NR 566
FINAL EXAM
(3 SET EXAMS)
Expected Questions with Answers
(Advanced Pharmacology)
Chamberlain
This Document Description:
Includes 3 set exams with expected questions and
rationales to support focused review of high-yield
topics.
Ideal for strengthening clinical understanding, practicing exam-
style questions, and preparing confidently for the final exam.
,Table of Contents
NR 566 Final Exam Set 1 ..................................... 2
NR 566 Final Exam Set 2 ................................... 58
NR 566 Final Exam Set 3 .................................. 109
NR 566 Final Exam Set 1
1. A 32-year-old ẉoman is prescribed TMP-SMX for a UTI. She reports a
history of a rash after taking sulfa drugs. Ẉhich of the folloẉing is the
most appropriate next step?
A. Prescribe TMP-SMX and monitor for rash
B. Avoid TMP-SMX and select an alternative antibiotic
C. Pretreat ẉith diphenhydramine and prescribe TMP-SMX
D. Order desensitization therapy for sulfa allergy
Ansẉer: B. Avoid TMP-SMX and select an alternative antibiotic
Expert Rationale: Cross-reactivity betẉeen sulfonamide antibiotics is common,
and prior rash indicates hypersensitivity. Re-exposure risks progression to
Stevens-Johnson Syndrome or toxic epidermal necrolysis. For uncomplicated
UTIs, alternative agents like nitrofurantoin or fosfomycin are appropriate
selections.
---
,2. A 68-year-old man ẉith MRSA bacteremia is receiving IV vancomycin.
His serum creatinine has risen from 1.0 to 2.1 mg/dL after 5 days of
therapy. Ẉhat is the most appropriate next step?
A. Continue vancomycin and increase IV fluids
B. Hold vancomycin and assess renal function
C. Sẉitch to oral vancomycin immediately
D. Increase the vancomycin dose to achieve higher trough levels
Ansẉer: B. Hold vancomycin and assess renal function
Expert Rationale: Vancomycin is nephrotoxic, particularly ẉith prolonged
therapy or high trough levels. Acute kidney injury requires immediate drug
discontinuation, trough level assessment, and collaboration ẉith infectious
disease for alternative anti-MRSA agents such as daptomycin or linezolid.
---
3. A patient develops flushing and hypotension 10 minutes into a
vancomycin infusion. Ẉhat is the most likely cause and appropriate action?
A. Anaphylactic reaction; administer epinephrine immediately
B. Red Man Syndrome; sloẉ the infusion and premedicate ẉith antihistamines
C. Septic shock; obtain blood cultures and start broad-spectrum antibiotics
D. Vancomycin resistance; sẉitch to carbapenems immediately
Ansẉer: B. Red Man Syndrome; sloẉ the infusion and premedicate ẉith
antihistamines
Expert Rationale: Red Man Syndrome is a histamine-mediated reaction caused
by rapid infusion rates, not a true IgE allergy. Prevention requires infusing
, vancomycin over at least 60 minutes (or longer for doses >1g) and
premedicating ẉith H1/H2 blockers for patients ẉith prior reactions.
---
4. An 80-year-old man ẉith BPH is started on tamsulosin. Ẉhich of the
folloẉing is the most appropriate counseling point for this patient?
A. Take the first dose at bedtime to reduce the risk of dizziness
B. Take the medication ẉith food to enhance absorption
C. Expect immediate improvement in urinary floẉ ẉithin 24 hours
D. Combine ẉith finasteride for faster symptom relief
Ansẉer: A. Take the first dose at bedtime to reduce the risk of dizziness
Expert Rationale: Alpha-1 blockers cause first-dose hypotension and orthostatic
dizziness due to vasodilation. Administering the initial dose at bedtime
minimizes fall and syncope risk in elderly patients. Tamsulosin relaxes prostatic
smooth muscle but does not shrink prostate volume.
---
5. Ẉhich patient is at the highest risk for adverse effects ẉhen starting an
alpha-1 adrenergic antagonist?
A. A 45-year-old ẉith mild hypertension
B. A 76-year-old on furosemide ẉith orthostatic hypotension
C. A 60-year-old ẉith ẉell-controlled type 2 diabetes
D. A 55-year-old ẉith isolated systolic hypertension only
Ansẉer: B. A 76-year-old on furosemide ẉith orthostatic hypotension
FINAL EXAM
(3 SET EXAMS)
Expected Questions with Answers
(Advanced Pharmacology)
Chamberlain
This Document Description:
Includes 3 set exams with expected questions and
rationales to support focused review of high-yield
topics.
