2026/2027
NR 566 Week 4 Midterm Exam
Advanced Pharmacology for Care of
the Family Study Guide and
Comprehensive Review 2026/2027 –
Chamberlain College Exam
Preparation
Question 1
A 32-year-old patient is started on pharmacologic therapy for obesity. The provider
selects a non-amphetamine stimulant approved for short-term use. Which medication
is most appropriate?
A. Orlistat
B. Naltrexone
C. Phentermine
D. Metformin
Correct Answer: C. Phentermine
Rationale: Phentermine is a centrally acting sympathomimetic approved for short-
term weight loss therapy and works by suppressing appetite through increased
norepinephrine activity in the brain. Orlistat works peripherally by reducing fat
absorption, not appetite suppression. Naltrexone is used in combination therapy
affecting reward pathways, not as a stimulant appetite suppressant. Metformin is
primarily an antidiabetic drug and is not FDA-approved for weight loss.
Question 2
Which statement best describes the mechanism of action of phentermine and
diethylpropion?
A. They inhibit fat absorption in the intestine
B. They increase serotonin reuptake
C. They increase norepinephrine availability in the CNS to suppress appetite
D. They block dopamine receptors in the brain
Correct Answer: C. They increase norepinephrine availability in the CNS to
suppress appetite
,2026/2027
Rationale: Both phentermine and diethylpropion are CNS stimulants that promote
weight loss by increasing norepinephrine release, leading to appetite suppression.
They do not inhibit fat absorption (orlistat does), nor do they primarily affect
serotonin reuptake or dopamine blockade.
Question 3
What is the recommended maximum duration of therapy for phentermine or
diethylpropion?
A. 6 months
B. 12 months
C. 3 months or less
D. Lifelong use is acceptable
Correct Answer: C. 3 months or less
Rationale: Non-amphetamine anorectic agents like phentermine and diethylpropion
are approved only for short-term use, typically up to 12 weeks (3 months). Prolonged
use increases risk of dependence and adverse cardiovascular effects.
Question 4
Phentermine and diethylpropion are classified under which controlled substance
schedule?
A. Schedule II
B. Schedule III
C. Schedule IV
D. Not scheduled
Correct Answer: C. Schedule IV
Rationale: These medications have a lower abuse potential compared to
amphetamines and are classified as Schedule IV controlled substances. Schedule II
drugs have higher abuse potential.
Question 5
Which baseline assessment is most appropriate before initiating phentermine therapy?
A. Liver biopsy
B. ECG only
C. CMP and depression screening
D. MRI brain scan
,2026/2027
Correct Answer: C. CMP and depression screening
Rationale: Baseline CMP evaluates renal function and electrolytes, while depression
screening is important due to CNS stimulant effects. Liver biopsy and MRI are
unnecessary. ECG may be considered but is not the primary baseline requirement.
Question 6
Which adverse effects are most commonly associated with phentermine?
A. Hypoglycemia and bradycardia
B. Increased heart rate, hypertension, dry mouth, constipation
C. Severe hypothermia
D. Renal failure and jaundice
Correct Answer: B. Increased heart rate, hypertension, dry mouth, constipation
Rationale: Phentermine stimulates the CNS leading to sympathomimetic effects such
as tachycardia, elevated blood pressure, dry mouth, and constipation. It does not
typically cause hypoglycemia or renal failure.
Question 7
What is the primary role of topiramate in weight management therapy?
A. Increases fat absorption
B. Increases appetite
C. Promotes satiety
D. Blocks insulin secretion
Correct Answer: C. Promotes satiety
Rationale: Topiramate enhances feelings of fullness (satiety), contributing to reduced
caloric intake. It does not increase appetite or fat absorption.
Question 8
Which instruction is appropriate for patients taking phentermine/topiramate to prevent
insomnia?
A. Take at bedtime
B. Take after 8 PM
C. Take before 4 PM
D. Take only on weekends
, 2026/2027
Correct Answer: C. Take before 4 PM
Rationale: Because this combination is stimulating, taking it early in the day reduces
insomnia risk. Late administration may disrupt sleep.
Question 9
Which condition is a contraindication for phentermine/topiramate therapy?
A. Hypertension
B. Hyperthyroidism
C. Mild asthma
D. Iron deficiency anemia
Correct Answer: B. Hyperthyroidism
Rationale: Hyperthyroidism increases sympathetic activity, and combining it with
stimulants increases cardiovascular risk. Mild asthma and anemia are not direct
contraindications.
Question 10
Which drug reduces fat absorption by inhibiting gastrointestinal lipase?
A. Lorcaserin
B. Orlistat
C. Phentermine
D. Bupropion
Correct Answer: B. Orlistat
Rationale: Orlistat inhibits gastric and pancreatic lipases, reducing fat absorption by
about 30%. It does not act on appetite centers.
Question 11
When should fat-soluble vitamin supplementation be taken with orlistat?
