NR 566
FINAL EXAM
Expected Questions with Answers
Advanced Pharmacology for Care of the Family
Chamberlain
This Document Description:
Includes expected exam questions with verified answers
to help students review core concepts, strengthen
clinical understanding, and prepare confidently for the
Final exam.
Ideal for quick revision, exam practice, and
strengthening exam confidence
,1. A 22-year-old with asthma presents with wheezing after exercise.
Which is the best immediate treatment?
A. Oral corticosteroids
B. Ipratropium bromide
C. Albuterol
D. Montelukast
Answer: C
Expert Rationale: Albuterol is a short-acting beta-agonist (SABA) that
provides rapid bronchodilation within minutes, making it the rescue drug of
choice for acute asthma symptoms and exercise-induced bronchospasm per
GINA guidelines.
2. A 55-year-old smoker with chronic cough and dyspnea has FEV1/FVC
ratio <70%. Which class is first-line for symptom control?
A. Inhaled corticosteroids alone
B. Long-acting bronchodilator
C. Theophylline
D. Systemic steroids
Answer: B
Expert Rationale: GOLD guidelines recommend long-acting bronchodilators
(LABAs or LAMAs) as first-line maintenance therapy for COPD to improve
airflow limitation and reduce symptoms; ICS alone is not first-line for COPD
without asthma features.
3. A 10-year-old with persistent asthma symptoms despite low-dose ICS
needs step-up therapy. Which is most appropriate?
A. Increase ICS dose
B. Add leukotriene receptor antagonist
C. Add a long-acting Beta-agonist (LABA)
D. Add systemic steroids
Answer: C
,Expert Rationale: Per EPR-3 guidelines, adding a LABA to ICS is the
preferred step-up therapy for children ≥12 and adults with persistent
asthma; combination therapy improves control better than increasing ICS
dose alone and reduces exacerbation risk.
4. A 36-year-old presents with nasal congestion, sneezing, and watery
eyes every spring. Which is the best first-line pharmacologic treatment?
A. Oral decongestants
B. Second-generation antihistamines
C. Intranasal corticosteroids
D. Intranasal antihistamines
Answer: C
Expert Rationale: Intranasal corticosteroids (fluticasone, mometasone) are
most effective for allergic rhinitis, addressing nasal congestion better than
oral antihistamines and providing anti-inflammatory action at the receptor
level.
5. A patient with pneumonia reports allergy to penicillin. Which
antibiotic is a safe alternative for atypical coverage?
A. Amoxicillin
B. Azithromycin
C. Cephalexin
D. Dicloxacillin
Answer: B
Expert Rationale: Azithromycin (macrolide) provides coverage for atypical
pathogens (Mycoplasma, Chlamydia, Legionella) without cross-reactivity
with penicillin; macrolides are recommended alternatives in true penicillin
allergy for community-acquired pneumonia.
6. A 60-year-old with type 2 diabetes has A1C of 9.2% on metformin
alone. Which is the best next agent?
A. Sulfonylurea
, B. DPP-4 inhibitor
C. GLP-1 receptor agonist
D. SGLT2 inhibitor
Answer: C
Expert Rationale: GLP-1 RAs (liraglutide, semaglutide) provide significant
A1C reduction (1.0-1.5%), promote weight loss, and offer cardiovascular
protection; ADA guidelines recommend GLP-1 RAs or SGLT2i as second-line
when metformin monotherapy fails and CV risk is present.
7. A patient on metformin develops diarrhea and GI upset. Which action
is best?
A. Discontinue immediately
B. Switch to insulin
C. Take with meals
D. Add antiemetic
Answer: C
Expert Rationale: Metformin GI side effects are dose-related and
minimized by titrating slowly and taking with food; discontinuation is
unnecessary initially as tolerance often develops, and extended-release
formulations may also help.
8. A 48-year-old with hypothyroidism is on levothyroxine. Which
instruction is most important?
