NURS 6521 ADV. PHARMACOLOGY FINAL EXAM 2026 | 300+ QUESTIONS AND CORRECT
ANSWERS | ALREADY GRADED A+ | LATEST RELEASE
Question 1
A 59-year-old man with a recent history of erectile dysfunction has been prescribed sildenafil
(Viagra). When providing patient education, which of the following common side effects should
the nurse practitioner emphasize?
A) Increased risk of urinary tract infections
B) Temporary hearing loss
C) Facial flushing and headaches
D) Persistent dry cough
E) General numbness in the extremities
Correct Answer: C) "You might find that your face becomes flushed, or you get a headache
after taking Viagra."
Rationale: Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor that promotes
vasodilation. Because it affects systemic vascular resistance, common side effects include
headache and facial flushing due to the dilation of cranial and skin vessels. Patients should
be warned about these to prevent unnecessary concern.
Question 2
A patient is receiving etoposide for a testicular tumor refractory to initial treatment. The nurse
practitioner notes the patient is also taking warfarin. Which of the following is the priority
assessment for this drug-drug interaction?
A) Increased serum albumin levels
B) Elevated prothrombin time (PT/INR)
C) Decreased white blood cell count
D) Hyperkalemia
E) Ototoxicity
Correct Answer: B) Elevated prothrombin time
Rationale: Etoposide can enhance the effects of warfarin by displacing it from protein-
binding sites or interfering with metabolism. This results in an increased risk of bleeding,
which is monitored via the Prothrombin Time (PT) and International Normalized Ratio
(INR). Failure to monitor this can lead to life-threatening hemorrhage.
Question 3
A male patient is prescribed ciprofloxacin to treat a sexually transmitted infection. To ensure
therapeutic success and prevent the development of antibiotic resistance, the nurse will instruct
the patient to:
A) Stop the medication as soon as symptoms resolve.
B) Double the dose if a day is missed.
C) Complete the entire course of drug therapy.
D) Take the medication with a large glass of milk.
E) Avoid all physical activity for 48 hours.
, 2
Correct Answer: C) to complete the entire course of drug therapy.
Rationale: Patient compliance is critical with fluoroquinolones like ciprofloxacin. Even if
the patient feels better after 24-48 hours, the underlying pathogen may not be fully
eradicated. Stopping early promotes the survival of resistant bacterial strains.
Question 4
A Nurse Practitioner is managing prescriptions for controlled substances. According to federal
law, which drug schedule has a valid medical use but a high potential for abuse, and requires a
new written prescription for every refill with no emergency telephone orders allowed unless a
written follow-up is provided within 72 hours?
A) Schedule I
B) Schedule II
C) Schedule III
D) Schedule IV
E) Schedule V
Correct Answer: B) Schedule II
Rationale: Schedule II drugs (e.g., morphine, oxycodone, amphetamines) have high abuse
potential. They cannot be refilled; a new prescription must be issued. In emergencies, a
telephone order is permitted but must be supported by a written "authorization for
emergency dispensing" within 72 hours.
Question 5
A 16-year-old boy is prescribed cromolyn sodium nasal spray for seasonal allergies. Which
instruction is vital to maximize the therapeutic effect of this mast cell stabilizer?
A) Use it only when the nose starts running.
B) Take it with a high-fat meal.
C) Use the drug for one whole week before coming in contact with allergens.
D) Sniff forcefully immediately after administration.
E) Discontinue use if sneezing occurs.
Correct Answer: C) Take the drug for one whole week before coming in contact with
allergens.
Rationale: Cromolyn sodium is a prophylactic agent. It prevents the release of
inflammatory mediators from mast cells but does not reverse an allergic reaction once it
has started. Therefore, it must be used consistently for several days to a week before
allergen exposure to be effective.
Question 6
A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is sweating, her
blood pressure is 88/50 mmHg, and her serum magnesium level is 10 mg/dL. How should the
nurse interpret these findings?
A) The patient is exhibiting a normal therapeutic response.
