Complete Study Guide for WGU
D116 Advanced Pharmacology
Pre-Assessment Expert-Verified
Questions and Step-by-Step
Solutions for Top Grades
1 Introduction
This study guide is tailored for the WGU D116 Advanced Pharmacology Pre-Assessment.
It provides 200 focused questions with concise answers and clear explanations to ensure
effective preparation. Content is streamlined, avoiding unnecessary details, and includes
100 additional relevant questions covering drug interactions, prescribing principles, mech-
anisms of action, and patient safety. Use this guide to review, self-test, and achieve high
scores.
2 Drug Interactions and Patient Safety (Questions
1-50)
Q1: How does propranolol interact with albuterol in an elderly patient with asthma and
hypertension?
A1: Propranolol reduces albuterols bronchodilation.
Step-by-Step Solution: 1. Propranolol, a non-selective beta-blocker, inhibits
beta-2 receptors. 2. Albuterol requires beta-2 activation for airway dilation. 3.
This interaction may worsen asthma symptoms. Action: Consider a cardioselective
beta-blocker.
Q2: What drug property minimizes transfer into breast milk for a mother with a sinus
infection?
A2: Low lipid solubility.
Step-by-Step Solution: 1. Lipid-soluble drugs penetrate breast milk more readily.
2. Select water-soluble antibiotics (e.g., penicillins). 3. Verify safety with lactation
guidelines.
Q3: Why does morphine cause constipation in a patient with cancer pain?
A3: It reduces gastrointestinal motility.
1
, Step-by-Step Solution: 1. Morphine activates opioid receptors in the gut. 2. This
slows peristalsis, leading to constipation. 3. Prescribe laxatives or stool softeners
concurrently.
Q4: What is the effect of dobutamine in a patient with cardiogenic shock?
A4: Increases heart rate and contractility.
Step-by-Step Solution: 1. Dobutamine stimulates beta-1 receptors. 2. Enhances
cardiac output in shock. 3. Monitor for tachyarrhythmias.
Q5: What is the next step for a hypertensive patient non-compliant due to medication
cost?
A5: Enroll in a prescription assistance program.
Step-by-Step Solution: 1. Identify financial barriers. 2. Programs like Mission
provide free or low-cost medications. 3. Schedule follow-up to ensure adherence.
Q6: Which glaucoma eye drop should be avoided in a patient with heart block?
A6: Timolol.
Step-by-Step Solution: 1. Timolol, a beta-blocker, can exacerbate bradycardia.
2. Use prostaglandin analogs instead. 3. Monitor heart rate if unavoidable.
Q7: Why switch medications for a patient on cimetidine and metoprolol with uncon-
trolled hypertension?
A7: Cimetidine inhibits metoprolol metabolism.
Step-by-Step Solution: 1. Cimetidine blocks CYP2D6, reducing metoprolol
clearance. 2. Switch to ranitidine to avoid interaction. 3. Reassess blood pres-
sure in 12 weeks.
Q8: What is the first action if a patient feels faint after receiving lidocaine?
A8: Assess for lidocaine toxicity.
Step-by-Step Solution: 1. Faintness suggests possible toxicity (CNS effects). 2.
Stop infusion, check levels. 3. Provide supportive care and monitor vitals.
Q9: Which NSAID is appropriate for shoulder pain with inflammation?
A9: Naproxen.
Step-by-Step Solution: 1. Naproxen inhibits COX enzymes, reducing inflamma-
tion. 2. Administer with food to minimize GI upset. 3. Limit use to 710 days.
Q10: Which opioid minimizes constipation risk in chronic pain management?
A10: Buprenorphine.
Step-by-Step Solution: 1. Partial mu-agonist, less GI slowing. 2. Start at low
dose, titrate slowly. 3. Monitor pain and side effects.
Q11: How do prescribing restrictions for APRNs impact healthcare?
A11: Increase costs and reduce access.
Step-by-Step Solution: 1. Restrictions delay care delivery. 2. Patients rely on
physicians, increasing costs. 3. Advocate for full practice authority.
Q12: What should be checked if a migraine medication is ineffective?
A12: Medication adherence.
Step-by-Step Solution: 1. Confirm correct dosing and frequency. 2. Educate on
proper use if non-compliant. 3. Consider alternative therapy if adherent.
Q13: Why might gentamicin levels be elevated despite prior tolerance?
2
, A13: Drug competition for albumin binding.
Step-by-Step Solution: 1. Another drug displaces gentamicin, increasing free
levels. 2. Adjust dose or switch antibiotics. 3. Monitor levels every 24 hours.
Q14: What occurs when two drugs compete for albumin binding?
A14: Increased free drug concentration.
Step-by-Step Solution: 1. Reduced binding elevates active drug levels. 2. May
enhance effects or toxicity. 3. Space administration or adjust doses.
