1
NR 565 WEEK 1 QUIZ 2026/2027 | Official Practice Exam |
Pharmacology for Primary Care | Pass Guaranteed - A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Pharmacokinetics & Pharmacodynamics | Q1 – Q10
Section 2 | Legal & Ethical Prescribing (DEA, FDA) | Q11 – Q20
Section 3 | Drug Interactions & Adverse Reactions | Q21 – Q30
Section 4 | Prescribing for Special Populations | Q31 – Q40
Section 5 | Controlled Substances & Monitoring | Q41 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
══════════════════════════════════════
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS Q1
– Q10
══════════════════════════════════════
Question 1 of 50
A 62-year-old woman with newly diagnosed atrial fibrillation is
started on apixaban 5 mg twice daily. She weighs 68 kg, her serum
creatinine is 1.1 mg/dL, and she takes no interacting medications. At
her 3-month follow-up, she asks why she never needed blood tests
to check her levels. The NP explains that apixaban is preferred over
,2
warfarin in this stable patient because its pharmacokinetic profile
eliminates the need for routine monitoring of which parameter?
A. Liver function tests every 6 months
B. International normalized ratio (INR) ✓ CORRECT
C. Complete blood count with differential
D. Serum creatinine every 3 months
Correct Answer: B
Rationale: Apixaban and other direct oral anticoagulants have
predictable pharmacokinetics that do not require routine INR
monitoring, unlike warfarin which needs frequent INR checks due to
its narrow therapeutic index and multiple drug-food interactions.
Some clinicians still check renal function periodically with DOACs, but
the INR is the specific parameter eliminated. The patient benefits
from both convenience and more stable anticoagulation without
dietary restrictions.
Question 2 of 50
A 45-year-old man with major depressive disorder is started on
sertraline 50 mg daily. After 2 weeks, he reports feeling somewhat
better but notices he feels jittery and has mild tremors in his hands.
The NP explains that these early effects are related to sertraline's
pharmacodynamic activity at which receptor or transporter site?
A. Dopamine D2 receptors
,3
B. Norepinephrine reuptake transporters
C. Serotonin reuptake transporters ✓ CORRECT
D. GABA-A receptors
Correct Answer: C
Rationale: Sertraline is a selective serotonin reuptake inhibitor (SSRI),
and its therapeutic and early adverse effects stem from increased
synaptic serotonin availability through blockade of the serotonin
reuptake transporter (SERT). Early activation symptoms like
jitteriness and tremor are common SSRI initiation effects caused by
excess serotonergic signaling. GABA-A receptors (D) are targeted by
benzodiazepines and alcohol, not SSRIs.
Question 3 of 50
A 38-year-old woman with epilepsy has been seizure-free on
phenytoin 300 mg daily for 5 years. She recently started taking
omeprazole for GERD and now presents with dizziness, blurred
vision, and nystagmus. Her phenytoin level is 28 mcg/mL
(therapeutic 10-20). The NP recognizes that omeprazole inhibited
which enzyme system, causing this clinically significant drug
interaction?
A. CYP2D6
B. CYP2C19
C. CYP3A4 and CYP2C9 ✓ CORRECT
D. CYP1A2
, 4
Correct Answer: C
Rationale: Omeprazole inhibits CYP2C19 and CYP3A4, and phenytoin
is metabolized primarily by CYP2C9 and CYP2C19, so concurrent use
reduces phenytoin clearance and causes toxicity manifesting as
nystagmus, ataxia, and cognitive changes. CYP2D6 (A) metabolizes
many antidepressants and antipsychotics but is not the primary
pathway for phenytoin. The NP should reduce the phenytoin dose or
switch to a different PPI like pantoprazole with less CYP interaction.
Question 4 of 50
A 71-year-old man with heart failure is prescribed lisinopril 10 mg
daily and furosemide 40 mg daily. He returns after 2 weeks
complaining of lightheadedness when standing. His blood pressure is
98/62 mmHg supine and 82/58 mmHg standing. The NP attributes
these findings to the combined pharmacodynamic effect of both
drugs on which physiological parameter?
