NR566 Final Exam Mastery Guide
(2026/2027): High-Yield Questions &
Answers with Clinical Rationales for
Advanced Family Pharmacology —
Chamberlain University
Section 1: Sexually Transmitted Infections (STIs) & Reproductive
Health (Questions 1–25)
1. A 22-year-old female presents with lower abdominal pain, fever,
and cervical motion tenderness. She is diagnosed with Pelvic
Inflammatory Disease (PID). According to CDC guidelines, which
outpatient regimen is appropriate?
Answer: A. Ceftriaxone 500 mg IM once + Doxycycline 100 mg BID for
14 days ± Metronidazole 500 mg BID for 14 days
Rationale: The recommended outpatient regimen for PID is a single
IM dose of ceftriaxone plus oral doxycycline for 14 days. The addition
of metronidazole covers anaerobic organisms. This regimen provides
coverage for N. gonorrhoeae, C. trachomatis, and anaerobes.
2. A patient has just been diagnosed with uncomplicated gonorrhea.
Which intramuscular (IM) antibiotic is the recommended first-line
treatment?
, Answer: B. Ceftriaxone 500 mg IM
Rationale: Due to rising resistance to fluoroquinolones and other
antibiotics, a single 500 mg IM dose of ceftriaxone is the standard of
care for uncomplicated gonorrhea.
3. In addition to IM ceftriaxone for gonorrhea, why is it recommended
to also treat the patient with oral doxycycline?
Answer: To cover co-infection with Chlamydia trachomatis
Rationale: Co-infection with chlamydia is common in patients with
gonorrhea. Doxycycline 100 mg BID for 7 days provides appropriate
coverage for chlamydia.
4. A 25-year-old male presents with urethral discharge and dysuria.
Gram stain shows intracellular gram-negative diplococci. What is the
most appropriate treatment?
Answer: Ceftriaxone 500 mg IM once + Doxycycline 100 mg BID for 7
days
Rationale: The presence of intracellular gram-negative diplococci is
diagnostic of gonorrhea. CDC guidelines recommend dual therapy
with ceftriaxone and doxycycline to cover both gonorrhea and
potential chlamydia co-infection.
5. A pregnant patient is diagnosed with chlamydia. Which antibiotic is
safe and recommended?
Answer: Azithromycin 1 gram PO once
Rationale: Azithromycin is the preferred treatment for chlamydia in
pregnancy. Doxycycline is contraindicated in pregnancy due to
teratogenic effects on fetal bone and tooth development.
, 6. A patient with a history of penicillin allergy presents with primary
syphilis. What is the recommended treatment?
Answer: Doxycycline 100 mg BID for 14 days (or Tetracycline)
Rationale: For non-pregnant patients with penicillin allergy,
doxycycline or tetracycline is the alternative for primary, secondary,
and early latent syphilis. Pregnant patients with penicillin allergy must
be desensitized and treated with penicillin.
7. A patient presents with a painless genital ulcer and bilateral inguinal
lymphadenopathy. Darkfield microscopy reveals Treponema pallidum.
What is the diagnosis and treatment?
Answer: Primary syphilis; treat with Benzathine penicillin G 2.4 million
units IM once
Rationale: The painless chancre of primary syphilis is caused by T.
pallidum. A single dose of benzathine penicillin G is the gold standard
treatment.
8. A 30-year-old woman presents with vaginal discharge, odor, and
itching. Wet mount shows clue cells and a fishy odor with KOH (whiff
test). What is the diagnosis and treatment?
Answer: Bacterial vaginosis; treat with Metronidazole 500 mg BID for
7 days OR Metronidazole gel 0.75% once daily for 5 days
Rationale: Clue cells on wet mount and a positive whiff test are
characteristic of bacterial vaginosis. Metronidazole provides excellent
coverage against the anaerobic overgrowth.
9. A patient is diagnosed with Trichomoniasis. What is the first-line
treatment?
