NUR 5351 Final Comprehensive Exam 2025/26.

NUR 5351 Final Comprehensive Exam 2025/26. 1. When initiating Levodopa/Carbidopa for Parkinson’s disease, which of the following is the most appropriate patient teaching point? A. Take the medication with a high-protein meal B. Stop medication if nausea occurs C. Take on an empty stomach to improve absorption D. Combine with antacids for better effect 2. What is the first-line pharmacologic treatment for mild to moderate Alzheimer’s disease? A. Memantine B. Haloperidol C. Donepezil D. Lithium 3. A patient with alcohol use disorder has advanced liver disease. Which pharmacologic agent should be avoided? A. Disulfiram B. Naltrexone C. Acamprosate D. Gabapentin 4. A 10-year-old boy with ADHD is prescribed a stimulant. Which side effect should you monitor closely? A. Weight gain B. Increased appetite C. Bradycardia D. Insomnia 5. Which is considered a first-line pharmacologic treatment for chronic insomnia? A. Alprazolam B. Diphenhydramine C. Zolpidem D. Amitriptyline 6. Which antidepressant is often preferred in patients with concerns about sexual side effects? A. Sertraline B. Fluoxetine C. Bupropion D. Paroxetine 7. Which ECG change is most commonly seen with Amiodarone therapy? A. ST depression B. QT prolongation C. PR shortening D. Sinus bradycardia with narrow QRS 8. Which medication is second-line for HFrEF after beta-blockers and ACE inhibitors? A. Diltiazem B. Spironolactone C. Hydrochlorothiazide D. Digoxin 9. What is the most appropriate nonpharmacologic education for a patient with CAD? A. Avoid all physical activity B. High-fat diet for energy C. Smoking cessation and cardiac rehab D. Regular alcohol use for heart health 10. Which of the following diuretics is contraindicated in a patient with gout? A. Hydrochlorothiazide B. Bumetanide C. Furosemide D. Mannitol 11. A 30-year-old pregnant woman with hypertension is best managed with which medication? A. Lisinopril B. Nifedipine C. Valsartan D. Hydrochlorothiazide 12. What is the first-line therapy for bacterial vaginosis? A. Clindamycin orally B. Metronidazole orally C. Fluconazole orally D. Miconazole vaginally 13. What is a common side effect of fluoxetine in the first few weeks? A. Constipation B. Excessive sleepiness C. Nausea D. Rash 14. A patient taking levothyroxine should be told to: A. Take it with food B. Take it at bedtime with calcium C. Take it in the morning on an empty stomach D. Stop if they feel better 15. Which diabetes drug promotes urinary glucose excretion? A. Metformin B. Sulfonylureas C. GLP-1 agonists D. SGLT2 inhibitors 16. What vaccine is recommended for all adults ≥65 years old? A. Hepatitis A B. Pneumococcal vaccine C. MMR D. Tdap booster 17. A key side effect of phenytoin is: A. Weight loss B. Hypotension C. Gingival hyperplasia D. Hyperkalemia 18. What is the mechanism of action of orlistat? A. Reduces appetite through serotonin B. Blocks fat absorption in the gut C. Increases metabolism via the thyroid D. Inhibits glucose reabsorption 19. What nonpharmacologic strategy is most supported for generalized anxiety disorder (GAD)? A. Hypnosis B. Cognitive behavioral therapy (CBT) C. Cold showers D. Avoiding social interaction 20. Which contraception method offers the highest efficacy? A. Oral contraceptive pills B. Condom C. Intrauterine device (IUD) D. Diaphragm 21. Which is an expected ECG finding with Class Ic antiarrhythmics? A. QT prolongation B. Widened QRS C. ST elevation D. PR shortening 22. What is the first-line treatment for pediatric acute otitis media? A. Azithromycin B. Amoxicillin C. Ceftriaxone D. Ciprofloxacin 23. Which of the following is a live vaccine? A. Influenza (injection) B. Hepatitis B C. MMR D. Tdap 24. Which vaccine should be given as a booster every 10 years in adults? A. Hepatitis A B. HPV C. Tdap D. Pneumococcal 25. Which medication should be avoided in hypothyroid patients due to risk of worsening the condition? A. Lisinopril B. Amiodarone C. Metoprolol D. Furosemide 26. How long does it take to reach steady state with levothyroxine? A. 1 week B. 2 weeks C. 4–6 weeks D. 3 months 27. What is the first-line treatment for migraine headaches? A. Propranolol B. Acetaminophen C. Sumatriptan D. Amitriptyline 28. Which condition is contraindicated for triptan use in migraines? A. Depression B. Asthma C. Coronary artery disease