NR-566 ADVANCED PHARMACOLOGY FOR CARE OF
THE FAMILY
ENHANCED FINAL EXAM REVIEWER • ORIGINAL Q&A; STUDY EDITION • 140 QUESTIONS
Important: This is an original educational study guide created from the accessible preview/topic signals of the referenced Stuvia listing. It does not
reproduce the paid document or its locked pages, and it is not an official Chamberlain exam or answer key.
How to study: Cover the answers, attempt each question aloud, then compare your reasoning with the model answer. Pay special attention to the
EXAM TRAP and MEMORY notes.
NR-566 Enhanced Final Reviewer • Page 1
, I. ENDOCRINE & REPRODUCTIVE PHARMACOLOGY
QUESTION 1. When is androgen therapy considered for delayed puberty?
Answer: A limited course may be considered in selected adolescents with significant psychosocial distress when delayed puberty is
likely constitutional. True hypogonadism requires evaluation and, when indicated, longer-term hormone replacement. Treatment should
be individualized rather than automatically prescribed.
EXAM TRAP: Do not equate delayed puberty with disease. Ask whether the pattern suggests constitutional delay or pathologic
hypogonadism.
QUESTION 2. What adverse effects are important with androgen therapy?
Answer: Possible effects include acne, mood changes, erythrocytosis, adverse lipid changes, suppression of endogenous gonadal
function and fertility, gynecomastia, and androgenic/virilizing effects. Hepatic effects are particularly relevant with some oral
anabolic-androgenic agents.
MEMORY: ANDROGEN = Acne, Neurobehavior changes, Dyslipidemia, Organ/liver concerns, Reproductive suppression, Erythrocytosis,
Gynecomastia/virilization.
QUESTION 3. What should be taught to a patient who can become pregnant and is prescribed an androgen?
Answer: Discuss reliable contraception when pregnancy is possible because androgen exposure can pose fetal risk. Also explain that
masculinizing changes may occur and some changes can be irreversible.
QUESTION 4. What is the mechanism of PDE-5 inhibitors such as sildenafil?
Answer: They inhibit phosphodiesterase-5, increasing cyclic GMP signaling in erectile tissue and facilitating smooth-muscle relaxation
in response to sexual stimulation. They do not create sexual desire and do not produce an erection without appropriate stimulation.
EXAM TRAP: PDE-5 inhibitors + nitrates can cause profound hypotension; this combination is contraindicated.
QUESTION 5. Why are nitrates contraindicated with sildenafil?
Answer: Both pathways promote vasodilation and reduction in vascular smooth-muscle tone. Together they can produce excessive
blood-pressure reduction. Patients should be specifically questioned about prescribed and recreational nitrate use.
QUESTION 6. What is alprostadil and when might it be used?
Answer: Alprostadil is a prostaglandin E1 analog used for erectile dysfunction. It can be administered by intracavernosal injection or an
intraurethral system. Route-specific counseling is essential because priapism and local adverse effects can occur.
QUESTION 7. What is a major counseling point for alprostadil?
Answer: Seek urgent medical attention for a prolonged erection, especially an erection lasting about four hours or longer, because
priapism can threaten erectile function. Use only the prescribed dose and technique.
QUESTION 8. How do combined oral contraceptives generally work?
Answer: They suppress ovulation through negative feedback on the hypothalamic-pituitary-ovarian axis and also alter cervical mucus
and the endometrium. Estrogen and progestin components contribute differently to the overall effect.
QUESTION 9. Which medications are classic enzyme inducers that can reduce hormonal contraceptive
effectiveness?
Answer: Examples include carbamazepine, phenytoin, phenobarbital, primidone, rifampin, and rifabutin. Enzyme induction can
increase hormone metabolism and lower contraceptive exposure.
EXAM TRAP: Do not memorize every drug interaction as an isolated fact. Think CYP induction → lower hormone concentration → possible
reduced contraceptive effectiveness.
QUESTION 10. What is the most important teaching point when a patient on an enzyme-inducing medication uses
a hormonal contraceptive?
Answer: Review the specific contraceptive method and interaction, consider a method less affected by enzyme induction when
appropriate, and discuss backup contraception according to current guidance and patient circumstances.
