NR 568 Advanced Pharmacology | Final Examination | Chamberlain University
Chamberlain University
College of Nursing FINAL
CARING. COMPETENT. COMPASSIONATE. NR 568
NR 568 — Final Examination
ADVANCED PHARMACOLOGY FOR THE ADULT-GERONTOLOGY PRIMARY CARE NP
INSTITUTION Chamberlain University COURSE CODE NR 568
PROGRAM Bachelor of Science in ACADEMIC YEAR
Nursing (BSN)
EXAM TITLE Final Examination — TOTAL QUESTIONS 35 Questions
Advanced Pharmacology
COURSE TITLE Advanced Pharmacology — FORMAT Multiple Choice — Select
Adult-Gerontology NP the Single Best Answer
EXAMINATION INSTRUCTIONS
▶ Select the single best answer for each question.
▶ This exam covers Parkinson's disease, Alzheimer's disease, seizure disorders, migraines, psychiatric
medications, ADHD, CAT, and hormonal therapies.
▶ Formulas, definitions, and conceptual applications are all testable content.
▶ Correct answers and academic rationales appear below each question for review purposes.
Page 1 • NR 568 • Chamberlain University • 2026/2027
, NR 568 Advanced Pharmacology | Final Examination | Chamberlain University
① SECTION I — ADVANCED PHARMACOLOGY: PD, AD, SEIZURES, Questions 1 –
PSYCH & HORMONAL THERAPY 35
1. How do you manage Parkinson's disease in early stages?
A. Levodopa/carbidopa in high doses immediately
B. Pramipexole (Mirapex) or Rotigotine (Neupro)
C. Amantadine alone as first-line monotherapy
D. Anticholinergics such as Cogentin as initial therapy
CORRECT ANSWER B — Pramipexole (Mirapex) or Rotigotine (Neupro)
RATIONALE In early PD, dopamine agonists such as Pramipexole (Mirapex) or Rotigotine (Neupro) are
preferred initial treatments. They delay the need for levodopa, reducing early onset of motor complications.
Levodopa is reserved for when dopamine agonists are insufficient or not tolerated.
2. What is the most effective therapy for Parkinson's disease?
A. Dopamine agonists alone at maximum dose
B. MAO-B inhibitors such as rasagiline as monotherapy
C. Combination therapy with levodopa/carbidopa or levodopa/carbidopa/entacapone
D. Anticholinergic therapy combined with amantadine
CORRECT ANSWER C — Combination therapy with levodopa/carbidopa or
levodopa/carbidopa/entacapone
RATIONALE Levodopa-based combination therapy remains the gold standard for PD. Adding carbidopa
reduces peripheral conversion of levodopa, improving CNS availability. Adding entacapone (a COMT
inhibitor) further extends levodopa half-life, providing more sustained symptom control.
3. Which medications are used to treat 'off' times including wearing-off experiences in
PD?
A. Anticholinergics, beta-blockers, and antacids
B. Dopamine agonists, COMT inhibitors, and MAO-B inhibitors
C. SSRIs, SNRIs, and benzodiazepines
D. Calcium channel blockers and ACE inhibitors
CORRECT ANSWER B — Dopamine agonists, COMT inhibitors, and MAO-B inhibitors
RATIONALE Off periods occur when levodopa levels drop between doses. Dopamine agonists extend
dopaminergic stimulation, COMT inhibitors (e.g., entacapone) block levodopa breakdown, and MAO-B
inhibitors (e.g., rasagiline) inhibit dopamine metabolism — all extending therapeutic windows.
4. Which of the following is a hallmark adverse effect of Pramipexole?
A. Hypertensive crisis and serotonin syndrome
B. QT prolongation and agranulocytosis
C. Nausea, daytime somnolence, hallucinations, and impulse control disorders
Page 2 • NR 568 • Chamberlain University • 2026/2027
, NR 568 Advanced Pharmacology | Final Examination | Chamberlain University
D. Hepatotoxicity and elevated LFTs
CORRECT ANSWER C — Nausea, daytime somnolence, hallucinations, and impulse control
disorders
RATIONALE Pramipexole, a dopamine agonist, commonly causes nausea, dizziness, daytime
somnolence, insomnia, constipation, weakness, hallucinations, and impulse control disorders (e.g.,
gambling, compulsive spending). Patients must be counseled on these behavioral risks prior to starting
therapy.
