6. A patient with bipolar disorder is prescribed lithium. What laboratory value must be
monitored closely during lithium therapy?
A) Serum creatinine and BUN
B) Serum potassium
C) Serum calcium
D) Liver function tests
Correct Answer: A) Serum creatinine and BUN
Rationale: Lithium has a narrow therapeutic index and is excreted by the kidneys. Renal
function (serum creatinine and BUN) must be monitored to prevent toxicity.
7. A 45-year-old male with schizophrenia is started on clozapine. Which of the following is a
significant adverse effect requiring regular monitoring?
A) Weight loss
B) Agranulocytosis
C) Hypernatremia
D) Tachyphylaxis
Correct Answer: B) Agranulocytosis
Rationale: Clozapine is associated with a risk of agranulocytosis, a potentially fatal drop in
white blood cell count. Regular monitoring of absolute neutrophil count (ANC) is required.