A. Take at bedtime
B. Take with calcium supplements
C. Take on an empty stomach
D. Take with breakfast
Answer: C
Expert Rationale: Levothyroxine absorption is decreased by food, coffee,
calcium, and iron; it must be taken on an empty stomach 30-60 minutes
FINAL EXAM
Expected Questions with Answers
Advanced Pharmacology for Care of the Family
Chamberlain
This Document Description:
Includes expected exam questions with verified answers
to help students review core concepts, strengthen
clinical understanding, and prepare confidently for the
Final exam.
Ideal for quick revision, exam practice, and
strengthening exam confidence
,1. A 22-year-old with asthma presents with wheezing after exercise.
Which is the best immediate treatment?
A. Oral corticosteroids
B. Ipratropium bromide
C. Albuterol
D. Montelukast
Answer: C
Expert Rationale: Albuterol is a short-acting beta-agonist (SABA) that
provides rapid bronchodilation within minutes, making it the rescue drug of
choice for acute asthma symptoms and exercise-induced bronchospasm per
GINA guidelines.
2. A 55-year-old smoker with chronic cough and dyspnea has FEV1/FVC
ratio <70%. Which class is first-line for symptom control?
A. Inhaled corticosteroids alone
B. Long-acting bronchodilator
C. Theophylline
D. Systemic steroids
Answer: B
Expert Rationale: GOLD guidelines recommend long-acting bronchodilators
(LABAs or LAMAs) as first-line maintenance therapy for COPD to improve
airflow limitation and reduce symptoms; ICS alone is not first-line for COPD
without asthma features.
3. A 10-year-old with persistent asthma symptoms despite low-dose ICS
needs step-up therapy. Which is most appropriate?
A. Increase ICS dose
B. Add leukotriene receptor antagonist
C. Add a long-acting Beta-agonist (LABA)
D. Add systemic steroids
Answer: C
,Expert Rationale: Per EPR-3 guidelines, adding a LABA to ICS is the
preferred step-up therapy for children ≥12 and adults with persistent
asthma; combination therapy improves control better than increasing ICS
dose alone and reduces exacerbation risk.
4. A 36-year-old presents with nasal congestion, sneezing, and watery
eyes every spring. Which is the best first-line pharmacologic treatment?
A. Oral decongestants
B. Second-generation antihistamines
C. Intranasal corticosteroids
D. Intranasal antihistamines
Answer: C
Expert Rationale: Intranasal corticosteroids (fluticasone, mometasone) are
most effective for allergic rhinitis, addressing nasal congestion better than
oral antihistamines and providing anti-inflammatory action at the receptor
level.
5. A patient with pneumonia reports allergy to penicillin. Which
antibiotic is a safe alternative for atypical coverage?
A. Amoxicillin
B. Azithromycin
C. Cephalexin
D. Dicloxacillin
Answer: B
Expert Rationale: Azithromycin (macrolide) provides coverage for atypical
pathogens (Mycoplasma, Chlamydia, Legionella) without cross-reactivity
with penicillin; macrolides are recommended alternatives in true penicillin
allergy for community-acquired pneumonia.
6. A 60-year-old with type 2 diabetes has A1C of 9.2% on metformin
alone. Which is the best next agent?
A. Sulfonylurea
, B. DPP-4 inhibitor
C. GLP-1 receptor agonist
D. SGLT2 inhibitor
Answer: C
Expert Rationale: GLP-1 RAs (liraglutide, semaglutide) provide significant
A1C reduction (1.0-1.5%), promote weight loss, and offer cardiovascular
protection; ADA guidelines recommend GLP-1 RAs or SGLT2i as second-line
when metformin monotherapy fails and CV risk is present.
7. A patient on metformin develops diarrhea and GI upset. Which action
is best?
A. Discontinue immediately
B. Switch to insulin
C. Take with meals
D. Add antiemetic
Answer: C
Expert Rationale: Metformin GI side effects are dose-related and
minimized by titrating slowly and taking with food; discontinuation is
unnecessary initially as tolerance often develops, and extended-release
formulations may also help.
8. A 48-year-old with hypothyroidism is on levothyroxine. Which
instruction is most important?
A. Take at bedtime
B. Take with calcium supplements
C. Take on an empty stomach
D. Take with breakfast
Answer: C
Expert Rationale: Levothyroxine absorption is decreased by food, coffee,
calcium, and iron; it must be taken on an empty stomach 30-60 minutes
