NUR 635 ADVANCED PHARMACOLOGY FINAL EXAM
2026-2027: ULTIMATE 200-QUESTION TEST BANK WITH
VERIFIED ANSWERS & CLINICAL RATIONALES
1. A patient with a protozoal infection caused by an obligate anaerobic
organism is prescribed which medication?
A) Ciprofloxacin
B) Metronidazole
C) Doxycycline
D) Azithromycin
Correct Answer: B – Metronidazole is the drug of choice for anaerobic
protozoal infections such as Giardia and Trichomonas. Ciprofloxacin
targets gram-negative bacteria, doxycycline covers atypical bacteria,
and azithromycin is a macrolide for respiratory pathogens.
2. A 22-year-old female is diagnosed with chlamydia. The NP prescribes
azithromycin 500 mg orally. When should the patient take the second
250 mg dose?
A) This time tomorrow and continue once daily for 5-7 days
B) In 12 hours
C) In 24 hours only
D) Not needed; only one dose is required
Correct Answer: A – CDC guidelines recommend azithromycin 1 g as a
single dose OR 500 mg on day 1 followed by 250 mg daily for 4 more
days; thus the second dose is taken the next day and continued daily.
,3. A patient on clindamycin calls reporting diarrhea. What is the NP's
best response?
A) Advise the patient to discontinue the medication
B) Prescribe an anti-diarrheal
C) Recommend probiotics
D) Advise to continue the medication and increase fluids
Correct Answer: A – Diarrhea with clindamycin suggests possible C.
difficile infection; the drug should be stopped immediately and the
patient evaluated, as anti-diarrheals can precipitate toxic megacolon.
4. A 16-year-old presents for acne treatment. Which medication does
the NP prescribe?
A) Oral isotretinoin
B) Combination antibiotic and topical
C) Oral corticosteroid
D) Single-agent topical only
Correct Answer: B – Combination topical antibiotic plus retinoid is first-
line for moderate adolescent acne; isotretinoin is reserved for severe
nodular acne unresponsive to other therapies.
5. A teenager on minocycline reports a headache. The NP suspects
which adverse effect?
A) Migraine
B) Pseudotumor cerebri (increased intracranial pressure)
C) Tension headache
D) Sinusitis
Correct Answer: B – Minocycline and other tetracyclines can cause
pseudotumor cerebri, presenting with headache and visual
disturbances; a fundoscopic exam is warranted.
,6. Which treatment is appropriate for a patient with new onset of
cluster headaches?
A) Sumatriptan orally
B) 100% oxygen for 15-30 minutes
C) Ibuprofen
D) Propranolol
Correct Answer: B – High-flow 100% oxygen is the first-line acute
treatment for cluster headaches; oral sumatriptan has delayed onset
and propranolol is for migraine prophylaxis.
7. When should the NP expect clinical improvement after starting
antibiotic therapy for pneumonia?
A) 12-24 hours
B) 2-3 days
C) 5-7 days
D) 10-14 days
Correct Answer: B – Most patients show improvement in fever and
symptoms within 48-72 hours; lack of improvement by day 3 warrants
reassessment.
8. A 4-year-old with fever 102.5°F, ear pain, and bulging non-mobile TM.
The NP proceeds with:
A) Watchful waiting
B) Start amoxicillin or Augmentin
C) Refer to ENT
D) Prescribe ear drops only
Correct Answer: B – This child has acute otitis media with severe
symptoms (fever >102.2°F) and requires immediate antibiotic therapy
with amoxicillin or Augmentin.
, 9. A 6-year-old with the same ear findings but no fever. The NP
recommends:
A) Amoxicillin
B) Augmentin
C) Start lidocaine drops for ear pain
D) Refer to ENT
Correct Answer: C – In children >2 years with non-severe AOM (no
fever, mild pain), watchful waiting or symptomatic relief with lidocaine
drops is appropriate; antibiotics can be deferred.
10. A patient with newly diagnosed open-angle glaucoma was
prescribed timolol. The NP expresses concern based on which history?
A) Hypertension
B) Asthma
C) Diabetes
D) Hyperlipidemia
Correct Answer: B – Timolol is a non-selective beta-blocker that can
cause bronchospasm; it is contraindicated in asthma and COPD.
11. First-line treatment for mild acne includes:
A) Benzoyl peroxide
B) Topical retinoid
C) Topical combination therapy
D) Any of the above
Correct Answer: D – All options are acceptable first-line therapies for
mild acne depending on patient preference and skin type.
