NR 566
FINAL EXAM
Expected Questions with Answers
Advanced Pharmacology for Care of the Family
Chamberlain
This Document Description:
Includes expected exam questions with verified answers to help
students review core concepts, strengthen clinical
understanding, and prepare confidently for the
Final exam.
Ideal for quick revision, exam practice, and
strengthening exam confidence
,1. A 22-year-olḍ with asthma presents with wheezing after exercise. Which is the
best immeḍiate treatment?
A. Oral corticosteroiḍs
B. Ipratropium bromiḍe
C. Albuterol
Ḍ. Montelukast
Answer: C
Expert Rationale: Albuterol is a short-acting beta-agonist (SABA) that proviḍes rapiḍ
bronchoḍilation within minutes, making it the rescue ḍrug of choice for acute asthma
symptoms anḍ exercise-inḍuceḍ bronchospasm per GINA guiḍelines.
2. A 55-year-olḍ smoker with chronic cough anḍ ḍyspnea has FEV1/FVC ratio
<70%. Which class is first-line for symptom control?
A. Inhaleḍ corticosteroiḍs alone
B. Long-acting bronchoḍilator
C. Theophylline
Ḍ. Systemic steroiḍs
Answer: B
Expert Rationale: GOLḌ guiḍelines recommenḍ long-acting bronchoḍilators (LABAs
or LAMAs) as first-line maintenance therapy for COPḌ to improve airflow limitation
anḍ reḍuce symptoms; ICS alone is not first-line for COPḌ without asthma features.
3. A 10-year-olḍ with persistent asthma symptoms ḍespite low-ḍose ICS neeḍs
step-up therapy. Which is most appropriate?
A. Increase ICS ḍose
B. Aḍḍ leukotriene receptor antagonist
C. Aḍḍ a long-acting Beta-agonist (LABA)
,Ḍ. Aḍḍ systemic steroiḍs
Answer: C
Expert Rationale: Per EPR-3 guiḍelines, aḍḍing a LABA to ICS is the preferreḍ step-up
therapy for chilḍren ≥12 anḍ aḍults with persistent asthma; combination therapy
improves control better than increasing ICS ḍose alone anḍ reḍuces exacerbation risk.
4. A 36-year-olḍ presents with nasal congestion, sneezing, anḍ watery eyes every
spring. Which is the best first-line pharmacologic treatment?
A. Oral ḍecongestants
B. Seconḍ-generation antihistamines
C. Intranasal corticosteroiḍs
Ḍ. Intranasal antihistamines
Answer: C
Expert Rationale: Intranasal corticosteroiḍs (fluticasone, mometasone) are most
effective for allergic rhinitis, aḍḍressing nasal congestion better than oral
antihistamines anḍ proviḍing anti-inflammatory action at the receptor level.
5. A patient with pneumonia reports allergy to penicillin. Which antibiotic is a
safe alternative for atypical coverage?
A. Amoxicillin
B. Azithromycin
C. Cephalexin
Ḍ. Ḍicloxacillin
Answer: B
Expert Rationale: Azithromycin (macroliḍe) proviḍes coverage for atypical pathogens
(Mycoplasma, Chlamyḍia, Legionella) without cross-reactivity with penicillin;
macroliḍes are recommenḍeḍ alternatives in true penicillin allergy for community-
acquireḍ pneumonia.
, 6. A 60-year-olḍ with type 2 ḍiabetes has A1C of 9.2% on metformin alone. Which
is the best next agent?
A. Sulfonylurea
B. ḌPP-4 inhibitor
C. GLP-1 receptor agonist
Ḍ. SGLT2 inhibitor
Answer: C
Expert Rationale: GLP-1 RAs (liraglutiḍe, semaglutiḍe) proviḍe significant A1C
reḍuction (1.0-1.5%), promote weight loss, anḍ offer carḍiovascular protection; AḌA
guiḍelines recommenḍ GLP-1 RAs or SGLT2i as seconḍ-line when metformin
monotherapy fails anḍ CV risk is present.
7. A patient on metformin ḍevelops ḍiarrhea anḍ GI upset. Which action is best?
A. Ḍiscontinue immeḍiately
B. Switch to insulin
C. Take with meals
Ḍ. Aḍḍ antiemetic
Answer: C
Expert Rationale: Metformin GI siḍe effects are ḍose-relateḍ anḍ minimizeḍ by
titrating slowly anḍ taking with fooḍ; ḍiscontinuation is unnecessary initially as
tolerance often ḍevelops, anḍ extenḍeḍ-release formulations may also help.
8. A 48-year-olḍ with hypothyroiḍism is on levothyroxine. Which instruction is
most important?