(2026/2027): High-Yield Questions &
Answers with Clinical Rationales for
Advanced Family Pharmacology —
Chamberlain University
Section 1: Sexually Transmitted Infections (STIs) & Reproductive
Health (Questions 1–25)
1. A 22-year-old female presents with lower abdominal pain, fever,
and cervical motion tenderness. She is diagnosed with Pelvic
Inflammatory Disease (PID). According to CDC guidelines, which
outpatient regimen is appropriate?
Answer: A. Ceftriaxone 500 mg IM once + Doxycycline 100 mg BID for
14 days ± Metronidazole 500 mg BID for 14 days
Rationale: The recommended outpatient regimen for PID is a single
IM dose of ceftriaxone plus oral doxycycline for 14 days. The addition
of metronidazole covers anaerobic organisms. This regimen provides
coverage for N. gonorrhoeae, C. trachomatis, and anaerobes.
2. A patient has just been diagnosed with uncomplicated gonorrhea.
Which intramuscular (IM) antibiotic is the recommended first-line
treatment?
, Answer: B. Ceftriaxone 500 mg IM
Rationale: Due to rising resistance to fluoroquinolones and other
antibiotics, a single 500 mg IM dose of ceftriaxone is the standard of
care for uncomplicated gonorrhea.
3. In addition to IM ceftriaxone for gonorrhea, why is it recommended
to also treat the patient with oral doxycycline?
Answer: To cover co-infection with Chlamydia trachomatis
Rationale: Co-infection with chlamydia is common in patients with
gonorrhea. Doxycycline 100 mg BID for 7 days provides appropriate
coverage for chlamydia.
4. A 25-year-old male presents with urethral discharge and dysuria.
Gram stain shows intracellular gram-negative diplococci. What is the
most appropriate treatment?
Answer: Ceftriaxone 500 mg IM once + Doxycycline 100 mg BID for 7
days
Rationale: The presence of intracellular gram-negative diplococci is
diagnostic of gonorrhea. CDC guidelines recommend dual therapy
with ceftriaxone and doxycycline to cover both gonorrhea and
potential chlamydia co-infection.
5. A pregnant patient is diagnosed with chlamydia. Which antibiotic is
safe and recommended?
Answer: Azithromycin 1 gram PO once
Rationale: Azithromycin is the preferred treatment for chlamydia in
pregnancy. Doxycycline is contraindicated in pregnancy due to
teratogenic effects on fetal bone and tooth development.
, 6. A patient with a history of penicillin allergy presents with primary
syphilis. What is the recommended treatment?
Answer: Doxycycline 100 mg BID for 14 days (or Tetracycline)
Rationale: For non-pregnant patients with penicillin allergy,
doxycycline or tetracycline is the alternative for primary, secondary,
and early latent syphilis. Pregnant patients with penicillin allergy must
be desensitized and treated with penicillin.
7. A patient presents with a painless genital ulcer and bilateral inguinal
lymphadenopathy. Darkfield microscopy reveals Treponema pallidum.
What is the diagnosis and treatment?
Answer: Primary syphilis; treat with Benzathine penicillin G 2.4 million
units IM once
Rationale: The painless chancre of primary syphilis is caused by T.
pallidum. A single dose of benzathine penicillin G is the gold standard
treatment.
8. A 30-year-old woman presents with vaginal discharge, odor, and
itching. Wet mount shows clue cells and a fishy odor with KOH (whiff
test). What is the diagnosis and treatment?
Answer: Bacterial vaginosis; treat with Metronidazole 500 mg BID for
7 days OR Metronidazole gel 0.75% once daily for 5 days
Rationale: Clue cells on wet mount and a positive whiff test are
characteristic of bacterial vaginosis. Metronidazole provides excellent
coverage against the anaerobic overgrowth.
9. A patient is diagnosed with Trichomoniasis. What is the first-line
treatment?
