NSG 533 — Advanced
1 MAXE · 335 GSN
NSG
533
Pharmacology
Exam 1 — Complete Medication Guide & Study Resource
EXAM 1
EVIDENCE-BASED PRESCRIBING · CLINICAL EXCELLENCE
NSG 533 Advanced Pharmacology Exam 1 — Complete
Medication Guide
CO M P R E H E N S I V E Q U E ST I O N S & V E R I F I E D A N S W E RS | G I , D I A B E T E S , T H Y R O I D ,
H O R M O N E S , PSYC H O P H A R M ACO LO G Y | 2 0 2 6
INSTITUTION Graduate Nursing Program — NSG COURSE CODE NSG 533 — Advanced
533 Pharmacology
PROGRAM Master of Science in Nursing / DNP ACADEMIC YEAR
EXAM TITLE NSG 533 Advanced Pharmacology TOTAL QUESTIONS 117 Questions
Exam 1 | Complete Medication
Guide
COURSE TITLE Advanced Pharmacology — GI, FORMAT Multiple Choice — Select the
Endocrine, Men's/Women's Single Best Answer
Health, Psychopharmacology
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover GI medications, diabetes agents, thyroid treatments, BPH/ED medications,
contraception/HRT, and all major psychotropic classes.
▸ Correct answers and detailed clinical rationales with memory aids appear below each question.
▸ Content aligned with NSG 533 Advanced Pharmacology curriculum and evidence-based prescribing
guidelines.
, SECTION I — ADVANCED PHARMACOLOGY EXAM 1
Questions 1 – 117
COMPREHENSIVE REVIEW
1. Calcium carbonate (antacid) works by ______. Key counseling includes ______.
A. Neutralizing gastric acid; separate from other medications by 2-4 hours and watch for
rebound hyperacidity
B. Blocking H2 receptors; take on an empty stomach
C. Inhibiting the proton pump; take 30 minutes before meals
D. Coating the gastric mucosa; take at bedtime only
CORRECT ANSWER A — Neutralizing gastric acid; separate from other medications by 2-4
hours and watch for rebound hyperacidity
RATIONALE Calcium carbonate directly neutralizes gastric acid. Key counseling: separate
from other medications (tetracyclines, fluoroquinolones, levothyroxine) by 2-4
hours because antacids decrease absorption. Watch for rebound hyperacidity —
the stomach may overcompensate when the antacid wears off. Adverse effects:
constipation (calcium/aluminum formulations), diarrhea (magnesium
formulations), kidney stones (calcium). Contraindicated in severe renal
impairment (Mg/Al accumulation). Dose: 500-1000 mg PRN.
2. Alginic acid + antacid combination is best taken ______.
A. After meals and at bedtime to form a raft barrier for reflux
B. First thing in the morning on an empty stomach
C. Only when symptoms are severe
D. With all other medications simultaneously
CORRECT ANSWER A — After meals and at bedtime to form a raft barrier for reflux
RATIONALE Alginic acid combined with antacids forms a viscous "raft" that floats on top of
gastric contents, creating a physical barrier preventing reflux into the
esophagus. It is most effective when taken after meals and at bedtime — when
reflux is most likely to occur. Adverse effects include bloating and nausea. Use
caution in heart failure/hypertension patients due to sodium load (product-
specific). Unlike H2RAs or PPIs, it provides mechanical rather than
pharmacological reflux protection.
,3. Which H2 receptor antagonist should be avoided in patients with polypharmacy due to
CYP450 interactions?
A. Famotidine
B. Cimetidine
C. Nizatidine
D. Ranitidine
CORRECT ANSWER B — Cimetidine
RATIONALE Cimetidine is a potent inhibitor of multiple CYP450 enzymes (CYP1A2, 2C9, 2D6,
3A4) — a "CYP nightmare." It significantly increases levels of warfarin,
phenytoin, theophylline, and many other drugs. Famotidine, nizatidine, and
ranitidine (withdrawn) do NOT significantly inhibit CYP enzymes. For patients
on multiple medications, famotidine is strongly preferred over cimetidine.
H2RAs are best for mild or nocturnal GERD symptoms and work by blocking
histamine-stimulated gastric acid secretion. Dose: famotidine 20 mg BID for 4-8
weeks. Renal impairment requires dose adjustment.
, 4. Proton pump inhibitors should be taken ______. Long-term risks include ______.
A. 30-60 minutes before the first meal; C. difficile, fractures, hypomagnesemia (Bad Bones
and Bugs)
B. At bedtime; only headache
C. With food; no long-term risks
D. Whenever symptoms occur; only diarrhea
CORRECT ANSWER A — 30-60 minutes before the first meal; C. difficile, fractures,
hypomagnesemia
RATIONALE PPIs are prodrugs that require activation by gastric acid — they must be taken
30-60 minutes BEFORE a meal (usually breakfast) to be present in parietal cells
when acid secretion begins after eating. Taking with food significantly reduces
efficacy. Long-term risks (mnemonic "Bad Bones and Bugs"): C. difficile
infection (reduced gastric acid barrier), osteoporosis/fractures (decreased
calcium absorption), hypomagnesemia, vitamin B12 deficiency, and potential
renal complications. Use the lowest effective dose for the shortest duration. If
long-term use is necessary, monitor magnesium and B12 levels. Common PPIs:
omeprazole, pantoprazole, esomeprazole, lansoprazole.
