NR566 Advanced Pharmacology FNP Midterm
2025/2026 - ANCC & AANP Aligned
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TOTAL 70 ITEMS | 54 MC + 10 SATA + 7 Rx-Writing + 6 Recent-FDA + 5 Lifespan
EXAM 3 – THEORETICAL + APPLIED FAMILY PHARMACOLOGY
DOMAIN A Pharmacology Principles & Safety (20 Q)
1. A 70-kg, 38-year-old on digoxin 0.25 mg PO daily has K⁺ 3.0 mEq/L, SCr 0.9
mg/dL, HR 54 bpm. Which 2025 AHA parameter MOST directly correlates with
toxicity risk?
A. Serum K⁺ 3.0 mEq/L
B. Heart rate 54 bpm
C. SCr 0.9 mg/dL
D. Daily dose 0.25 mg
Answer: A Rationale: Hypokalemia ↑ digoxin binding to Na⁺/K⁺-ATPase →
toxicity; monitor K⁺ q24 h, maintain 3.5-5.0.
2. (SATA) Which actions reflect rights of medication administration 2025? (Select
ALL)
A. Scanning barcodes at bedside
B. Verifying allergies in EHR
C. Explaining purpose to patient
D. Checking expiration date
E. Documenting after administration
Answer: A, B, C, D, E All remain current rights.
[3-20 continue: first-pass metabolism, therapeutic index, pregnancy categories 2025,
Beers Criteria updates, cultural considerations in pain expression, pharmacogenomics
CYP2C19 & clopidogrel, etc.]
, DOMAIN B Common Family Conditions Management (25 Q)
Respiratory & Infectious (6 Q)
21. A 6-year-old (22 kg) has otitis media; amoxicillin 45 mg/kg/day BID × 10 days.
Available 400 mg/5 mL. Calculate mL per dose.
Solution: 45 × 22 = 990 mg/day → 495 mg/dose. (400 mg/5 mL → 80 mg/mL) →
495 ÷ 80 = 6.2 mL.
Answer: 6.2 mL BID × 10 days
22. (SATA) 2025 IDSA outpatient CAP guidelines recommend amoxicillin 1 g BID for
which patients? (Select ALL)
A. Age ≥ 5 years
B. No comorbidities
C. Fully immunized
D. Atypical pathogen suspected
E. No recent antibiotics
Answer: A, B, C, E D = macrolides preferred for atypicals.
Cardiovascular & HTN (5 Q)
23. A 45-year-old HTN (BP 150/92 mmHg) no comorbidities; 2025 ACC/AHA Step 1?
A. Lisinopril 10 mg daily
B. Amlodipine 5 mg daily
C. HCTZ 25 mg daily
D. Lifestyle only 3 months
Answer: D Stage 1 HTN = lifestyle 3-6 months unless ASCVD risk ≥ 10 %.
Mental Health (4 Q)
24. A 14-year-old with MDD starts sertraline 25 mg daily. After 7 days reports tremor,
diarrhea, agitation. Which mechanism?
A. Serotonin syndrome from excess 5-HT
B. Anticholinergic toxicity
C. Dopamine supersensitivity
D. GABA withdrawal
2025/2026 - ANCC & AANP Aligned
==========================================================
TOTAL 70 ITEMS | 54 MC + 10 SATA + 7 Rx-Writing + 6 Recent-FDA + 5 Lifespan
EXAM 3 – THEORETICAL + APPLIED FAMILY PHARMACOLOGY
DOMAIN A Pharmacology Principles & Safety (20 Q)
1. A 70-kg, 38-year-old on digoxin 0.25 mg PO daily has K⁺ 3.0 mEq/L, SCr 0.9
mg/dL, HR 54 bpm. Which 2025 AHA parameter MOST directly correlates with
toxicity risk?
A. Serum K⁺ 3.0 mEq/L
B. Heart rate 54 bpm
C. SCr 0.9 mg/dL
D. Daily dose 0.25 mg
Answer: A Rationale: Hypokalemia ↑ digoxin binding to Na⁺/K⁺-ATPase →
toxicity; monitor K⁺ q24 h, maintain 3.5-5.0.
2. (SATA) Which actions reflect rights of medication administration 2025? (Select
ALL)
A. Scanning barcodes at bedside
B. Verifying allergies in EHR
C. Explaining purpose to patient
D. Checking expiration date
E. Documenting after administration
Answer: A, B, C, D, E All remain current rights.
[3-20 continue: first-pass metabolism, therapeutic index, pregnancy categories 2025,
Beers Criteria updates, cultural considerations in pain expression, pharmacogenomics
CYP2C19 & clopidogrel, etc.]
, DOMAIN B Common Family Conditions Management (25 Q)
Respiratory & Infectious (6 Q)
21. A 6-year-old (22 kg) has otitis media; amoxicillin 45 mg/kg/day BID × 10 days.
Available 400 mg/5 mL. Calculate mL per dose.
Solution: 45 × 22 = 990 mg/day → 495 mg/dose. (400 mg/5 mL → 80 mg/mL) →
495 ÷ 80 = 6.2 mL.
Answer: 6.2 mL BID × 10 days
22. (SATA) 2025 IDSA outpatient CAP guidelines recommend amoxicillin 1 g BID for
which patients? (Select ALL)
A. Age ≥ 5 years
B. No comorbidities
C. Fully immunized
D. Atypical pathogen suspected
E. No recent antibiotics
Answer: A, B, C, E D = macrolides preferred for atypicals.
Cardiovascular & HTN (5 Q)
23. A 45-year-old HTN (BP 150/92 mmHg) no comorbidities; 2025 ACC/AHA Step 1?
A. Lisinopril 10 mg daily
B. Amlodipine 5 mg daily
C. HCTZ 25 mg daily
D. Lifestyle only 3 months
Answer: D Stage 1 HTN = lifestyle 3-6 months unless ASCVD risk ≥ 10 %.
Mental Health (4 Q)
24. A 14-year-old with MDD starts sertraline 25 mg daily. After 7 days reports tremor,
diarrhea, agitation. Which mechanism?
A. Serotonin syndrome from excess 5-HT
B. Anticholinergic toxicity
C. Dopamine supersensitivity
D. GABA withdrawal
