NURS 5334 Advanced Pharmacology Quiz 2 Test
Bank | UTA | Verified Questions and Answers |
100% Correct | A+ Graded (2026–2027)
Question 1
A 12-year-old child has extensive psoriatic lesions covering his back. Which topical
therapy applied with continuous use has the potential to prevent him from reaching his
full adult height?
Salicylic acid
Clobetasol propionate
Calcipotriene
Calcitriol
, Correct Answer: Clobetasol propionate
Rationale: Excessive use of potent corticosteroids applied to a large surface area can
cause systemic adverse effects, including hypothalamic-pituitary-adrenal (HPA) axis
suppression and growth retardation.
Question 2
A 32-year-old woman with papulopustular rosacea prefers to use a topical agent, rather
than an oral agent, to treat her lesions. Which of the following agents is the most
appropriate recommendation?
Brimonidine
Doxycycline
Oxymetazoline
Metronidazole
Correct Answer: Metronidazole
Rationale: Metronidazole is a topical antibacterial agent used first-line for
papulopustular rosacea. It is believed to work through local anti-inflammatory or
immunosuppressive effects. While oral doxycycline is also effective for rosacea, it is an
oral systemic agent rather than a topical option. Brimonidine and oxymetazoline target
persistent facial erythema (redness) rather than the inflammatory papules and pustules.
Question 3
A 24-year-old male presents with severe plaque psoriasis covering roughly 15% of his
body surface area. The provider decides to initiate a systemic biologic response
modifier that inhibits tumor necrosis factor-alpha (TNF-\(\alpha \)). Before administering
the first dose, which screening evaluation is absolute and mandatory?
Serum creatinine and urea nitrogen clearance
Latent tuberculosis screening (IGRA or TST)
Baseline pulmonary function testing
Continuous 12-lead electrocardiogram evaluation
Correct Answer: Latent tuberculosis screening (IGRA or TST)
Rationale: TNF-\(\alpha \) plays a key operational role in maintaining granulomas that
sequester Mycobacterium tuberculosis. Blocking this cytokine can lead to rapid
reactivation of latent tuberculosis into active, life-threatening disseminated disease.
, Question 4
A 66-year-old male with chronic open-angle glaucoma is prescribed latanoprost
ophthalmic drops daily. Which structural or cosmetic side effect must the patient be
thoroughly counseled on prior to starting this drug?
Irreversible iris hyperpigmentation
Permanent pupil dilation (mydriasis)
Severe systemic orthostatic hypotension
Transient corneal opacification
Correct Answer: Irreversible iris hyperpigmentation
Rationale: Prostaglandin analogs like latanoprost increase melanin content in iris
stromal melanocytes. This often results in a permanent turning of light-colored (blue,
green, hazel) eyes to brown. It also promotes reversible eyelash lengthening and
periocular skin hyperpigmentation.
Question 5
A 21-year-old female patient with severe, scarring nodulocystic acne is being evaluated
for systemic isotretinoin therapy. Which safety management registry and protocol must
be satisfied before a prescription can be legally dispensed?
The DEA Controlled Substance Monitoring Network
The iPLEDGE risk evaluation and mitigation strategy (REMS)
Baseline renal biopsy and clearance registration
Weekly serum drug concentration therapeutic indexing
Correct Answer: The iPLEDGE risk evaluation and mitigation strategy (REMS)
Rationale: Isotretinoin is a highly potent teratogen capable of causing devastating
congenital malformations. The mandatory iPLEDGE program requires strict multi-step
verification of dual effective contraception methods and successive negative monthly
pregnancy tests.
Question 6
A patient with chronic moderate-to-severe atopic dermatitis on sensitive areas of the
face is prescribed topical tacrolimus 0.03% ointment. What is the molecular mechanism
of action of this non-steroidal immunosuppressive agent?
