1
NR 566 Advanced Pharmacology for
Care of the Family Exam Bundle 2025
– Actual Midterm & Final Exam
Questions | Verified & Graded A
Midterm Exam Questions (1–100)
1. A family nurse practitioner (FNP) is prescribing amoxicillin for a pediatric patient
with acute otitis media. What is the most appropriate dose for a 4-year-old child
weighing 20 kg?
A. 500 mg every 8 hours
B. 80 mg/kg/day divided every 12 hours
C. 250 mg every 12 hours
D. 40 mg/kg/day divided every 8 hours
Correct Answer: B. 80 mg/kg/day divided every 12 hours
Rationale: For pediatric patients with acute otitis media, amoxicillin is dosed at 80–90
mg/kg/day, divided every 12 hours, to achieve adequate middle ear concentrations. For a
20-kg child, this equates to 1600 mg/day, or 800 mg every 12 hours. Option A is
excessive, C is too low, and D uses an incorrect frequency for this indication.
2. An FNP is managing a patient with hypertension who is prescribed lisinopril. Which
electrolyte should be monitored closely due to the risk of hyperkalemia?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct Answer: B. Potassium
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia by reducing
aldosterone-mediated potassium excretion. Monitoring serum potassium is critical in
family practice to prevent arrhythmias, especially in patients with renal impairment or
those taking potassium-sparing diuretics.
3. A 45-year-old patient with type 2 diabetes is started on metformin. What is the most
common side effect the FNP should educate the patient about?
A. Hypoglycemia
B. Gastrointestinal upset
C. Weight gain
D. Hypertension
Correct Answer: B. Gastrointestinal upset
, 2
Rationale: Metformin commonly causes gastrointestinal side effects such as nausea,
diarrhea, and abdominal discomfort, particularly when initiated. The FNP should counsel
patients to take it with food to minimize these effects. Hypoglycemia (A) is rare with
metformin alone, and it does not cause weight gain (C) or hypertension (D).
4. An FNP is prescribing a beta-blocker for a patient with angina. Which medication is
most appropriate for this condition?
A. Propranolol
B. Atenolol
C. Metoprolol
D. Carvedilol
Correct Answer: C. Metoprolol
Rationale: Metoprolol, a cardioselective beta-blocker, is preferred for angina as it
reduces myocardial oxygen demand by decreasing heart rate and contractility while
minimizing bronchoconstriction in patients with asthma or COPD. Propranolol (A) and
carvedilol (D) are non-selective, and atenolol (B) is less commonly used for angina.
5. A 10-year-old patient with asthma is prescribed an inhaled corticosteroid. Which
instruction should the FNP emphasize to prevent a common adverse effect?
A. Use a spacer device
B. Rinse the mouth after inhalation
C. Take the medication before meals
D. Avoid physical activity after use
Correct Answer: B. Rinse the mouth after inhalation
Rationale: Rinsing the mouth after using an inhaled corticosteroid prevents oral thrush, a
common adverse effect due to local deposition of the drug. A spacer (A) improves
delivery but does not prevent thrush, and options C and D are irrelevant to this adverse
effect.
6. An FNP is reviewing a patient’s medication list and notes they are taking warfarin.
Which food should the patient be counseled to consume consistently?
A. Green leafy vegetables
B. Citrus fruits
C. Dairy products
D. Red meat
Correct Answer: A. Green leafy vegetables
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes warfarin’s
anticoagulant effect. Consistent intake is crucial to maintain stable INR levels in family
practice. Other foods (B, C, D) have minimal impact on warfarin’s efficacy.
7. A 60-year-old patient with heart failure is prescribed furosemide. Which laboratory
value should the FNP monitor closely?
A. Serum potassium
B. Serum calcium
C. Blood glucose
D. Serum sodium
Correct Answer: A. Serum potassium
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, increasing the risk of
arrhythmias in heart failure patients. The FNP must monitor potassium levels closely to
ensure patient safety, particularly in family practice where polypharmacy is common.
, 3
8. An FNP is prescribing an antibiotic for a patient with a urinary tract infection
(UTI). Which medication is the first-line treatment for uncomplicated UTI in non-
pregnant women?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Azithromycin
Correct Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is the first-line treatment for uncomplicated UTIs in non-
pregnant women due to its efficacy and low resistance rates. Ciprofloxacin (A) is
reserved for complicated UTIs, amoxicillin (C) is less effective, and azithromycin (D) is
not indicated for UTIs.
