NR568/ NR 568 Advanced Pharmacology
Weeks 5-8 Final Exam (Latest 2026/2027
Update) | Complete Exam Questions with
Verified Answers and Detailed Rationales
| Hormone Therapy, Contraceptives,
Androgens, ED, BPH, STIs | A+ Graded
SECTION I: HORMONE REPLACEMENT THERAPY (WEEK 5)
Q1: A 52-year-old female presents with severe
vasomotor symptoms and has an intact uterus. Which
hormone therapy regimen is most appropriate?
A) Estradiol monotherapy
B) Conjugated equine estrogens plus
medroxyprogesterone acetate
C) High-dose testosterone therapy
D) Ethinyl estradiol 50 mcg monotherapy
Answer: B
Rationale: In a woman with an intact uterus, systemic
estrogen monotherapy increases the risk of endometrial
hyperplasia and endometrial cancer. A progestin must be
added to provide endometrial protection by opposing
,estrogen-driven cellular proliferation. Progestin should be
used to oppose estrogen effects in women with an intact
uterus to prevent endometrial hyperplasia .
Q2: A 48-year-old perimenopausal woman reports hot
flashes and night sweats. She has a history of migraines
with aura. What is the safest estrogen administration
route?
A) Oral conjugated equine estrogen
B) Transdermal estradiol patch
C) Vaginal estrogen cream
D) Sublingual estradiol
Answer: B
Rationale: Transdermal estrogen therapy has fewer
adverse effects and does not undergo first-pass hepatic
metabolism. It is preferred in patients with migraine with
aura due to lower thrombotic risk compared to oral
estrogen. Transdermal administration delivers estrogen
directly into the bloodstream, avoiding hepatic first-pass
metabolism .
,Q3: A patient on hormone replacement therapy asks
about osteoporosis prevention. Which medication is a
selective estrogen receptor modulator (SERM) used for
this indication?
A) Medroxyprogesterone
B) Bazedoxifene
C) Estradiol
D) Testosterone
Answer: B
Rationale: Bazedoxifene is a SERM that provides
estrogenic effects on bone without stimulating the
endometrium. It is used for osteoporosis prevention and
treatment. SERMs are preferred when estrogen therapy is
contraindicated. Bazedoxifene can be used with
conjugated estrogens for osteoporosis prevention .
Q4: A 60-year-old woman with a history of breast cancer
is experiencing vaginal atrophy. Which treatment option
is most appropriate?
A) Systemic oral estrogen
B) Transdermal estrogen
, C) Vaginal estrogen cream
D) Medroxyprogesterone acetate
Answer: C
Rationale: For patients with a history of breast cancer,
systemic estrogen is generally contraindicated. Topical
vaginal estrogen delivers minimal systemic absorption
and is appropriate for genitourinary symptoms while
avoiding significant systemic hormone exposure. This is
why local therapy would be chosen over systemic
options .
Q5: A patient reports using Ginkgo biloba supplements
for memory. What should the NP monitor for?
A) Increased risk of bleeding
B) Liver toxicity
C) Hypertension
D) Hyperglycemia
Answer: A
Rationale: Ginkgo biloba inhibits platelet-activating factor
and can increase bleeding risk, especially when combined
with antiplatelet drugs or anticoagulants such as warfarin
Weeks 5-8 Final Exam (Latest 2026/2027
Update) | Complete Exam Questions with
Verified Answers and Detailed Rationales
| Hormone Therapy, Contraceptives,
Androgens, ED, BPH, STIs | A+ Graded
SECTION I: HORMONE REPLACEMENT THERAPY (WEEK 5)
Q1: A 52-year-old female presents with severe
vasomotor symptoms and has an intact uterus. Which
hormone therapy regimen is most appropriate?
A) Estradiol monotherapy
B) Conjugated equine estrogens plus
medroxyprogesterone acetate
C) High-dose testosterone therapy
D) Ethinyl estradiol 50 mcg monotherapy
Answer: B
Rationale: In a woman with an intact uterus, systemic
estrogen monotherapy increases the risk of endometrial
hyperplasia and endometrial cancer. A progestin must be
added to provide endometrial protection by opposing
,estrogen-driven cellular proliferation. Progestin should be
used to oppose estrogen effects in women with an intact
uterus to prevent endometrial hyperplasia .
Q2: A 48-year-old perimenopausal woman reports hot
flashes and night sweats. She has a history of migraines
with aura. What is the safest estrogen administration
route?
A) Oral conjugated equine estrogen
B) Transdermal estradiol patch
C) Vaginal estrogen cream
D) Sublingual estradiol
Answer: B
Rationale: Transdermal estrogen therapy has fewer
adverse effects and does not undergo first-pass hepatic
metabolism. It is preferred in patients with migraine with
aura due to lower thrombotic risk compared to oral
estrogen. Transdermal administration delivers estrogen
directly into the bloodstream, avoiding hepatic first-pass
metabolism .
,Q3: A patient on hormone replacement therapy asks
about osteoporosis prevention. Which medication is a
selective estrogen receptor modulator (SERM) used for
this indication?
A) Medroxyprogesterone
B) Bazedoxifene
C) Estradiol
D) Testosterone
Answer: B
Rationale: Bazedoxifene is a SERM that provides
estrogenic effects on bone without stimulating the
endometrium. It is used for osteoporosis prevention and
treatment. SERMs are preferred when estrogen therapy is
contraindicated. Bazedoxifene can be used with
conjugated estrogens for osteoporosis prevention .
Q4: A 60-year-old woman with a history of breast cancer
is experiencing vaginal atrophy. Which treatment option
is most appropriate?
A) Systemic oral estrogen
B) Transdermal estrogen
, C) Vaginal estrogen cream
D) Medroxyprogesterone acetate
Answer: C
Rationale: For patients with a history of breast cancer,
systemic estrogen is generally contraindicated. Topical
vaginal estrogen delivers minimal systemic absorption
and is appropriate for genitourinary symptoms while
avoiding significant systemic hormone exposure. This is
why local therapy would be chosen over systemic
options .
Q5: A patient reports using Ginkgo biloba supplements
for memory. What should the NP monitor for?
A) Increased risk of bleeding
B) Liver toxicity
C) Hypertension
D) Hyperglycemia
Answer: A
Rationale: Ginkgo biloba inhibits platelet-activating factor
and can increase bleeding risk, especially when combined
with antiplatelet drugs or anticoagulants such as warfarin
