Wilkes University
1 MAXE · 335 GSN
W
Passan School of Nursing
EST. 1933
UNITY AMIDST DIVERSITY
NSG 533 Advanced Pharmacology Exam 1
G I P H A R M ACO LO G Y: G E R D , H . PY LO R I , N AUS E A / VO M I T I N G , CO N ST I PAT I O N , D I A R R H E A & I BS
INSTITUTION Wilkes University COURSE CODE NSG 533
PROGRAM Advanced Pharmacology — Graduate ACADEMIC YEAR 2026
Nursing
EXAM TITLE NSG 533 Advanced Pharmacology Exam 1 TOTAL QUESTIONS 30 Questions
COURSE TITLE Advanced Pharmacology FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ GERD medications (antacids, H2RAs, PPIs, prokinetics), H. pylori treatment regimens, antiemetics, constipation and diarrhea
medications, and IBS pharmacotherapy are all testable content.
▸ Mechanisms of action, key adverse effects, contraindications, and clinical pearls are emphasized.
▸ Correct answers and detailed clinical rationales appear below each question for comprehensive exam preparation.
▸ All content reflects NSG 533 Advanced Pharmacology course objectives and current clinical guidelines.
, SECTION I — GI PHARMACOLOGY: GERD THROUGH IBS Questions 1 – 30
1. Which medication is a proton pump inhibitor (PPI) used as first-line treatment for GERD?
A. Famotidine
B. Omeprazole — inhibits H⁺/K⁺ ATPase (the proton pump), providing the most potent acid suppression; dosed
20–40 mg daily for 4–8 weeks
C. Calcium carbonate
D. Sucralfate
CORRECT ANSWER B — Omeprazole — PPI; first-line GERD treatment
RATIONALE Omeprazole is a proton pump inhibitor (PPI) that irreversibly inhibits the H⁺/K⁺ ATPase enzyme
system (the proton pump) at the gastric parietal cell surface — this is the final common pathway for
acid secretion, making PPIs the most potent acid suppressors available. PPIs are first-line for GERD,
especially with erosive esophagitis. Standard dosing: 20–40 mg daily for 4–8 weeks. Key adverse
effects include increased risk of C. difficile infection, bone fractures (with long-term use),
hypomagnesemia, and vitamin B12 deficiency. Famotidine (Choice A) is an H2 receptor antagonist —
less potent acid suppression. Calcium carbonate (Choice C) is an antacid — short-acting, used PRN.
Sucralfate (Choice D) is a mucosal protectant — adjunctive therapy.
2. What is the mechanism of action of ondansetron (Zofran)?
A. Dopamine D2 receptor blockade
B. 5-HT3 (serotonin) receptor antagonism — blocks serotonin receptors in the chemoreceptor trigger zone and
GI tract; used for CINV and PONV
C. Histamine H1 receptor blockade
D. Substance P/NK1 receptor antagonism
CORRECT ANSWER B — 5-HT3 receptor antagonism — blocks serotonin in CTZ and GI tract
RATIONALE Ondansetron is a selective 5-HT3 (serotonin) receptor antagonist. It blocks serotonin receptors in the
chemoreceptor trigger zone (CTZ) of the medulla and on vagal afferents in the GI tract, preventing
chemotherapy-induced and postoperative nausea and vomiting (CINV and PONV). Adult dose: 4–8
mg IV or PO. Key adverse effect: QT prolongation — ECG monitoring may be warranted with high
doses or in patients with cardiac risk factors. Dopamine D2 blockade (Choice A) is the mechanism of
metoclopramide. H1 blockade (Choice C) is the mechanism of meclizine and other antihistamines.
NK1 antagonism (Choice D) is the mechanism of aprepitant. The NSG 533 emphasizes understanding
antiemetic mechanisms for rational selection in different clinical scenarios.
, 3. Misoprostol is used for NSAID-induced ulcer prevention. Its mechanism of action is:
A. H2 receptor blockade to reduce acid secretion
B. Prostaglandin E1 analog — increases mucus and bicarbonate production, protecting the gastric mucosa;
dosed 200 mcg QID
C. Proton pump inhibition
D. Formation of a protective barrier over ulcers
CORRECT ANSWER B — Prostaglandin E1 analog — increases mucus and bicarbonate
RATIONALE Misoprostol is a synthetic prostaglandin E1 analog that replaces the prostaglandins suppressed by
NSAIDs. It increases gastric mucus and bicarbonate secretion, enhances mucosal blood flow, and
promotes healing. It is specifically indicated for prevention of NSAID-induced gastric ulcers in high-
risk patients. Dosing: 200 mcg QID. Key adverse effect: DIARRHEA (prostaglandin-mediated increased
GI motility). Critical contraindication: PREGNANCY — misoprostol causes uterine contractions and is
an abortifacient (FDA Category X). H2 receptor blockade (Choice A) is the mechanism of famotidine.
Proton pump inhibition (Choice C) is omeprazole. Protective barrier formation (Choice D) is
sucralfate. The NSG 533 emphasizes misoprostol's unique role and its absolute contraindication in
women of childbearing potential.
