NR 568 Exam 4 V3 | NR 568 Advanced
Pharmacology for the Adult-Gerontology
Primary Care Nurse Practitioner | Actual
Q&A with Rationale (NR568 Exam 4) |
Chamberlain University
1. A 72-year-old male is diagnosed with mild Alzheimer’s disease. Which of the following is
the preferred initial pharmacological treatment?
A. Memantine
B. Risperidone
C. Donepezil
D. Selegiline
Answer: C
Rationale: Donepezil is a cholinesterase inhibitor typically used as first-line therapy for
mild to moderate Alzheimer’s disease. It works by increasing the availability of
acetylcholine in the synaptic cleft, which helps improve cognitive function. Memantine is
generally reserved for moderate to severe stages of the disease or used as adjunctive
therapy.
2. When prescribing Lithium for a patient with Bipolar Disorder, which lab value is most
critical to monitor due to the risk of toxicity?
A. Serum Potassium
,B. Liver Transaminases
C. Serum Creatinine
D. Platelet Count
Answer: C
Rationale: Lithium is primarily excreted by the kidneys, making renal function assessment
via serum creatinine and BUN essential. Dehydration or decreased renal clearance can lead
to toxic accumulation of lithium levels in the blood. Patients should also have their thyroid
function monitored regularly as lithium can cause hypothyroidism.
3. A patient taking a Monoamine Oxidase Inhibitor (MAOI) should be educated to avoid
which of the following foods to prevent a hypertensive crisis?
A. Aged cheeses and cured meats
B. Fresh leafy greens
C. Whole grain bread
D. Citrus fruits
Answer: A
Rationale: MAOIs prevent the breakdown of tyramine, which is found in high
concentrations in aged and fermented foods. High levels of tyramine can cause a massive
release of norepinephrine, leading to a life-threatening hypertensive crisis. Patients must
be strictly counseled on dietary restrictions before starting medications like Phenelzine.
, 4. Which of the following antidepressants is most likely to cause significant weight gain and
sedation in an elderly patient?
A. Fluoxetine
B. Bupropion
C. Mirtazapine
D. Sertraline
Answer: C
Rationale: Mirtazapine is often used in the elderly specifically for its side effect profile of
sedation and weight gain, which can benefit patients with insomnia and cachexia. It acts as
an alpha-2 antagonist that increases serotonin and norepinephrine. In contrast, Bupropion
is more likely to cause weight loss and stimulation.
5. A patient with Parkinson’s disease is experiencing ‘off’ periods between doses of
Levodopa/Carbidopa. Which medication could be added as an adjunct?
A. Entacapone
B. Haloperidol
C. Metoclopramide
D. Diphenhydramine
Answer: A
Pharmacology for the Adult-Gerontology
Primary Care Nurse Practitioner | Actual
Q&A with Rationale (NR568 Exam 4) |
Chamberlain University
1. A 72-year-old male is diagnosed with mild Alzheimer’s disease. Which of the following is
the preferred initial pharmacological treatment?
A. Memantine
B. Risperidone
C. Donepezil
D. Selegiline
Answer: C
Rationale: Donepezil is a cholinesterase inhibitor typically used as first-line therapy for
mild to moderate Alzheimer’s disease. It works by increasing the availability of
acetylcholine in the synaptic cleft, which helps improve cognitive function. Memantine is
generally reserved for moderate to severe stages of the disease or used as adjunctive
therapy.
2. When prescribing Lithium for a patient with Bipolar Disorder, which lab value is most
critical to monitor due to the risk of toxicity?
A. Serum Potassium
,B. Liver Transaminases
C. Serum Creatinine
D. Platelet Count
Answer: C
Rationale: Lithium is primarily excreted by the kidneys, making renal function assessment
via serum creatinine and BUN essential. Dehydration or decreased renal clearance can lead
to toxic accumulation of lithium levels in the blood. Patients should also have their thyroid
function monitored regularly as lithium can cause hypothyroidism.
3. A patient taking a Monoamine Oxidase Inhibitor (MAOI) should be educated to avoid
which of the following foods to prevent a hypertensive crisis?
A. Aged cheeses and cured meats
B. Fresh leafy greens
C. Whole grain bread
D. Citrus fruits
Answer: A
Rationale: MAOIs prevent the breakdown of tyramine, which is found in high
concentrations in aged and fermented foods. High levels of tyramine can cause a massive
release of norepinephrine, leading to a life-threatening hypertensive crisis. Patients must
be strictly counseled on dietary restrictions before starting medications like Phenelzine.
, 4. Which of the following antidepressants is most likely to cause significant weight gain and
sedation in an elderly patient?
A. Fluoxetine
B. Bupropion
C. Mirtazapine
D. Sertraline
Answer: C
Rationale: Mirtazapine is often used in the elderly specifically for its side effect profile of
sedation and weight gain, which can benefit patients with insomnia and cachexia. It acts as
an alpha-2 antagonist that increases serotonin and norepinephrine. In contrast, Bupropion
is more likely to cause weight loss and stimulation.
5. A patient with Parkinson’s disease is experiencing ‘off’ periods between doses of
Levodopa/Carbidopa. Which medication could be added as an adjunct?
A. Entacapone
B. Haloperidol
C. Metoclopramide
D. Diphenhydramine
Answer: A