, 3
B) The patient is experiencing magnesium sulfate toxicity.
C) The patient has developed a secondary bacterial infection.
D) The magnesium level is too low to prevent seizures.
E) The patient is having an allergic reaction to the IV tubing.
Correct Answer: B) Magnesium Sulfate toxicity.
Rationale: Therapeutic magnesium levels range from 4-7 mg/dL. A level of 10 mg/dL,
accompanied by hypotension and sweating, indicates toxicity. Progression can lead to loss
of deep tendon reflexes and respiratory arrest. The nurse must stop the infusion and
prepare calcium gluconate.
Question 7
A patient with chronic myelogenous leukemia (CML) is being considered for cyclophosphamide
therapy. Which of the following findings would be a definitive contraindication for this drug?
A) History of seasonal allergies
B) A recent diagnosis of cataracts
C) Significantly depressed bone marrow function
D) Mild hypertension
E) Use of a hearing aid
Correct Answer: C) The patient's bone marrow function is significantly depressed.
Rationale: Cyclophosphamide is an alkylating agent that causes significant
myelosuppression. If a patient already has severely depressed bone marrow (low WBC,
RBC, and platelets), the drug could lead to fatal infection or hemorrhage.
Question 8
A 31-year-old woman is struggling with infertility due to ovulatory failure. Which medication
should the Nurse Practitioner anticipate will be prescribed to stimulate ovulation?
A) Testosterone
B) Clomiphene
C) Progesterone
D) Leuprolide
E) Finasteride
Correct Answer: B) clomiphene.
Rationale: Clomiphene is a selective estrogen receptor modulator (SERM) that stimulates
the release of FSH and LH, which in turn induces ovulation. It is the first-line treatment for
women with ovulatory dysfunction seeking pregnancy.
Question 9
A 34-year-old male diagnosed with tuberculosis is starting Isoniazid (INH). The patient regularly
takes antacids for heartburn. What instruction should the NP provide regarding antacid use?
A) Stop taking antacids indefinitely.
B) Take the antacid at the same time as INH to prevent GI upset.
, 4
C) Take antacids at least 1 hour before or 2 hours after taking INH.
D) Only use liquid antacids, never tablets.
E) Drink milk instead of using antacids.
Correct Answer: C) to take antacids not less than 1 hour before or 2 hours after taking INH.
Rationale: Antacids, particularly those containing aluminum, can interfere with the
absorption of INH from the GI tract. Separating the doses ensures the antibiotic reaches
therapeutic levels in the blood.
Question 10
A Nurse Practitioner is preparing to calculate a medication dosage for a 5-year-old child in an
oncology unit. Which method is considered the most accurate for pediatric dosing in this
population?
A) Age-based calculation (Young’s Rule)
B) Weight-based calculation (mg/kg)
C) Body Surface Area (BSA)
D) Standard adult dosing
E) Finger-to-toe measurement
Correct Answer: C) Body Surface Area
Rationale: BSA is considered the most accurate method for calculating pediatric dosages,
especially for high-toxicity drugs like chemotherapy, because it accounts for both height
and weight, reflecting the metabolic rate more accurately than weight alone.
Question 11
An older adult woman with acute lymphoblastic leukemia (ALL) is a candidate for imatinib.
Which of the following conditions might preclude her from using this targeted therapy?
A) Glaucoma
B) Osteoarthritis
C) Chronic heart failure with significant peripheral edema
D) Presbycusis
E) History of appendectomy
Correct Answer: C) The patient has chronic heart failure resulting in significant peripheral
edema
Rationale: Imatinib is associated with severe fluid retention and edema. In patients with
pre-existing heart failure, this drug can cause life-threatening exacerbations and
pulmonary edema, requiring extreme caution or alternative therapy.
Question 12
A male patient is considering finasteride (Proscar) for benign prostatic hypertrophy (BPH). What
specific risk should the nurse discuss with the patient?