Competitive antagonism of peripheral H1 histamine receptors
Inhibition of calcineurin, preventing T-cell activation and cytokine transcription
Chemical destruction of hyperkeratotic epidermal cell matrices
Downregulation of alpha-adrenergic smooth muscle responses
Correct Answer: Inhibition of calcineurin, preventing T-cell activation and cytokine
transcription
, Rationale: Tacrolimus binds to intracellular immunophilins to inhibit calcineurin. This
stops the dephosphorylation and nuclear translocation of nuclear factor of activated T-
cells (NFAT), mitigating inflammation without causing the skin atrophy seen with topical
steroids.
Question 7
A 54-year-old male presents with a severe acute gouty flare localized to his right first
metatarsophalangeal joint. His laboratory evaluation reveals a baseline stage 4 chronic
kidney disease (eGFR 22 mL/min). Which of the following represents the safest acute
abortive treatment selection?
High-dose oral indomethacin
Intravenous or high-dose oral colchicine
A short, tapering course of systemic corticosteroids (e.g., prednisone)
Immediate high-dose initiation of allopurinol
Correct Answer: A short, tapering course of systemic corticosteroids (e.g., prednisone)
Rationale: High-dose NSAIDs are strictly contraindicated in advanced renal impairment
due to the risk of precipitating acute-on-chronic kidney injury. Colchicine builds up to
toxic levels when renal clearance is severely reduced, making systemic or intra-articular
corticosteroids the preferred alternative for acute inflammation. Allopurinol is an urban
myth for acute flares; it lowers uric acid long-term but should not be initiated or scaled
up during an active acute attack.
Question 8
A 28-year-old pregnant patient requires localized management for a cutaneous
dermatophyte infection (tinea corporis). Which topical antifungal drug choice is
classified as highly safe (Category B) for use across all trimesters?
Topical clotrimazole
Oral griseofulvin
Topical selenium sulfide
Oral ketoconazole
Correct Answer: Topical clotrimazole
Rationale: Topical azoles such as clotrimazole and miconazole have negligible
systemic absorption when applied directly to intact skin surfaces, making them the
preferred first-line agents for superficial fungal infections in pregnant individuals.
Bank | UTA | Verified Questions and Answers |
100% Correct | A+ Graded (2026–2027)
Question 1
A 12-year-old child has extensive psoriatic lesions covering his back. Which topical
therapy applied with continuous use has the potential to prevent him from reaching his
full adult height?
Salicylic acid
Clobetasol propionate
Calcipotriene
Calcitriol
, Correct Answer: Clobetasol propionate
Rationale: Excessive use of potent corticosteroids applied to a large surface area can
cause systemic adverse effects, including hypothalamic-pituitary-adrenal (HPA) axis
suppression and growth retardation.
Question 2
A 32-year-old woman with papulopustular rosacea prefers to use a topical agent, rather
than an oral agent, to treat her lesions. Which of the following agents is the most
appropriate recommendation?
Brimonidine
Doxycycline
Oxymetazoline
Metronidazole
Correct Answer: Metronidazole
Rationale: Metronidazole is a topical antibacterial agent used first-line for
papulopustular rosacea. It is believed to work through local anti-inflammatory or
immunosuppressive effects. While oral doxycycline is also effective for rosacea, it is an
oral systemic agent rather than a topical option. Brimonidine and oxymetazoline target
persistent facial erythema (redness) rather than the inflammatory papules and pustules.
Question 3
A 24-year-old male presents with severe plaque psoriasis covering roughly 15% of his
body surface area. The provider decides to initiate a systemic biologic response
modifier that inhibits tumor necrosis factor-alpha (TNF-\(\alpha \)). Before administering
the first dose, which screening evaluation is absolute and mandatory?
Serum creatinine and urea nitrogen clearance
Latent tuberculosis screening (IGRA or TST)
Baseline pulmonary function testing
Continuous 12-lead electrocardiogram evaluation
Correct Answer: Latent tuberculosis screening (IGRA or TST)
Rationale: TNF-\(\alpha \) plays a key operational role in maintaining granulomas that
sequester Mycobacterium tuberculosis. Blocking this cytokine can lead to rapid
reactivation of latent tuberculosis into active, life-threatening disseminated disease.