5. What are the hallmark motor features of Parkinson's disease?
A. Spasticity, hyperreflexia, clonus, and Babinski sign
B. Resting tremor, rigidity, akinesia, bradykinesia, and postural instability
C. Intention tremor, ataxia, nystagmus, and dysarthria
D. Chorea, hemiballismus, dystonia, and myoclonus
CORRECT ANSWER B — Resting tremor, rigidity, akinesia, bradykinesia, and postural instability
RATIONALE The cardinal features of PD arise from dopaminergic neuron degeneration in the substantia
nigra. Resting tremor (pill-rolling), cogwheel rigidity, akinesia (inability to initiate movement), bradykinesia
(slow movement), and postural instability are the classic hallmarks.
6. What medication reduces cardiovascular responses to levodopa and is commonly
combined with it?
A. Entacapone
B. Rasagiline
C. Carbidopa
D. Amantadine
CORRECT ANSWER C — Carbidopa
RATIONALE Carbidopa is a peripheral decarboxylase inhibitor that prevents conversion of levodopa to
dopamine outside the CNS. This reduces peripheral dopamine-mediated cardiovascular effects
(tachycardia, hypotension, nausea) and allows more levodopa to reach the brain, improving efficacy.
7. What is Amantadine (Symmetrel) used for in Parkinson's disease?
A. It is a COMT inhibitor used to extend levodopa half-life
B. It is an NMDA receptor antagonist that blocks glutamate, promotes dopamine release, and
reduces dyskinesia
C. It is a selective MAO-B inhibitor that prevents dopamine breakdown
D. It is an anticholinergic that specifically reduces postural instability
CORRECT ANSWER B — It is an NMDA receptor antagonist that blocks glutamate, promotes
dopamine release, and reduces dyskinesia
RATIONALE Amantadine acts as an NMDA receptor antagonist, blocking glutamate transmission,
promoting dopamine release, and blocking acetylcholine. It is effective as both monotherapy and adjunct
therapy for off-time management. The FDA-approved ER formulation (Gocouri) is specifically indicated for
PD-associated dyskinesia.
Page 3 • NR 568 • Chamberlain University • 2026/2027
, NR 568 Advanced Pharmacology | Final Examination | Chamberlain University
8. What is dopamine dysregulation syndrome (DDS) in the context of PD treatment?
A. An extrapyramidal side effect causing tardive dyskinesia
B. Sudden sleep attacks caused by dopamine agonists
C. A drug-seeking behavior and impulse control disorder such as gambling and compulsive
spending
D. A withdrawal syndrome when levodopa is abruptly stopped
CORRECT ANSWER C — A drug-seeking behavior and impulse control disorder such as gambling
and compulsive spending
RATIONALE DDS manifests as compulsive dopaminergic drug use and associated impulse control
disorders including pathological gambling, hypersexuality, and compulsive spending. It is associated with
dopamine agonist therapy and requires dose reduction or discontinuation of the offending agent.
9. What is the drug of choice for moderate Alzheimer's disease?
A. Memantine as monotherapy
B. Haloperidol for behavioral management
C. Cholinesterase inhibitors: Aricept (donepezil), Razadyne ER (galantamine), or Exelon
(rivastigmine)
D. Benzodiazepines for agitation and anxiety
CORRECT ANSWER C — Cholinesterase inhibitors: Aricept (donepezil), Razadyne ER (galantamine),
or Exelon (rivastigmine)
RATIONALE Cholinesterase inhibitors are first-line for mild to moderate AD. They inhibit
acetylcholinesterase, increasing synaptic acetylcholine, thereby compensating for cholinergic neuron loss.
Donepezil, galantamine, and rivastigmine are the three approved agents. They are not combined with each
other.
10. What is the only NMDA-receptor antagonist approved for moderate to severe
Alzheimer's disease?
A. Donepezil (Aricept)
B. Memantine (Namenda)
C. Rivastigmine (Exelon)
D. Galantamine (Razadyne)
CORRECT ANSWER B — Memantine (Namenda)
RATIONALE Memantine (Namenda) is an NMDA receptor antagonist that blocks excessive glutamate
activity, which is thought to contribute to neuronal damage in AD. It is indicated for moderate to severe AD
and is NOT recommended for mild AD as studies show no symptomatic benefit in early disease.
