lOMoARcPSD| 57911371
NR 566 Advanced Pharmacology for Care of
the Family Midterm Actual Exam 100
Questions, answers and rationale
1. Which antibiotic is specifically known for its association with the risk of tendon
rupture?
A. Doxycycline
B. Azithromycin C. Ciprofloxacin
D. Amoxicillin
Correct Answer: C
Rationale: Fluoroquinolones like Ciprofloxacin carry a Black Box Warning for tendonitis and
tendon rupture, especially in patients over 60.
2. A 24-year-old female presents with a primary syphilis infection. She has an
anaphylactic allergy to Penicillin. What is the alternative treatment?
A. Ceftriaxone
B. Doxycycline
C. Azithromycin D. Gentamicin
Correct Answer: B
Rationale: Doxycycline or Tetracycline are the preferred alternatives for non-pregnant,
penicillin-allergic patients with syphilis.
3. A patient is diagnosed with Community-Acquired Pneumonia (CAP). He has no
comorbidities and has not taken antibiotics in the last 90 days. Which is the first-line
treatment?
A. Levofloxacin
B. Amoxicillin 1g PO TID
C. Ciprofloxacin
D. Ceftriaxone IV
Correct Answer: B
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Rationale: Current guidelines recommend high-dose Amoxicillin or Doxycycline as first-line for
healthy outpatients without comorbidities.
4. SATA: Which of the following are considered "Bactericidal" agents? (Select all that
apply)
A. Penicillins
B. Tetracyclines
C. Cephalosporins
D. Macrolides
E. Vancomycin
Correct Answer: A, C, E
Rationale: Penicillins, Cephalosporins, and Vancomycin kill bacteria directly. Tetracyclines and
Macrolides are typically bacteriostatic (inhibit growth).
5. A patient is being treated with Gentamicin. The NP knows that the two most
significant toxicities to monitor for are:
A. Hepatotoxicity and Cardiotoxicity
B. Ototoxicity and Nephrotoxicity
C. Neurotoxicity and GI upset
D. Skin rash and Photosensitivity
Correct Answer: B
Rationale: Aminoglycosides are notoriously nephrotoxic (kidney) and ototoxic
(hearing/balance).
6. Which instructions should be given to a patient prescribed Tetracycline? A.
Take with a glass of milk.
B. Avoid sunlight and wear sunscreen.
C. Safe for use during pregnancy.
D. Take it immediately before lying down.
Correct Answer: B
Rationale: Tetracyclines cause significant photosensitivity and can cause esophageal irritation if
taken immediately before lying down.
7. SATA: Which host factors increase the risk of antibiotic toxicity? (Select all that
apply)
A. Very young age (infants)
B. History of hypertension
C. Advanced age (geriatrics)
D. Pregnancy
E. Renal insufficiency
Correct Answer: A, C, D, E
Rationale: Extremes of age, pregnancy, and poor kidney function all alter the way drugs are
cleared, increasing toxicity risk.
8. The "Gold Standard" for diagnosing Community-Acquired Pneumonia (CAP) is:
A. Sputum Culture
B. Clinical symptoms alone
C. Chest X-Ray
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D. Pulse Oximetry
Correct Answer: C
Rationale: A chest radiograph showing an infiltrate is required for a definitive medical diagnosis
of CAP.
9. A patient on Warfarin is prescribed Bactrim for a UTI. The NP expects the INR to:
A. Decrease significantly
B. Increase significantly
C. Remain stable
D. Disappear from the blood
Correct Answer: B
Rationale: Bactrim inhibits the metabolism of Warfarin, increasing its concentration and raising
the risk of bleeding.
10. Which medication is the drug of choice for treating Clostridium difficile (C. diff)?
A. Amoxicillin
B. Metronidazole (Flagyl)
C. Doxycycline
D. Clindamycin
Correct Answer: B
Rationale: Metronidazole is standard for mild-to-moderate C. diff, though oral Vancomycin is
also used for severe cases.
11. SATA: When prescribing Oseltamivir (Tamiflu), the NP must educate the patient
that: (Select all that apply)
A. It must be started within 48 hours of symptom onset.
B. It will "cure" the flu immediately.
C. It may cause nausea/vomiting.
D. It is only for patients over age 65.
Correct Answer: A, C
Rationale: Tamiflu is ineffective if started late and is known for causing significant GI upset.
12. Which antifungal medication requires an acidic environment for absorption?
A. Fluconazole B. Itraconazole
C. Nystatin
D. Terbinafine
Correct Answer: B
Rationale: Itraconazole absorption is significantly decreased if taken with PPIs or H2 blockers.
13. A patient uses an Albuterol inhaler (SABA) 4 times a week. The next step in
management is:
A. Increase Albuterol frequency
B. Add a Low-Dose Inhaled Corticosteroid (ICS)
C. Start a LABA alone
D. Start oral Prednisone
Correct Answer: B
Rationale: SABA use >2 days/week signals poor control and requires an anti-inflammatory
controller like an ICS.
