NR565 / NR566 ADVANCED PHARMACOLOGY
EXAM BUNDLE | MIDTERM & FINAL EXAMS |
CHAMBERLAIN COLLEGE 2024/2025
Question 1
Which medication is the first-line treatment for type 2 diabetes mellitus according to ADA
guidelines?
A. Insulin glargine
B. Metformin
C. Pioglitazone
D. Sitagliptin
Correct Answer: B
Rationale: Metformin is the first-line treatment for type 2 diabetes mellitus per ADA guidelines
due to its efficacy in lowering HbA1c, low cost, and favorable safety profile, including minimal
risk of hypoglycemia. Insulin glargine (A) is used for advanced disease, pioglitazone (C) is a
second-line option, and sitagliptin (D) is an adjunct therapy.
Question 2
What is the primary mechanism of action of ezetimibe in treating hyperlipidemia?
A. Inhibits HMG-CoA reductase
B. Decreases cholesterol absorption in the small intestine
C. Increases bile acid excretion
D. Enhances lipoprotein lipase activity
Correct Answer: B
Rationale: Ezetimibe is a cholesterol absorption inhibitor that reduces cholesterol uptake in the
small intestine, lowering LDL levels. HMG-CoA reductase inhibition (A) is the mechanism of
statins, bile acid excretion (C) is for bile acid sequestrants, and lipoprotein lipase activity (D) is
unrelated.
Question 3
A 34-year-old patient starting paroxetine (Paxil) for depression should be educated about:
A. Immediate symptom relief
B. Risk of withdrawal syndrome with abrupt discontinuation
,C. Weight loss as a common side effect
D. No need for laboratory monitoring
Correct Answer: B
Rationale: Paroxetine has a shorter half-life than other SSRIs, increasing the risk of withdrawal
syndrome if stopped abruptly. Symptom relief (A) takes 2–4 weeks, weight gain (not loss, C) is
common, and laboratory monitoring (D) may be needed for comorbidities.
Question 4
Which schedule of controlled substances can advanced practice registered nurses (APRNs)
prescribe in most states?
A. Schedule I only
B. Schedules II–V
C. Schedule V only
D. None
Correct Answer: B
Rationale: In most states, APRNs can prescribe Schedules II–V controlled substances,
depending on state regulations and DEA authority. Schedule I (A) drugs have no medical use,
Schedule V (C) is a subset, and “none” (D) is incorrect.
Question 5
A 6-year-old with ADHD is prescribed methylphenidate (Ritalin). What are common side
effects?
A. Weight gain and sedation
B. Insomnia and decreased appetite
C. Hypertension and tremors
D. Nausea and diarrhea
Correct Answer: B
Rationale: Methylphenidate commonly causes insomnia and decreased appetite in children with
ADHD. Weight gain and sedation (A) are unlikely, hypertension and tremors (C) are less
common, and nausea/diarrhea (D) are not typical.
Question 6
Which antibiotic is first-line for treating uncomplicated chlamydia in adolescents?
A. Azithromycin
, B. Amoxicillin
C. Ceftriaxone
D. Levofloxacin
Correct Answer: A
Rationale: Azithromycin (single 1g dose) is the first-line treatment for uncomplicated chlamydia
per CDC guidelines due to its efficacy and ease of administration. Amoxicillin (B) is used in
pregnancy, ceftriaxone (C) for gonorrhea, and levofloxacin (D) is not recommended in
adolescents.
Question 7
What is the significance of the VCORC1 mutation in patients taking warfarin?
A. Increased risk of bleeding
B. Reduced drug metabolism
C. No effect on dosing
D. Enhanced anticoagulant effect
Correct Answer: A
Rationale: The VCORC1 mutation is associated with warfarin resistance, increasing the risk of
bleeding due to altered metabolism. Reduced metabolism (B) is incorrect, no effect (C) is false,
and enhanced effect (D) applies to CYP2C9 mutations.
Question 8
Which medication is contraindicated in patients with kidney disease due to phosphate
accumulation?
A. Sodium bicarbonate
B. Sodium phosphate
C. Potassium chloride
D. Calcium carbonate
Correct Answer: B
Rationale: Sodium phosphate is contraindicated in kidney disease as excess phosphate can
worsen renal function and cause hyperphosphatemia. Sodium bicarbonate (A), potassium
chloride (C), and calcium carbonate (D) are not primarily contraindicated for this reason.
