CHAMBERLAIN UNIVERSITY – NR566 ADVANCED
PHARMACOLOGY FOR CARE OF THE FAMILY
WEEK 8 FINAL EXAM – QUESTIONS AND
ANSWERS | 2026/2027 LATEST UPDATE
SECTION 1: WEEK 5 — PHARMACOTHERAPY FOR EYES, EARS, NOSE, AND SKIN
Questions 1–25
1. Which adverse effect most strongly explains why first-generation H1 antihistamines
are generally avoided in many older adults?
A) Sedation and anticholinergic effects
B) Severe hypoglycemia
C) Nephrolithiasis
D) Hyperkalemia
Correct Answer: Sedation and anticholinergic effects
Rationale: First-generation antihistamines readily cross the blood-brain barrier and can
cause substantial sedation. Their anticholinergic activity may produce dry mouth, urinary
retention, constipation, blurred vision, and confusion. Older adults are particularly vulnerable
to these effects, including falls and cognitive impairment, making second-generation agents
preferable when appropriate.
2. Which medication is classified as a second-generation antihistamine with relatively
limited central nervous system penetration?
A) Diphenhydramine
B) Fexofenadine
C) Promethazine
D) Hydroxyzine
Correct Answer: Fexofenadine
Rationale: Fexofenadine is a second-generation H1 antagonist designed to provide
antihistamine activity with substantially less sedation than first-generation agents.
Diphenhydramine, promethazine, and hydroxyzine have greater central nervous system
,effects. Second-generation antihistamines are commonly preferred when allergic symptoms
require treatment without significant impairment of alertness.
3. A corticosteroid prescribed for inflammatory disease should generally be taken in the
morning because this timing most closely follows which physiologic pattern?
A) Peak insulin secretion
B) Maximum renal filtration
C) Normal endogenous cortisol rhythm
D) Increased gastric emptying
Correct Answer: Normal endogenous cortisol rhythm
Rationale: Endogenous cortisol secretion normally peaks during the morning. Administering
systemic glucocorticoids earlier in the day can better approximate this rhythm and may
reduce sleep disturbance. Taking the medication with food can also reduce gastrointestinal
irritation. Long-term systemic therapy should not be abruptly discontinued because adrenal
suppression may occur.
4. Which instruction is most appropriate for someone using a topical corticosteroid for
dermatitis?
A) Apply a thick layer several times hourly
B) Cover every treated area with an occlusive dressing
C) Stop immediately after the first application
D) Apply a thin layer only to affected areas as prescribed
Correct Answer: Apply a thin layer only to affected areas as prescribed
Rationale: Topical corticosteroids should generally be applied as a thin layer to affected skin
according to the prescribed frequency. Excessive application increases systemic and local
adverse effects, including skin atrophy. Occlusion can markedly increase corticosteroid
absorption and therefore should be used only when specifically directed.
5. Which intranasal medication is primarily used to reduce nasal inflammation in
allergic rhinitis?
A) Fluticasone
B) Oxymetazoline
C) Pseudoephedrine
D) Dextromethorphan
Correct Answer: Fluticasone
,Rationale: Fluticasone is an intranasal corticosteroid that suppresses inflammatory
mediators involved in allergic rhinitis. It is effective for congestion, sneezing, itching, and
rhinorrhea when used correctly. Oxymetazoline is a topical sympathomimetic decongestant,
whereas pseudoephedrine is systemic and dextromethorphan is an antitussive.
6. Prolonged use of topical nasal oxymetazoline can produce which complication?
A) Permanent bacterial eradication
B) Rebound nasal congestion
C) Severe hypocalcemia
D) Increased tear production
Correct Answer: Rebound nasal congestion
Rationale: Oxymetazoline causes vasoconstriction of nasal mucosal blood vessels and can
rapidly relieve congestion. Extended use can lead to rhinitis medicamentosa, characterized
by rebound congestion when the medication is stopped or wears off. Limiting duration is
therefore important, especially when treating uncomplicated allergic or viral congestion.
7. Which mechanism best describes cromolyn used for allergic conditions?
A) Directly stimulates beta-2 receptors
B) Blocks bacterial cell-wall synthesis
C) Stabilizes mast cells and limits mediator release
D) Irreversibly inhibits cyclooxygenase
Correct Answer: Stabilizes mast cells and limits mediator release
Rationale: Cromolyn is a mast-cell stabilizer that reduces release of inflammatory mediators
after allergen exposure. It is primarily preventive rather than a rapid rescue treatment.
