WGU D116 ADVANCED PHARMACOLOGY FINAL EXAM OBJECTIVE ASSESSMENT
& PRE-ASSESSMENT
LATEST UPDATE – 2026
Question 1
A nurse is teaching a group of nurses about Parkinson's medications. The nurse is
correct in stating that one side effect associated with pramipexole that is less
likely to occur with other dopamine agonists is which of the following?
A. Dizziness
B. Dyskinesias
C. Hallucinations
D. Sleep attacks
Correct ANSWER: D
Rationale:
A. Dizziness: Incorrect. Dizziness is a common side effect of all dopamine agonists
due to orthostatic hypotension.
B. Dyskinesias: Incorrect. Dyskinesias are involuntary muscle movements that are
common with long-term levodopa therapy and can occur with dopamine agonists.
C. Hallucinations: Incorrect. Hallucinations are a known adverse effect of
dopamine agonists, particularly in elderly patients.
,D. Sleep attacks: Correct. While sleep attacks can occur with other dopamine
agonists, they are notably associated with pramipexole. Patients may experience
an overwhelming and irresistible sleepiness that comes on without warning.
Question 2
A nursing student wants to know why a patient who has been taking levodopa for
years will now receive carbidopa. As the provider, you explain the reasons that
levodopa as a single agent is no longer available. Which statement by the student
indicates a need for further education?
A. "Carbidopa increases the amount of levodopa that reaches the brain."
B. "Carbidopa reduces the side effects of levodopa, such as nausea and vomiting."
C. "Carbidopa allows for a lower dose of levodopa to be used."
D. "Carbidopa prevents the breakdown of levodopa in the periphery."
Correct ANSWER: A
Rationale:
A. "Carbidopa increases the amount of levodopa that reaches the brain." Correct
(as the wrong ANSWER indicating need for education). Carbidopa does not
directly increase the amount of levodopa that reaches the brain; rather, it
prevents the peripheral breakdown of levodopa, allowing more of the drug to
reach the brain unchanged. The statement is slightly inaccurate because it implies
carbidopa actively transports levodopa, which it does not.
B. "Carbidopa reduces the side effects of levodopa, such as nausea and vomiting."
Incorrect (True statement). By blocking peripheral decarboxylation, carbidopa
reduces nausea and vomiting caused by dopamine in the stomach.
,C. "Carbidopa allows for a lower dose of levodopa to be used." Incorrect (True
statement). Because more levodopa reaches the brain, the total required dose is
reduced.
D. "Carbidopa prevents the breakdown of levodopa in the periphery." Incorrect
(True statement). This is the primary mechanism of action of carbidopa.
Question 3
A patient is prescribed benztropine for Parkinson's disease. The nurse should
monitor the patient for which of the following anticholinergic effects?
A. Diarrhea
B. Bradycardia
C. Dry mouth
D. Miosis
Correct ANSWER: C
Rationale:
A. Diarrhea: Incorrect. Anticholinergic drugs cause constipation, not diarrhea.
B. Bradycardia: Incorrect. Anticholinergic drugs cause tachycardia (increased heart
rate).
C. Dry mouth: Correct. Dry mouth (xerostomia) is a classic anticholinergic side
effect.
D. Miosis: Incorrect. Anticholinergic drugs cause mydriasis (dilation of pupils), not
constriction.
, Question 4
A patient with Alzheimer's disease is prescribed donepezil. The nurse understands
that this medication works by which mechanism?
A. Blocking dopamine receptors
B. Inhibiting acetylcholinesterase
C. Stimulating GABA receptors
D. Inhibiting monoamine oxidase
Correct ANSWER: B
Rationale:
A. Blocking dopamine receptors: Incorrect. This is the mechanism for
antipsychotics.
B. Inhibiting acetylcholinesterase: Correct. Donepezil is a cholinesterase inhibitor.
It prevents the breakdown of acetylcholine, increasing its availability in the brain
to improve cognition.
C. Stimulating GABA receptors: Incorrect. This is the mechanism for
benzodiazepines and barbiturates.
D. Inhibiting monoamine oxidase: Incorrect. This is the mechanism for MAOIs
used in depression and Parkinson's.
Question 5
A patient is taking phenytoin for epilepsy. The nurse should instruct the patient to
avoid which of the following regarding oral hygiene?
