NR566 FINAL EXAM 2026 LATEST
QUESTIONS AND CORRECT ANSWERS
Advanced Pharmacology for Care of the Family | Chamberlain University | A+ Grade
SECTION 1: EYES, EARS, NOSE, AND SKIN (Q1–Q25)
Q1. A patient with seasonal allergies is prescribed a first-generation antihistamine. Which side
effect should the NP warn the patient about?
- A) Hypertension
- B) Significant sedation and anticholinergic effects
- C) Tachypnea
- D) Excessive tearing
Correct Answer: B
Rationale: First-generation antihistamines (e.g., diphenhydramine, hydroxyzine) cross the
blood-brain barrier, causing CNS depression (sedation) and anticholinergic effects (dry mouth,
urinary retention, constipation).
Q2. Which of the following is a second-generation antihistamine preferred for its non-sedating
properties?
- A) Diphenhydramine
- B) Loratadine
- C) Hydroxyzine
- D) Chlorpheniramine
Correct Answer: B
Rationale: Second-generation antihistamines (loratadine, cetirizine, fexofenadine) do not readily
cross the blood-brain barrier, making them non-sedating and preferred for daytime use.
,Q3. When educating a patient on intranasal cromolyn sodium, the NP should state that it is most
effective when:
- A) Used only when symptoms are severe
- B) Administered as a rescue inhaler
- C) Used prophylactically before allergen exposure
- D) Taken orally with a high-fat meal
Correct Answer: C
Rationale: Cromolyn sodium is a mast cell stabilizer that prevents release of inflammatory
mediators. It requires prophylactic use (days to weeks) before allergen exposure for
effectiveness.
Q4. What is the primary mechanism of action for sympathomimetics used in allergic rhinitis?
- A) Mast cell stabilization
- B) Blockade of H1 receptors
- C) Activation of alpha-1 adrenergic receptors causing vasoconstriction
- D) Inhibition of leukotrienes
Correct Answer: C
Rationale: Sympathomimetics (e.g., pseudoephedrine, oxymetazoline) are alpha-1 agonists that
cause vasoconstriction, reducing nasal congestion by decreasing blood flow to nasal mucosa.
Q5. Which medication is indicated for the treatment of both Influenza A and B?
- A) Amoxicillin
- B) Oseltamivir
- C) Acyclovir
- D) Cromolyn
Correct Answer: B
Rationale: Oseltamivir (Tamiflu) is a neuraminidase inhibitor active against both influenza A and
B viruses. It is most effective when started within 48 hours of symptom onset.
,Q6. A patient using prostaglandin analogs for glaucoma should be monitored for which unique
side effect?
- A) Temporary blindness
- B) Heightened brown pigmentation of the iris
- C) Increased systemic blood pressure
- D) Hearing loss
Correct Answer: B
Rationale: Prostaglandin analogs (latanoprost, bimatoprost) increase uveoscleral outflow.
Unique side effects include increased iris pigmentation and eyelash growth (hypertrichosis) due
to melanin stimulation.
Q7. Which drug is used for the treatment of chronic dry eye by suppressing the immune
response?
- A) Latanoprost
- B) Cyclosporine
- C) Naphazoline
- D) Timolol
Correct Answer: B
Rationale: Cyclosporine (Restasis) is an immunomodulator that reduces T-cell activation and
inflammation on the ocular surface, indicated for keratoconjunctivitis sicca (chronic dry eye).
Q8. What is the first-line antibiotic for a child with Acute Otitis Media (AOM) according to clinical
guidelines?
- A) Azithromycin
- B) Amoxicillin
- C) Ciprofloxacin
- D) Ceftriaxone
Correct Answer: B
Rationale: High-dose amoxicillin (80-90 mg/kg/day) is first-line for AOM due to efficacy against
Streptococcus pneumoniae, narrow spectrum, and favorable safety profile.
, Q9. In a patient with persistent AOM that failed initial therapy, the NP should prescribe:
- A) A higher dose of Amoxicillin
- B) Amoxicillin-Clavulanate (Augmentin)
- C) Topical Neomycin
- D) Watchful waiting for 48 hours
Correct Answer: B
Rationale: For treatment failure after 48-72 hours of amoxicillin, amoxicillin-clavulanate is
recommended to cover beta-lactamase-producing organisms (H. influenzae, M. catarrhalis).
Q10. A patient with severe cystic acne is starting Isotretinoin. Which of the following is a strict
contraindication?
- A) History of asthma
- B) Pregnancy
- C) Peanut allergy
- D) Use of topical moisturizers
Correct Answer: B
Rationale: Isotretinoin is teratogenic (pregnancy category X) with high risk of severe fetal
malformations. Female patients must be on two forms of contraception and have negative
pregnancy tests before each refill[iPLEDGE program].
Q11. What is the black box warning associated with topical calcineurin inhibitors like
Tacrolimus?