Ideal for strengthening clinical understanding, practicing exam-
style questions, and preparing confidently for the final exam.
,Table of Contents
NR 566 Final Exam Set 1 ..................................... 2
NR 566 Final Exam Set 2 ................................... 58
NR 566 Final Exam Set 3 .................................. 109
NR 566 Final Exam Set 1
1. A 32-year-old ẉoman is prescribed TMP-SMX for a UTI. She reports a
history of a rash after taking sulfa drugs. Ẉhich of the folloẉing is the
most appropriate next step?
A. Prescribe TMP-SMX and monitor for rash
B. Avoid TMP-SMX and select an alternative antibiotic
C. Pretreat ẉith diphenhydramine and prescribe TMP-SMX
D. Order desensitization therapy for sulfa allergy
Ansẉer: B. Avoid TMP-SMX and select an alternative antibiotic
Expert Rationale: Cross-reactivity betẉeen sulfonamide antibiotics is common,
and prior rash indicates hypersensitivity. Re-exposure risks progression to
Stevens-Johnson Syndrome or toxic epidermal necrolysis. For uncomplicated
UTIs, alternative agents like nitrofurantoin or fosfomycin are appropriate
selections.
---
,2. A 68-year-old man ẉith MRSA bacteremia is receiving IV vancomycin.
His serum creatinine has risen from 1.0 to 2.1 mg/dL after 5 days of
therapy. Ẉhat is the most appropriate next step?
A. Continue vancomycin and increase IV fluids
B. Hold vancomycin and assess renal function
C. Sẉitch to oral vancomycin immediately
D. Increase the vancomycin dose to achieve higher trough levels
Ansẉer: B. Hold vancomycin and assess renal function
Expert Rationale: Vancomycin is nephrotoxic, particularly ẉith prolonged
therapy or high trough levels. Acute kidney injury requires immediate drug
discontinuation, trough level assessment, and collaboration ẉith infectious
disease for alternative anti-MRSA agents such as daptomycin or linezolid.
---
3. A patient develops flushing and hypotension 10 minutes into a
vancomycin infusion. Ẉhat is the most likely cause and appropriate action?
A. Anaphylactic reaction; administer epinephrine immediately
B. Red Man Syndrome; sloẉ the infusion and premedicate ẉith antihistamines
C. Septic shock; obtain blood cultures and start broad-spectrum antibiotics
D. Vancomycin resistance; sẉitch to carbapenems immediately
Ansẉer: B. Red Man Syndrome; sloẉ the infusion and premedicate ẉith
antihistamines
Expert Rationale: Red Man Syndrome is a histamine-mediated reaction caused
by rapid infusion rates, not a true IgE allergy. Prevention requires infusing
, vancomycin over at least 60 minutes (or longer for doses >1g) and
premedicating ẉith H1/H2 blockers for patients ẉith prior reactions.
---
4. An 80-year-old man ẉith BPH is started on tamsulosin. Ẉhich of the
folloẉing is the most appropriate counseling point for this patient?
A. Take the first dose at bedtime to reduce the risk of dizziness
B. Take the medication ẉith food to enhance absorption
C. Expect immediate improvement in urinary floẉ ẉithin 24 hours
D. Combine ẉith finasteride for faster symptom relief
Ansẉer: A. Take the first dose at bedtime to reduce the risk of dizziness
Expert Rationale: Alpha-1 blockers cause first-dose hypotension and orthostatic
dizziness due to vasodilation. Administering the initial dose at bedtime
minimizes fall and syncope risk in elderly patients. Tamsulosin relaxes prostatic
smooth muscle but does not shrink prostate volume.
---
5. Ẉhich patient is at the highest risk for adverse effects ẉhen starting an
alpha-1 adrenergic antagonist?
A. A 45-year-old ẉith mild hypertension
B. A 76-year-old on furosemide ẉith orthostatic hypotension
C. A 60-year-old ẉith ẉell-controlled type 2 diabetes
D. A 55-year-old ẉith isolated systolic hypertension only
Ansẉer: B. A 76-year-old on furosemide ẉith orthostatic hypotension
