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 well-controlled epilepsy on lamotrigine 200 mg BID
requests pre-conception counseling. She plans to conceive in 3 months. The most
appropriate prescribing action is:
A. Continue lamotrigine at current dose throughout pregnancy.
B. Switch to levetiracetam 500 mg BID prior to conception.
C. Taper off all antiseizure medications during the first trimester.
D. Maintain lamotrigine and start folic acid 0.4 mg when pregnancy is confirmed.
Correct Answer: B
Rationale:
● Guideline: AAN & ACOG 2026 – levetiracetam has favorable pregnancy registry
data (major-malformation rate ~2 %) vs lamotrigine (~3–4 % at > 200 mg/day)
and stable clearance.
, ● Algorithm: Step 1 – Assess seizure frequency & teratogenic risk; Step 2 – Choose
agent with lowest teratogenicity & stable PK; Step 3 – Optimize pre-conception (≥
3 months).
● Monitoring: Check drug level every trimester and 4 weeks postpartum.
● Black-Box: None for levetiracetam; valproate has highest risk.
● Distractor D: Folic acid should be 4 mg daily pre-conception – 0.4 mg is
insufficient.
Q2: Which medication carries an FDA Black Box Warning for increased suicidal ideation
in adults ≤ 24 y?
A. Metoprolol
B. Lisinopril
C. Sertraline
D. Metformin
Correct Answer: C
Rationale: FDA BBW – all SSRIs; requires weekly face-to-face contact during
initiation/titration. Others lack this warning.
Q3: A 45-year-old is started on clozapine. REMS mandates which lab before dispensing?
A. Liver function panel
B. Absolute neutrophil count (ANC)
C. Serum lithium level
D. Lipid panel
Correct Answer: B
,Rationale: Clozapine REMS – ANC ≥ 1500/μL required; weekly × 6 months, then q2
weeks × 6 months, then monthly.
Q4: A prescriber’s DEA number is AB1234563. The check-digit verification is:
A. Invalid – last digit should be 7
B. Valid
C. Invalid – last digit should be 5
D. Invalid – letters must be lowercase
Correct Answer: B
Rationale: DEA algorithm: 1-2-4-7-5-3-2-1 weights → sum = 63 → 3 is correct check
digit.
Q5: A 32-year-old G1P0 at 8 weeks is prescribed isotretinoin for severe acne. The NP’s
legal action is:
A. Continue prescription – patient understands risks
B. Stop prescription and switch to topical clindamycin
C. Reduce dose by 50 %
D. Obtain written consent only
Correct Answer: B
Rationale: iPledge REMS – Category X; pregnancy exclusion mandatory. Teratogenicity
risk > 25 %.
, Q6: Telehealth prescribing across state lines requires:
A. Active license in patient’s physical location
B. DEA registration in prescriber’s home state only
C. Collaborative agreement in all states
D. No additional requirements for Schedule III-V
Correct Answer: A
Rationale: NCSBN 2026 – prescriber must hold license where patient is physically
located at time of consultation.
Q7: A newly marketed drug has limited post-marketing data. The best source for
adverse-event surveillance is:
A. PubMed meta-analysis
B. FDA FAERS database
C. DrugFactsAndComparisons.com
D. Lexicomp dosing handbook
Correct Answer: B
Rationale: FAERS = FDA Adverse Event Reporting System; real-world pharmacovigilance.
Q8: Generic substitution is prohibited for which narrow therapeutic index drug?
A. Metformin
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 well-controlled epilepsy on lamotrigine 200 mg BID
requests pre-conception counseling. She plans to conceive in 3 months. The most
appropriate prescribing action is:
A. Continue lamotrigine at current dose throughout pregnancy.
B. Switch to levetiracetam 500 mg BID prior to conception.
C. Taper off all antiseizure medications during the first trimester.
D. Maintain lamotrigine and start folic acid 0.4 mg when pregnancy is confirmed.
Correct Answer: B
Rationale:
● Guideline: AAN & ACOG 2026 – levetiracetam has favorable pregnancy registry
data (major-malformation rate ~2 %) vs lamotrigine (~3–4 % at > 200 mg/day)
and stable clearance.
, ● Algorithm: Step 1 – Assess seizure frequency & teratogenic risk; Step 2 – Choose
agent with lowest teratogenicity & stable PK; Step 3 – Optimize pre-conception (≥
3 months).
● Monitoring: Check drug level every trimester and 4 weeks postpartum.
● Black-Box: None for levetiracetam; valproate has highest risk.
● Distractor D: Folic acid should be 4 mg daily pre-conception – 0.4 mg is
insufficient.
Q2: Which medication carries an FDA Black Box Warning for increased suicidal ideation
in adults ≤ 24 y?
A. Metoprolol
B. Lisinopril
C. Sertraline
D. Metformin
Correct Answer: C
Rationale: FDA BBW – all SSRIs; requires weekly face-to-face contact during
initiation/titration. Others lack this warning.
Q3: A 45-year-old is started on clozapine. REMS mandates which lab before dispensing?
A. Liver function panel
B. Absolute neutrophil count (ANC)
C. Serum lithium level
D. Lipid panel
Correct Answer: B
,Rationale: Clozapine REMS – ANC ≥ 1500/μL required; weekly × 6 months, then q2
weeks × 6 months, then monthly.
Q4: A prescriber’s DEA number is AB1234563. The check-digit verification is:
A. Invalid – last digit should be 7
B. Valid
C. Invalid – last digit should be 5
D. Invalid – letters must be lowercase
Correct Answer: B
Rationale: DEA algorithm: 1-2-4-7-5-3-2-1 weights → sum = 63 → 3 is correct check
digit.
Q5: A 32-year-old G1P0 at 8 weeks is prescribed isotretinoin for severe acne. The NP’s
legal action is:
A. Continue prescription – patient understands risks
B. Stop prescription and switch to topical clindamycin
C. Reduce dose by 50 %
D. Obtain written consent only
Correct Answer: B
Rationale: iPledge REMS – Category X; pregnancy exclusion mandatory. Teratogenicity
risk > 25 %.
, Q6: Telehealth prescribing across state lines requires:
A. Active license in patient’s physical location
B. DEA registration in prescriber’s home state only
C. Collaborative agreement in all states
D. No additional requirements for Schedule III-V
Correct Answer: A
Rationale: NCSBN 2026 – prescriber must hold license where patient is physically
located at time of consultation.
Q7: A newly marketed drug has limited post-marketing data. The best source for
adverse-event surveillance is:
A. PubMed meta-analysis
B. FDA FAERS database
C. DrugFactsAndComparisons.com
D. Lexicomp dosing handbook
Correct Answer: B
Rationale: FAERS = FDA Adverse Event Reporting System; real-world pharmacovigilance.
Q8: Generic substitution is prohibited for which narrow therapeutic index drug?
A. Metformin