A. Afterload reduction and intravascular volume depletion ✓
CORRECT
B. Increased myocardial contractility
C. Increased heart rate variability
D. Decreased pulmonary vascular resistance
Correct Answer: A
NR 565 WEEK 1 QUIZ 2026/2027 | Official Practice Exam |
Pharmacology for Primary Care | Pass Guaranteed - A+ Graded
Total Questions: 50 | Time: 90 min | Pass: 80%
TABLE OF CONTENTS
Section 1 | Pharmacokinetics & Pharmacodynamics | Q1 – Q10
Section 2 | Legal & Ethical Prescribing (DEA, FDA) | Q11 – Q20
Section 3 | Drug Interactions & Adverse Reactions | Q21 – Q30
Section 4 | Prescribing for Special Populations | Q31 – Q40
Section 5 | Controlled Substances & Monitoring | Q41 – Q50
Instructions: Choose the single best answer. Pass: 40 in 90 minutes.
══════════════════════════════════════
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS Q1
– Q10
══════════════════════════════════════
Question 1 of 50
A 62-year-old woman with newly diagnosed atrial fibrillation is
started on apixaban 5 mg twice daily. She weighs 68 kg, her serum
creatinine is 1.1 mg/dL, and she takes no interacting medications. At
her 3-month follow-up, she asks why she never needed blood tests
to check her levels. The NP explains that apixaban is preferred over
,2
warfarin in this stable patient because its pharmacokinetic profile
eliminates the need for routine monitoring of which parameter?
A. Liver function tests every 6 months
B. International normalized ratio (INR) ✓ CORRECT
C. Complete blood count with differential
D. Serum creatinine every 3 months
Correct Answer: B
Rationale: Apixaban and other direct oral anticoagulants have
predictable pharmacokinetics that do not require routine INR
monitoring, unlike warfarin which needs frequent INR checks due to
its narrow therapeutic index and multiple drug-food interactions.
Some clinicians still check renal function periodically with DOACs, but
the INR is the specific parameter eliminated. The patient benefits
from both convenience and more stable anticoagulation without
dietary restrictions.
Question 2 of 50
A 45-year-old man with major depressive disorder is started on
sertraline 50 mg daily. After 2 weeks, he reports feeling somewhat
better but notices he feels jittery and has mild tremors in his hands.
The NP explains that these early effects are related to sertraline's
pharmacodynamic activity at which receptor or transporter site?
A. Dopamine D2 receptors
,3
B. Norepinephrine reuptake transporters
C. Serotonin reuptake transporters ✓ CORRECT
D. GABA-A receptors
Correct Answer: C
Rationale: Sertraline is a selective serotonin reuptake inhibitor (SSRI),
and its therapeutic and early adverse effects stem from increased
synaptic serotonin availability through blockade of the serotonin
reuptake transporter (SERT). Early activation symptoms like
jitteriness and tremor are common SSRI initiation effects caused by
excess serotonergic signaling. GABA-A receptors (D) are targeted by
benzodiazepines and alcohol, not SSRIs.
Question 3 of 50
A 38-year-old woman with epilepsy has been seizure-free on
phenytoin 300 mg daily for 5 years. She recently started taking
omeprazole for GERD and now presents with dizziness, blurred
vision, and nystagmus. Her phenytoin level is 28 mcg/mL
(therapeutic 10-20). The NP recognizes that omeprazole inhibited
which enzyme system, causing this clinically significant drug
interaction?
A. CYP2D6
B. CYP2C19
C. CYP3A4 and CYP2C9 ✓ CORRECT
D. CYP1A2
, 4
Correct Answer: C
Rationale: Omeprazole inhibits CYP2C19 and CYP3A4, and phenytoin
is metabolized primarily by CYP2C9 and CYP2C19, so concurrent use
reduces phenytoin clearance and causes toxicity manifesting as
nystagmus, ataxia, and cognitive changes. CYP2D6 (A) metabolizes
many antidepressants and antipsychotics but is not the primary
pathway for phenytoin. The NP should reduce the phenytoin dose or
switch to a different PPI like pantoprazole with less CYP interaction.
Question 4 of 50
A 71-year-old man with heart failure is prescribed lisinopril 10 mg
daily and furosemide 40 mg daily. He returns after 2 weeks
complaining of lightheadedness when standing. His blood pressure is
98/62 mmHg supine and 82/58 mmHg standing. The NP attributes
these findings to the combined pharmacodynamic effect of both
drugs on which physiological parameter?
A. Afterload reduction and intravascular volume depletion ✓
CORRECT
B. Increased myocardial contractility
C. Increased heart rate variability
D. Decreased pulmonary vascular resistance
Correct Answer: A