Q15: Why do patients respond differently to the same drug?
A15: Genetic variations in metabolism.
Step-by-Step Solution: 1. Polymorphisms in CYP enzymes alter drug metabolism.
2. Consider pharmacogenomic testing. 3. Tailor therapy accordingly.
Q16: What should a patient understand about beta-blockers for migraine prevention?
A16: Taken daily to reduce frequency.
Step-by-Step Solution: 1. Propranolol is prophylactic, not abortive. 2. Effects
take 46 weeks. 3. Monitor blood pressure regularly.
Q17: What is key teaching for a clonidine patch?
A17: Change weekly, rotate sites.
Step-by-Step Solution: 1. Ensures steady drug release. 2. Prevents skin irrita-
tion. 3. Taper to avoid rebound hypertension.
Q18: What should be assessed before prescribing pramipexole for Parkinsons?
A18: History of alcohol use or compulsive behaviors.
Step-by-Step Solution: 1. Dopamine agonists increase impulse control risks. 2.
Screen for gambling or addiction history. 3. Monitor behavior changes.
Q19: When should memantine dosing be adjusted?
A19: In renal impairment (CrCl <30 mL/min).
Step-by-Step Solution: 1. Reduced clearance increases toxicity risk. 2. Halve
dose in severe renal failure. 3. Check renal function regularly.
Q20: What is the mechanism of memantine in Alzheimers disease?
A20: NMDA receptor antagonist.
Step-by-Step Solution: 1. Blocks glutamate-mediated excitotoxicity. 2. Pre-
serves neuronal function. 3. Used in moderate-to-severe cases.
Q21: How do APRN prescribing limits affect collaboration?
A21: Hinder effective teamwork.
Step-by-Step Solution: 1. Require physician oversight, slowing care. 2. Reduce
interdisciplinary efficiency. 3. Support policy changes for autonomy.
Q22: What is a key risk of reflux medications in infants?
A22: Increased adverse effects.
Step-by-Step Solution: 1. Immature metabolism heightens risks. 2. Use minimal
effective dose. 3. Monitor for respiratory or GI issues.
Q23: What risk increases in ICU patients on multiple medications?
A23: Drug interactions and adverse events.
Step-by-Step Solution: 1. Polypharmacy elevates interaction risk. 2. Review
medication list daily. 3. Discontinue non-essential drugs.
3
D116 Advanced Pharmacology
Pre-Assessment Expert-Verified
Questions and Step-by-Step
Solutions for Top Grades
1 Introduction
This study guide is tailored for the WGU D116 Advanced Pharmacology Pre-Assessment.
It provides 200 focused questions with concise answers and clear explanations to ensure
effective preparation. Content is streamlined, avoiding unnecessary details, and includes
100 additional relevant questions covering drug interactions, prescribing principles, mech-
anisms of action, and patient safety. Use this guide to review, self-test, and achieve high
scores.
2 Drug Interactions and Patient Safety (Questions
1-50)
Q1: How does propranolol interact with albuterol in an elderly patient with asthma and
hypertension?
A1: Propranolol reduces albuterols bronchodilation.
Step-by-Step Solution: 1. Propranolol, a non-selective beta-blocker, inhibits
beta-2 receptors. 2. Albuterol requires beta-2 activation for airway dilation. 3.
This interaction may worsen asthma symptoms. Action: Consider a cardioselective
beta-blocker.
Q2: What drug property minimizes transfer into breast milk for a mother with a sinus
infection?
A2: Low lipid solubility.
Step-by-Step Solution: 1. Lipid-soluble drugs penetrate breast milk more readily.
2. Select water-soluble antibiotics (e.g., penicillins). 3. Verify safety with lactation
guidelines.
Q3: Why does morphine cause constipation in a patient with cancer pain?
A3: It reduces gastrointestinal motility.
1
, Step-by-Step Solution: 1. Morphine activates opioid receptors in the gut. 2. This
slows peristalsis, leading to constipation. 3. Prescribe laxatives or stool softeners
concurrently.
Q4: What is the effect of dobutamine in a patient with cardiogenic shock?
A4: Increases heart rate and contractility.
Step-by-Step Solution: 1. Dobutamine stimulates beta-1 receptors. 2. Enhances
cardiac output in shock. 3. Monitor for tachyarrhythmias.
Q5: What is the next step for a hypertensive patient non-compliant due to medication
cost?
A5: Enroll in a prescription assistance program.
Step-by-Step Solution: 1. Identify financial barriers. 2. Programs like Mission
provide free or low-cost medications. 3. Schedule follow-up to ensure adherence.
Q6: Which glaucoma eye drop should be avoided in a patient with heart block?
A6: Timolol.
