NURS 684 FINAL EXAM 2025: 75
CORRECTLY ANSWERED QUESTIONS FOR
WEST COAST UNIVERSITY
Question 1 (Pharmacokinetics)
A drug with a half-life of 6 hours is administered at 0900. When will 75% of the drug be
eliminated?
A: 1500
B: 2100
C: 0300 the next day
D: 0900 the next day
Correct Answer: B
Rationale: After one half-life (6 hours), 50% of the drug remains; after two half-lives (12 hours,
by 2100), 25% remains, meaning 75% is eliminated.
Question 2 (Drug Interactions)
A patient on warfarin is prescribed rifampin. What is the nurse practitioner’s priority action?
A: Increase warfarin dose
B: Monitor INR frequently
C: Discontinue rifampin
D: Administer vitamin K
Correct Answer: B
Rationale: Rifampin induces CYP2C9, decreasing warfarin’s effect. Frequent INR monitoring
ensures therapeutic anticoagulation.
Question 3 (Pharmacodynamics)
What is the primary mechanism of action of losartan?
A: Inhibits ACE
B: Blocks angiotensin II receptors
C: Blocks beta-adrenergic receptors
D: Inhibits sodium reabsorption
Correct Answer: B
Rationale: Losartan, an ARB, blocks angiotensin II receptors, reducing vasoconstriction and
blood pressure.
Question 4 (Patient Education)
,A patient is prescribed ciprofloxacin. What should the nurse practitioner teach?
A: Take with dairy to enhance absorption
B: Avoid calcium-rich foods for 2 hours after dosing
C: Expect permanent tendon damage
D: Take at bedtime only
Correct Answer: B
Rationale: Calcium binds ciprofloxacin, reducing absorption. Patients should avoid dairy or
calcium supplements around dosing.
Question 5 (Special Populations)
Which antibiotic is safest for a pregnant patient at 32 weeks with a sinus infection?
A: Doxycycline
B: Amoxicillin
C: Levofloxacin
D: Trimethoprim-sulfamethoxazole
Correct Answer: B
Rationale: Amoxicillin (Category B) is safe in pregnancy, while doxycycline (Category D),
levofloxacin, and trimethoprim-sulfamethoxazole are contraindicated due to fetal risks.
Question 6 (Adverse Effects)
A patient on lisinopril reports a dry cough. What should the nurse practitioner do?
A: Increase the dose
B: Consider switching to an ARB
C: Continue lisinopril
D: Administer a bronchodilator
Correct Answer: B
Rationale: Dry cough is a common ACE inhibitor side effect. Switching to an ARB like losartan
often resolves the issue.
Question 7 (Pharmacokinetics, Fill-in-the-Blank)
A patient receives gentamicin 80 mg IV (weight 60 kg, volume of distribution 0.2 L/kg).
Calculate the peak plasma concentration. (Enter numeric value in mg/L.)
Correct Answer: 6.67
Rationale: Volume of distribution = 0.2 L/kg × 60 kg = 12 L. Peak concentration = 80 mg ÷ 12
L = 6.67 mg/L.
Question 8 (Drug Interactions, SATA)
Which medications increase bleeding risk when combined with clopidogrel? (Select all that
apply)
A: Warfarin
, B: Metformin
C: Aspirin
D: Ibuprofen
Correct Answers: A, C, D
Rationale: Warfarin, aspirin, and ibuprofen increase bleeding risk by affecting anticoagulation
or platelet function. Metformin does not.
Question 9 (Prescribing)
A patient with type 2 diabetes has an A1C of 9% on metformin. What is the next step?
A: Continue metformin alone
B: Add an SGLT2 inhibitor
C: Discontinue metformin
D: Start basal insulin immediately
Correct Answer: B
Rationale: An A1C >9% indicates poor control. Adding an SGLT2 inhibitor is appropriate
before insulin in most cases.
Question 10 (Adverse Effects)
A patient on simvastatin reports muscle weakness. What should the nurse practitioner do?
A: Continue the medication
B: Check creatine kinase levels
C: Double the dose
D: Switch to a PCSK9 inhibitor
Correct Answer: B
Rationale: Muscle weakness may indicate myopathy, requiring creatine kinase monitoring to
assess for rhabdomyolysis.
Question 11 (Pharmacodynamics)
What is the primary action of montelukast in asthma management?
A: Relaxes bronchial smooth muscle
B: Inhibits leukotriene receptors
C: Reduces mucus production
D: Inhibits histamine release
Correct Answer: B
Rationale: Montelukast blocks leukotriene receptors, reducing inflammation and
bronchoconstriction in asthma.
Question 12 (Special Populations)
A 75-year-old patient with CrCl 20 mL/min is prescribed an antibiotic. Which requires dose
adjustment?