- A) Risk of sudden cardiac death
- B) Risk of skin cancer and lymphoma
- C) Risk of tendon rupture
- D) Risk of permanent hair loss
Correct Answer: B
QUESTIONS AND CORRECT ANSWERS
Advanced Pharmacology for Care of the Family | Chamberlain University | A+ Grade
SECTION 1: EYES, EARS, NOSE, AND SKIN (Q1–Q25)
Q1. A patient with seasonal allergies is prescribed a first-generation antihistamine. Which side
effect should the NP warn the patient about?
- A) Hypertension
- B) Significant sedation and anticholinergic effects
- C) Tachypnea
- D) Excessive tearing
Correct Answer: B
Rationale: First-generation antihistamines (e.g., diphenhydramine, hydroxyzine) cross the
blood-brain barrier, causing CNS depression (sedation) and anticholinergic effects (dry mouth,
urinary retention, constipation).
Q2. Which of the following is a second-generation antihistamine preferred for its non-sedating
properties?
- A) Diphenhydramine
- B) Loratadine
- C) Hydroxyzine
- D) Chlorpheniramine
Correct Answer: B
Rationale: Second-generation antihistamines (loratadine, cetirizine, fexofenadine) do not readily
cross the blood-brain barrier, making them non-sedating and preferred for daytime use.
,Q3. When educating a patient on intranasal cromolyn sodium, the NP should state that it is most
effective when:
- A) Used only when symptoms are severe
- B) Administered as a rescue inhaler
- C) Used prophylactically before allergen exposure
- D) Taken orally with a high-fat meal
Correct Answer: C
Rationale: Cromolyn sodium is a mast cell stabilizer that prevents release of inflammatory
mediators. It requires prophylactic use (days to weeks) before allergen exposure for
effectiveness.
Q4. What is the primary mechanism of action for sympathomimetics used in allergic rhinitis?
- A) Mast cell stabilization
- B) Blockade of H1 receptors
- C) Activation of alpha-1 adrenergic receptors causing vasoconstriction
- D) Inhibition of leukotrienes
Correct Answer: C
Rationale: Sympathomimetics (e.g., pseudoephedrine, oxymetazoline) are alpha-1 agonists that
cause vasoconstriction, reducing nasal congestion by decreasing blood flow to nasal mucosa.
Q5. Which medication is indicated for the treatment of both Influenza A and B?
- A) Amoxicillin
- B) Oseltamivir
- C) Acyclovir
- D) Cromolyn
Correct Answer: B
Rationale: Oseltamivir (Tamiflu) is a neuraminidase inhibitor active against both influenza A and
B viruses. It is most effective when started within 48 hours of symptom onset.
,Q6. A patient using prostaglandin analogs for glaucoma should be monitored for which unique
side effect?
- A) Temporary blindness
- B) Heightened brown pigmentation of the iris
- C) Increased systemic blood pressure
- D) Hearing loss
Correct Answer: B
Rationale: Prostaglandin analogs (latanoprost, bimatoprost) increase uveoscleral outflow.
Unique side effects include increased iris pigmentation and eyelash growth (hypertrichosis) due
to melanin stimulation.
Q7. Which drug is used for the treatment of chronic dry eye by suppressing the immune
response?
- A) Latanoprost
- B) Cyclosporine
- C) Naphazoline
- D) Timolol
Correct Answer: B
Rationale: Cyclosporine (Restasis) is an immunomodulator that reduces T-cell activation and
inflammation on the ocular surface, indicated for keratoconjunctivitis sicca (chronic dry eye).
Q8. What is the first-line antibiotic for a child with Acute Otitis Media (AOM) according to clinical
guidelines?
- A) Azithromycin
- B) Amoxicillin
- C) Ciprofloxacin
- D) Ceftriaxone
Correct Answer: B
Rationale: High-dose amoxicillin (80-90 mg/kg/day) is first-line for AOM due to efficacy against
Streptococcus pneumoniae, narrow spectrum, and favorable safety profile.
, Q9. In a patient with persistent AOM that failed initial therapy, the NP should prescribe:
- A) A higher dose of Amoxicillin
- B) Amoxicillin-Clavulanate (Augmentin)
- C) Topical Neomycin
- D) Watchful waiting for 48 hours
Correct Answer: B
Rationale: For treatment failure after 48-72 hours of amoxicillin, amoxicillin-clavulanate is
recommended to cover beta-lactamase-producing organisms (H. influenzae, M. catarrhalis).
Q10. A patient with severe cystic acne is starting Isotretinoin. Which of the following is a strict
contraindication?
- A) History of asthma
- B) Pregnancy
- C) Peanut allergy
- D) Use of topical moisturizers
Correct Answer: B
Rationale: Isotretinoin is teratogenic (pregnancy category X) with high risk of severe fetal
malformations. Female patients must be on two forms of contraception and have negative
pregnancy tests before each refill[iPLEDGE program].
Q11. What is the black box warning associated with topical calcineurin inhibitors like
Tacrolimus?
- A) Risk of sudden cardiac death
- B) Risk of skin cancer and lymphoma
- C) Risk of tendon rupture
- D) Risk of permanent hair loss
Correct Answer: B