Step-by-Step Solution: 1. Timolol, a beta-blocker, can exacerbate bradycardia.
2. Use prostaglandin analogs instead. 3. Monitor heart rate if unavoidable.
Q7: Why switch medications for a patient on cimetidine and metoprolol with uncon-
trolled hypertension?
A7: Cimetidine inhibits metoprolol metabolism.
Step-by-Step Solution: 1. Cimetidine blocks CYP2D6, reducing metoprolol
clearance. 2. Switch to ranitidine to avoid interaction. 3. Reassess blood pres-
sure in 12 weeks.
Q8: What is the first action if a patient feels faint after receiving lidocaine?
A8: Assess for lidocaine toxicity.
Step-by-Step Solution: 1. Faintness suggests possible toxicity (CNS effects). 2.
Stop infusion, check levels. 3. Provide supportive care and monitor vitals.
Q9: Which NSAID is appropriate for shoulder pain with inflammation?
A9: Naproxen.
Step-by-Step Solution: 1. Naproxen inhibits COX enzymes, reducing inflamma-
tion. 2. Administer with food to minimize GI upset. 3. Limit use to 710 days.
Q10: Which opioid minimizes constipation risk in chronic pain management?
A10: Buprenorphine.
Step-by-Step Solution: 1. Partial mu-agonist, less GI slowing. 2. Start at low
dose, titrate slowly. 3. Monitor pain and side effects.
Q11: How do prescribing restrictions for APRNs impact healthcare?
A11: Increase costs and reduce access.
Step-by-Step Solution: 1. Restrictions delay care delivery. 2. Patients rely on
physicians, increasing costs. 3. Advocate for full practice authority.
Q12: What should be checked if a migraine medication is ineffective?
A12: Medication adherence.
Step-by-Step Solution: 1. Confirm correct dosing and frequency. 2. Educate on
proper use if non-compliant. 3. Consider alternative therapy if adherent.
Q13: Why might gentamicin levels be elevated despite prior tolerance?
2
, A13: Drug competition for albumin binding.
Step-by-Step Solution: 1. Another drug displaces gentamicin, increasing free
levels. 2. Adjust dose or switch antibiotics. 3. Monitor levels every 24 hours.
Q14: What occurs when two drugs compete for albumin binding?
A14: Increased free drug concentration.
Step-by-Step Solution: 1. Reduced binding elevates active drug levels. 2. May
enhance effects or toxicity. 3. Space administration or adjust doses.
Q15: Why do patients respond differently to the same drug?
A15: Genetic variations in metabolism.
Step-by-Step Solution: 1. Polymorphisms in CYP enzymes alter drug metabolism.
2. Consider pharmacogenomic testing. 3. Tailor therapy accordingly.
Q16: What should a patient understand about beta-blockers for migraine prevention?
A16: Taken daily to reduce frequency.
Step-by-Step Solution: 1. Propranolol is prophylactic, not abortive. 2. Effects
take 46 weeks. 3. Monitor blood pressure regularly.
Q17: What is key teaching for a clonidine patch?
A17: Change weekly, rotate sites.
Step-by-Step Solution: 1. Ensures steady drug release. 2. Prevents skin irrita-
tion. 3. Taper to avoid rebound hypertension.
Q18: What should be assessed before prescribing pramipexole for Parkinsons?
A18: History of alcohol use or compulsive behaviors.
Step-by-Step Solution: 1. Dopamine agonists increase impulse control risks. 2.
Screen for gambling or addiction history. 3. Monitor behavior changes.
Q19: When should memantine dosing be adjusted?
A19: In renal impairment (CrCl <30 mL/min).
Step-by-Step Solution: 1. Reduced clearance increases toxicity risk. 2. Halve
dose in severe renal failure. 3. Check renal function regularly.
Q20: What is the mechanism of memantine in Alzheimers disease?
A20: NMDA receptor antagonist.
Step-by-Step Solution: 1. Blocks glutamate-mediated excitotoxicity. 2. Pre-
serves neuronal function. 3. Used in moderate-to-severe cases.
Q21: How do APRN prescribing limits affect collaboration?
A21: Hinder effective teamwork.
Step-by-Step Solution: 1. Require physician oversight, slowing care. 2. Reduce
interdisciplinary efficiency. 3. Support policy changes for autonomy.
Q22: What is a key risk of reflux medications in infants?
A22: Increased adverse effects.
Step-by-Step Solution: 1. Immature metabolism heightens risks. 2. Use minimal
effective dose. 3. Monitor for respiratory or GI issues.
Q23: What risk increases in ICU patients on multiple medications?
A23: Drug interactions and adverse events.
Step-by-Step Solution: 1. Polypharmacy elevates interaction risk. 2. Review
medication list daily. 3. Discontinue non-essential drugs.
3
