1|Page
NR 508 FINAL EXAM/ NR 508 ADVANCED
PHARMACOLOGY WITH 150+ QUESTIONS AND
DETAILED ANSWERS THE LATEST UPDATED EXAM
BANK INCLUDING EXPERT VERIFIED SOLUTIONS FOR
A SURE PASS
Question 1
pts
A patient who has diabetes reports intense discomfort when needing to void. Aurinalysis
is normal. To treat this, the primary care NP should consider prescribing:
flavoxate (Urispas).
bethanechol (Urecholine).
phenazopyridine (Pyridium).
oxybutynin chloride (Ditropan XL).
This patient is describing urge incontinence, or overactive bladder, which occurs when
the detrusor muscle is hyperactive, causing an intense urge to void before the bladder is
full. Urge incontinence is associated with many conditions, including diabetes.
Oxybutynin chloride, which is an anticholinergic, acts to decrease detrusor overactivity
and is indicated for treatment of urge incontinence. Flavoxate is used to treat dysuria
associated with UTI. Bethanecholis indicated for urinary retention. Phenazopyridine is
used to treat dysuria.
Question 2
pts
A patient reports difficulty returning to sleep after getting up to go to the bathroomevery
night. A physical examination and a sleep hygiene history are noncontributory. The
primary care NP should prescribe:
zaleplon.
ZolpiMist.
ramelteon.
,2|Page
chloral hydrate.
ZolpiMist oral spray is useful for patients who have trouble returning to sleep in the
middle of the night. Zaleplon and ramelteon are used for insomnia caused bydifficulty
with sleep onset. Chloral hydrate is not typically used as outpatient therapy.
Question 3
pts
A 5-year-old child who has no previous history of otitis media is seen in clinic witha
temperature of 100° F. The primary care NP visualizes bilateral erythematous,
nonbulging, intact tympanic membranes. The child is taking fluids well and is playing
with toys in the examination room. The NP should:
prescribe azithromycin once daily for 5 days.
prescribe amoxicillin twice daily for 10 days.
prescribe amoxicillin-clavulanate twice daily for 10 days.
initiate antibiotic therapy if the child’s condition worsens.
Signs and symptoms of otitis media that indicate a need for antibiotic treatment include
otalgia, fever, otorrhea, or a bulging yellow or red tympanic membrane. This child has a
low-grade fever, no history of otitis media, a nonbulging tympanicmembrane, and no
otorrhea, so watchful waiting is appropriate. When an antibiotic is started, amoxicillin is
the drug of choice.
Question 4
pts
An 80-year-old patient with congestive heart failure has a viral upper respiratory
infection. The patient asks the primary care NP about treating the fever, which is38.5° C.
The NP should:
recommend acetaminophen.
,3|Page
recommend high-dose acetaminophen.
tell the patient that antibiotics are needed with a fever that high. tell the
patient a fever less than 40° C does not need to be treated.
Patients with congestive heart failure may have tachycardia from fever that aggravates
their symptoms, so fever should be treated. High doses should be given with caution in
elderly patients because of possible decreased hepatic function. Antibiotics should not be
given without evidence of bacterial infection.
Question 5
pts
A patient who takes levodopa and carbidopa for Parkinson’s disease reports
experiencing freezing episodes between doses. The primary care NP shouldconsider
using:
selegiline.
amantadine.
apomorphine.
modified-release levodopa.
Apomorphine injection is used for acute treatment of immobility known as
“freezing.”
Question 6
pts
A patient is being tapered from long-term therapy with prednisolone and reportsweight
loss and fatigue. The primary care NP should counsel this patient to:
consume foods high in vitamin D and calcium.
begin taking dexamethasone because it has longer effects.
, 4|Page
expect these side effects to occur as the medication is tapered.
increase the dose of prednisolone to the most recent amount taken.
Sudden discontinuation or rapid tapering of glucocorticoids in patients who have
developed adrenal suppression can precipitate symptoms of adrenal insufficiency,
including nausea, weakness, depression, anorexia, myalgia, hypotension, and
hypoglycemia. When patients experience these symptoms during a drug taper, the dose
should be increased to the last dose. Vitamin D deficiency is common while taking
glucocorticoids, but these are not symptoms ofvitamin D deficiency. Changing to another
glucocorticoid is not recommended.
Patients should be taught to report the side effects so that action can be takenand should
not be told that they are to be expected.
Question 7
pts
The primary care nurse practitioner (NP) sees a 50-year-old woman who reportsfrequent
leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also
reports having an increased urge to void even when her bladder is not full. She is not
taking any medications. The NP should:
perform a dipstick urinalysis.
prescribe desmopressin (DDAVP).
prescribe oxybutynin chloride (Ditropan XL).
teach exercises to strengthen the pelvic muscles.
A focused history with a careful physical examination is essential for determiningthe
cause of incontinence. Urinalysis can rule out urinary tract infection (UTI), which can
cause incontinence. Medications are prescribed after determining thecause, if any, and
treating underlying conditions. Exercises to strengthen the pelvic muscles are part of
treatment.