NR-566 Enhanced Final Reviewer • Page 2
THE FAMILY
ENHANCED FINAL EXAM REVIEWER • ORIGINAL Q&A; STUDY EDITION • 140 QUESTIONS
Important: This is an original educational study guide created from the accessible preview/topic signals of the referenced Stuvia listing. It does not
reproduce the paid document or its locked pages, and it is not an official Chamberlain exam or answer key.
How to study: Cover the answers, attempt each question aloud, then compare your reasoning with the model answer. Pay special attention to the
EXAM TRAP and MEMORY notes.
NR-566 Enhanced Final Reviewer • Page 1
, I. ENDOCRINE & REPRODUCTIVE PHARMACOLOGY
QUESTION 1. When is androgen therapy considered for delayed puberty?
Answer: A limited course may be considered in selected adolescents with significant psychosocial distress when delayed puberty is
likely constitutional. True hypogonadism requires evaluation and, when indicated, longer-term hormone replacement. Treatment should
be individualized rather than automatically prescribed.
EXAM TRAP: Do not equate delayed puberty with disease. Ask whether the pattern suggests constitutional delay or pathologic
hypogonadism.
QUESTION 2. What adverse effects are important with androgen therapy?
Answer: Possible effects include acne, mood changes, erythrocytosis, adverse lipid changes, suppression of endogenous gonadal
function and fertility, gynecomastia, and androgenic/virilizing effects. Hepatic effects are particularly relevant with some oral
anabolic-androgenic agents.
MEMORY: ANDROGEN = Acne, Neurobehavior changes, Dyslipidemia, Organ/liver concerns, Reproductive suppression, Erythrocytosis,
Gynecomastia/virilization.
QUESTION 3. What should be taught to a patient who can become pregnant and is prescribed an androgen?
Answer: Discuss reliable contraception when pregnancy is possible because androgen exposure can pose fetal risk. Also explain that
masculinizing changes may occur and some changes can be irreversible.
QUESTION 4. What is the mechanism of PDE-5 inhibitors such as sildenafil?
Answer: They inhibit phosphodiesterase-5, increasing cyclic GMP signaling in erectile tissue and facilitating smooth-muscle relaxation
in response to sexual stimulation. They do not create sexual desire and do not produce an erection without appropriate stimulation.
EXAM TRAP: PDE-5 inhibitors + nitrates can cause profound hypotension; this combination is contraindicated.
QUESTION 5. Why are nitrates contraindicated with sildenafil?
Answer: Both pathways promote vasodilation and reduction in vascular smooth-muscle tone. Together they can produce excessive
blood-pressure reduction. Patients should be specifically questioned about prescribed and recreational nitrate use.
QUESTION 6. What is alprostadil and when might it be used?
Answer: Alprostadil is a prostaglandin E1 analog used for erectile dysfunction. It can be administered by intracavernosal injection or an
intraurethral system. Route-specific counseling is essential because priapism and local adverse effects can occur.
QUESTION 7. What is a major counseling point for alprostadil?
Answer: Seek urgent medical attention for a prolonged erection, especially an erection lasting about four hours or longer, because
priapism can threaten erectile function. Use only the prescribed dose and technique.
QUESTION 8. How do combined oral contraceptives generally work?
Answer: They suppress ovulation through negative feedback on the hypothalamic-pituitary-ovarian axis and also alter cervical mucus
and the endometrium. Estrogen and progestin components contribute differently to the overall effect.
QUESTION 9. Which medications are classic enzyme inducers that can reduce hormonal contraceptive
effectiveness?
Answer: Examples include carbamazepine, phenytoin, phenobarbital, primidone, rifampin, and rifabutin. Enzyme induction can
increase hormone metabolism and lower contraceptive exposure.
EXAM TRAP: Do not memorize every drug interaction as an isolated fact. Think CYP induction → lower hormone concentration → possible
reduced contraceptive effectiveness.
QUESTION 10. What is the most important teaching point when a patient on an enzyme-inducing medication uses
a hormonal contraceptive?
Answer: Review the specific contraceptive method and interaction, consider a method less affected by enzyme induction when
appropriate, and discuss backup contraception according to current guidance and patient circumstances.
NR-566 Enhanced Final Reviewer • Page 2