A. Simultaneously with each dose
B. 2 hours before or after orlistat
C. Only at night
D. It is not required
Correct Answer: B. 2 hours before or after orlistat
NR 566 Week 4 Midterm Exam
Advanced Pharmacology for Care of
the Family Study Guide and
Comprehensive Review 2026/2027 –
Chamberlain College Exam
Preparation
Question 1
A 32-year-old patient is started on pharmacologic therapy for obesity. The provider
selects a non-amphetamine stimulant approved for short-term use. Which medication
is most appropriate?
A. Orlistat
B. Naltrexone
C. Phentermine
D. Metformin
Correct Answer: C. Phentermine
Rationale: Phentermine is a centrally acting sympathomimetic approved for short-
term weight loss therapy and works by suppressing appetite through increased
norepinephrine activity in the brain. Orlistat works peripherally by reducing fat
absorption, not appetite suppression. Naltrexone is used in combination therapy
affecting reward pathways, not as a stimulant appetite suppressant. Metformin is
primarily an antidiabetic drug and is not FDA-approved for weight loss.
Question 2
Which statement best describes the mechanism of action of phentermine and
diethylpropion?
A. They inhibit fat absorption in the intestine
B. They increase serotonin reuptake
C. They increase norepinephrine availability in the CNS to suppress appetite
D. They block dopamine receptors in the brain
Correct Answer: C. They increase norepinephrine availability in the CNS to
suppress appetite
,2026/2027
Rationale: Both phentermine and diethylpropion are CNS stimulants that promote
weight loss by increasing norepinephrine release, leading to appetite suppression.
They do not inhibit fat absorption (orlistat does), nor do they primarily affect
serotonin reuptake or dopamine blockade.
Question 3
What is the recommended maximum duration of therapy for phentermine or
diethylpropion?
A. 6 months
B. 12 months
C. 3 months or less
D. Lifelong use is acceptable
Correct Answer: C. 3 months or less
Rationale: Non-amphetamine anorectic agents like phentermine and diethylpropion
are approved only for short-term use, typically up to 12 weeks (3 months). Prolonged
use increases risk of dependence and adverse cardiovascular effects.
Question 4
Phentermine and diethylpropion are classified under which controlled substance
schedule?
A. Schedule II
B. Schedule III
C. Schedule IV
D. Not scheduled
Correct Answer: C. Schedule IV
Rationale: These medications have a lower abuse potential compared to
amphetamines and are classified as Schedule IV controlled substances. Schedule II
drugs have higher abuse potential.
Question 5
Which baseline assessment is most appropriate before initiating phentermine therapy?
A. Liver biopsy
B. ECG only
C. CMP and depression screening
D. MRI brain scan
,2026/2027
Correct Answer: C. CMP and depression screening
Rationale: Baseline CMP evaluates renal function and electrolytes, while depression
screening is important due to CNS stimulant effects. Liver biopsy and MRI are
unnecessary. ECG may be considered but is not the primary baseline requirement.
Question 6
Which adverse effects are most commonly associated with phentermine?
A. Hypoglycemia and bradycardia
B. Increased heart rate, hypertension, dry mouth, constipation
C. Severe hypothermia
D. Renal failure and jaundice
Correct Answer: B. Increased heart rate, hypertension, dry mouth, constipation
Rationale: Phentermine stimulates the CNS leading to sympathomimetic effects such
as tachycardia, elevated blood pressure, dry mouth, and constipation. It does not
typically cause hypoglycemia or renal failure.
Question 7
What is the primary role of topiramate in weight management therapy?
A. Increases fat absorption
B. Increases appetite
C. Promotes satiety
D. Blocks insulin secretion
Correct Answer: C. Promotes satiety
Rationale: Topiramate enhances feelings of fullness (satiety), contributing to reduced
caloric intake. It does not increase appetite or fat absorption.
Question 8
Which instruction is appropriate for patients taking phentermine/topiramate to prevent
insomnia?
A. Take at bedtime
B. Take after 8 PM
C. Take before 4 PM
D. Take only on weekends
, 2026/2027
Correct Answer: C. Take before 4 PM
Rationale: Because this combination is stimulating, taking it early in the day reduces
insomnia risk. Late administration may disrupt sleep.
Question 9
Which condition is a contraindication for phentermine/topiramate therapy?
A. Hypertension
B. Hyperthyroidism
C. Mild asthma
D. Iron deficiency anemia
Correct Answer: B. Hyperthyroidism
Rationale: Hyperthyroidism increases sympathetic activity, and combining it with
stimulants increases cardiovascular risk. Mild asthma and anemia are not direct
contraindications.
Question 10
Which drug reduces fat absorption by inhibiting gastrointestinal lipase?
A. Lorcaserin
B. Orlistat
C. Phentermine
D. Bupropion
Correct Answer: B. Orlistat
Rationale: Orlistat inhibits gastric and pancreatic lipases, reducing fat absorption by
about 30%. It does not act on appetite centers.
Question 11
When should fat-soluble vitamin supplementation be taken with orlistat?
A. Simultaneously with each dose
B. 2 hours before or after orlistat
C. Only at night
D. It is not required
Correct Answer: B. 2 hours before or after orlistat
