NR565 Advanced Pharmacology Fundamentals
Week 8 Final Exam Actual Exam 2026/2027 |
Questions with Verified Answers | 100% Correct |
Pass Guaranteed
SECTION 1: Prescribing Principles & Safety (15 Questions)
Q1: A 28-year-old woman with epilepsy stabilized on lamotrigine requests prepregnancy
counseling. She is planning to conceive in 3 months. What is the MOST appropriate
pharmacological advice?
A. Continue current lamotrigine dose throughout pregnancy.
B. Switch to levetiracetam prior to conception due to better pregnancy safety data.
C. Discontinue all antiseizure drugs during first trimester.
D. Add folic acid 0.4 mg daily when she becomes pregnant.
Correct Answer: B
Rationale: Guideline & Safety: Per AAN and ACOG guidelines, prepregnancy planning
is critical for women with epilepsy. Drug-Specific Risk: Lamotrigine has increased
clearance during pregnancy, requiring frequent level monitoring and dose adjustments.
,Levetiracetam has more consistent pharmacokinetics and favorable pregnancy registry
data. Folic Acid: Should be started at higher dose (4 mg daily) at least 1 month before
conception in women on antiseizure drugs to prevent neural tube defects (D is incorrect
dose and timing). Monitoring: Drug levels should be monitored each trimester and
postpartum. Reference: Epilepsy Foundation & AAN Practice Guidelines.
Q2: Which medication carries a Black Box Warning for increased risk of suicidal
thoughts and behaviors in young adults?
A. Metoprolol
B. Lisinopril
C. Sertraline
D. Metformin
Correct Answer: C
Rationale: FDA Requirement: All SSRI antidepressants (including sertraline) carry a
Black Box Warning for increased risk of suicidal thinking and behavior in children,
adolescents, and young adults (ages 18-24), especially during initial treatment or dose
changes. NP Monitoring Responsibility: Requires close monitoring for worsening
depression, agitation, or unusual behavior changes, particularly during first few months
of therapy. Patient Education: Must discuss this risk with patient/family. Comparison:
The other medications do not have this specific warning.
Q3: A 35-year-old man with treatment-resistant depression is starting phenelzine
(Nardil), an MAOI. Which dietary teaching is MOST critical?
, A. Avoid all dairy products.
B. Limit foods high in tyramine (aged cheeses, cured meats) to prevent hypertensive
crisis.
C. Increase intake of green leafy vegetables.
D. Take with grapefruit juice to enhance absorption.
Correct Answer: B
Rationale: Black Box Warning: MAOIs can cause hypertensive crisis when combined
with tyramine-rich foods. Mechanism: MAO inhibition prevents tyramine breakdown →
catecholamine release → severe hypertension. Dietary Restrictions: Avoid aged
cheeses, cured meats, soy sauce, tap beer, etc. Patient Education: Provide detailed
food list and emergency symptoms (severe headache, palpitations). Monitoring: BP
monitoring during therapy initiation. Reference: FDA Medication Guide for MAOIs.
Q4: A 45-year-old woman with chronic pain is prescribed tramadol 50 mg BID. She is
currently on sertraline 100 mg daily. Which monitoring parameter is MOST important?
A. Liver function tests monthly
B. Signs of serotonin syndrome (hyperthermia, agitation, clonus)
C. INR levels weekly
D. TSH every 6 months
Week 8 Final Exam Actual Exam 2026/2027 |
Questions with Verified Answers | 100% Correct |
Pass Guaranteed
SECTION 1: Prescribing Principles & Safety (15 Questions)
Q1: A 28-year-old woman with epilepsy stabilized on lamotrigine requests prepregnancy
counseling. She is planning to conceive in 3 months. What is the MOST appropriate
pharmacological advice?
A. Continue current lamotrigine dose throughout pregnancy.
B. Switch to levetiracetam prior to conception due to better pregnancy safety data.
C. Discontinue all antiseizure drugs during first trimester.
D. Add folic acid 0.4 mg daily when she becomes pregnant.
Correct Answer: B
Rationale: Guideline & Safety: Per AAN and ACOG guidelines, prepregnancy planning
is critical for women with epilepsy. Drug-Specific Risk: Lamotrigine has increased
clearance during pregnancy, requiring frequent level monitoring and dose adjustments.
,Levetiracetam has more consistent pharmacokinetics and favorable pregnancy registry
data. Folic Acid: Should be started at higher dose (4 mg daily) at least 1 month before
conception in women on antiseizure drugs to prevent neural tube defects (D is incorrect
dose and timing). Monitoring: Drug levels should be monitored each trimester and
postpartum. Reference: Epilepsy Foundation & AAN Practice Guidelines.
Q2: Which medication carries a Black Box Warning for increased risk of suicidal
thoughts and behaviors in young adults?
A. Metoprolol
B. Lisinopril
C. Sertraline
D. Metformin
Correct Answer: C
Rationale: FDA Requirement: All SSRI antidepressants (including sertraline) carry a
Black Box Warning for increased risk of suicidal thinking and behavior in children,
adolescents, and young adults (ages 18-24), especially during initial treatment or dose
changes. NP Monitoring Responsibility: Requires close monitoring for worsening
depression, agitation, or unusual behavior changes, particularly during first few months
of therapy. Patient Education: Must discuss this risk with patient/family. Comparison:
The other medications do not have this specific warning.
Q3: A 35-year-old man with treatment-resistant depression is starting phenelzine
(Nardil), an MAOI. Which dietary teaching is MOST critical?
, A. Avoid all dairy products.
B. Limit foods high in tyramine (aged cheeses, cured meats) to prevent hypertensive
crisis.
C. Increase intake of green leafy vegetables.
D. Take with grapefruit juice to enhance absorption.
Correct Answer: B
Rationale: Black Box Warning: MAOIs can cause hypertensive crisis when combined
with tyramine-rich foods. Mechanism: MAO inhibition prevents tyramine breakdown →
catecholamine release → severe hypertension. Dietary Restrictions: Avoid aged
cheeses, cured meats, soy sauce, tap beer, etc. Patient Education: Provide detailed
food list and emergency symptoms (severe headache, palpitations). Monitoring: BP
monitoring during therapy initiation. Reference: FDA Medication Guide for MAOIs.
Q4: A 45-year-old woman with chronic pain is prescribed tramadol 50 mg BID. She is
currently on sertraline 100 mg daily. Which monitoring parameter is MOST important?
A. Liver function tests monthly
B. Signs of serotonin syndrome (hyperthermia, agitation, clonus)
C. INR levels weekly
D. TSH every 6 months