9. A 25-year-old pregnant patient presents with nausea and vomiting. Which
medication should the FNP prescribe as a first-line treatment?
A. Ondansetron
B. Metoclopramide
C. Doxylamine-pyridoxine
D. Promethazine
Correct Answer: C. Doxylamine-pyridoxine
Rationale: Doxylamine-pyridoxine is the first-line treatment for nausea and vomiting in
pregnancy due to its safety profile and efficacy. Ondansetron (A) and metoclopramide
(B) are second-line, and promethazine (D) has more side effects.
10. An FNP is managing a patient with type 2 diabetes who is non-compliant with
metformin. Which alternative medication should the FNP consider?
A. Glipizide
B. Insulin glargine
C. Sitagliptin
D. Acarbose
Correct Answer: C. Sitagliptin
Rationale: Sitagliptin, a DPP-4 inhibitor, is an oral alternative for type 2 diabetes with a
low risk of hypoglycemia, suitable for non-compliant patients who prefer oral therapy.
Glipizide (A) risks hypoglycemia, insulin (B) is injectable, and acarbose (D) causes
significant GI side effects.
11. A 55-year-old patient with hypertension is prescribed hydrochlorothiazide. Which
adverse effect should the FNP monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypoglycemia
Correct Answer: B. Hypokalemia
Rationale: Hydrochlorothiazide, a thiazide diuretic, can cause hypokalemia by
increasing potassium excretion. The FNP should monitor potassium levels to prevent
complications like muscle weakness or arrhythmias in family practice.
12. An FNP is prescribing albuterol for a patient with asthma. Which instruction
should the FNP provide to ensure proper use?
A. Use the inhaler daily to prevent attacks
, 4
B. Use the inhaler as needed for acute symptoms
C. Take the inhaler with meals
D. Avoid using a spacer device
Correct Answer: B. Use the inhaler as needed for acute symptoms
Rationale: Albuterol, a short-acting beta-agonist, is used as a rescue inhaler for acute
asthma symptoms. The FNP should educate patients to use it as needed, not daily (A),
and spacers (D) improve delivery. Taking with meals (C) is irrelevant.
13. A 30-year-old patient with depression is prescribed sertraline. Which adverse effect
should the FNP counsel the patient about?
A. Weight loss
B. Sexual dysfunction
C. Hypotension
D. Hyperglycemia
Correct Answer: B. Sexual dysfunction
Rationale: Sertraline, an SSRI, commonly causes sexual dysfunction, which the FNP
should discuss to promote adherence in family practice. Weight loss (A), hypotension
(C), and hyperglycemia (D) are less common.
14. An FNP is managing a pediatric patient with a seizure disorder. Which medication
is the first-line treatment for generalized tonic-clonic seizures?
A. Phenytoin
B. Levetiracetam
C. Carbamazepine
D. Valproic acid
Correct Answer: B. Levetiracetam
Rationale: Levetiracetam is the first-line treatment for generalized tonic-clonic seizures
in children due to its efficacy and favorable side effect profile. Phenytoin (A) and
carbamazepine (C) are alternatives, and valproic acid (D) has more side effects.
15. A 65-year-old patient with osteoarthritis is prescribed ibuprofen. Which condition
requires close monitoring due to this medication?
A. Renal function
B. Blood glucose
C. Thyroid function
D. Liver function
Correct Answer: A. Renal function
Rationale: Ibuprofen, an NSAID, can impair renal function, especially in older adults.
The FNP must monitor renal function to prevent acute kidney injury in family practice.
Glucose (B), thyroid (C), and liver (D) are less directly affected.
16. An FNP is prescribing an oral contraceptive for a 25-year-old female patient. Which
condition is an absolute contraindication?
A. Hypertension
B. History of migraine with aura
C. Obesity
D. Smoking
Correct Answer: B. History of migraine with aura
Rationale: Migraine with aura is an absolute contraindication for combined oral
NR 566 Advanced Pharmacology for
Care of the Family Exam Bundle 2025
– Actual Midterm & Final Exam
Questions | Verified & Graded A
Midterm Exam Questions (1–100)
1. A family nurse practitioner (FNP) is prescribing amoxicillin for a pediatric patient
with acute otitis media. What is the most appropriate dose for a 4-year-old child
weighing 20 kg?