11. Who should NOT take Rivastigmine (Exelon)?
A. Patients with hypertension and diabetes
B. Patients with COPD
C. Patients taking antidepressants
D. Patients over 80 years old
Page 4 • NR 568 • Chamberlain University • 2026/2027
Chamberlain University
College of Nursing FINAL
CARING. COMPETENT. COMPASSIONATE. NR 568
NR 568 — Final Examination
ADVANCED PHARMACOLOGY FOR THE ADULT-GERONTOLOGY PRIMARY CARE NP
INSTITUTION Chamberlain University COURSE CODE NR 568
PROGRAM Bachelor of Science in ACADEMIC YEAR
Nursing (BSN)
EXAM TITLE Final Examination — TOTAL QUESTIONS 35 Questions
Advanced Pharmacology
COURSE TITLE Advanced Pharmacology — FORMAT Multiple Choice — Select
Adult-Gerontology NP the Single Best Answer
EXAMINATION INSTRUCTIONS
▶ Select the single best answer for each question.
▶ This exam covers Parkinson's disease, Alzheimer's disease, seizure disorders, migraines, psychiatric
medications, ADHD, CAT, and hormonal therapies.
▶ Formulas, definitions, and conceptual applications are all testable content.
▶ Correct answers and academic rationales appear below each question for review purposes.
Page 1 • NR 568 • Chamberlain University • 2026/2027
, NR 568 Advanced Pharmacology | Final Examination | Chamberlain University
① SECTION I — ADVANCED PHARMACOLOGY: PD, AD, SEIZURES, Questions 1 –
PSYCH & HORMONAL THERAPY 35
1. How do you manage Parkinson's disease in early stages?
A. Levodopa/carbidopa in high doses immediately
B. Pramipexole (Mirapex) or Rotigotine (Neupro)
C. Amantadine alone as first-line monotherapy
D. Anticholinergics such as Cogentin as initial therapy
CORRECT ANSWER B — Pramipexole (Mirapex) or Rotigotine (Neupro)
RATIONALE In early PD, dopamine agonists such as Pramipexole (Mirapex) or Rotigotine (Neupro) are
preferred initial treatments. They delay the need for levodopa, reducing early onset of motor complications.
Levodopa is reserved for when dopamine agonists are insufficient or not tolerated.
2. What is the most effective therapy for Parkinson's disease?
A. Dopamine agonists alone at maximum dose
B. MAO-B inhibitors such as rasagiline as monotherapy
C. Combination therapy with levodopa/carbidopa or levodopa/carbidopa/entacapone
D. Anticholinergic therapy combined with amantadine
CORRECT ANSWER C — Combination therapy with levodopa/carbidopa or
levodopa/carbidopa/entacapone
RATIONALE Levodopa-based combination therapy remains the gold standard for PD. Adding carbidopa
reduces peripheral conversion of levodopa, improving CNS availability. Adding entacapone (a COMT
inhibitor) further extends levodopa half-life, providing more sustained symptom control.
3. Which medications are used to treat 'off' times including wearing-off experiences in
PD?
A. Anticholinergics, beta-blockers, and antacids
B. Dopamine agonists, COMT inhibitors, and MAO-B inhibitors
C. SSRIs, SNRIs, and benzodiazepines
D. Calcium channel blockers and ACE inhibitors
CORRECT ANSWER B — Dopamine agonists, COMT inhibitors, and MAO-B inhibitors
RATIONALE Off periods occur when levodopa levels drop between doses. Dopamine agonists extend
dopaminergic stimulation, COMT inhibitors (e.g., entacapone) block levodopa breakdown, and MAO-B
inhibitors (e.g., rasagiline) inhibit dopamine metabolism — all extending therapeutic windows.
4. Which of the following is a hallmark adverse effect of Pramipexole?
A. Hypertensive crisis and serotonin syndrome
B. QT prolongation and agranulocytosis
C. Nausea, daytime somnolence, hallucinations, and impulse control disorders
Page 2 • NR 568 • Chamberlain University • 2026/2027
, NR 568 Advanced Pharmacology | Final Examination | Chamberlain University
D. Hepatotoxicity and elevated LFTs
CORRECT ANSWER C — Nausea, daytime somnolence, hallucinations, and impulse control
disorders
RATIONALE Pramipexole, a dopamine agonist, commonly causes nausea, dizziness, daytime
somnolence, insomnia, constipation, weakness, hallucinations, and impulse control disorders (e.g.,
gambling, compulsive spending). Patients must be counseled on these behavioral risks prior to starting
therapy.
