NR 568 Exam 4 V2 | NR 568 Advanced
Pharmacology for the Adult-Gerontology
Primary Care Nurse Practitioner | Actual
Q&A with Rationale (NR568 Exam 4) |
Chamberlain University
1. A 68-year-old patient is prescribed Ciprofloxacin for a complicated urinary tract infection.
Which Black Box Warning should the nurse practitioner specifically discuss with this older
adult?
A. Increased risk of tendonitis and tendon rupture
B. Risk of severe hepatotoxicity and liver failure
C. Potential for Stevens-Johnson Syndrome
D. Risk of fatal cardiac arrhythmias and QT prolongation
Answer: A
Rationale: Fluoroquinolones like ciprofloxacin carry a black box warning for tendonitis
and tendon rupture. This risk is significantly higher in patients over the age of 60 and those
concurrently taking corticosteroids. The nurse practitioner must advise the patient to
discontinue the drug and seek medical attention if they experience any sudden pain or
swelling in their joints.
,2. When initiating therapy for a patient newly diagnosed with HIV, which of the following is
the primary goal of highly active antiretroviral therapy (HAART)?
A. To eradicate the virus from the body completely
B. To increase the CD4 count to at least 1000 cells/mm3
C. To achieve and maintain maximal suppression of viral load
D. To prevent the transmission of the virus to partners only
Answer: C
Rationale: The primary clinical goal of HIV therapy is to reduce the viral load to
undetectable levels. Achieving maximal suppression helps to preserve immune function
and prevent the progression to AIDS. While increasing CD4 counts is a positive outcome,
the target is the suppression of viral replication to reduce morbidity and mortality.
3. A patient is diagnosed with syphilis. Which medication remains the gold standard for
treating all stages of syphilis?
A. Azithromycin
B. Ceftriaxone
C. Penicillin G Benzathine
D. Doxycycline
Answer: C
, Rationale: Penicillin G Benzathine administered intramuscularly is the treatment of choice
for Treponema pallidum infections. It is highly effective and has not shown significant
resistance in the treatment of syphilis. If a patient has a severe penicillin allergy, alternative
treatments like doxycycline may be considered, but penicillin is preferred, especially in
pregnant patients.
4. Which laboratory value must be monitored closely in a patient receiving long-term
Vancomycin therapy to prevent nephrotoxicity?
A. Serum peak levels
B. Serum trough levels
C. Liver function tests
D. Complete blood count
Answer: B
Rationale: Monitoring Vancomycin trough levels is critical to ensure efficacy and minimize
the risk of kidney damage. Trough levels should typically be drawn just before the next
dose is administered. Maintaining the correct therapeutic range helps prevent
nephrotoxicity and ototoxicity associated with high concentrations of the drug.
5. A patient is starting Rifampin for the treatment of tuberculosis. What is a common and
harmless side effect the patient should be warned about?
A. Orange discoloration of sweat, tears, and urine
B. Peripheral neuropathy
Pharmacology for the Adult-Gerontology
Primary Care Nurse Practitioner | Actual
Q&A with Rationale (NR568 Exam 4) |
Chamberlain University
1. A 68-year-old patient is prescribed Ciprofloxacin for a complicated urinary tract infection.
Which Black Box Warning should the nurse practitioner specifically discuss with this older
adult?
A. Increased risk of tendonitis and tendon rupture
B. Risk of severe hepatotoxicity and liver failure
C. Potential for Stevens-Johnson Syndrome
D. Risk of fatal cardiac arrhythmias and QT prolongation
Answer: A
Rationale: Fluoroquinolones like ciprofloxacin carry a black box warning for tendonitis
and tendon rupture. This risk is significantly higher in patients over the age of 60 and those
concurrently taking corticosteroids. The nurse practitioner must advise the patient to
discontinue the drug and seek medical attention if they experience any sudden pain or
swelling in their joints.
,2. When initiating therapy for a patient newly diagnosed with HIV, which of the following is
the primary goal of highly active antiretroviral therapy (HAART)?
A. To eradicate the virus from the body completely
B. To increase the CD4 count to at least 1000 cells/mm3
C. To achieve and maintain maximal suppression of viral load
D. To prevent the transmission of the virus to partners only
Answer: C
Rationale: The primary clinical goal of HIV therapy is to reduce the viral load to
undetectable levels. Achieving maximal suppression helps to preserve immune function
and prevent the progression to AIDS. While increasing CD4 counts is a positive outcome,
the target is the suppression of viral replication to reduce morbidity and mortality.
3. A patient is diagnosed with syphilis. Which medication remains the gold standard for
treating all stages of syphilis?
A. Azithromycin
B. Ceftriaxone
C. Penicillin G Benzathine
D. Doxycycline
Answer: C
, Rationale: Penicillin G Benzathine administered intramuscularly is the treatment of choice
for Treponema pallidum infections. It is highly effective and has not shown significant
resistance in the treatment of syphilis. If a patient has a severe penicillin allergy, alternative
treatments like doxycycline may be considered, but penicillin is preferred, especially in
pregnant patients.
4. Which laboratory value must be monitored closely in a patient receiving long-term
Vancomycin therapy to prevent nephrotoxicity?
A. Serum peak levels
B. Serum trough levels
C. Liver function tests
D. Complete blood count
Answer: B
Rationale: Monitoring Vancomycin trough levels is critical to ensure efficacy and minimize
the risk of kidney damage. Trough levels should typically be drawn just before the next
dose is administered. Maintaining the correct therapeutic range helps prevent
nephrotoxicity and ototoxicity associated with high concentrations of the drug.
5. A patient is starting Rifampin for the treatment of tuberculosis. What is a common and
harmless side effect the patient should be warned about?
A. Orange discoloration of sweat, tears, and urine
B. Peripheral neuropathy