A. 500 mg every 8 hours
B. 80 mg/kg/day divided every 12 hours
C. 250 mg every 12 hours
D. 40 mg/kg/day divided every 8 hours
Correct Answer: B. 80 mg/kg/day divided every 12 hours
Rationale: For pediatric patients with acute otitis media, amoxicillin is dosed at 80–90
mg/kg/day, divided every 12 hours, to achieve adequate middle ear concentrations. For a
20-kg child, this equates to 1600 mg/day, or 800 mg every 12 hours. Option A is
excessive, C is too low, and D uses an incorrect frequency for this indication.
2. An FNP is managing a patient with hypertension who is prescribed lisinopril. Which
electrolyte should be monitored closely due to the risk of hyperkalemia?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Correct Answer: B. Potassium
Rationale: Lisinopril, an ACE inhibitor, can cause hyperkalemia by reducing
aldosterone-mediated potassium excretion. Monitoring serum potassium is critical in
family practice to prevent arrhythmias, especially in patients with renal impairment or
those taking potassium-sparing diuretics.
3. A 45-year-old patient with type 2 diabetes is started on metformin. What is the most
common side effect the FNP should educate the patient about?
A. Hypoglycemia
B. Gastrointestinal upset
C. Weight gain
D. Hypertension
Correct Answer: B. Gastrointestinal upset
, 2
Rationale: Metformin commonly causes gastrointestinal side effects such as nausea,
diarrhea, and abdominal discomfort, particularly when initiated. The FNP should counsel
patients to take it with food to minimize these effects. Hypoglycemia (A) is rare with
metformin alone, and it does not cause weight gain (C) or hypertension (D).
4. An FNP is prescribing a beta-blocker for a patient with angina. Which medication is
most appropriate for this condition?
A. Propranolol
B. Atenolol
C. Metoprolol
D. Carvedilol
Correct Answer: C. Metoprolol
Rationale: Metoprolol, a cardioselective beta-blocker, is preferred for angina as it
reduces myocardial oxygen demand by decreasing heart rate and contractility while
minimizing bronchoconstriction in patients with asthma or COPD. Propranolol (A) and
carvedilol (D) are non-selective, and atenolol (B) is less commonly used for angina.
5. A 10-year-old patient with asthma is prescribed an inhaled corticosteroid. Which
instruction should the FNP emphasize to prevent a common adverse effect?
A. Use a spacer device
B. Rinse the mouth after inhalation
C. Take the medication before meals
D. Avoid physical activity after use
Correct Answer: B. Rinse the mouth after inhalation
Rationale: Rinsing the mouth after using an inhaled corticosteroid prevents oral thrush, a
common adverse effect due to local deposition of the drug. A spacer (A) improves
delivery but does not prevent thrush, and options C and D are irrelevant to this adverse
effect.
6. An FNP is reviewing a patient’s medication list and notes they are taking warfarin.
Which food should the patient be counseled to consume consistently?
A. Green leafy vegetables
B. Citrus fruits
C. Dairy products
D. Red meat
Correct Answer: A. Green leafy vegetables
Rationale: Green leafy vegetables are high in vitamin K, which antagonizes warfarin’s
anticoagulant effect. Consistent intake is crucial to maintain stable INR levels in family
practice. Other foods (B, C, D) have minimal impact on warfarin’s efficacy.
7. A 60-year-old patient with heart failure is prescribed furosemide. Which laboratory
value should the FNP monitor closely?
A. Serum potassium
B. Serum calcium
C. Blood glucose
D. Serum sodium
Correct Answer: A. Serum potassium
Rationale: Furosemide, a loop diuretic, can cause hypokalemia, increasing the risk of
arrhythmias in heart failure patients. The FNP must monitor potassium levels closely to
ensure patient safety, particularly in family practice where polypharmacy is common.