Because its effect depends on regular use, patients should understand that it does not
provide the immediate bronchodilation or decongestion associated with rescue medications.
8. A patient with primary open-angle glaucoma is prescribed a prostaglandin analog.
Which expected pharmacologic effect lowers intraocular pressure?
A) Increased aqueous humor production
B) Increased uveoscleral outflow
C) Paralysis of the optic nerve
D) Increased lens opacity
Correct Answer: Increased uveoscleral outflow
, Rationale: Prostaglandin analogs such as latanoprost lower intraocular pressure primarily by
increasing aqueous humor outflow through the uveoscleral pathway. They are widely used in
primary open-angle glaucoma. Iris pigmentation and eyelash changes can occur, while
significant ocular pain or vision changes require clinical evaluation.
9. Which adverse effect should be discussed before initiating latanoprost?
A) Permanent hearing loss
B) Severe constipation
C) Increased iris pigmentation
D) Profound hypoglycemia
Correct Answer: Increased iris pigmentation
Rationale: Latanoprost and related prostaglandin analogs can gradually increase iris
pigmentation, particularly in individuals with mixed-color irides. Eyelash growth and
periocular skin changes may also occur. These effects differ from systemic adverse effects
expected with many oral medications because ophthalmic prostaglandin therapy primarily
acts locally.
10. A child develops uncomplicated acute otitis media. Which antibiotic is commonly
considered first-line therapy when bacterial treatment is indicated?
A) Amoxicillin
B) Ciprofloxacin
C) Doxycycline
D) Fluconazole
Correct Answer: Amoxicillin
Rationale: Amoxicillin is commonly used as first-line antimicrobial therapy for uncomplicated
acute otitis media when antibiotics are indicated. Selection can change with allergy history,
recent antibiotic exposure, or treatment failure. Fluoroquinolone ear preparations are more
associated with selected otic conditions rather than routine first-line systemic treatment of
uncomplicated AOM.
11. Which finding most strongly suggests otitis externa rather than acute otitis media?
A) Bulging tympanic membrane without canal tenderness
B) Conductive hearing loss from middle-ear fluid
C) Pain produced by manipulation of the tragus
D) Fever with mastoid swelling
Correct Answer: Pain produced by manipulation of the tragus
PHARMACOLOGY FOR CARE OF THE FAMILY
WEEK 8 FINAL EXAM – QUESTIONS AND
ANSWERS | 2026/2027 LATEST UPDATE
SECTION 1: WEEK 5 — PHARMACOTHERAPY FOR EYES, EARS, NOSE, AND SKIN
Questions 1–25
1. Which adverse effect most strongly explains why first-generation H1 antihistamines
are generally avoided in many older adults?
A) Sedation and anticholinergic effects
B) Severe hypoglycemia
C) Nephrolithiasis
D) Hyperkalemia
Correct Answer: Sedation and anticholinergic effects
Rationale: First-generation antihistamines readily cross the blood-brain barrier and can
cause substantial sedation. Their anticholinergic activity may produce dry mouth, urinary
retention, constipation, blurred vision, and confusion. Older adults are particularly vulnerable
to these effects, including falls and cognitive impairment, making second-generation agents
preferable when appropriate.
2. Which medication is classified as a second-generation antihistamine with relatively
limited central nervous system penetration?
A) Diphenhydramine
B) Fexofenadine
C) Promethazine
D) Hydroxyzine
Correct Answer: Fexofenadine
Rationale: Fexofenadine is a second-generation H1 antagonist designed to provide
antihistamine activity with substantially less sedation than first-generation agents.
Diphenhydramine, promethazine, and hydroxyzine have greater central nervous system
,effects. Second-generation antihistamines are commonly preferred when allergic symptoms
require treatment without significant impairment of alertness.
3. A corticosteroid prescribed for inflammatory disease should generally be taken in the
morning because this timing most closely follows which physiologic pattern?
A) Peak insulin secretion
B) Maximum renal filtration
C) Normal endogenous cortisol rhythm
D) Increased gastric emptying
Correct Answer: Normal endogenous cortisol rhythm
Rationale: Endogenous cortisol secretion normally peaks during the morning. Administering
systemic glucocorticoids earlier in the day can better approximate this rhythm and may
reduce sleep disturbance. Taking the medication with food can also reduce gastrointestinal
irritation. Long-term systemic therapy should not be abruptly discontinued because adrenal
suppression may occur.