CORRECTLY ANSWERED QUESTIONS FOR
WEST COAST UNIVERSITY
Question 1 (Pharmacokinetics)
A drug with a half-life of 6 hours is administered at 0900. When will 75% of the drug be
eliminated?
A: 1500
B: 2100
C: 0300 the next day
D: 0900 the next day
Correct Answer: B
Rationale: After one half-life (6 hours), 50% of the drug remains; after two half-lives (12 hours,
by 2100), 25% remains, meaning 75% is eliminated.
Question 2 (Drug Interactions)
A patient on warfarin is prescribed rifampin. What is the nurse practitioner’s priority action?
A: Increase warfarin dose
B: Monitor INR frequently
C: Discontinue rifampin
D: Administer vitamin K
Correct Answer: B
Rationale: Rifampin induces CYP2C9, decreasing warfarin’s effect. Frequent INR monitoring
ensures therapeutic anticoagulation.
Question 3 (Pharmacodynamics)
What is the primary mechanism of action of losartan?
A: Inhibits ACE
B: Blocks angiotensin II receptors
C: Blocks beta-adrenergic receptors
D: Inhibits sodium reabsorption
Correct Answer: B
Rationale: Losartan, an ARB, blocks angiotensin II receptors, reducing vasoconstriction and
blood pressure.
Question 4 (Patient Education)
,A patient is prescribed ciprofloxacin. What should the nurse practitioner teach?
A: Take with dairy to enhance absorption
B: Avoid calcium-rich foods for 2 hours after dosing
C: Expect permanent tendon damage
D: Take at bedtime only
Correct Answer: B
Rationale: Calcium binds ciprofloxacin, reducing absorption. Patients should avoid dairy or
calcium supplements around dosing.
Question 5 (Special Populations)
Which antibiotic is safest for a pregnant patient at 32 weeks with a sinus infection?
A: Doxycycline
B: Amoxicillin
C: Levofloxacin
D: Trimethoprim-sulfamethoxazole
Correct Answer: B
Rationale: Amoxicillin (Category B) is safe in pregnancy, while doxycycline (Category D),
levofloxacin, and trimethoprim-sulfamethoxazole are contraindicated due to fetal risks.
Question 6 (Adverse Effects)
A patient on lisinopril reports a dry cough. What should the nurse practitioner do?
A: Increase the dose
B: Consider switching to an ARB
C: Continue lisinopril
D: Administer a bronchodilator
Correct Answer: B
Rationale: Dry cough is a common ACE inhibitor side effect. Switching to an ARB like losartan
often resolves the issue.
Question 7 (Pharmacokinetics, Fill-in-the-Blank)
A patient receives gentamicin 80 mg IV (weight 60 kg, volume of distribution 0.2 L/kg).
Calculate the peak plasma concentration. (Enter numeric value in mg/L.)
Correct Answer: 6.67
Rationale: Volume of distribution = 0.2 L/kg × 60 kg = 12 L. Peak concentration = 80 mg ÷ 12
L = 6.67 mg/L.
Question 8 (Drug Interactions, SATA)
Which medications increase bleeding risk when combined with clopidogrel? (Select all that
apply)
A: Warfarin
, B: Metformin
C: Aspirin
D: Ibuprofen
Correct Answers: A, C, D
Rationale: Warfarin, aspirin, and ibuprofen increase bleeding risk by affecting anticoagulation
or platelet function. Metformin does not.
Question 9 (Prescribing)
A patient with type 2 diabetes has an A1C of 9% on metformin. What is the next step?
A: Continue metformin alone
B: Add an SGLT2 inhibitor
C: Discontinue metformin
D: Start basal insulin immediately
Correct Answer: B
Rationale: An A1C >9% indicates poor control. Adding an SGLT2 inhibitor is appropriate
before insulin in most cases.
Question 10 (Adverse Effects)
A patient on simvastatin reports muscle weakness. What should the nurse practitioner do?
A: Continue the medication
B: Check creatine kinase levels
C: Double the dose
D: Switch to a PCSK9 inhibitor
Correct Answer: B
Rationale: Muscle weakness may indicate myopathy, requiring creatine kinase monitoring to
assess for rhabdomyolysis.
Question 11 (Pharmacodynamics)
What is the primary action of montelukast in asthma management?
A: Relaxes bronchial smooth muscle
B: Inhibits leukotriene receptors
C: Reduces mucus production
D: Inhibits histamine release
Correct Answer: B
Rationale: Montelukast blocks leukotriene receptors, reducing inflammation and
bronchoconstriction in asthma.
Question 12 (Special Populations)
A 75-year-old patient with CrCl 20 mL/min is prescribed an antibiotic. Which requires dose
adjustment?
