NUR635 PHARMACOLOGY FOR ADVANCED PRACTICE NURSING GRAND CANYON UNIVERSITY FINAL EXAMINATION COMPREHENSIVE QUESTION & ANSWER BANK WITH EVIDENCE-BASED RATIONALES COVERING ALL SEMESTER TOPICS: PHARMACOKINETICS, PHARMACODYNAMICS, DRUG INTERACTIONS, ADVERSE

NUR635 PHARMACOLOGY FOR ADVANCED PRACTICE NURSING GRAND CANYON UNIVERSITY FINAL EXAMINATION COMPREHENSIVE QUESTION & ANSWER BANK WITH EVIDENCE-BASED RATIONALES COVERING ALL SEMESTER TOPICS: PHARMACOKINETICS, PHARMACODYNAMICS, DRUG INTERACTIONS, ADVERSE EFFECTS, AND CLINICAL APPLICATION 1. A 45-year-old previously healthy patient presents with community acquired pneumonia. What is the first line treatment? A. Amoxicillin B. Azithromycin C. Ciprofloxacin D. Doxycycline Answer: B. Azithromycin Rationale: Azithromycin is the first line treatment for CAP in previously healthy patients without comorbidities. Amoxicillin is not the first choice despite common misconception. Macrolides like azithromycin provide coverage for atypical organisms. ________________________________________ 2. A patient's medication list shows an SSRI and St. John's Wort together. What is the primary concern? A. Increased bleeding risk B. Serotonin syndrome C. Hypertensive crisis D. Liver toxicity Answer: B. Serotonin syndrome Rationale: Combining SSRIs with St. John's Wort significantly increases serotonin levels, leading to serotonin syndrome. This is a potentially life-threatening condition characterized by agitation, confusion, tachycardia, hyperthermia, and muscle rigidity. ________________________________________ 3. Phenytoin is primarily indicated for which condition? A. Hypertension B. Diabetes mellitus C. Seizures and epilepsy D. Asthma Answer: C. Seizures and epilepsy Rationale: Phenytoin is an anticonvulsant medication used primarily for the treatment of seizures and epilepsy. It works by stabilizing neuronal membranes and reducing seizure activity. ________________________________________ 4. When does hypersensitivity reaction to phenytoin typically present? A. Within 24 hours B. 1-2 weeks C. 3-8 weeks D. 3-6 months Answer: C. 3-8 weeks Rationale: Phenytoin hypersensitivity reactions typically occur 3-8 weeks after starting treatment. Symptoms include rash, fever, tender generalized lymphadenopathy, leukocytosis with atypical lymphocytes, and eosinophilia. ________________________________________ 5. Which anticonvulsant medication can auto-induce its own metabolism? A. Phenytoin B. Gabapentin C. Carbamazepine D. Lamotrigine Answer: C. Carbamazepine Rationale: Carbamazepine is known for auto-induction of metabolism, meaning it stimulates its own breakdown over time, potentially requiring dose adjustments. It is used for epilepsy, trigeminal neuralgia, and bipolar disorder. ________________________________________ 6. What is the black box warning associated with carbamazepine? A. Hepatotoxicity B. Stevens-Johnson Syndrome C. Cardiotoxicity D. Nephrotoxicity Answer: B. Stevens-Johnson Syndrome Rationale: Carbamazepine carries a black box warning for Stevens-Johnson Syndrome, a severe skin reaction. This risk is particularly elevated in patients of Asian ancestry with the HLA-B*1502 allele. ________________________________________ 7. How often should CBC be monitored in patients taking carbamazepine? A. Monthly B. Every 3-4 months C. Every 6 months D. Annually Answer: B. Every 3-4 months Rationale: CBC should be monitored every 3-4 months in patients taking carbamazepine due to the risk of agranulocytosis (low WBC) or blood dyscrasias. Regular monitoring allows for early detection of these potentially serious hematological effects. ________________________________________ 8. Gabapentin is primarily used to treat which type of pain? A. Acute postoperative pain B. Neuropathic pain C. Musculoskeletal pain D. Migraine pain Answer: B. Neuropathic pain Rationale: Gabapentin is an anticonvulsant that is widely used for neuropathic pain conditions. It works by modulating calcium channels and reducing excitatory neurotransmitter release.