NURS 5433 FNP II FINAL EXAM REVIEW (2026/2027) (PDF) |
FAMILY NURSING | UTA
200 Practice Questions with Answers and Explanations
Topic: Pharmacology & Medication Management
1. A patient is prescribed a medication that is known to be eliminated primarily by the kidneys. Which of
the following changes would most likely require a dosage adjustment for this patient?
A) Increased age
B) History of heavy alcohol use
C) Elevated liver enzymes
D) Presence of a urinary tract infection
> Correct Answer: A
Rationale: Kidney function declines with age. Drug elimination via the kidneys means decreased renal
clearance in older or renally impaired patients requires a dosage adjustment to prevent toxicity. The
liver, alcohol history, or a UTI are not the primary concerns for renally eliminated drugs.
2. Which of the following is the primary mechanism of action for Penicillins?
A) Inhibiting bacterial protein synthesis
B) Inhibiting bacterial DNA synthesis
C) Inhibiting bacterial cell wall synthesis
D) Disrupting bacterial cell membrane integrity
> Correct Answer: C
Rationale: Penicillins inhibit bacterial cell wall synthesis by binding to and activating enzymes essential
for cell wall function. This makes them particularly effective against gram-positive bacteria.
3. The most serious adverse effect of angiotensin-converting enzyme (ACE) inhibitors that requires
immediate discontinuation is:
A) Dry cough
B) Angioedema
, C) Hypotension
D) Hyperkalemia
> Correct Answer: B
Rationale: Angioedema, a rapid swelling of deep dermal, subcutaneous, or mucosal tissue, is a
potentially life-threatening reaction to ACE inhibitors. While a dry cough is a common side effect, it does
not necessitate immediate discontinuation unless severe.
4. A patient presents to the clinic with a suspected urinary tract infection (UTI). Which first-line
antibiotic is most appropriate for an uncomplicated UTI in a non-pregnant female?
A) Ciprofloxacin
B) Nitrofurantoin
C) Azithromycin
D) Cephalexin
> Correct Answer: B
Rationale: According to IDSA guidelines, nitrofurantoin is a first-line agent for uncomplicated cystitis
due to its narrow spectrum and low resistance rates. Fluoroquinolones (e.g., ciprofloxacin) are reserved
for more complicated cases.
5. A patient is newly prescribed warfarin (Coumadin). Patient education should include a warning about
increasing their intake of which of the following foods?
A) Grapefruit juice
B) Dark green, leafy vegetables
C) Dairy products
D) Complex carbohydrates
> Correct Answer: B
Rationale: Dark green vegetables are high in Vitamin K, which directly antagonizes the effects of
warfarin. Patients should maintain a consistent intake to keep the INR stable.
6. Cephalosporins are a class of antibiotics that are structurally and chemically related to which class of
antibiotics?
A) Macrolides
B) Penicillins
, C) Fluoroquinolones
D) Tetracyclines
> Correct Answer: B
Rationale: Cephalosporins and penicillins both belong to the beta-lactam class of antibiotics. They
share a similar mechanism of action (inhibiting cell wall synthesis). Due to this similarity, there is a risk of
cross-sensitivity in patients with penicillin allergies.
7. A patient asks you about using herbal supplements to treat symptoms of depression. Hypericum
perforatum, more commonly known as St. John's Wort, interacts with many prescription drugs by:
A) Inhibiting cytochrome P450 enzymes
B) Inducing cytochrome P450 enzymes
C) Blocking drug absorption in the gut
D) Competing for protein binding sites
> Correct Answer: B
Rationale: St. John's Wort is a potent inducer of the CYP3A4 enzyme pathway in the liver. This
induction leads to the rapid metabolism and reduced efficacy of many drugs, including oral
contraceptives, warfarin, and antiretrovirals.
8. Which of the following medications is a bisphosphonate used to prevent and treat osteoporosis?
A) Teriparatide
B) Raloxifene
C) Alendronate
D) Denosumab
> Correct Answer: C
Rationale: Alendronate (Fosamax) is a bisphosphonate. It works by inhibiting osteoclast-mediated
bone resorption, reducing bone loss and fracture risk. Teriparatide (Forteo) actually stimulates bone
growth, while raloxifene is an SERM and denosumab is a monoclonal antibody.
9. Which drug is specifically known for stimulating bone growth in patients with osteoporosis?
A) Raloxifene
B) Alendronate
, C) Teriparatide
D) Denosumab
> Correct Answer: C
Rationale: Teriparatide (Forteo) is a recombinant human parathyroid hormone analog. Unlike
antiresorptive agents, it stimulates osteoblastic activity to promote new bone formation.
10. Macrolide antibiotics (e.g., azithromycin) are generally most effective against which type of
bacteria?
A) Gram-positive bacteria
B) Gram-negative bacteria
C) Anaerobic bacteria
D) Atypical bacteria
> Correct Answer: A
Rationale: Macrolides are primarily effective against gram-positive organisms, though some later-
generation macrolides have expanded gram-negative coverage. They are commonly used for respiratory
infections, STIs, and skin infections.
11. Which of the following is the mechanism of action for fluoroquinolones?
A) Inhibition of cell wall synthesis
B) Inhibition of bacterial protein synthesis
C) Inhibition of bacterial DNA synthesis
D) Disruption of bacterial cell membranes
> Correct Answer: C
Rationale: Fluoroquinolones inhibit bacterial DNA gyrase and topoisomerase IV, enzymes essential for
bacterial DNA replication and transcription.
12. A 72-year-old patient with a history of heart failure presents with a dry, persistent cough, mild ankle
edema, and fatigue. Which of the following medications is most likely the cause of the cough?