14. Which GI medication forms a protective "bandage" over a gastric ulcer?
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NR 566 Advanced Pharmacology for Care of
the Family Midterm Actual Exam 100
Questions, answers and rationale
1. Which antibiotic is specifically known for its association with the risk of tendon
rupture?
A. Doxycycline
B. Azithromycin C. Ciprofloxacin
D. Amoxicillin
Correct Answer: C
Rationale: Fluoroquinolones like Ciprofloxacin carry a Black Box Warning for tendonitis and
tendon rupture, especially in patients over 60.
2. A 24-year-old female presents with a primary syphilis infection. She has an
anaphylactic allergy to Penicillin. What is the alternative treatment?
A. Ceftriaxone
B. Doxycycline
C. Azithromycin D. Gentamicin
Correct Answer: B
Rationale: Doxycycline or Tetracycline are the preferred alternatives for non-pregnant,
penicillin-allergic patients with syphilis.
3. A patient is diagnosed with Community-Acquired Pneumonia (CAP). He has no
comorbidities and has not taken antibiotics in the last 90 days. Which is the first-line
treatment?
A. Levofloxacin
B. Amoxicillin 1g PO TID
C. Ciprofloxacin
D. Ceftriaxone IV
Correct Answer: B
Downloaded by cardi hunch ()
, lOMoARcPSD| 57911371
Rationale: Current guidelines recommend high-dose Amoxicillin or Doxycycline as first-line for
healthy outpatients without comorbidities.
4. SATA: Which of the following are considered "Bactericidal" agents? (Select all that
apply)
A. Penicillins
B. Tetracyclines
C. Cephalosporins
D. Macrolides
E. Vancomycin
Correct Answer: A, C, E
Rationale: Penicillins, Cephalosporins, and Vancomycin kill bacteria directly. Tetracyclines and
Macrolides are typically bacteriostatic (inhibit growth).
5. A patient is being treated with Gentamicin. The NP knows that the two most
significant toxicities to monitor for are:
A. Hepatotoxicity and Cardiotoxicity
B. Ototoxicity and Nephrotoxicity
C. Neurotoxicity and GI upset
D. Skin rash and Photosensitivity
Correct Answer: B
Rationale: Aminoglycosides are notoriously nephrotoxic (kidney) and ototoxic
(hearing/balance).
6. Which instructions should be given to a patient prescribed Tetracycline? A.
Take with a glass of milk.
B. Avoid sunlight and wear sunscreen.
C. Safe for use during pregnancy.
D. Take it immediately before lying down.
Correct Answer: B
Rationale: Tetracyclines cause significant photosensitivity and can cause esophageal irritation if
taken immediately before lying down.
7. SATA: Which host factors increase the risk of antibiotic toxicity? (Select all that
apply)
A. Very young age (infants)
B. History of hypertension
C. Advanced age (geriatrics)
D. Pregnancy
E. Renal insufficiency
Correct Answer: A, C, D, E
Rationale: Extremes of age, pregnancy, and poor kidney function all alter the way drugs are
cleared, increasing toxicity risk.
8. The "Gold Standard" for diagnosing Community-Acquired Pneumonia (CAP) is:
A. Sputum Culture
B. Clinical symptoms alone
C. Chest X-Ray
Downloaded by cardi hunch ()
, lOMoARcPSD| 57911371
D. Pulse Oximetry
Correct Answer: C
Rationale: A chest radiograph showing an infiltrate is required for a definitive medical diagnosis
of CAP.
9. A patient on Warfarin is prescribed Bactrim for a UTI. The NP expects the INR to:
A. Decrease significantly
B. Increase significantly
C. Remain stable
D. Disappear from the blood
Correct Answer: B
Rationale: Bactrim inhibits the metabolism of Warfarin, increasing its concentration and raising
the risk of bleeding.
10. Which medication is the drug of choice for treating Clostridium difficile (C. diff)?
A. Amoxicillin
B. Metronidazole (Flagyl)
C. Doxycycline
D. Clindamycin
Correct Answer: B
Rationale: Metronidazole is standard for mild-to-moderate C. diff, though oral Vancomycin is
also used for severe cases.
11. SATA: When prescribing Oseltamivir (Tamiflu), the NP must educate the patient
that: (Select all that apply)
A. It must be started within 48 hours of symptom onset.
B. It will "cure" the flu immediately.
C. It may cause nausea/vomiting.
D. It is only for patients over age 65.
Correct Answer: A, C
Rationale: Tamiflu is ineffective if started late and is known for causing significant GI upset.
12. Which antifungal medication requires an acidic environment for absorption?
A. Fluconazole B. Itraconazole
C. Nystatin
D. Terbinafine
Correct Answer: B
Rationale: Itraconazole absorption is significantly decreased if taken with PPIs or H2 blockers.
13. A patient uses an Albuterol inhaler (SABA) 4 times a week. The next step in
management is:
A. Increase Albuterol frequency
B. Add a Low-Dose Inhaled Corticosteroid (ICS)
C. Start a LABA alone
D. Start oral Prednisone
Correct Answer: B
Rationale: SABA use >2 days/week signals poor control and requires an anti-inflammatory
controller like an ICS.
14. Which GI medication forms a protective "bandage" over a gastric ulcer?
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