NR 565 Midterm Mastery Practice
Questions & Rationales for
Advanced Pharmacology Plus
Verified Answers Most
Recent/[Graded A+]
1. A nurse practitioner is explaining to a patient how a
medication produces its therapeutic effect. The NP correctly
defines pharmacodynamics as:
• A) What the body does to the drug (absorption, distribution,
metabolism, excretion)
• B) What the drug does to the body (physiological and biochemical
effects)
• C) The study of genetic factors influencing drug response
• D) The time course of drug absorption and elimination
• Correct Answer: B
• *Rationale: Pharmacodynamics refers to the study of what the
drug does to the body, including mechanisms of action,
receptor binding, and therapeutic effects. Pharmacokinetics
(A) is what the body does to the drug. *
2. During which trimester of pregnancy is a fetus most at risk for
adverse drug reactions with potential long-term consequences?
• A) First trimester
• B) Second trimester
• C) Third trimester
• D) Equal risk throughout all trimesters
• Correct Answer: A
, • *Rationale: The first trimester is the period of organogenesis.
Drug exposure carries the highest risk of congenital
malformations. *
3. The BEERS criteria are used by healthcare providers to:
• A) Determine appropriate antibiotic dosing in pediatric patients
• B) Identify medications that are potentially inappropriate for
elderly patients (65 and older)
• C) Calculate opioid morphine milligram equivalents
• D) Classify pregnancy safety categories for medications
• Correct Answer: B
• *Rationale: The Beers Criteria provides recommendations
about medications that are potentially inappropriate for adults
65 and older. *
4. A patient asks the NP why their friend needs a lower dose of the
same medication they are taking. The NP explains that genetic
variations in drug metabolism can affect drug levels. This field of
study is known as:
• A) Pharmacodynamics
• B) Pharmacogenomics
• C) Pharmacokinetics
• D) Pharmacotherapeutics
• Correct Answer: B
• *Rationale: Pharmacogenomics is the study of genetic
variations that influence individual drug responses. *
5. A drug interaction where one medication inhibits the metabolism
of another drug, leading to increased serum levels, is classified as:
• A) Pharmacodynamic interaction
• B) Pharmacokinetic interaction
• C) Additive effect
• D) Synergistic effect
• Correct Answer: B
• *Rationale: This describes a pharmacokinetic interaction
affecting the metabolism (a component of ADME). *
,6. A 58-year-old male with a history of hypertension and type 2
diabetes is taking lisinopril. He reports a persistent dry cough.
Which is the most appropriate next step?
• A) Continue lisinopril and add a cough suppressant
• B) Discontinue lisinopril and initiate losartan
• C) Reduce lisinopril dose to 10 mg
• D) Switch to a calcium channel blocker
• Correct Answer: B
• *Rationale: ACE inhibitors like lisinopril increase bradykinin
levels, leading to a dry cough. The best alternative is an ARB
(like losartan), which provides similar benefits without
increasing bradykinin. *
7. A 72-year-old female with chronic kidney disease (eGFR 32
mL/min) is prescribed metformin. What is the most appropriate
action?
• A) Continue metformin without changes
• B) Reduce dose by half
• C) Discontinue metformin due to lactic acidosis risk
• D) Add insulin therapy only at night
• Correct Answer: C
• *Rationale: Metformin is contraindicated in patients with
significantly reduced renal function (eGFR <30, caution <45)
due to increased risk of lactic acidosis. *
8. A patient with asthma is prescribed propranolol for migraine
prevention and develops wheezing. What explains this reaction?
• A) Drug allergy
• B) Beta-1 receptor stimulation
• C) Beta-2 receptor blockade
• D) Histamine release
• Correct Answer: C
• *Rationale: Propranolol is a non-selective beta-blocker.
Blocking β2 receptors in the lungs causes bronchoconstriction,
worsening asthma. *
, 9. A patient taking simvastatin reports muscle pain and elevated
creatine kinase. What is the priority action?
• A) Continue medication and monitor
• B) Reduce dose
• C) Discontinue statin immediately
• D) Add NSAIDs
• Correct Answer: C
• *Rationale: This suggests statin-induced myopathy or
rhabdomyolysis. Immediate discontinuation is necessary to
prevent kidney damage. *
10. A patient on opioids for chronic pain develops constipation.
What is the best preventative measure?
• A) Increase opioid dose
• B) Prescribe stool softener and stimulant laxative
• C) Encourage fluid restriction
• D) Stop opioids immediately
• Correct Answer: B
• *Rationale: Opioid-induced constipation is predictable and
should be proactively treated with a bowel regimen. *
11. A 66-year-old male with heart failure on spironolactone has a
potassium level of 5.8 mEq/L. What is the most appropriate next
step?