A) Increased risk of lung cancer
B) Prostatic neoplasia (high-grade)
ANSWERS | ALREADY GRADED A+ | LATEST RELEASE
Question 1
A 59-year-old man with a recent history of erectile dysfunction has been prescribed sildenafil
(Viagra). When providing patient education, which of the following common side effects should
the nurse practitioner emphasize?
A) Increased risk of urinary tract infections
B) Temporary hearing loss
C) Facial flushing and headaches
D) Persistent dry cough
E) General numbness in the extremities
Correct Answer: C) "You might find that your face becomes flushed, or you get a headache
after taking Viagra."
Rationale: Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor that promotes
vasodilation. Because it affects systemic vascular resistance, common side effects include
headache and facial flushing due to the dilation of cranial and skin vessels. Patients should
be warned about these to prevent unnecessary concern.
Question 2
A patient is receiving etoposide for a testicular tumor refractory to initial treatment. The nurse
practitioner notes the patient is also taking warfarin. Which of the following is the priority
assessment for this drug-drug interaction?
A) Increased serum albumin levels
B) Elevated prothrombin time (PT/INR)
C) Decreased white blood cell count
D) Hyperkalemia
E) Ototoxicity
Correct Answer: B) Elevated prothrombin time
Rationale: Etoposide can enhance the effects of warfarin by displacing it from protein-
binding sites or interfering with metabolism. This results in an increased risk of bleeding,
which is monitored via the Prothrombin Time (PT) and International Normalized Ratio
(INR). Failure to monitor this can lead to life-threatening hemorrhage.
Question 3
A male patient is prescribed ciprofloxacin to treat a sexually transmitted infection. To ensure
therapeutic success and prevent the development of antibiotic resistance, the nurse will instruct
the patient to:
A) Stop the medication as soon as symptoms resolve.
B) Double the dose if a day is missed.
C) Complete the entire course of drug therapy.
D) Take the medication with a large glass of milk.
E) Avoid all physical activity for 48 hours.
, 2
Correct Answer: C) to complete the entire course of drug therapy.
Rationale: Patient compliance is critical with fluoroquinolones like ciprofloxacin. Even if
the patient feels better after 24-48 hours, the underlying pathogen may not be fully
eradicated. Stopping early promotes the survival of resistant bacterial strains.
Question 4
A Nurse Practitioner is managing prescriptions for controlled substances. According to federal
law, which drug schedule has a valid medical use but a high potential for abuse, and requires a
new written prescription for every refill with no emergency telephone orders allowed unless a
written follow-up is provided within 72 hours?
A) Schedule I
B) Schedule II
C) Schedule III
D) Schedule IV
E) Schedule V
Correct Answer: B) Schedule II
Rationale: Schedule II drugs (e.g., morphine, oxycodone, amphetamines) have high abuse
potential. They cannot be refilled; a new prescription must be issued. In emergencies, a
telephone order is permitted but must be supported by a written "authorization for
emergency dispensing" within 72 hours.
Question 5
A 16-year-old boy is prescribed cromolyn sodium nasal spray for seasonal allergies. Which
instruction is vital to maximize the therapeutic effect of this mast cell stabilizer?
A) Use it only when the nose starts running.
B) Take it with a high-fat meal.
C) Use the drug for one whole week before coming in contact with allergens.
D) Sniff forcefully immediately after administration.
E) Discontinue use if sneezing occurs.
Correct Answer: C) Take the drug for one whole week before coming in contact with
allergens.
Rationale: Cromolyn sodium is a prophylactic agent. It prevents the release of
inflammatory mediators from mast cells but does not reverse an allergic reaction once it
has started. Therefore, it must be used consistently for several days to a week before
allergen exposure to be effective.
Question 6
A woman is receiving magnesium sulfate for intrapartum eclampsia. The patient is sweating, her
blood pressure is 88/50 mmHg, and her serum magnesium level is 10 mg/dL. How should the
nurse interpret these findings?
A) The patient is exhibiting a normal therapeutic response.
