NR 566
FINAL EXAM
(Week’s 5 - 8)
Advanced Pharmacology for the Care of the Family
Exam-Style Qs that mirror the actual Exam
Chamberlain
This Exam Features:
• NR 566 Final Exam – Advanced Pharmacology
featuring 100 high-yield exam-style questions with
verified answers and detailed rationales.
• Designed for advanced practice nursing students
preparing for pharmacology finals, boards, and clinical application
exams.
,Question 1:
Which adverse effect is the main reason first-generation H₁ antihistamines
are avoided in most older adults?
A. Diarrhea
B. Nephrotoxicity
C. Sedation with anticholinergic effects
D. Hepatotoxicity
Answer: C. Sedation with anticholinergic effects
Expert Explanation: First-generation antihistamines cross the blood–brain
barrier and have strong anticholinergic properties, leading to confusion,
falls, urinary retention, and dry mouth in older adults. These risks make
them Beers-criteria drugs that are generally avoided when safer second-
generation options exist.
Question 2:
A patient taking diphenhydramine nightly for sleep reports daytime
grogginess and decreased effectiveness after a week. What is the best
explanation?
A. The drug has accumulated to toxic levels
B. Tolerance has developed to the sedative effects
C. The half-life is too short to maintain sleep
D. The medication has induced hepatic enzymes
Answer: B. Tolerance has developed to the sedative effects
Expert Explanation: Diphenhydramine can initially aid sleep, but tolerance
to its sedating effect often develops within a few days, while anticholinergic
adverse effects persist. This pattern explains ongoing grogginess without
sustained benefit.
Question 3:
Which patient scenario makes a second-generation H₁ antihistamine the
,BEST choice?
A. Young adult needing short-term help with motion sickness on a cruise
B. Preschool child with acute anaphylaxis
C. Older adult needing daytime relief of allergic rhinitis symptoms
D. Postoperative patient with severe nausea and vomiting
Answer: C. Older adult needing daytime relief of allergic rhinitis symptoms
Expert Explanation: Second-generation antihistamines cause minimal
sedation and less anticholinergic burden, making them preferred for older
adults who need daytime allergy control and must avoid falls, confusion,
and urinary retention.
Question 4:
Which teaching point is MOST appropriate for a patient starting a systemic
glucocorticoid taper for an asthma exacerbation?
A. “Stop the medication as soon as you feel better.”
B. “Avoid all sources of dietary calcium while on this drug.”
C. “Report black, tarry stools or severe abdominal pain.”
D. “You no longer need to carry your rescue inhaler.”
Answer: C. Report black, tarry stools or severe abdominal pain.
Expert Explanation: Systemic glucocorticoids increase the risk of peptic
ulcer disease and GI bleeding, especially with NSAIDs. Patients should be
taught to report signs of GI bleeding such as melena or severe abdominal
pain.
Question 5:
Which adverse effect is most closely linked to long-term high-dose
glucocorticoid therapy?
A. Bradycardia and heart block
B. Osteoporosis with vertebral fractures
C. Severe hypoglycemia
D. Hemolytic anemia
, Answer: B. Osteoporosis with vertebral fractures
Expert Explanation: Chronic glucocorticoid use accelerates bone loss by
inhibiting bone formation and increasing calcium excretion, leading to
osteoporosis and compression fractures, particularly in the ribs and
vertebrae.
Question 6:
A patient on chronic prednisone asks why they must increase their dose
during surgery. What is the BEST explanation?
A. To prevent rebound hypertension
B. To avoid adrenal crisis during physiologic stress
C. To reduce perioperative blood loss
D. To prevent serotonin syndrome
Answer: B. To avoid adrenal crisis during physiologic stress
Expert Explanation: Long-term glucocorticoid therapy suppresses
endogenous adrenal function. During significant stress such as surgery,
supplemental “stress doses” are required to prevent adrenal insufficiency
and cardiovascular collapse.
Question 7:
Which therapy is considered first-line for persistent allergic rhinitis with
nasal congestion, sneezing, and itching?
A. Oral first-generation antihistamine alone
B. Intranasal glucocorticoid spray
C. Short-acting oral decongestant as needed
D. Intranasal cromolyn as needed
Answer: B. Intranasal glucocorticoid spray
Expert Explanation: Intranasal glucocorticoids are the mainstay of allergic
rhinitis therapy because they reduce nasal inflammation and effectively
relieve congestion, rhinorrhea, itching, and sneezing when used regularly.