12. Treatment for moderate acne includes:
A) Benzoyl peroxide and antibiotics/retinoid
B) Oral antibiotics
2026-2027: ULTIMATE 200-QUESTION TEST BANK WITH
VERIFIED ANSWERS & CLINICAL RATIONALES
1. A patient with a protozoal infection caused by an obligate anaerobic
organism is prescribed which medication?
A) Ciprofloxacin
B) Metronidazole
C) Doxycycline
D) Azithromycin
Correct Answer: B – Metronidazole is the drug of choice for anaerobic
protozoal infections such as Giardia and Trichomonas. Ciprofloxacin
targets gram-negative bacteria, doxycycline covers atypical bacteria,
and azithromycin is a macrolide for respiratory pathogens.
2. A 22-year-old female is diagnosed with chlamydia. The NP prescribes
azithromycin 500 mg orally. When should the patient take the second
250 mg dose?
A) This time tomorrow and continue once daily for 5-7 days
B) In 12 hours
C) In 24 hours only
D) Not needed; only one dose is required
Correct Answer: A – CDC guidelines recommend azithromycin 1 g as a
single dose OR 500 mg on day 1 followed by 250 mg daily for 4 more
days; thus the second dose is taken the next day and continued daily.
,3. A patient on clindamycin calls reporting diarrhea. What is the NP's
best response?
A) Advise the patient to discontinue the medication
B) Prescribe an anti-diarrheal
C) Recommend probiotics
D) Advise to continue the medication and increase fluids
Correct Answer: A – Diarrhea with clindamycin suggests possible C.
difficile infection; the drug should be stopped immediately and the
patient evaluated, as anti-diarrheals can precipitate toxic megacolon.
4. A 16-year-old presents for acne treatment. Which medication does
the NP prescribe?
A) Oral isotretinoin
B) Combination antibiotic and topical
C) Oral corticosteroid
D) Single-agent topical only
Correct Answer: B – Combination topical antibiotic plus retinoid is first-
line for moderate adolescent acne; isotretinoin is reserved for severe
nodular acne unresponsive to other therapies.
5. A teenager on minocycline reports a headache. The NP suspects
which adverse effect?
A) Migraine
B) Pseudotumor cerebri (increased intracranial pressure)
C) Tension headache
D) Sinusitis
Correct Answer: B – Minocycline and other tetracyclines can cause
pseudotumor cerebri, presenting with headache and visual
disturbances; a fundoscopic exam is warranted.
,6. Which treatment is appropriate for a patient with new onset of
cluster headaches?
A) Sumatriptan orally
B) 100% oxygen for 15-30 minutes
C) Ibuprofen
D) Propranolol
Correct Answer: B – High-flow 100% oxygen is the first-line acute
treatment for cluster headaches; oral sumatriptan has delayed onset
and propranolol is for migraine prophylaxis.
7. When should the NP expect clinical improvement after starting
antibiotic therapy for pneumonia?
A) 12-24 hours
B) 2-3 days
C) 5-7 days
D) 10-14 days
Correct Answer: B – Most patients show improvement in fever and
symptoms within 48-72 hours; lack of improvement by day 3 warrants
reassessment.
8. A 4-year-old with fever 102.5°F, ear pain, and bulging non-mobile TM.
The NP proceeds with:
A) Watchful waiting
B) Start amoxicillin or Augmentin
C) Refer to ENT
D) Prescribe ear drops only
Correct Answer: B – This child has acute otitis media with severe
symptoms (fever >102.2°F) and requires immediate antibiotic therapy
with amoxicillin or Augmentin.
, 9. A 6-year-old with the same ear findings but no fever. The NP
recommends:
A) Amoxicillin
B) Augmentin
C) Start lidocaine drops for ear pain
D) Refer to ENT
Correct Answer: C – In children >2 years with non-severe AOM (no
fever, mild pain), watchful waiting or symptomatic relief with lidocaine
drops is appropriate; antibiotics can be deferred.
10. A patient with newly diagnosed open-angle glaucoma was
prescribed timolol. The NP expresses concern based on which history?
A) Hypertension
B) Asthma
C) Diabetes
D) Hyperlipidemia
Correct Answer: B – Timolol is a non-selective beta-blocker that can
cause bronchospasm; it is contraindicated in asthma and COPD.
11. First-line treatment for mild acne includes:
A) Benzoyl peroxide
B) Topical retinoid
C) Topical combination therapy
D) Any of the above
Correct Answer: D – All options are acceptable first-line therapies for
mild acne depending on patient preference and skin type.
12. Treatment for moderate acne includes:
A) Benzoyl peroxide and antibiotics/retinoid
B) Oral antibiotics