• A) Continue medication and recheck in 1 week
• B) Discontinue spironolactone
• C) Add potassium supplement
• D) Increase spironolactone dose
• Correct Answer: B
• *Rationale: Spironolactone is potassium-sparing. A potassium
of 5.8 is elevated and dangerous; immediate discontinuation is
required. *
12. What are medication examples of Schedule II drugs? (Select all
that apply)
Questions & Rationales for
Advanced Pharmacology Plus
Verified Answers Most
Recent/[Graded A+]
1. A nurse practitioner is explaining to a patient how a
medication produces its therapeutic effect. The NP correctly
defines pharmacodynamics as:
• A) What the body does to the drug (absorption, distribution,
metabolism, excretion)
• B) What the drug does to the body (physiological and biochemical
effects)
• C) The study of genetic factors influencing drug response
• D) The time course of drug absorption and elimination
• Correct Answer: B
• *Rationale: Pharmacodynamics refers to the study of what the
drug does to the body, including mechanisms of action,
receptor binding, and therapeutic effects. Pharmacokinetics
(A) is what the body does to the drug. *
2. During which trimester of pregnancy is a fetus most at risk for
adverse drug reactions with potential long-term consequences?
• A) First trimester
• B) Second trimester
• C) Third trimester
• D) Equal risk throughout all trimesters
• Correct Answer: A
, • *Rationale: The first trimester is the period of organogenesis.
Drug exposure carries the highest risk of congenital
malformations. *
3. The BEERS criteria are used by healthcare providers to:
• A) Determine appropriate antibiotic dosing in pediatric patients
• B) Identify medications that are potentially inappropriate for
elderly patients (65 and older)
• C) Calculate opioid morphine milligram equivalents
• D) Classify pregnancy safety categories for medications
• Correct Answer: B
• *Rationale: The Beers Criteria provides recommendations
about medications that are potentially inappropriate for adults
65 and older. *
4. A patient asks the NP why their friend needs a lower dose of the
same medication they are taking. The NP explains that genetic
variations in drug metabolism can affect drug levels. This field of
study is known as:
• A) Pharmacodynamics
• B) Pharmacogenomics
• C) Pharmacokinetics
• D) Pharmacotherapeutics
• Correct Answer: B
• *Rationale: Pharmacogenomics is the study of genetic
variations that influence individual drug responses. *
5. A drug interaction where one medication inhibits the metabolism
of another drug, leading to increased serum levels, is classified as:
• A) Pharmacodynamic interaction
• B) Pharmacokinetic interaction
• C) Additive effect
• D) Synergistic effect
• Correct Answer: B
• *Rationale: This describes a pharmacokinetic interaction
affecting the metabolism (a component of ADME). *
,6. A 58-year-old male with a history of hypertension and type 2
diabetes is taking lisinopril. He reports a persistent dry cough.
Which is the most appropriate next step?
• A) Continue lisinopril and add a cough suppressant
• B) Discontinue lisinopril and initiate losartan
• C) Reduce lisinopril dose to 10 mg
• D) Switch to a calcium channel blocker
• Correct Answer: B
• *Rationale: ACE inhibitors like lisinopril increase bradykinin
levels, leading to a dry cough. The best alternative is an ARB
(like losartan), which provides similar benefits without
increasing bradykinin. *
7. A 72-year-old female with chronic kidney disease (eGFR 32
mL/min) is prescribed metformin. What is the most appropriate
action?
• A) Continue metformin without changes
• B) Reduce dose by half
• C) Discontinue metformin due to lactic acidosis risk
• D) Add insulin therapy only at night
• Correct Answer: C
• *Rationale: Metformin is contraindicated in patients with
significantly reduced renal function (eGFR <30, caution <45)
due to increased risk of lactic acidosis. *
8. A patient with asthma is prescribed propranolol for migraine
prevention and develops wheezing. What explains this reaction?
• A) Drug allergy
• B) Beta-1 receptor stimulation
• C) Beta-2 receptor blockade
• D) Histamine release
• Correct Answer: C
• *Rationale: Propranolol is a non-selective beta-blocker.
Blocking β2 receptors in the lungs causes bronchoconstriction,
worsening asthma. *
, 9. A patient taking simvastatin reports muscle pain and elevated
creatine kinase. What is the priority action?
• A) Continue medication and monitor
• B) Reduce dose
• C) Discontinue statin immediately
• D) Add NSAIDs
• Correct Answer: C
• *Rationale: This suggests statin-induced myopathy or
rhabdomyolysis. Immediate discontinuation is necessary to
prevent kidney damage. *
10. A patient on opioids for chronic pain develops constipation.
What is the best preventative measure?
• A) Increase opioid dose
• B) Prescribe stool softener and stimulant laxative
• C) Encourage fluid restriction
• D) Stop opioids immediately
• Correct Answer: B
• *Rationale: Opioid-induced constipation is predictable and
should be proactively treated with a bowel regimen. *
11. A 66-year-old male with heart failure on spironolactone has a
potassium level of 5.8 mEq/L. What is the most appropriate next
step?
• A) Continue medication and recheck in 1 week
• B) Discontinue spironolactone
• C) Add potassium supplement
• D) Increase spironolactone dose
• Correct Answer: B
• *Rationale: Spironolactone is potassium-sparing. A potassium
of 5.8 is elevated and dangerous; immediate discontinuation is
required. *
12. What are medication examples of Schedule II drugs? (Select all
that apply)