5. What are the hallmark motor features of Parkinson's disease?
A. Spasticity, hyperreflexia, clonus, and Babinski sign
B. Resting tremor, rigidity, akinesia, bradykinesia, and postural instability
C. Intention tremor, ataxia, nystagmus, and dysarthria
D. Chorea, hemiballismus, dystonia, and myoclonus
CORRECT ANSWER B — Resting tremor, rigidity, akinesia, bradykinesia, and postural instability
RATIONALE The cardinal features of PD arise from dopaminergic neuron degeneration in the substantia
nigra. Resting tremor (pill-rolling), cogwheel rigidity, akinesia (inability to initiate movement), bradykinesia
(slow movement), and postural instability are the classic hallmarks.
6. What medication reduces cardiovascular responses to levodopa and is commonly
combined with it?
A. Entacapone
B. Rasagiline
C. Carbidopa
D. Amantadine
CORRECT ANSWER C — Carbidopa
RATIONALE Carbidopa is a peripheral decarboxylase inhibitor that prevents conversion of levodopa to
dopamine outside the CNS. This reduces peripheral dopamine-mediated cardiovascular effects
(tachycardia, hypotension, nausea) and allows more levodopa to reach the brain, improving efficacy.
7. What is Amantadine (Symmetrel) used for in Parkinson's disease?
A. It is a COMT inhibitor used to extend levodopa half-life
B. It is an NMDA receptor antagonist that blocks glutamate, promotes dopamine release, and
reduces dyskinesia
C. It is a selective MAO-B inhibitor that prevents dopamine breakdown
D. It is an anticholinergic that specifically reduces postural instability
CORRECT ANSWER B — It is an NMDA receptor antagonist that blocks glutamate, promotes
dopamine release, and reduces dyskinesia
RATIONALE Amantadine acts as an NMDA receptor antagonist, blocking glutamate transmission,
promoting dopamine release, and blocking acetylcholine. It is effective as both monotherapy and adjunct
therapy for off-time management. The FDA-approved ER formulation (Gocouri) is specifically indicated for
PD-associated dyskinesia.
Page 3 • NR 568 • Chamberlain University • 2026/2027
, NR 568 Advanced Pharmacology | Final Examination | Chamberlain University
8. What is dopamine dysregulation syndrome (DDS) in the context of PD treatment?
A. An extrapyramidal side effect causing tardive dyskinesia
B. Sudden sleep attacks caused by dopamine agonists
C. A drug-seeking behavior and impulse control disorder such as gambling and compulsive
spending
D. A withdrawal syndrome when levodopa is abruptly stopped
CORRECT ANSWER C — A drug-seeking behavior and impulse control disorder such as gambling
and compulsive spending
RATIONALE DDS manifests as compulsive dopaminergic drug use and associated impulse control
disorders including pathological gambling, hypersexuality, and compulsive spending. It is associated with
dopamine agonist therapy and requires dose reduction or discontinuation of the offending agent.
9. What is the drug of choice for moderate Alzheimer's disease?
A. Memantine as monotherapy
B. Haloperidol for behavioral management
C. Cholinesterase inhibitors: Aricept (donepezil), Razadyne ER (galantamine), or Exelon
(rivastigmine)
D. Benzodiazepines for agitation and anxiety
CORRECT ANSWER C — Cholinesterase inhibitors: Aricept (donepezil), Razadyne ER (galantamine),
or Exelon (rivastigmine)
RATIONALE Cholinesterase inhibitors are first-line for mild to moderate AD. They inhibit
acetylcholinesterase, increasing synaptic acetylcholine, thereby compensating for cholinergic neuron loss.
Donepezil, galantamine, and rivastigmine are the three approved agents. They are not combined with each
other.
10. What is the only NMDA-receptor antagonist approved for moderate to severe
Alzheimer's disease?
A. Donepezil (Aricept)
B. Memantine (Namenda)
C. Rivastigmine (Exelon)
D. Galantamine (Razadyne)
CORRECT ANSWER B — Memantine (Namenda)
RATIONALE Memantine (Namenda) is an NMDA receptor antagonist that blocks excessive glutamate
activity, which is thought to contribute to neuronal damage in AD. It is indicated for moderate to severe AD
and is NOT recommended for mild AD as studies show no symptomatic benefit in early disease.
11. Who should NOT take Rivastigmine (Exelon)?
A. Patients with hypertension and diabetes
B. Patients with COPD
C. Patients taking antidepressants
D. Patients over 80 years old
Page 4 • NR 568 • Chamberlain University • 2026/2027