4. Which instruction is most appropriate for someone using a topical corticosteroid for
dermatitis?
A) Apply a thick layer several times hourly
B) Cover every treated area with an occlusive dressing
C) Stop immediately after the first application
D) Apply a thin layer only to affected areas as prescribed
Correct Answer: Apply a thin layer only to affected areas as prescribed
Rationale: Topical corticosteroids should generally be applied as a thin layer to affected skin
according to the prescribed frequency. Excessive application increases systemic and local
adverse effects, including skin atrophy. Occlusion can markedly increase corticosteroid
absorption and therefore should be used only when specifically directed.
5. Which intranasal medication is primarily used to reduce nasal inflammation in
allergic rhinitis?
A) Fluticasone
B) Oxymetazoline
C) Pseudoephedrine
D) Dextromethorphan
Correct Answer: Fluticasone
,Rationale: Fluticasone is an intranasal corticosteroid that suppresses inflammatory
mediators involved in allergic rhinitis. It is effective for congestion, sneezing, itching, and
rhinorrhea when used correctly. Oxymetazoline is a topical sympathomimetic decongestant,
whereas pseudoephedrine is systemic and dextromethorphan is an antitussive.
6. Prolonged use of topical nasal oxymetazoline can produce which complication?
A) Permanent bacterial eradication
B) Rebound nasal congestion
C) Severe hypocalcemia
D) Increased tear production
Correct Answer: Rebound nasal congestion
Rationale: Oxymetazoline causes vasoconstriction of nasal mucosal blood vessels and can
rapidly relieve congestion. Extended use can lead to rhinitis medicamentosa, characterized
by rebound congestion when the medication is stopped or wears off. Limiting duration is
therefore important, especially when treating uncomplicated allergic or viral congestion.
7. Which mechanism best describes cromolyn used for allergic conditions?
A) Directly stimulates beta-2 receptors
B) Blocks bacterial cell-wall synthesis
C) Stabilizes mast cells and limits mediator release
D) Irreversibly inhibits cyclooxygenase
Correct Answer: Stabilizes mast cells and limits mediator release
Rationale: Cromolyn is a mast-cell stabilizer that reduces release of inflammatory mediators
after allergen exposure. It is primarily preventive rather than a rapid rescue treatment.
Because its effect depends on regular use, patients should understand that it does not
provide the immediate bronchodilation or decongestion associated with rescue medications.
8. A patient with primary open-angle glaucoma is prescribed a prostaglandin analog.
Which expected pharmacologic effect lowers intraocular pressure?
A) Increased aqueous humor production
B) Increased uveoscleral outflow
C) Paralysis of the optic nerve
D) Increased lens opacity
Correct Answer: Increased uveoscleral outflow
, Rationale: Prostaglandin analogs such as latanoprost lower intraocular pressure primarily by
increasing aqueous humor outflow through the uveoscleral pathway. They are widely used in
primary open-angle glaucoma. Iris pigmentation and eyelash changes can occur, while
significant ocular pain or vision changes require clinical evaluation.
9. Which adverse effect should be discussed before initiating latanoprost?
A) Permanent hearing loss
B) Severe constipation
C) Increased iris pigmentation
D) Profound hypoglycemia
Correct Answer: Increased iris pigmentation
Rationale: Latanoprost and related prostaglandin analogs can gradually increase iris
pigmentation, particularly in individuals with mixed-color irides. Eyelash growth and
periocular skin changes may also occur. These effects differ from systemic adverse effects
expected with many oral medications because ophthalmic prostaglandin therapy primarily
acts locally.
10. A child develops uncomplicated acute otitis media. Which antibiotic is commonly
considered first-line therapy when bacterial treatment is indicated?
A) Amoxicillin
B) Ciprofloxacin
C) Doxycycline
D) Fluconazole
Correct Answer: Amoxicillin
Rationale: Amoxicillin is commonly used as first-line antimicrobial therapy for uncomplicated
acute otitis media when antibiotics are indicated. Selection can change with allergy history,
recent antibiotic exposure, or treatment failure. Fluoroquinolone ear preparations are more
associated with selected otic conditions rather than routine first-line systemic treatment of
uncomplicated AOM.
11. Which finding most strongly suggests otitis externa rather than acute otitis media?
A) Bulging tympanic membrane without canal tenderness
B) Conductive hearing loss from middle-ear fluid
C) Pain produced by manipulation of the tragus
D) Fever with mastoid swelling
Correct Answer: Pain produced by manipulation of the tragus
