NURS 6521 FINAL EXAM Advanced Pharmacology.
Winter 2026-2027 QUESTIONS & ANSWERS ( A+
GRADED 100% VERIFIED)
QUESTION — PHARMACOKINETICS (HIGH-YIELD CONCEPT)
A 72-year-old patient with chronic kidney disease (eGFR 28 mL/min) is prescribed a medication
that is primarily renally excreted. Which pharmacokinetic change MOST increases the patient’s
risk for toxicity?
A. Increased hepatic metabolism
B. Decreased renal clearance
C. Increased protein binding
D. Increased volume of distribution
✅ Correct Answer: B
Rationale:
Reduced renal function leads to drug accumulation when clearance is impaired. Dose reduction
or extended dosing intervals are required.
Question 1
A 59-year-old man with a recent history of erectile dysfunction has been assessed and
prescribed sildenafil (Viagra). When providing patient education to this man, the nurse
should tell him which of the following?
Correct Answer:
“You might find that your face becomes flushed, or you get a headache after taking Viagra.”
Explanation:
Sildenafil is a phosphodiesterase-5 (PDE-5) inhibitor that enhances nitric oxide–mediated
vasodilation. Vasodilation commonly leads to:
• Facial flushing
, • Headache
• Nasal congestion
• Mild hypotension
These effects are expected, dose-related, and usually transient.
Key Exam Points:
• Never combine sildenafil with nitrates → severe hypotension
• Priapism (>4 hours) requires urgent care
• Visual disturbances may occur
Question 2
A patient takes etoposide for refractory testicular cancer. The nursing assessment reveals
that he is also taking warfarin. The nurse must carefully monitor which of the following?
Correct Answer:
Elevated prothrombin time
Explanation:
Etoposide potentiates the anticoagulant effects of warfarin by altering hepatic metabolism,
leading to:
• Increased INR/PT
• Increased bleeding risk
Key Exam Points:
• Monitor PT/INR closely
• Watch for bleeding (gums, urine, stool)
• Dosage adjustments are often required
Question 3
A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will
instruct the patient to do which of the following?
Correct Answer:
Complete the entire course of drug therapy.
,Explanation:
Incomplete antibiotic therapy increases:
• Bacterial resistance
• Treatment failure
• Reinfection
Key Exam Points:
• Avoid antacids, iron, and calcium near dosing
• Risk of tendon rupture
• Photosensitivity possible
Question 4
Drugs have a valid medical use but a high potential for psychological and physiologic abuse.
In an emergency, a Schedule II drug may be prescribed by telephone if a written prescription
cannot be provided at the time, but a written prescription must follow within 72 hours. These
prescriptions cannot be refilled. These drugs are classified as which schedule?
Correct Answer:
Schedule II
Explanation:
Schedule II drugs have:
• Accepted medical use
• High abuse potential
• Strict prescribing regulations
Examples:
• Morphine
• Amphetamines
• Fentanyl
Question 5
, A 16-year-old boy has been prescribed cromolyn sodium nasal spray to treat nasal allergies.
To maximize therapeutic effects, which instruction should the nurse provide?
Correct Answer:
Take the drug for one whole week before coming in contact with allergens.
Explanation:
Cromolyn sodium:
• Stabilizes mast cells
• Prevents histamine release
• Is preventive, not fast-acting
Key Exam Points:
• Not for acute allergy relief
• Requires consistent use
Question 6
A woman is receiving magnesium sulfate for intrapartum eclampsia. She is diaphoretic,
hypotensive (BP 88/50), and has a serum magnesium level of 10 mg/dL. The nurse interprets
these findings as which of the following?