1 MAXE · 335 GSN
W
Passan School of Nursing
EST. 1933
UNITY AMIDST DIVERSITY
NSG 533 Advanced Pharmacology Exam 1
G I P H A R M ACO LO G Y: G E R D , H . PY LO R I , N AUS E A / VO M I T I N G , CO N ST I PAT I O N , D I A R R H E A & I BS
INSTITUTION Wilkes University COURSE CODE NSG 533
PROGRAM Advanced Pharmacology — Graduate ACADEMIC YEAR 2026
Nursing
EXAM TITLE NSG 533 Advanced Pharmacology Exam 1 TOTAL QUESTIONS 30 Questions
COURSE TITLE Advanced Pharmacology FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ GERD medications (antacids, H2RAs, PPIs, prokinetics), H. pylori treatment regimens, antiemetics, constipation and diarrhea
medications, and IBS pharmacotherapy are all testable content.
▸ Mechanisms of action, key adverse effects, contraindications, and clinical pearls are emphasized.
▸ Correct answers and detailed clinical rationales appear below each question for comprehensive exam preparation.
▸ All content reflects NSG 533 Advanced Pharmacology course objectives and current clinical guidelines.
, SECTION I — GI PHARMACOLOGY: GERD THROUGH IBS Questions 1 – 30
1. Which medication is a proton pump inhibitor (PPI) used as first-line treatment for GERD?
A. Famotidine
B. Omeprazole — inhibits H⁺/K⁺ ATPase (the proton pump), providing the most potent acid suppression; dosed
20–40 mg daily for 4–8 weeks
C. Calcium carbonate
D. Sucralfate
CORRECT ANSWER B — Omeprazole — PPI; first-line GERD treatment
RATIONALE Omeprazole is a proton pump inhibitor (PPI) that irreversibly inhibits the H⁺/K⁺ ATPase enzyme
system (the proton pump) at the gastric parietal cell surface — this is the final common pathway for
acid secretion, making PPIs the most potent acid suppressors available. PPIs are first-line for GERD,
especially with erosive esophagitis. Standard dosing: 20–40 mg daily for 4–8 weeks. Key adverse
effects include increased risk of C. difficile infection, bone fractures (with long-term use),
hypomagnesemia, and vitamin B12 deficiency. Famotidine (Choice A) is an H2 receptor antagonist —
less potent acid suppression. Calcium carbonate (Choice C) is an antacid — short-acting, used PRN.
Sucralfate (Choice D) is a mucosal protectant — adjunctive therapy.
2. What is the mechanism of action of ondansetron (Zofran)?
A. Dopamine D2 receptor blockade
B. 5-HT3 (serotonin) receptor antagonism — blocks serotonin receptors in the chemoreceptor trigger zone and
GI tract; used for CINV and PONV
C. Histamine H1 receptor blockade
D. Substance P/NK1 receptor antagonism
CORRECT ANSWER B — 5-HT3 receptor antagonism — blocks serotonin in CTZ and GI tract
RATIONALE Ondansetron is a selective 5-HT3 (serotonin) receptor antagonist. It blocks serotonin receptors in the
chemoreceptor trigger zone (CTZ) of the medulla and on vagal afferents in the GI tract, preventing
chemotherapy-induced and postoperative nausea and vomiting (CINV and PONV). Adult dose: 4–8
mg IV or PO. Key adverse effect: QT prolongation — ECG monitoring may be warranted with high
doses or in patients with cardiac risk factors. Dopamine D2 blockade (Choice A) is the mechanism of
metoclopramide. H1 blockade (Choice C) is the mechanism of meclizine and other antihistamines.
NK1 antagonism (Choice D) is the mechanism of aprepitant. The NSG 533 emphasizes understanding
antiemetic mechanisms for rational selection in different clinical scenarios.
, 3. Misoprostol is used for NSAID-induced ulcer prevention. Its mechanism of action is:
A. H2 receptor blockade to reduce acid secretion
B. Prostaglandin E1 analog — increases mucus and bicarbonate production, protecting the gastric mucosa;
dosed 200 mcg QID
C. Proton pump inhibition
D. Formation of a protective barrier over ulcers
CORRECT ANSWER B — Prostaglandin E1 analog — increases mucus and bicarbonate
RATIONALE Misoprostol is a synthetic prostaglandin E1 analog that replaces the prostaglandins suppressed by
NSAIDs. It increases gastric mucus and bicarbonate secretion, enhances mucosal blood flow, and
promotes healing. It is specifically indicated for prevention of NSAID-induced gastric ulcers in high-
risk patients. Dosing: 200 mcg QID. Key adverse effect: DIARRHEA (prostaglandin-mediated increased
GI motility). Critical contraindication: PREGNANCY — misoprostol causes uterine contractions and is
an abortifacient (FDA Category X). H2 receptor blockade (Choice A) is the mechanism of famotidine.
Proton pump inhibition (Choice C) is omeprazole. Protective barrier formation (Choice D) is
sucralfate. The NSG 533 emphasizes misoprostol's unique role and its absolute contraindication in
women of childbearing potential.
