NR566 Advanced Pharmacology for Care
of the Family Study Guide – Chamberlain
2025/2026 | Questions, Verified Correct
Answers, and Detailed Rationales
Key Pharmacology Concepts
1. Pharmacokinetics
• Absorption: How a drug enters the bloodstream (e.g., oral, IV, subcutaneous). Affected
by route, formulation, and patient factors (e.g., gastric pH).
• Distribution: Drug movement to tissues, influenced by protein binding and blood flow.
Volume of distribution (Vd) indicates tissue penetration.
• Metabolism: Primarily in the liver via cytochrome P450 enzymes. First-pass metabolism
reduces bioavailability of oral drugs.
• Excretion: Primarily renal, but also biliary or pulmonary. Clearance rate determines
dosing intervals.
• Key Consideration: Age, renal/hepatic function, and drug interactions alter
pharmacokinetics, requiring dose adjustments.
2. Pharmacodynamics
• Mechanism of Action: How drugs produce effects (e.g., receptor agonism, enzyme
inhibition).
• Therapeutic Index: Ratio of toxic dose to effective dose. Narrow therapeutic index
drugs (e.g., warfarin, digoxin) require close monitoring.
• Adverse Effects: Predictable (e.g., beta-blocker bradycardia) or idiosyncratic (e.g.,
Stevens-Johnson syndrome). Monitor for black box warnings.
• Key Consideration: Patient-specific factors (e.g., genetics, comorbidities) influence drug
response.
3. Prescribing Principles
• Individualization: Tailor therapy based on age, weight, renal/hepatic function, and
allergies.
• Polypharmacy: Common in older adults; assess for drug interactions and deprescribe
when possible.
• Patient Education: Include indications, administration, side effects, and adherence
strategies.
, 2
• Controlled Substances: Follow DEA schedules (e.g., Schedule II for opioids) and state
prescribing laws.
• Key Consideration: Use evidence-based guidelines (e.g., JNC-8 for hypertension, ADA
for diabetes) to guide therapy.
4. Special Populations
• Pediatrics: Adjust doses by weight (mg/kg). Avoid certain drugs (e.g., tetracyclines <8
years).
• Geriatrics: Start low, go slow due to reduced renal/hepatic function and polypharmacy
risks.
• Pregnancy: Use FDA pregnancy categories or updated labeling (e.g., PLLR) to assess
risks. Avoid teratogens (e.g., isotretinoin).
• Key Consideration: Monitor for age-specific adverse effects and adjust doses
accordingly.
5. Drug Classes and Clinical Applications
• Antibiotics: Select based on culture/sensitivity. Avoid overuse to prevent resistance (e.g.,
MRSA).
• Antihypertensives: ACE inhibitors, beta-blockers, diuretics. Monitor electrolytes and
blood pressure.
• Antidiabetics: Metformin, insulin, SGLT2 inhibitors. Monitor A1c and glucose levels.
• Analgesics: Opioids for severe pain, NSAIDs for inflammation. Monitor for dependence
or GI bleeding.
• Anticoagulants: Warfarin (INR), DOACs (renal function). Assess bleeding risk.
• Key Consideration: Understand indications, contraindications, and monitoring for each
class.
Exam-Style Questions
Question 1
A nurse practitioner (NP) prescribes amoxicillin for a child with otitis media. What is the
standard pediatric dose?
A. 10 mg/kg/day
B. 80–90 mg/kg/day divided twice daily
C. 500 mg once daily
D. 25 mg/kg/day
Correct Answer: B. 80–90 mg/kg/day divided twice daily
Rationale: Amoxicillin dosing for pediatric otitis media is 80–90 mg/kg/day, divided into
two doses, to achieve therapeutic levels against Streptococcus pneumoniae, per AAP guidelines.