D. Hypothyroidism 29. What distinguishes hyperthyroidism from hypothyroidism on labs? A. Both have high TSH B. Hyper: ↑TSH, Hypo: ↓TSH C. Hypo: ↑TSH, Hyper: ↓TSH D. TSH always normal 30. What is the mechanism of action of metformin? A. Stimulates insulin release B. Delays gastric emptying C. Inhibits hepatic glucose production D. Blocks glucose absorption in the gut 31. What is the first nonpharmacologic intervention in SVT? A. Defibrillation B. Carotid massage C. Amiodarone D. Beta-blocker IV 32. Which nonpharmacologic strategy improves post-MI outcomes? A. Yoga B. Cardiac rehab C. Vitamin supplements D. High-protein diet 33. A patient on statins reports muscle pain. What should you check first? A. TSH B. CK level C. Glucose D. BUN 34. What is the preferred antihypertensive in African American patients? A. ACE inhibitor B. ARB C. Calcium channel blocker D. Beta-blocker 35. Which BP range qualifies as Stage 2 hypertension? A. 120–129/<80 B. 130–139/80–89 C. ≥140/≥90 D. ≥160/≥100 36. What is first-line for otitis externa? A. Oral amoxicillin B. Ciprofloxacin-dexamethasone ear drops C. Clindamycin D. Fluconazole 37. What is the cornerstone of nonpharmacologic weight loss? A. Herbal teas B. Caloric restriction and exercise C. Vitamin B12 D. High-protein diets 38. Which weight loss medication works through GLP-1 agonism? A. Bupropion B. Orlistat C. Semaglutide D. Topiramate 39. A patient misses two OCPs in a row. What is your advice? A. Stop the pack B. Use backup method for 7 days C. Wait for period D. Double dose next day only 40. What are common signs of bacterial vaginosis? A. Thick, white discharge B. Itching and burning C. Thin gray discharge with fishy odor D. Pelvic pain and fever 41. What is the most common cause of vaginal yeast infections? A. Trichomonas B. E. coli C. Candida albicans D. Gardnerella 42. HRT is contraindicated in patients with: A. Vasomotor symptoms B. Osteoporosis C. Personal history of breast cancer D. Vaginal dryness 43. What is the most appropriate menopause therapy for vaginal atrophy only? A. Oral estrogen B. SSRI C. Vaginal estrogen cream D. Oral contraceptive 44. Which contraception method is most effective? A. Patch B. Implant C. Condoms D. Pills 45. How does Orlistat promote weight loss? A. Inhibits fat absorption B. Suppresses appetite C. Blocks glucose reabsorption D. Stimulates thermogenesis 46. Which drug causes weight gain? A. GLP-1 agonists B. Bupropion C. Insulin D. Orlistat 47. What teaching should be included for patients using varenicline? A. May cause vivid dreams B. Not effective if smoking C. Must be taken with food D. Avoid sunlight 48. Which adult vaccine requires a booster every 10 years? A. MMR B. Tdap C. Zoster D. Influenza 49. What is the best time to recheck TSH after starting levothyroxine? A. 1 week B. 2 weeks C. 4–6 weeks D. 3 months 50. What is the first-line treatment for type 2 diabetes in most adults? A. Insulin B. Sulfonylureas C. Metformin D. GLP-1 agonists 51. Which is a common side effect of buprenorphine for opioid withdrawal? A. Hypertension B. Nausea C. Insomnia D. Hyperglycemia 52. Which agent is preferred for alcohol use disorder in a patient with renal disease? A. Naltrexone B. Acamprosate C. Disulfiram D. Gabapentin 53. Which drug is first-line for narcolepsy with daytime sleepiness? A. Armodafinil B. Dextroamphetamine C. Benzodiazepines D. SSRIs 54. Which nonpharmacologic intervention is most supported for GAD? A. Journaling B. CBT C. Acupuncture D. Music therapy 55. Which antidepressant class is most associated with GI upset and sexual dysfunction? A. MAOIs B. SSRIs C. TCAs D. SNRIs 56. Which drug must be avoided in GAD with bipolar disorder? A. Buspirone B. SSRI monotherapy C. Lithium D. Valproate 57. When should treatment for Parkinson’s disease be initiated? A. When tremor begins B. When symptoms interfere with ADLs C. After 10 years of diagnosis D. Only if dementia develops 58. How should Alzheimer’s pharmacotherapy be evaluated? A. TSH levels B. MMSE score over 6–12 months C. Brain MRI D. Liver enzymes 59. What are diagnostic criteria for migraine without aura? A. At least 1 attack per year B. ≥5 attacks, 4–72 hours with specific features C. Always includes nausea D. Bilateral head pain only . 60. What is the most effective non-drug treatment for GAD? A. Exercise B. CBT C. Deep breathing D. Massage