1 MAXE · 335 GSN
NSG
533
Pharmacology
Exam 1 — Complete Medication Guide & Study Resource
EXAM 1
EVIDENCE-BASED PRESCRIBING · CLINICAL EXCELLENCE
NSG 533 Advanced Pharmacology Exam 1 — Complete
Medication Guide
CO M P R E H E N S I V E Q U E ST I O N S & V E R I F I E D A N S W E RS | G I , D I A B E T E S , T H Y R O I D ,
H O R M O N E S , PSYC H O P H A R M ACO LO G Y | 2 0 2 6
INSTITUTION Graduate Nursing Program — NSG COURSE CODE NSG 533 — Advanced
533 Pharmacology
PROGRAM Master of Science in Nursing / DNP ACADEMIC YEAR
EXAM TITLE NSG 533 Advanced Pharmacology TOTAL QUESTIONS 117 Questions
Exam 1 | Complete Medication
Guide
COURSE TITLE Advanced Pharmacology — GI, FORMAT Multiple Choice — Select the
Endocrine, Men's/Women's Single Best Answer
Health, Psychopharmacology
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover GI medications, diabetes agents, thyroid treatments, BPH/ED medications,
contraception/HRT, and all major psychotropic classes.
▸ Correct answers and detailed clinical rationales with memory aids appear below each question.
▸ Content aligned with NSG 533 Advanced Pharmacology curriculum and evidence-based prescribing
guidelines.
, SECTION I — ADVANCED PHARMACOLOGY EXAM 1
Questions 1 – 117
COMPREHENSIVE REVIEW
1. Calcium carbonate (antacid) works by ______. Key counseling includes ______.
A. Neutralizing gastric acid; separate from other medications by 2-4 hours and watch for
rebound hyperacidity
B. Blocking H2 receptors; take on an empty stomach
C. Inhibiting the proton pump; take 30 minutes before meals
D. Coating the gastric mucosa; take at bedtime only
CORRECT ANSWER A — Neutralizing gastric acid; separate from other medications by 2-4
hours and watch for rebound hyperacidity
RATIONALE Calcium carbonate directly neutralizes gastric acid. Key counseling: separate
from other medications (tetracyclines, fluoroquinolones, levothyroxine) by 2-4
hours because antacids decrease absorption. Watch for rebound hyperacidity —
the stomach may overcompensate when the antacid wears off. Adverse effects:
constipation (calcium/aluminum formulations), diarrhea (magnesium
formulations), kidney stones (calcium). Contraindicated in severe renal
impairment (Mg/Al accumulation). Dose: 500-1000 mg PRN.
2. Alginic acid + antacid combination is best taken ______.
A. After meals and at bedtime to form a raft barrier for reflux
B. First thing in the morning on an empty stomach
C. Only when symptoms are severe
D. With all other medications simultaneously
CORRECT ANSWER A — After meals and at bedtime to form a raft barrier for reflux
RATIONALE Alginic acid combined with antacids forms a viscous "raft" that floats on top of
gastric contents, creating a physical barrier preventing reflux into the
esophagus. It is most effective when taken after meals and at bedtime — when
reflux is most likely to occur. Adverse effects include bloating and nausea. Use
caution in heart failure/hypertension patients due to sodium load (product-
specific). Unlike H2RAs or PPIs, it provides mechanical rather than
pharmacological reflux protection.
,3. Which H2 receptor antagonist should be avoided in patients with polypharmacy due to
CYP450 interactions?
A. Famotidine
B. Cimetidine
C. Nizatidine
D. Ranitidine
CORRECT ANSWER B — Cimetidine
RATIONALE Cimetidine is a potent inhibitor of multiple CYP450 enzymes (CYP1A2, 2C9, 2D6,
3A4) — a "CYP nightmare." It significantly increases levels of warfarin,
phenytoin, theophylline, and many other drugs. Famotidine, nizatidine, and
ranitidine (withdrawn) do NOT significantly inhibit CYP enzymes. For patients
on multiple medications, famotidine is strongly preferred over cimetidine.
H2RAs are best for mild or nocturnal GERD symptoms and work by blocking
histamine-stimulated gastric acid secretion. Dose: famotidine 20 mg BID for 4-8
weeks. Renal impairment requires dose adjustment.
, 4. Proton pump inhibitors should be taken ______. Long-term risks include ______.
A. 30-60 minutes before the first meal; C. difficile, fractures, hypomagnesemia (Bad Bones
and Bugs)
B. At bedtime; only headache
C. With food; no long-term risks
D. Whenever symptoms occur; only diarrhea
CORRECT ANSWER A — 30-60 minutes before the first meal; C. difficile, fractures,
hypomagnesemia
RATIONALE PPIs are prodrugs that require activation by gastric acid — they must be taken
30-60 minutes BEFORE a meal (usually breakfast) to be present in parietal cells
when acid secretion begins after eating. Taking with food significantly reduces
efficacy. Long-term risks (mnemonic "Bad Bones and Bugs"): C. difficile
infection (reduced gastric acid barrier), osteoporosis/fractures (decreased
calcium absorption), hypomagnesemia, vitamin B12 deficiency, and potential
renal complications. Use the lowest effective dose for the shortest duration. If
long-term use is necessary, monitor magnesium and B12 levels. Common PPIs:
omeprazole, pantoprazole, esomeprazole, lansoprazole.