& PRE-ASSESSMENT
LATEST UPDATE – 2026
Question 1
A nurse is teaching a group of nurses about Parkinson's medications. The nurse is
correct in stating that one side effect associated with pramipexole that is less
likely to occur with other dopamine agonists is which of the following?
A. Dizziness
B. Dyskinesias
C. Hallucinations
D. Sleep attacks
Correct ANSWER: D
Rationale:
A. Dizziness: Incorrect. Dizziness is a common side effect of all dopamine agonists
due to orthostatic hypotension.
B. Dyskinesias: Incorrect. Dyskinesias are involuntary muscle movements that are
common with long-term levodopa therapy and can occur with dopamine agonists.
C. Hallucinations: Incorrect. Hallucinations are a known adverse effect of
dopamine agonists, particularly in elderly patients.
,D. Sleep attacks: Correct. While sleep attacks can occur with other dopamine
agonists, they are notably associated with pramipexole. Patients may experience
an overwhelming and irresistible sleepiness that comes on without warning.
Question 2
A nursing student wants to know why a patient who has been taking levodopa for
years will now receive carbidopa. As the provider, you explain the reasons that
levodopa as a single agent is no longer available. Which statement by the student
indicates a need for further education?
A. "Carbidopa increases the amount of levodopa that reaches the brain."
B. "Carbidopa reduces the side effects of levodopa, such as nausea and vomiting."
C. "Carbidopa allows for a lower dose of levodopa to be used."
D. "Carbidopa prevents the breakdown of levodopa in the periphery."
Correct ANSWER: A
Rationale:
A. "Carbidopa increases the amount of levodopa that reaches the brain." Correct
(as the wrong ANSWER indicating need for education). Carbidopa does not
directly increase the amount of levodopa that reaches the brain; rather, it
prevents the peripheral breakdown of levodopa, allowing more of the drug to
reach the brain unchanged. The statement is slightly inaccurate because it implies
carbidopa actively transports levodopa, which it does not.
B. "Carbidopa reduces the side effects of levodopa, such as nausea and vomiting."
Incorrect (True statement). By blocking peripheral decarboxylation, carbidopa
reduces nausea and vomiting caused by dopamine in the stomach.
,C. "Carbidopa allows for a lower dose of levodopa to be used." Incorrect (True
statement). Because more levodopa reaches the brain, the total required dose is
reduced.
D. "Carbidopa prevents the breakdown of levodopa in the periphery." Incorrect
(True statement). This is the primary mechanism of action of carbidopa.
Question 3
A patient is prescribed benztropine for Parkinson's disease. The nurse should
monitor the patient for which of the following anticholinergic effects?
A. Diarrhea
B. Bradycardia
C. Dry mouth
D. Miosis
Correct ANSWER: C
Rationale:
A. Diarrhea: Incorrect. Anticholinergic drugs cause constipation, not diarrhea.
B. Bradycardia: Incorrect. Anticholinergic drugs cause tachycardia (increased heart
rate).
C. Dry mouth: Correct. Dry mouth (xerostomia) is a classic anticholinergic side
effect.
D. Miosis: Incorrect. Anticholinergic drugs cause mydriasis (dilation of pupils), not
constriction.
, Question 4
A patient with Alzheimer's disease is prescribed donepezil. The nurse understands
that this medication works by which mechanism?
A. Blocking dopamine receptors
B. Inhibiting acetylcholinesterase
C. Stimulating GABA receptors
D. Inhibiting monoamine oxidase
Correct ANSWER: B
Rationale:
A. Blocking dopamine receptors: Incorrect. This is the mechanism for
antipsychotics.
B. Inhibiting acetylcholinesterase: Correct. Donepezil is a cholinesterase inhibitor.
It prevents the breakdown of acetylcholine, increasing its availability in the brain
to improve cognition.
C. Stimulating GABA receptors: Incorrect. This is the mechanism for
benzodiazepines and barbiturates.
D. Inhibiting monoamine oxidase: Incorrect. This is the mechanism for MAOIs
used in depression and Parkinson's.
Question 5
A patient is taking phenytoin for epilepsy. The nurse should instruct the patient to
avoid which of the following regarding oral hygiene?
