NR 567 Final Exam – Advanced
Pharmacology for the AGACNP | Verified
Questions & Answers | 100/100 | Grade A
– Chamberlain (2026–2027)
1. Which medication should be given to patients presenting to the ED
with altered mental status, seizures, or both, if concern for Wernicke-
Korsakoff syndrome exists?
• A) Folate (Folic acid)
• B) Chlordiazepoxide (Librium)
• C) Thiamine (Vitamin B1)
• D) Lorazepam (Ativan)
Correct Answer: C
Rationale: Thiamine (Vitamin B1) is the essential treatment for Wernicke-
Korsakoff syndrome, which results from thiamine deficiency often
associated with alcohol use disorder. Thiamine should be administered
before glucose to prevent precipitating acute neurological symptoms.
2. A 35-year-old female with long-standing anxiety treated with
diazepam (Valium) triples her daily dose due to increased stress. She is
found lethargic and obtunded. Which agent should be administered?
• A) Naloxone (Narcan)
• B) Flumazenil (Romazicon)
• C) Activated charcoal
, • D) Thiamine
Correct Answer: B
Rationale: Flumazenil is a competitive benzodiazepine antagonist at the
GABA-A receptor. It reverses the sedative effects of benzodiazepine
overdose. However, caution is needed as it may precipitate seizures in
benzodiazepine-dependent patients. Naloxone is used for opioid overdose,
not benzodiazepines.
3. Which antiseizure medication is preferred for a generalized seizure
disorder in a 25-year-old pregnant female?
• A) Phenobarbital (Solfoton)
• B) Valproate (Valproic acid)
• C) Levetiracetam (Keppra)
• D) Topiramate (Topamax)
Correct Answer: C
Rationale: Levetiracetam is preferred in pregnancy due to its lower
teratogenic risk profile. Valproate is associated with neural tube defects and
increased risk of autism spectrum disorder; phenobarbital and topiramate
also carry higher risks.
4. A patient with Parkinson's disease is prescribed pramipexole. What
is the mechanism of action of this medication?
• A) Inhibits monoamine oxidase-B
• B) Stimulates dopamine-2 and dopamine-3 receptors
• C) Increases dopamine synthesis and release
• D) Inhibits COMT enzyme
Correct Answer: B
Rationale: Pramipexole is a nonergot dopamine agonist that works by
,stimulating dopamine-2 and dopamine-3 receptors in the brain,
compensating for decreased dopamine levels and improving motor
function.
5. Which side effect is commonly associated with pramipexole
therapy?
• A) Hyperglycemia
• B) Impulse control disorders
• C) Hypertension
• D) Weight gain
Correct Answer: B
Rationale: Impulse control disorders (such as compulsive gambling,
shopping, or eating) are a significant side effect of pramipexole. Other side
effects include GI effects (nausea, constipation), CNS effects (dizziness,
hallucinations), and orthostatic hypotension.
6. A patient on entacapone for Parkinson's disease reports dark
discoloration of their urine. What is the most appropriate nursing
response?
• A) Notify the provider immediately
• B) Reassure the patient that this is a known side effect
• C) Obtain a urine culture
• D) Discontinue the medication
Correct Answer: B
Rationale: Entacapone, a COMT inhibitor, can cause discoloration of body
fluids including urine. This is a harmless side effect and does not require
discontinuation or provider notification.
, 7. Which of the following is the prototype medication for MAO-B
inhibitors used in Parkinson's disease?
• A) Pramipexole
• B) Bromocriptine
• C) Selegiline
• D) Amantadine
Correct Answer: C
Rationale: Selegiline is the prototype MAO-B inhibitor. It selectively and
irreversibly inhibits monoamine oxidase-B, the enzyme responsible for the
inactivation of dopamine in the brain.
8. A patient on selegiline reports confusion, dizziness, and
hallucinations. Which action should the nurse take?
• A) Reassure the patient that these are expected side effects
• B) Discontinue the medication immediately
• C) Assess for orthostatic hypotension and notify the provider
• D) Increase the dose to improve symptom control
Correct Answer: C
Rationale: CNS effects (agitation, confusion, dizziness, hallucinations) and
orthostatic hypotension are side effects of selegiline that should be
assessed and reported.
9. Amantadine is used in Parkinson's disease primarily through which
mechanism?