Question 8
pts
NR 508 FINAL EXAM/ NR 508 ADVANCED
PHARMACOLOGY WITH 150+ QUESTIONS AND
DETAILED ANSWERS THE LATEST UPDATED EXAM
BANK INCLUDING EXPERT VERIFIED SOLUTIONS FOR
A SURE PASS
Question 1
pts
A patient who has diabetes reports intense discomfort when needing to void. Aurinalysis
is normal. To treat this, the primary care NP should consider prescribing:
flavoxate (Urispas).
bethanechol (Urecholine).
phenazopyridine (Pyridium).
oxybutynin chloride (Ditropan XL).
This patient is describing urge incontinence, or overactive bladder, which occurs when
the detrusor muscle is hyperactive, causing an intense urge to void before the bladder is
full. Urge incontinence is associated with many conditions, including diabetes.
Oxybutynin chloride, which is an anticholinergic, acts to decrease detrusor overactivity
and is indicated for treatment of urge incontinence. Flavoxate is used to treat dysuria
associated with UTI. Bethanecholis indicated for urinary retention. Phenazopyridine is
used to treat dysuria.
Question 2
pts
A patient reports difficulty returning to sleep after getting up to go to the bathroomevery
night. A physical examination and a sleep hygiene history are noncontributory. The
primary care NP should prescribe:
zaleplon.
ZolpiMist.
ramelteon.
,2|Page
chloral hydrate.
ZolpiMist oral spray is useful for patients who have trouble returning to sleep in the
middle of the night. Zaleplon and ramelteon are used for insomnia caused bydifficulty
with sleep onset. Chloral hydrate is not typically used as outpatient therapy.
Question 3
pts
A 5-year-old child who has no previous history of otitis media is seen in clinic witha
temperature of 100° F. The primary care NP visualizes bilateral erythematous,
nonbulging, intact tympanic membranes. The child is taking fluids well and is playing
with toys in the examination room. The NP should:
prescribe azithromycin once daily for 5 days.
prescribe amoxicillin twice daily for 10 days.
prescribe amoxicillin-clavulanate twice daily for 10 days.
initiate antibiotic therapy if the child’s condition worsens.
Signs and symptoms of otitis media that indicate a need for antibiotic treatment include
otalgia, fever, otorrhea, or a bulging yellow or red tympanic membrane. This child has a
low-grade fever, no history of otitis media, a nonbulging tympanicmembrane, and no
otorrhea, so watchful waiting is appropriate. When an antibiotic is started, amoxicillin is
the drug of choice.
Question 4
pts
An 80-year-old patient with congestive heart failure has a viral upper respiratory
infection. The patient asks the primary care NP about treating the fever, which is38.5° C.
The NP should:
recommend acetaminophen.
,3|Page
recommend high-dose acetaminophen.
tell the patient that antibiotics are needed with a fever that high. tell the
patient a fever less than 40° C does not need to be treated.
Patients with congestive heart failure may have tachycardia from fever that aggravates
their symptoms, so fever should be treated. High doses should be given with caution in
elderly patients because of possible decreased hepatic function. Antibiotics should not be
given without evidence of bacterial infection.
Question 5
pts
A patient who takes levodopa and carbidopa for Parkinson’s disease reports
experiencing freezing episodes between doses. The primary care NP shouldconsider
using:
selegiline.
amantadine.
apomorphine.
modified-release levodopa.
Apomorphine injection is used for acute treatment of immobility known as
“freezing.”
Question 6
pts
A patient is being tapered from long-term therapy with prednisolone and reportsweight
loss and fatigue. The primary care NP should counsel this patient to:
consume foods high in vitamin D and calcium.
begin taking dexamethasone because it has longer effects.
, 4|Page
expect these side effects to occur as the medication is tapered.
increase the dose of prednisolone to the most recent amount taken.
Sudden discontinuation or rapid tapering of glucocorticoids in patients who have
developed adrenal suppression can precipitate symptoms of adrenal insufficiency,
including nausea, weakness, depression, anorexia, myalgia, hypotension, and
hypoglycemia. When patients experience these symptoms during a drug taper, the dose
should be increased to the last dose. Vitamin D deficiency is common while taking
glucocorticoids, but these are not symptoms ofvitamin D deficiency. Changing to another
glucocorticoid is not recommended.
Patients should be taught to report the side effects so that action can be takenand should
not be told that they are to be expected.
Question 7
pts
The primary care nurse practitioner (NP) sees a 50-year-old woman who reportsfrequent
leakage of urine. The NP learns that this occurs when she laughs or sneezes. She also
reports having an increased urge to void even when her bladder is not full. She is not
taking any medications. The NP should:
perform a dipstick urinalysis.
prescribe desmopressin (DDAVP).
prescribe oxybutynin chloride (Ditropan XL).
teach exercises to strengthen the pelvic muscles.
A focused history with a careful physical examination is essential for determiningthe
cause of incontinence. Urinalysis can rule out urinary tract infection (UTI), which can
cause incontinence. Medications are prescribed after determining thecause, if any, and
treating underlying conditions. Exercises to strengthen the pelvic muscles are part of
treatment.
Question 8
pts