, Question 4
A 66-year-old male with chronic open-angle glaucoma is prescribed latanoprost
ophthalmic drops daily. Which structural or cosmetic side effect must the patient be
thoroughly counseled on prior to starting this drug?
Irreversible iris hyperpigmentation
Permanent pupil dilation (mydriasis)
Severe systemic orthostatic hypotension
Transient corneal opacification
Correct Answer: Irreversible iris hyperpigmentation
Rationale: Prostaglandin analogs like latanoprost increase melanin content in iris
stromal melanocytes. This often results in a permanent turning of light-colored (blue,
green, hazel) eyes to brown. It also promotes reversible eyelash lengthening and
periocular skin hyperpigmentation.
Question 5
A 21-year-old female patient with severe, scarring nodulocystic acne is being evaluated
for systemic isotretinoin therapy. Which safety management registry and protocol must
be satisfied before a prescription can be legally dispensed?
The DEA Controlled Substance Monitoring Network
The iPLEDGE risk evaluation and mitigation strategy (REMS)
Baseline renal biopsy and clearance registration
Weekly serum drug concentration therapeutic indexing
Correct Answer: The iPLEDGE risk evaluation and mitigation strategy (REMS)
Rationale: Isotretinoin is a highly potent teratogen capable of causing devastating
congenital malformations. The mandatory iPLEDGE program requires strict multi-step
verification of dual effective contraception methods and successive negative monthly
pregnancy tests.
Question 6
A patient with chronic moderate-to-severe atopic dermatitis on sensitive areas of the
face is prescribed topical tacrolimus 0.03% ointment. What is the molecular mechanism
of action of this non-steroidal immunosuppressive agent?
Competitive antagonism of peripheral H1 histamine receptors
Inhibition of calcineurin, preventing T-cell activation and cytokine transcription
Chemical destruction of hyperkeratotic epidermal cell matrices
Downregulation of alpha-adrenergic smooth muscle responses
Correct Answer: Inhibition of calcineurin, preventing T-cell activation and cytokine
transcription
, Rationale: Tacrolimus binds to intracellular immunophilins to inhibit calcineurin. This
stops the dephosphorylation and nuclear translocation of nuclear factor of activated T-
cells (NFAT), mitigating inflammation without causing the skin atrophy seen with topical
steroids.
Question 7
A 54-year-old male presents with a severe acute gouty flare localized to his right first
metatarsophalangeal joint. His laboratory evaluation reveals a baseline stage 4 chronic
kidney disease (eGFR 22 mL/min). Which of the following represents the safest acute
abortive treatment selection?
High-dose oral indomethacin
Intravenous or high-dose oral colchicine
A short, tapering course of systemic corticosteroids (e.g., prednisone)
Immediate high-dose initiation of allopurinol
Correct Answer: A short, tapering course of systemic corticosteroids (e.g., prednisone)
Rationale: High-dose NSAIDs are strictly contraindicated in advanced renal impairment
due to the risk of precipitating acute-on-chronic kidney injury. Colchicine builds up to
toxic levels when renal clearance is severely reduced, making systemic or intra-articular
corticosteroids the preferred alternative for acute inflammation. Allopurinol is an urban
myth for acute flares; it lowers uric acid long-term but should not be initiated or scaled
up during an active acute attack.
Question 8
A 28-year-old pregnant patient requires localized management for a cutaneous
dermatophyte infection (tinea corporis). Which topical antifungal drug choice is
classified as highly safe (Category B) for use across all trimesters?
Topical clotrimazole
Oral griseofulvin
Topical selenium sulfide
Oral ketoconazole
Correct Answer: Topical clotrimazole
Rationale: Topical azoles such as clotrimazole and miconazole have negligible
systemic absorption when applied directly to intact skin surfaces, making them the
preferred first-line agents for superficial fungal infections in pregnant individuals.