• A) Stimulating dopamine receptors
• B) Inhibiting COMT enzyme
• C) Increasing dopamine synthesis, release, or reuptake
• D) Irreversibly inhibiting MAO-B
Pharmacology for the AGACNP | Verified
Questions & Answers | 100/100 | Grade A
– Chamberlain (2026–2027)
1. Which medication should be given to patients presenting to the ED
with altered mental status, seizures, or both, if concern for Wernicke-
Korsakoff syndrome exists?
• A) Folate (Folic acid)
• B) Chlordiazepoxide (Librium)
• C) Thiamine (Vitamin B1)
• D) Lorazepam (Ativan)
Correct Answer: C
Rationale: Thiamine (Vitamin B1) is the essential treatment for Wernicke-
Korsakoff syndrome, which results from thiamine deficiency often
associated with alcohol use disorder. Thiamine should be administered
before glucose to prevent precipitating acute neurological symptoms.
2. A 35-year-old female with long-standing anxiety treated with
diazepam (Valium) triples her daily dose due to increased stress. She is
found lethargic and obtunded. Which agent should be administered?
• A) Naloxone (Narcan)
• B) Flumazenil (Romazicon)
• C) Activated charcoal
, • D) Thiamine
Correct Answer: B
Rationale: Flumazenil is a competitive benzodiazepine antagonist at the
GABA-A receptor. It reverses the sedative effects of benzodiazepine
overdose. However, caution is needed as it may precipitate seizures in
benzodiazepine-dependent patients. Naloxone is used for opioid overdose,
not benzodiazepines.
3. Which antiseizure medication is preferred for a generalized seizure
disorder in a 25-year-old pregnant female?
• A) Phenobarbital (Solfoton)
• B) Valproate (Valproic acid)
• C) Levetiracetam (Keppra)
• D) Topiramate (Topamax)
Correct Answer: C
Rationale: Levetiracetam is preferred in pregnancy due to its lower
teratogenic risk profile. Valproate is associated with neural tube defects and
increased risk of autism spectrum disorder; phenobarbital and topiramate
also carry higher risks.
4. A patient with Parkinson's disease is prescribed pramipexole. What
is the mechanism of action of this medication?
• A) Inhibits monoamine oxidase-B
• B) Stimulates dopamine-2 and dopamine-3 receptors
• C) Increases dopamine synthesis and release
• D) Inhibits COMT enzyme
Correct Answer: B
Rationale: Pramipexole is a nonergot dopamine agonist that works by
,stimulating dopamine-2 and dopamine-3 receptors in the brain,
compensating for decreased dopamine levels and improving motor
function.
5. Which side effect is commonly associated with pramipexole
therapy?
• A) Hyperglycemia
• B) Impulse control disorders
• C) Hypertension
• D) Weight gain
Correct Answer: B
Rationale: Impulse control disorders (such as compulsive gambling,
shopping, or eating) are a significant side effect of pramipexole. Other side
effects include GI effects (nausea, constipation), CNS effects (dizziness,
hallucinations), and orthostatic hypotension.
6. A patient on entacapone for Parkinson's disease reports dark
discoloration of their urine. What is the most appropriate nursing
response?
• A) Notify the provider immediately
• B) Reassure the patient that this is a known side effect
• C) Obtain a urine culture
• D) Discontinue the medication
Correct Answer: B
Rationale: Entacapone, a COMT inhibitor, can cause discoloration of body
fluids including urine. This is a harmless side effect and does not require
discontinuation or provider notification.
, 7. Which of the following is the prototype medication for MAO-B
inhibitors used in Parkinson's disease?
• A) Pramipexole
• B) Bromocriptine
• C) Selegiline
• D) Amantadine
Correct Answer: C
Rationale: Selegiline is the prototype MAO-B inhibitor. It selectively and
irreversibly inhibits monoamine oxidase-B, the enzyme responsible for the
inactivation of dopamine in the brain.
8. A patient on selegiline reports confusion, dizziness, and
hallucinations. Which action should the nurse take?
• A) Reassure the patient that these are expected side effects
• B) Discontinue the medication immediately
• C) Assess for orthostatic hypotension and notify the provider
• D) Increase the dose to improve symptom control
Correct Answer: C
Rationale: CNS effects (agitation, confusion, dizziness, hallucinations) and
orthostatic hypotension are side effects of selegiline that should be
assessed and reported.
9. Amantadine is used in Parkinson's disease primarily through which
mechanism?
• A) Stimulating dopamine receptors
• B) Inhibiting COMT enzyme
• C) Increasing dopamine synthesis, release, or reuptake
• D) Irreversibly inhibiting MAO-B