, 3
8. An FNP is prescribing an antibiotic for a patient with a urinary tract infection
(UTI). Which medication is the first-line treatment for uncomplicated UTI in non-
pregnant women?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Azithromycin
Correct Answer: B. Nitrofurantoin
Rationale: Nitrofurantoin is the first-line treatment for uncomplicated UTIs in non-
pregnant women due to its efficacy and low resistance rates. Ciprofloxacin (A) is
reserved for complicated UTIs, amoxicillin (C) is less effective, and azithromycin (D) is
not indicated for UTIs.
9. A 25-year-old pregnant patient presents with nausea and vomiting. Which
medication should the FNP prescribe as a first-line treatment?
A. Ondansetron
B. Metoclopramide
C. Doxylamine-pyridoxine
D. Promethazine
Correct Answer: C. Doxylamine-pyridoxine
Rationale: Doxylamine-pyridoxine is the first-line treatment for nausea and vomiting in
pregnancy due to its safety profile and efficacy. Ondansetron (A) and metoclopramide
(B) are second-line, and promethazine (D) has more side effects.
10. An FNP is managing a patient with type 2 diabetes who is non-compliant with
metformin. Which alternative medication should the FNP consider?
A. Glipizide
B. Insulin glargine
C. Sitagliptin
D. Acarbose
Correct Answer: C. Sitagliptin
Rationale: Sitagliptin, a DPP-4 inhibitor, is an oral alternative for type 2 diabetes with a
low risk of hypoglycemia, suitable for non-compliant patients who prefer oral therapy.
Glipizide (A) risks hypoglycemia, insulin (B) is injectable, and acarbose (D) causes
significant GI side effects.
11. A 55-year-old patient with hypertension is prescribed hydrochlorothiazide. Which
adverse effect should the FNP monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypoglycemia
Correct Answer: B. Hypokalemia
Rationale: Hydrochlorothiazide, a thiazide diuretic, can cause hypokalemia by
increasing potassium excretion. The FNP should monitor potassium levels to prevent
complications like muscle weakness or arrhythmias in family practice.
12. An FNP is prescribing albuterol for a patient with asthma. Which instruction
should the FNP provide to ensure proper use?
A. Use the inhaler daily to prevent attacks
, 4
B. Use the inhaler as needed for acute symptoms
C. Take the inhaler with meals
D. Avoid using a spacer device
Correct Answer: B. Use the inhaler as needed for acute symptoms
Rationale: Albuterol, a short-acting beta-agonist, is used as a rescue inhaler for acute
asthma symptoms. The FNP should educate patients to use it as needed, not daily (A),
and spacers (D) improve delivery. Taking with meals (C) is irrelevant.
13. A 30-year-old patient with depression is prescribed sertraline. Which adverse effect
should the FNP counsel the patient about?
A. Weight loss
B. Sexual dysfunction
C. Hypotension
D. Hyperglycemia
Correct Answer: B. Sexual dysfunction
Rationale: Sertraline, an SSRI, commonly causes sexual dysfunction, which the FNP
should discuss to promote adherence in family practice. Weight loss (A), hypotension
(C), and hyperglycemia (D) are less common.
14. An FNP is managing a pediatric patient with a seizure disorder. Which medication
is the first-line treatment for generalized tonic-clonic seizures?
A. Phenytoin
B. Levetiracetam
C. Carbamazepine
D. Valproic acid
Correct Answer: B. Levetiracetam
Rationale: Levetiracetam is the first-line treatment for generalized tonic-clonic seizures
in children due to its efficacy and favorable side effect profile. Phenytoin (A) and
carbamazepine (C) are alternatives, and valproic acid (D) has more side effects.
15. A 65-year-old patient with osteoarthritis is prescribed ibuprofen. Which condition
requires close monitoring due to this medication?
A. Renal function
B. Blood glucose
C. Thyroid function
D. Liver function
Correct Answer: A. Renal function
Rationale: Ibuprofen, an NSAID, can impair renal function, especially in older adults.
The FNP must monitor renal function to prevent acute kidney injury in family practice.
Glucose (B), thyroid (C), and liver (D) are less directly affected.
16. An FNP is prescribing an oral contraceptive for a 25-year-old female patient. Which
condition is an absolute contraindication?
A. Hypertension
B. History of migraine with aura
C. Obesity
D. Smoking
Correct Answer: B. History of migraine with aura
Rationale: Migraine with aura is an absolute contraindication for combined oral
