,NURS 6521 Week 4 Quiz | Advanced Pharmacology (2026)
Q&A | Walden University
1. Which of the following best describes the primary mechanism of action of
fexofenadine (Allegra) in treating allergic rhinitis?
A) Blocking histamine H1 receptors in the peripheral nervous system
B) Inhibiting the release of histamine from mast cells
C) Blocking leukotriene receptors in the airways
D) Stimulating beta-2 adrenergic receptors in the lungs
Correct Answer: Blocking histamine H1 receptors in the peripheral nervous system
Rationale: Fexofenadine is a second-generation antihistamine that selectively
blocks peripheral H1 receptors, reducing symptoms of allergic rhinitis such as
sneezing, rhinorrhea, and itching, while causing less sedation than first-generation
antihistamines. It does not inhibit mast cell degranulation, block leukotriene
receptors, or stimulate beta-2 receptors.
2. A 20-year-old woman forgets her morning dose of fexofenadine and usually takes
her evening dose at 8 PM. What is the most appropriate instruction?
A) Skip the missed dose and take the evening dose at 8 PM
B) Take the missed dose immediately and then take the evening dose at 8 PM
C) Take the missed dose immediately and delay the evening dose until 10 PM
D) Double the evening dose to make up for the missed dose
Correct Answer: Skip the missed dose and take the evening dose at 8 PM
Rationale: When a dose of fexofenadine is missed, it should be taken as soon as
remembered unless it is almost time for the next dose. Taking a double dose is not
,recommended due to increased risk of adverse effects. The patient should resume
the normal schedule with the evening dose.
3. Which physiological process primarily protects the lower respiratory system from
inhaled particles?
A) Cough reflex
B) Mucociliary clearance
C) Surfactant production
D) Alveolar macrophage phagocytosis
Correct Answer: Mucociliary clearance
Rationale: The mucociliary escalator traps inhaled particles in mucus and moves
them upward toward the pharynx for expulsion. While the cough reflex, surfactant,
and alveolar macrophages all contribute to pulmonary defense, mucociliary
clearance is the primary mechanism protecting the lower respiratory system from
particulate matter.
4. A patient with impaired liver function is being treated for a respiratory infection.
Which medication requires the most caution?
A) Amoxicillin
B) Azithromycin
C) Doxycycline
D) Ceftriaxone
Correct Answer: Azithromycin
Rationale: Azithromycin is metabolized by the liver and should be used with caution
in patients with hepatic impairment. Doxycycline is also hepatically metabolized but
, to a lesser extent. Amoxicillin and ceftriaxone are primarily renally cleared and do not
require significant hepatic dose adjustment.
5. A 53-year-old man on long-term prednisone for asthma asks about alternate-day
therapy. What is the best response?
A) Alternate-day therapy is equally effective and reduces adrenal suppression
B) Alternate-day therapy is never recommended for asthma
C) He should take the medication every day to prevent confusion
D) Alternate-day therapy increases the risk of adrenal crisis
Correct Answer: Alternate-day therapy is equally effective and reduces adrenal
suppression
Rationale: Alternate-day prednisone therapy can maintain therapeutic efficacy while
reducing the risk of adrenal suppression and other corticosteroid adverse effects. It
is a commonly used strategy for chronic conditions. Patients should be educated on
the rationale to promote adherence.
6. A patient taking zafirlukast should be monitored for which serious adverse effect?
A) Hepatotoxicity
B) Nephrotoxicity
C) Cardiotoxicity
D) Neurotoxicity
Correct Answer: Hepatotoxicity
Rationale: Zafirlukast is associated with asymptomatic elevated hepatic enzyme
levels and symptomatic hepatitis with hyperbilirubinemia. Liver function tests should
be monitored periodically. It is not associated with significant nephrotoxicity,
cardiotoxicity, or neurotoxicity.
Q&A | Walden University
1. Which of the following best describes the primary mechanism of action of
fexofenadine (Allegra) in treating allergic rhinitis?
A) Blocking histamine H1 receptors in the peripheral nervous system
B) Inhibiting the release of histamine from mast cells
C) Blocking leukotriene receptors in the airways
D) Stimulating beta-2 adrenergic receptors in the lungs
Correct Answer: Blocking histamine H1 receptors in the peripheral nervous system
Rationale: Fexofenadine is a second-generation antihistamine that selectively
blocks peripheral H1 receptors, reducing symptoms of allergic rhinitis such as
sneezing, rhinorrhea, and itching, while causing less sedation than first-generation
antihistamines. It does not inhibit mast cell degranulation, block leukotriene
receptors, or stimulate beta-2 receptors.
2. A 20-year-old woman forgets her morning dose of fexofenadine and usually takes
her evening dose at 8 PM. What is the most appropriate instruction?
A) Skip the missed dose and take the evening dose at 8 PM
B) Take the missed dose immediately and then take the evening dose at 8 PM
C) Take the missed dose immediately and delay the evening dose until 10 PM
D) Double the evening dose to make up for the missed dose
Correct Answer: Skip the missed dose and take the evening dose at 8 PM
Rationale: When a dose of fexofenadine is missed, it should be taken as soon as
remembered unless it is almost time for the next dose. Taking a double dose is not
,recommended due to increased risk of adverse effects. The patient should resume
the normal schedule with the evening dose.
3. Which physiological process primarily protects the lower respiratory system from
inhaled particles?
A) Cough reflex
B) Mucociliary clearance
C) Surfactant production
D) Alveolar macrophage phagocytosis
Correct Answer: Mucociliary clearance
Rationale: The mucociliary escalator traps inhaled particles in mucus and moves
them upward toward the pharynx for expulsion. While the cough reflex, surfactant,
and alveolar macrophages all contribute to pulmonary defense, mucociliary
clearance is the primary mechanism protecting the lower respiratory system from
particulate matter.
4. A patient with impaired liver function is being treated for a respiratory infection.
Which medication requires the most caution?
A) Amoxicillin
B) Azithromycin
C) Doxycycline
D) Ceftriaxone
Correct Answer: Azithromycin
Rationale: Azithromycin is metabolized by the liver and should be used with caution
in patients with hepatic impairment. Doxycycline is also hepatically metabolized but
, to a lesser extent. Amoxicillin and ceftriaxone are primarily renally cleared and do not
require significant hepatic dose adjustment.
5. A 53-year-old man on long-term prednisone for asthma asks about alternate-day
therapy. What is the best response?
A) Alternate-day therapy is equally effective and reduces adrenal suppression
B) Alternate-day therapy is never recommended for asthma
C) He should take the medication every day to prevent confusion
D) Alternate-day therapy increases the risk of adrenal crisis
Correct Answer: Alternate-day therapy is equally effective and reduces adrenal
suppression
Rationale: Alternate-day prednisone therapy can maintain therapeutic efficacy while
reducing the risk of adrenal suppression and other corticosteroid adverse effects. It
is a commonly used strategy for chronic conditions. Patients should be educated on
the rationale to promote adherence.
6. A patient taking zafirlukast should be monitored for which serious adverse effect?
A) Hepatotoxicity
B) Nephrotoxicity
C) Cardiotoxicity
D) Neurotoxicity
Correct Answer: Hepatotoxicity
Rationale: Zafirlukast is associated with asymptomatic elevated hepatic enzyme
levels and symptomatic hepatitis with hyperbilirubinemia. Liver function tests should
be monitored periodically. It is not associated with significant nephrotoxicity,
cardiotoxicity, or neurotoxicity.
