D116 NURS 6800
Advanced Pharmacology
Final Assessment Review
2025
A patient has three consecutive blood pressure readings of 140/95 mm Hg. The patient’s body mass
index is 24. A fasting plasma glucose is 100 mg/dL. Creatinine clearance and cholesterol tests are normal.
The primary care NP should order:
a β-blocker.
an angiotensin-converting enzyme inhibitor.
Correct!
a thiazide diuretic.
dietary and lifestyle changes.
The patient has stage I hypertension. Because there are no compelling indications for other treatment, a
thiazide diuretic should be used initially to treat the hypertension. Dietary and lifestyle changes should
also be recommended but are not sufficient for patients with stage I hypertension. Other drugs may be
added later if thiazide diuretic therapy fails.
,Question 2
pts
An African-American patient is taking captopril (Capoten) 25 mg twice daily. When performing a physical
examination, the primary care nurse practitioner (NP) learns that the patient continues to have blood
pressure readings of 135/90 mm Hg. The NP should:
increase the captopril dose to 50 mg twice daily.
Correct!
add a thiazide diuretic to this patient’s regimen.
change the drug to losartan (Cozaar) 50 mg once daily.
recommend a low-sodium diet in addition to the medication.
Some African-American patients do not appear to respond as well as whites in terms of blood pressure
reduction. The addition of a low-dose thiazide diuretic often allows for efficacy in blood pressure
lowering that is comparable with that seen in white patients. Increasing the captopril dose is not
indicated. Losartan is an angiotensin receptor blocker (ARB) and is not indicated in this case.
Question 3
pts
A 50-year-old woman reports severe, frequent hot flashes and vaginal dryness. She is having irregular
periods. She has no family history of CHD or breast cancer and has no personal risk factors. The primary
care NP should recommend:
,estrogen-only HT.
Correct!
low-dose oral contraceptive therapy.
selective serotonin reuptake inhibitor therapy until menopause begins.
estrogen-progesterone HT.
Oral contraceptive pills are not approved by the U.S. Food and Drug Administration for management of
perimenopausal symptoms except to treat irregular menstrual bleeding. This patient has a low risk for
CHD and breast cancer, so oral contraceptive pills are relatively safe. She is also at risk for pregnancy, so
oral contraceptive pills can help to prevent that.
Question 4
pts
The primary care NP is prescribing a medication for an off-label use. To help prevent a medication error,
the NP should:
Correct!
write “off-label use” on the prescription and provide a rationale.
, call the pharmacist to explain why the instructions deviate from common use.
write the alternative drug regimen on the prescription and send it to the pharmacy.
tell the patient to ignore the label directions and follow the verbal instructions given in the clinic.
When prescribing a drug for an off-label use, the provider should specify this on the written prescription
and should provide a rationale so that the pharmacist understands why the prescription is different from
the normal use. Calling the pharmacist would not provide written documentation. Merely writing the
different instructions can lead to errors if the pharmacist changes the label to conform to usual
standards. The patient may forget verbal instructions and follow the usual regimen instead.
Question 5
pts
The primary care nurse practitioner (NP) sees a patient in the clinic who has a blood pressure of 130/85
mm Hg. The patient’s laboratory tests reveal high-density lipoprotein, 35 mg/dL; triglycerides, 120
mg/dL; and fasting plasma glucose, 100 mg/dL. The NP calculates a body mass index of 29. The patient
has a positive family history for cardiovascular disease. The NP should:
prescribe a thiazide diuretic.
consider treatment with an angiotensin-converting enzyme inhibitor.
Advanced Pharmacology
Final Assessment Review
2025
A patient has three consecutive blood pressure readings of 140/95 mm Hg. The patient’s body mass
index is 24. A fasting plasma glucose is 100 mg/dL. Creatinine clearance and cholesterol tests are normal.
The primary care NP should order:
a β-blocker.
an angiotensin-converting enzyme inhibitor.
Correct!
a thiazide diuretic.
dietary and lifestyle changes.
The patient has stage I hypertension. Because there are no compelling indications for other treatment, a
thiazide diuretic should be used initially to treat the hypertension. Dietary and lifestyle changes should
also be recommended but are not sufficient for patients with stage I hypertension. Other drugs may be
added later if thiazide diuretic therapy fails.
,Question 2
pts
An African-American patient is taking captopril (Capoten) 25 mg twice daily. When performing a physical
examination, the primary care nurse practitioner (NP) learns that the patient continues to have blood
pressure readings of 135/90 mm Hg. The NP should:
increase the captopril dose to 50 mg twice daily.
Correct!
add a thiazide diuretic to this patient’s regimen.
change the drug to losartan (Cozaar) 50 mg once daily.
recommend a low-sodium diet in addition to the medication.
Some African-American patients do not appear to respond as well as whites in terms of blood pressure
reduction. The addition of a low-dose thiazide diuretic often allows for efficacy in blood pressure
lowering that is comparable with that seen in white patients. Increasing the captopril dose is not
indicated. Losartan is an angiotensin receptor blocker (ARB) and is not indicated in this case.
Question 3
pts
A 50-year-old woman reports severe, frequent hot flashes and vaginal dryness. She is having irregular
periods. She has no family history of CHD or breast cancer and has no personal risk factors. The primary
care NP should recommend:
,estrogen-only HT.
Correct!
low-dose oral contraceptive therapy.
selective serotonin reuptake inhibitor therapy until menopause begins.
estrogen-progesterone HT.
Oral contraceptive pills are not approved by the U.S. Food and Drug Administration for management of
perimenopausal symptoms except to treat irregular menstrual bleeding. This patient has a low risk for
CHD and breast cancer, so oral contraceptive pills are relatively safe. She is also at risk for pregnancy, so
oral contraceptive pills can help to prevent that.
Question 4
pts
The primary care NP is prescribing a medication for an off-label use. To help prevent a medication error,
the NP should:
Correct!
write “off-label use” on the prescription and provide a rationale.
, call the pharmacist to explain why the instructions deviate from common use.
write the alternative drug regimen on the prescription and send it to the pharmacy.
tell the patient to ignore the label directions and follow the verbal instructions given in the clinic.
When prescribing a drug for an off-label use, the provider should specify this on the written prescription
and should provide a rationale so that the pharmacist understands why the prescription is different from
the normal use. Calling the pharmacist would not provide written documentation. Merely writing the
different instructions can lead to errors if the pharmacist changes the label to conform to usual
standards. The patient may forget verbal instructions and follow the usual regimen instead.
Question 5
pts
The primary care nurse practitioner (NP) sees a patient in the clinic who has a blood pressure of 130/85
mm Hg. The patient’s laboratory tests reveal high-density lipoprotein, 35 mg/dL; triglycerides, 120
mg/dL; and fasting plasma glucose, 100 mg/dL. The NP calculates a body mass index of 29. The patient
has a positive family history for cardiovascular disease. The NP should:
prescribe a thiazide diuretic.
consider treatment with an angiotensin-converting enzyme inhibitor.