Question 9
EXAM BUNDLE | MIDTERM & FINAL EXAMS |
CHAMBERLAIN COLLEGE 2024/2025
Question 1
Which medication is the first-line treatment for type 2 diabetes mellitus according to ADA
guidelines?
A. Insulin glargine
B. Metformin
C. Pioglitazone
D. Sitagliptin
Correct Answer: B
Rationale: Metformin is the first-line treatment for type 2 diabetes mellitus per ADA guidelines
due to its efficacy in lowering HbA1c, low cost, and favorable safety profile, including minimal
risk of hypoglycemia. Insulin glargine (A) is used for advanced disease, pioglitazone (C) is a
second-line option, and sitagliptin (D) is an adjunct therapy.
Question 2
What is the primary mechanism of action of ezetimibe in treating hyperlipidemia?
A. Inhibits HMG-CoA reductase
B. Decreases cholesterol absorption in the small intestine
C. Increases bile acid excretion
D. Enhances lipoprotein lipase activity
Correct Answer: B
Rationale: Ezetimibe is a cholesterol absorption inhibitor that reduces cholesterol uptake in the
small intestine, lowering LDL levels. HMG-CoA reductase inhibition (A) is the mechanism of
statins, bile acid excretion (C) is for bile acid sequestrants, and lipoprotein lipase activity (D) is
unrelated.
Question 3
A 34-year-old patient starting paroxetine (Paxil) for depression should be educated about:
A. Immediate symptom relief
B. Risk of withdrawal syndrome with abrupt discontinuation
,C. Weight loss as a common side effect
D. No need for laboratory monitoring
Correct Answer: B
Rationale: Paroxetine has a shorter half-life than other SSRIs, increasing the risk of withdrawal
syndrome if stopped abruptly. Symptom relief (A) takes 2–4 weeks, weight gain (not loss, C) is
common, and laboratory monitoring (D) may be needed for comorbidities.
Question 4
Which schedule of controlled substances can advanced practice registered nurses (APRNs)
prescribe in most states?
A. Schedule I only
B. Schedules II–V
C. Schedule V only
D. None
Correct Answer: B
Rationale: In most states, APRNs can prescribe Schedules II–V controlled substances,
depending on state regulations and DEA authority. Schedule I (A) drugs have no medical use,
Schedule V (C) is a subset, and “none” (D) is incorrect.
Question 5
A 6-year-old with ADHD is prescribed methylphenidate (Ritalin). What are common side
effects?
A. Weight gain and sedation
B. Insomnia and decreased appetite
C. Hypertension and tremors
D. Nausea and diarrhea
Correct Answer: B
Rationale: Methylphenidate commonly causes insomnia and decreased appetite in children with
ADHD. Weight gain and sedation (A) are unlikely, hypertension and tremors (C) are less
common, and nausea/diarrhea (D) are not typical.
Question 6
Which antibiotic is first-line for treating uncomplicated chlamydia in adolescents?
A. Azithromycin
, B. Amoxicillin
C. Ceftriaxone
D. Levofloxacin
Correct Answer: A
Rationale: Azithromycin (single 1g dose) is the first-line treatment for uncomplicated chlamydia
per CDC guidelines due to its efficacy and ease of administration. Amoxicillin (B) is used in
pregnancy, ceftriaxone (C) for gonorrhea, and levofloxacin (D) is not recommended in
adolescents.
Question 7
What is the significance of the VCORC1 mutation in patients taking warfarin?
A. Increased risk of bleeding
B. Reduced drug metabolism
C. No effect on dosing
D. Enhanced anticoagulant effect
Correct Answer: A
Rationale: The VCORC1 mutation is associated with warfarin resistance, increasing the risk of
bleeding due to altered metabolism. Reduced metabolism (B) is incorrect, no effect (C) is false,
and enhanced effect (D) applies to CYP2C9 mutations.
Question 8
Which medication is contraindicated in patients with kidney disease due to phosphate
accumulation?
A. Sodium bicarbonate
B. Sodium phosphate
C. Potassium chloride
D. Calcium carbonate
Correct Answer: B
Rationale: Sodium phosphate is contraindicated in kidney disease as excess phosphate can
worsen renal function and cause hyperphosphatemia. Sodium bicarbonate (A), potassium
chloride (C), and calcium carbonate (D) are not primarily contraindicated for this reason.
Question 9