A) Furosemide (Lasix)
B) Carvedilol (Coreg)
C) Lisinopril (Prinivil, Zestril)
FAMILY NURSING | UTA
200 Practice Questions with Answers and Explanations
Topic: Pharmacology & Medication Management
1. A patient is prescribed a medication that is known to be eliminated primarily by the kidneys. Which of
the following changes would most likely require a dosage adjustment for this patient?
A) Increased age
B) History of heavy alcohol use
C) Elevated liver enzymes
D) Presence of a urinary tract infection
> Correct Answer: A
Rationale: Kidney function declines with age. Drug elimination via the kidneys means decreased renal
clearance in older or renally impaired patients requires a dosage adjustment to prevent toxicity. The
liver, alcohol history, or a UTI are not the primary concerns for renally eliminated drugs.
2. Which of the following is the primary mechanism of action for Penicillins?
A) Inhibiting bacterial protein synthesis
B) Inhibiting bacterial DNA synthesis
C) Inhibiting bacterial cell wall synthesis
D) Disrupting bacterial cell membrane integrity
> Correct Answer: C
Rationale: Penicillins inhibit bacterial cell wall synthesis by binding to and activating enzymes essential
for cell wall function. This makes them particularly effective against gram-positive bacteria.
3. The most serious adverse effect of angiotensin-converting enzyme (ACE) inhibitors that requires
immediate discontinuation is:
A) Dry cough
B) Angioedema
, C) Hypotension
D) Hyperkalemia
> Correct Answer: B
Rationale: Angioedema, a rapid swelling of deep dermal, subcutaneous, or mucosal tissue, is a
potentially life-threatening reaction to ACE inhibitors. While a dry cough is a common side effect, it does
not necessitate immediate discontinuation unless severe.
4. A patient presents to the clinic with a suspected urinary tract infection (UTI). Which first-line
antibiotic is most appropriate for an uncomplicated UTI in a non-pregnant female?
A) Ciprofloxacin
B) Nitrofurantoin
C) Azithromycin
D) Cephalexin
> Correct Answer: B
Rationale: According to IDSA guidelines, nitrofurantoin is a first-line agent for uncomplicated cystitis
due to its narrow spectrum and low resistance rates. Fluoroquinolones (e.g., ciprofloxacin) are reserved
for more complicated cases.
5. A patient is newly prescribed warfarin (Coumadin). Patient education should include a warning about
increasing their intake of which of the following foods?
A) Grapefruit juice
B) Dark green, leafy vegetables
C) Dairy products
D) Complex carbohydrates
> Correct Answer: B
Rationale: Dark green vegetables are high in Vitamin K, which directly antagonizes the effects of
warfarin. Patients should maintain a consistent intake to keep the INR stable.
6. Cephalosporins are a class of antibiotics that are structurally and chemically related to which class of
antibiotics?
A) Macrolides
B) Penicillins
, C) Fluoroquinolones
D) Tetracyclines
> Correct Answer: B
Rationale: Cephalosporins and penicillins both belong to the beta-lactam class of antibiotics. They
share a similar mechanism of action (inhibiting cell wall synthesis). Due to this similarity, there is a risk of
cross-sensitivity in patients with penicillin allergies.
7. A patient asks you about using herbal supplements to treat symptoms of depression. Hypericum
perforatum, more commonly known as St. John's Wort, interacts with many prescription drugs by:
A) Inhibiting cytochrome P450 enzymes
B) Inducing cytochrome P450 enzymes
C) Blocking drug absorption in the gut
D) Competing for protein binding sites
> Correct Answer: B
Rationale: St. John's Wort is a potent inducer of the CYP3A4 enzyme pathway in the liver. This
induction leads to the rapid metabolism and reduced efficacy of many drugs, including oral
contraceptives, warfarin, and antiretrovirals.
8. Which of the following medications is a bisphosphonate used to prevent and treat osteoporosis?
A) Teriparatide
B) Raloxifene
C) Alendronate
D) Denosumab
> Correct Answer: C
Rationale: Alendronate (Fosamax) is a bisphosphonate. It works by inhibiting osteoclast-mediated
bone resorption, reducing bone loss and fracture risk. Teriparatide (Forteo) actually stimulates bone
growth, while raloxifene is an SERM and denosumab is a monoclonal antibody.
9. Which drug is specifically known for stimulating bone growth in patients with osteoporosis?
A) Raloxifene
B) Alendronate
, C) Teriparatide
D) Denosumab
> Correct Answer: C
Rationale: Teriparatide (Forteo) is a recombinant human parathyroid hormone analog. Unlike
antiresorptive agents, it stimulates osteoblastic activity to promote new bone formation.
10. Macrolide antibiotics (e.g., azithromycin) are generally most effective against which type of
bacteria?
A) Gram-positive bacteria
B) Gram-negative bacteria
C) Anaerobic bacteria
D) Atypical bacteria
> Correct Answer: A
Rationale: Macrolides are primarily effective against gram-positive organisms, though some later-
generation macrolides have expanded gram-negative coverage. They are commonly used for respiratory
infections, STIs, and skin infections.
11. Which of the following is the mechanism of action for fluoroquinolones?
A) Inhibition of cell wall synthesis
B) Inhibition of bacterial protein synthesis
C) Inhibition of bacterial DNA synthesis
D) Disruption of bacterial cell membranes
> Correct Answer: C
Rationale: Fluoroquinolones inhibit bacterial DNA gyrase and topoisomerase IV, enzymes essential for
bacterial DNA replication and transcription.
12. A 72-year-old patient with a history of heart failure presents with a dry, persistent cough, mild ankle
edema, and fatigue. Which of the following medications is most likely the cause of the cough?
A) Furosemide (Lasix)
B) Carvedilol (Coreg)
C) Lisinopril (Prinivil, Zestril)