, 3
B) The patient is experiencing magnesium sulfate toxicity.
C) The patient has developed a secondary bacterial infection.
D) The magnesium level is too low to prevent seizures.
E) The patient is having an allergic reaction to the IV tubing.
Correct Answer: B) Magnesium Sulfate toxicity.
Rationale: Therapeutic magnesium levels range from 4-7 mg/dL. A level of 10 mg/dL,
accompanied by hypotension and sweating, indicates toxicity. Progression can lead to loss
of deep tendon reflexes and respiratory arrest. The nurse must stop the infusion and
prepare calcium gluconate.
Question 7
A patient with chronic myelogenous leukemia (CML) is being considered for cyclophosphamide
therapy. Which of the following findings would be a definitive contraindication for this drug?
A) History of seasonal allergies
B) A recent diagnosis of cataracts
C) Significantly depressed bone marrow function
D) Mild hypertension
E) Use of a hearing aid
Correct Answer: C) The patient's bone marrow function is significantly depressed.
Rationale: Cyclophosphamide is an alkylating agent that causes significant
myelosuppression. If a patient already has severely depressed bone marrow (low WBC,
RBC, and platelets), the drug could lead to fatal infection or hemorrhage.
Question 8
A 31-year-old woman is struggling with infertility due to ovulatory failure. Which medication
should the Nurse Practitioner anticipate will be prescribed to stimulate ovulation?
A) Testosterone
B) Clomiphene
C) Progesterone
D) Leuprolide
E) Finasteride
Correct Answer: B) clomiphene.
Rationale: Clomiphene is a selective estrogen receptor modulator (SERM) that stimulates
the release of FSH and LH, which in turn induces ovulation. It is the first-line treatment for
women with ovulatory dysfunction seeking pregnancy.
Question 9
A 34-year-old male diagnosed with tuberculosis is starting Isoniazid (INH). The patient regularly
takes antacids for heartburn. What instruction should the NP provide regarding antacid use?
A) Stop taking antacids indefinitely.
B) Take the antacid at the same time as INH to prevent GI upset.
, 4
C) Take antacids at least 1 hour before or 2 hours after taking INH.
D) Only use liquid antacids, never tablets.
E) Drink milk instead of using antacids.
Correct Answer: C) to take antacids not less than 1 hour before or 2 hours after taking INH.
Rationale: Antacids, particularly those containing aluminum, can interfere with the
absorption of INH from the GI tract. Separating the doses ensures the antibiotic reaches
therapeutic levels in the blood.
Question 10
A Nurse Practitioner is preparing to calculate a medication dosage for a 5-year-old child in an
oncology unit. Which method is considered the most accurate for pediatric dosing in this
population?
A) Age-based calculation (Young’s Rule)
B) Weight-based calculation (mg/kg)
C) Body Surface Area (BSA)
D) Standard adult dosing
E) Finger-to-toe measurement
Correct Answer: C) Body Surface Area
Rationale: BSA is considered the most accurate method for calculating pediatric dosages,
especially for high-toxicity drugs like chemotherapy, because it accounts for both height
and weight, reflecting the metabolic rate more accurately than weight alone.
Question 11
An older adult woman with acute lymphoblastic leukemia (ALL) is a candidate for imatinib.
Which of the following conditions might preclude her from using this targeted therapy?
A) Glaucoma
B) Osteoarthritis
C) Chronic heart failure with significant peripheral edema
D) Presbycusis
E) History of appendectomy
Correct Answer: C) The patient has chronic heart failure resulting in significant peripheral
edema
Rationale: Imatinib is associated with severe fluid retention and edema. In patients with
pre-existing heart failure, this drug can cause life-threatening exacerbations and
pulmonary edema, requiring extreme caution or alternative therapy.
Question 12
A male patient is considering finasteride (Proscar) for benign prostatic hypertrophy (BPH). What
specific risk should the nurse discuss with the patient?
A) Increased risk of lung cancer
B) Prostatic neoplasia (high-grade)