Correct Answer:
Magnesium sulfate toxicity
Explanation:
Normal Mg level: 1.5–2.5 mg/dL
Toxicity occurs at >8 mg/dL
Signs of Toxicity:
• Hypotension
• Flushing
• Respiratory depression
• Loss of reflexes
Antidote: Calcium gluconate
Winter 2026-2027 QUESTIONS & ANSWERS ( A+
GRADED 100% VERIFIED)
QUESTION — PHARMACOKINETICS (HIGH-YIELD CONCEPT)
A 72-year-old patient with chronic kidney disease (eGFR 28 mL/min) is prescribed a medication
that is primarily renally excreted. Which pharmacokinetic change MOST increases the patient’s
risk for toxicity?
A. Increased hepatic metabolism
B. Decreased renal clearance
C. Increased protein binding
D. Increased volume of distribution
✅ Correct Answer: B
Rationale:
Reduced renal function leads to drug accumulation when clearance is impaired. Dose reduction
or extended dosing intervals are required.
Question 1
A 59-year-old man with a recent history of erectile dysfunction has been assessed and
prescribed sildenafil (Viagra). When providing patient education to this man, the nurse
should tell him which of the following?
Correct Answer:
“You might find that your face becomes flushed, or you get a headache after taking Viagra.”
Explanation:
Sildenafil is a phosphodiesterase-5 (PDE-5) inhibitor that enhances nitric oxide–mediated
vasodilation. Vasodilation commonly leads to:
• Facial flushing
, • Headache
• Nasal congestion
• Mild hypotension
These effects are expected, dose-related, and usually transient.
Key Exam Points:
• Never combine sildenafil with nitrates → severe hypotension
• Priapism (>4 hours) requires urgent care
• Visual disturbances may occur
Question 2
A patient takes etoposide for refractory testicular cancer. The nursing assessment reveals
that he is also taking warfarin. The nurse must carefully monitor which of the following?
Correct Answer:
Elevated prothrombin time
Explanation:
Etoposide potentiates the anticoagulant effects of warfarin by altering hepatic metabolism,
leading to:
• Increased INR/PT
• Increased bleeding risk
Key Exam Points:
• Monitor PT/INR closely
• Watch for bleeding (gums, urine, stool)
• Dosage adjustments are often required
Question 3
A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will
instruct the patient to do which of the following?
Correct Answer:
Complete the entire course of drug therapy.
,Explanation:
Incomplete antibiotic therapy increases:
• Bacterial resistance
• Treatment failure
• Reinfection
Key Exam Points:
• Avoid antacids, iron, and calcium near dosing
• Risk of tendon rupture
• Photosensitivity possible
Question 4
Drugs have a valid medical use but a high potential for psychological and physiologic abuse.
In an emergency, a Schedule II drug may be prescribed by telephone if a written prescription
cannot be provided at the time, but a written prescription must follow within 72 hours. These
prescriptions cannot be refilled. These drugs are classified as which schedule?
Correct Answer:
Schedule II
Explanation:
Schedule II drugs have:
• Accepted medical use
• High abuse potential
• Strict prescribing regulations
Examples:
• Morphine
• Amphetamines
• Fentanyl
Question 5
, A 16-year-old boy has been prescribed cromolyn sodium nasal spray to treat nasal allergies.
To maximize therapeutic effects, which instruction should the nurse provide?
Correct Answer:
Take the drug for one whole week before coming in contact with allergens.
Explanation:
Cromolyn sodium:
• Stabilizes mast cells
• Prevents histamine release
• Is preventive, not fast-acting
Key Exam Points:
• Not for acute allergy relief
• Requires consistent use
Question 6
A woman is receiving magnesium sulfate for intrapartum eclampsia. She is diaphoretic,
hypotensive (BP 88/50), and has a serum magnesium level of 10 mg/dL. The nurse interprets
these findings as which of the following?
Correct Answer:
Magnesium sulfate toxicity
Explanation:
Normal Mg level: 1.5–2.5 mg/dL
Toxicity occurs at >8 mg/dL
Signs of Toxicity:
• Hypotension
• Flushing
• Respiratory depression
• Loss of reflexes
Antidote: Calcium gluconate