FINAL EXAM
(Week’s 5 - 8)
Advanced Pharmacology for the Care of the Family
Exam-Style Qs that mirror the actual Exam
Chamberlain
This Exam Features:
• NR 566 Final Exam – Advanced Pharmacology
featuring 100 high-yield exam-style questions with
verified answers and detailed rationales.
• Designed for advanced practice nursing students
preparing for pharmacology finals, boards, and clinical application
exams.
,Question 1:
Which adverse effect is the main reason first-generation H₁ antihistamines
are avoided in most older adults?
A. Diarrhea
B. Nephrotoxicity
C. Sedation with anticholinergic effects
D. Hepatotoxicity
Answer: C. Sedation with anticholinergic effects
Expert Explanation: First-generation antihistamines cross the blood–brain
barrier and have strong anticholinergic properties, leading to confusion,
falls, urinary retention, and dry mouth in older adults. These risks make
them Beers-criteria drugs that are generally avoided when safer second-
generation options exist.
Question 2:
A patient taking diphenhydramine nightly for sleep reports daytime
grogginess and decreased effectiveness after a week. What is the best
explanation?
A. The drug has accumulated to toxic levels
B. Tolerance has developed to the sedative effects
C. The half-life is too short to maintain sleep
D. The medication has induced hepatic enzymes
Answer: B. Tolerance has developed to the sedative effects
Expert Explanation: Diphenhydramine can initially aid sleep, but tolerance
to its sedating effect often develops within a few days, while anticholinergic
adverse effects persist. This pattern explains ongoing grogginess without
sustained benefit.
Question 3:
Which patient scenario makes a second-generation H₁ antihistamine the
,BEST choice?
A. Young adult needing short-term help with motion sickness on a cruise
B. Preschool child with acute anaphylaxis
C. Older adult needing daytime relief of allergic rhinitis symptoms
D. Postoperative patient with severe nausea and vomiting
Answer: C. Older adult needing daytime relief of allergic rhinitis symptoms
Expert Explanation: Second-generation antihistamines cause minimal
sedation and less anticholinergic burden, making them preferred for older
adults who need daytime allergy control and must avoid falls, confusion,
and urinary retention.
Question 4:
Which teaching point is MOST appropriate for a patient starting a systemic
glucocorticoid taper for an asthma exacerbation?
A. “Stop the medication as soon as you feel better.”
B. “Avoid all sources of dietary calcium while on this drug.”
C. “Report black, tarry stools or severe abdominal pain.”
D. “You no longer need to carry your rescue inhaler.”
Answer: C. Report black, tarry stools or severe abdominal pain.
Expert Explanation: Systemic glucocorticoids increase the risk of peptic
ulcer disease and GI bleeding, especially with NSAIDs. Patients should be
taught to report signs of GI bleeding such as melena or severe abdominal
pain.
Question 5:
Which adverse effect is most closely linked to long-term high-dose
glucocorticoid therapy?
A. Bradycardia and heart block
B. Osteoporosis with vertebral fractures
C. Severe hypoglycemia
D. Hemolytic anemia
, Answer: B. Osteoporosis with vertebral fractures
Expert Explanation: Chronic glucocorticoid use accelerates bone loss by
inhibiting bone formation and increasing calcium excretion, leading to
osteoporosis and compression fractures, particularly in the ribs and
vertebrae.
Question 6:
A patient on chronic prednisone asks why they must increase their dose
during surgery. What is the BEST explanation?
A. To prevent rebound hypertension
B. To avoid adrenal crisis during physiologic stress
C. To reduce perioperative blood loss
D. To prevent serotonin syndrome
Answer: B. To avoid adrenal crisis during physiologic stress
Expert Explanation: Long-term glucocorticoid therapy suppresses
endogenous adrenal function. During significant stress such as surgery,
supplemental “stress doses” are required to prevent adrenal insufficiency
and cardiovascular collapse.
Question 7:
Which therapy is considered first-line for persistent allergic rhinitis with
nasal congestion, sneezing, and itching?
A. Oral first-generation antihistamine alone
B. Intranasal glucocorticoid spray
C. Short-acting oral decongestant as needed
D. Intranasal cromolyn as needed
Answer: B. Intranasal glucocorticoid spray
Expert Explanation: Intranasal glucocorticoids are the mainstay of allergic
rhinitis therapy because they reduce nasal inflammation and effectively
relieve congestion, rhinorrhea, itching, and sneezing when used regularly.