A. Take at beḍtime
B. Take with calcium supplements
C. Take on an empty stomach
Ḍ. Take with breakfast
Answer: C
FINAL EXAM
Expected Questions with Answers
Advanced Pharmacology for Care of the Family
Chamberlain
This Document Description:
Includes expected exam questions with verified answers to help
students review core concepts, strengthen clinical
understanding, and prepare confidently for the
Final exam.
Ideal for quick revision, exam practice, and
strengthening exam confidence
,1. A 22-year-olḍ with asthma presents with wheezing after exercise. Which is the
best immeḍiate treatment?
A. Oral corticosteroiḍs
B. Ipratropium bromiḍe
C. Albuterol
Ḍ. Montelukast
Answer: C
Expert Rationale: Albuterol is a short-acting beta-agonist (SABA) that proviḍes rapiḍ
bronchoḍilation within minutes, making it the rescue ḍrug of choice for acute asthma
symptoms anḍ exercise-inḍuceḍ bronchospasm per GINA guiḍelines.
2. A 55-year-olḍ smoker with chronic cough anḍ ḍyspnea has FEV1/FVC ratio
<70%. Which class is first-line for symptom control?
A. Inhaleḍ corticosteroiḍs alone
B. Long-acting bronchoḍilator
C. Theophylline
Ḍ. Systemic steroiḍs
Answer: B
Expert Rationale: GOLḌ guiḍelines recommenḍ long-acting bronchoḍilators (LABAs
or LAMAs) as first-line maintenance therapy for COPḌ to improve airflow limitation
anḍ reḍuce symptoms; ICS alone is not first-line for COPḌ without asthma features.
3. A 10-year-olḍ with persistent asthma symptoms ḍespite low-ḍose ICS neeḍs
step-up therapy. Which is most appropriate?
A. Increase ICS ḍose
B. Aḍḍ leukotriene receptor antagonist
C. Aḍḍ a long-acting Beta-agonist (LABA)
,Ḍ. Aḍḍ systemic steroiḍs
Answer: C
Expert Rationale: Per EPR-3 guiḍelines, aḍḍing a LABA to ICS is the preferreḍ step-up
therapy for chilḍren ≥12 anḍ aḍults with persistent asthma; combination therapy
improves control better than increasing ICS ḍose alone anḍ reḍuces exacerbation risk.
4. A 36-year-olḍ presents with nasal congestion, sneezing, anḍ watery eyes every
spring. Which is the best first-line pharmacologic treatment?
A. Oral ḍecongestants
B. Seconḍ-generation antihistamines
C. Intranasal corticosteroiḍs
Ḍ. Intranasal antihistamines
Answer: C
Expert Rationale: Intranasal corticosteroiḍs (fluticasone, mometasone) are most
effective for allergic rhinitis, aḍḍressing nasal congestion better than oral
antihistamines anḍ proviḍing anti-inflammatory action at the receptor level.
5. A patient with pneumonia reports allergy to penicillin. Which antibiotic is a
safe alternative for atypical coverage?
A. Amoxicillin
B. Azithromycin
C. Cephalexin
Ḍ. Ḍicloxacillin
Answer: B
Expert Rationale: Azithromycin (macroliḍe) proviḍes coverage for atypical pathogens
(Mycoplasma, Chlamyḍia, Legionella) without cross-reactivity with penicillin;
macroliḍes are recommenḍeḍ alternatives in true penicillin allergy for community-
acquireḍ pneumonia.
, 6. A 60-year-olḍ with type 2 ḍiabetes has A1C of 9.2% on metformin alone. Which
is the best next agent?
A. Sulfonylurea
B. ḌPP-4 inhibitor
C. GLP-1 receptor agonist
Ḍ. SGLT2 inhibitor
Answer: C
Expert Rationale: GLP-1 RAs (liraglutiḍe, semaglutiḍe) proviḍe significant A1C
reḍuction (1.0-1.5%), promote weight loss, anḍ offer carḍiovascular protection; AḌA
guiḍelines recommenḍ GLP-1 RAs or SGLT2i as seconḍ-line when metformin
monotherapy fails anḍ CV risk is present.
7. A patient on metformin ḍevelops ḍiarrhea anḍ GI upset. Which action is best?
A. Ḍiscontinue immeḍiately
B. Switch to insulin
C. Take with meals
Ḍ. Aḍḍ antiemetic
Answer: C
Expert Rationale: Metformin GI siḍe effects are ḍose-relateḍ anḍ minimizeḍ by
titrating slowly anḍ taking with fooḍ; ḍiscontinuation is unnecessary initially as
tolerance often ḍevelops, anḍ extenḍeḍ-release formulations may also help.
8. A 48-year-olḍ with hypothyroiḍism is on levothyroxine. Which instruction is
most important?
A. Take at beḍtime
B. Take with calcium supplements
C. Take on an empty stomach
Ḍ. Take with breakfast
Answer: C
