NR565 / NR 565 Final Exam Question Bank (Latest 2024 / 2025): Advanced Pharmacology Fundamentals – Chamberlain
NR-565 Advanced Pharmacology Fundamentals
NR565 Final Exam Question Bank
A patient is prescribed ondansetron 30 minutes before initiation of
chemotherapy. The patient reports that the ondansetron did not work as well
as it had previously. What action will the prescriber take?
Correct Answer:
Prescribe dexamethasone to be given with the ondansetron
A patient receives ondansetron and dexamethasone for chemotherapyinduced nausea and vomiting (CINV). The patient states that the drugs
provide relief during and immediately after chemotherapy, but that
significant nausea and vomiting occur several days after each chemotherapy
treatment. What action will the prescriber take to address this outcome?
Correct Answer:
Suggest adding aprepitant to the medication regimen.
A patient who experiences motion sickness plans to go on a cruise. The
prescriber orders transdermal scopolamine [transderm scop]. The patient
asks why an oral agent is not ordered. What response will the provider give
to explain the benefit of a transdermal preparation?
Correct Answer:
This form has less anticholinergic effects than the oral form.
A patient plans to perform missionary work in a region with poor drinking
water. The provider gives the patient a prescription for ciprofloxacin to take
on the trip. What instructions will the prescriber discuss with this patient?
Correct Answer:
Use the drug if symptoms develop and are severe or do not improve in a few
days.
A patient reports a 6-month history of daily episodes of recurrent, crampy
abdominal pain followed by diarrhea that usually relieves the pain. The
patient undergoes a colonoscopy, for which the findings are normal. What
will the provider discuss with the patient?
Correct Answer:
Keeping a food, stress, and symptom diary
A provider discusses the use of immunosuppressants for the treatment of
inflammatory bowel disease (IBD) with a patient. Which statement by the
patient indicates understanding of the teaching?
Correct Answer:
Cyclosporine can be used to induce remission of IBD>
A patient with Crohn disease will receive an initial infusion of infliximab. The
prescriber explains how this drug works to treat this disease. Which
statement by the patient indicates a need for further teaching?
Correct Answer:
This drug sometimes provides a complete cure of inflammatory bowel
disease.
The parent of a child with cerebral palsy reports that the child has pebblelike stools most of the time and seems uncomfortable if several days have
passed between stools. The nurse will suggest that the parent discuss which
medication with the child’s provider?
Correct Answer:
Polyethylene glycol
A patient has been taking psyllium two to three times daily for several days
but has not passed a stool. What initial action will the prescriber take when
the patient reports abdominal pain?
Correct Answer:
Palpate the patient’s abdomen and auscultate for bowel sounds.
Which new diagnosis would prompt the provider to discontinue a PRN order
for magnesium hydroxide?
Correct Answer:
Renal failure
An older adult patient takes an opioid analgesic right after a hip ORIF. Which
medication will the provoider prescribe to prevent constipation?
Correct Answer:
Docusate sodium.
A provider has a routine order for sodium phosphate as a bowel cleanser
before a patient’s colonoscopy. The lab report shows that the patient’s
creatinine clearance and blood urea nitrogen are both elevated. What will
the provider do in response to these lab results?
Correct Answer:
Prescribe polyethylene glycol and electrolytes (PEG-ELS) instead.
A patient reports taking an oral bisacodyl laxative for several years. What
instructions will the provider give the patient to guide the discontinuation of
the laxative?
Correct Answer:
Stop taking the laxative immediately and expect no stool for several days.
A patient with a history of chronic alcohol use has been admitted to the unit
with a diagnosis of cirrhosis. Admission laboratory reports show that the
patient’s ammonia level is elevated at 218 ug/dL. What medication will the
provider prescribe to address the lab result?
Correct Answer:
Lactulose
A patient who has been taking Senna for several days notes that their urine
is yellowish brown. What response will the prescriber provide when the
patient expresses concern about this change?
Correct Answer:
It is an expected, harmless effect of Senna.
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A patient will be discharged from the hospital with a prescription for TMP/SMZ. When providing teaching for this patient, the provider will discuss the importance of what action while taking this medication?
Drinking 8-10 glasses of water every day
A patient presents to the emergency department with chills, severe flank pain, dysuria, and urinary frequency. The patient has a temperature of 102.9F, a pulse of 92 beats/minute, respirations of 24 breaths/minute, and a blood pressure of 119/58 mm Hg. The provider suspects that the patient is showing signs and symptoms of what pathology?
Pyelonephritis
An older male patient comes to the clinic with reports of chills, malaise, myalgia, localized pain, dysuria, nocturia, and urinary retention. The provider will suspect what cause for the patient’s symptomology?
Prostatitis
A 20-year-old female patient presents with suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment?
Uncomplicated lower urinary tract infection treatable with short-course therapy
A patient with a history of renal calculi has fever, flank pain, and bacteriuria. What action will the provider take?
Prescribe antibiotic therapy after urine culture and sensitivity results are available.
A patient has a positive urine culture 1 week after completion of a 3-day course of antibiotics. What action will the prescriber take?
Prescribe a 2-week course of antibiotics.
A patient complains of painful urination. A physical examination reveals vesicles on her labia, vagina, and the foreskin of her clitoris. Which medication will the provider prescribe?
Acyclovir
A patient is diagnosed with pelvic inflammatory disease (PID). Which treatment regimen is most appropriate for reducing the risk of sterility in this patient?
Doxycycline, 100 mg IV twice daily, and cefoxitin, 2 g IV every 6 hours in the hospital
An adolescent patient with mild cervicitis is diagnosed with gonorrhea. The provider will order which treatment regimen?
Ceftriaxone, 250 mg IM once, and azithromycin, 1 g PO once
During a routine screening, an asymptomatic, pregnant patient at 37 weeks’ gestation learns that she has an infection caused by Chlamydia trachomatis. The provider will order which drug?
Azithromycin
A patient with peptic ulcer disease is otherwise healthy. The patient does not smoke and states drinking 1 or 2 glasses of wine with meals each week. Which drugs will the provider prescribe?
Amoxicillin, clarithromycin, and omeprazole
A patient is diagnosed with Zollinger-Ellison syndrome. Which medication does the provider recognize as most effective for this patient’s condition?
Omeprazole
A patient with lower abdominal pain and nausea is admitted to the hospital. The patient’s abdomen is distended and firm with hypoactive bowel sounds. The patient reports of not having a bowel movement for 3 days. What initial action will the provider take?
Order diagnostic tests.
A patient diagnosed with renal disease is scheduled for a colonoscopy. What drug will the provider prescribe for administration before the procedure?
Polyethylene glycol plus electrolytes (PEG-ELS)
The parent of a child with cerebral palsy reports that the child has pebble-like stools most of the time and seems uncomfortable if several days have passed between stools. Which medication will the provider recommend to the child’s parents?
Polyethylene glycol
A patient has been taking psyllium two to three times daily for several days but has not passed a stool. What initial action will the prescriber take when the patient reports abdominal pain?
Palpate the patient’s abdomen and auscultate for bowel sounds.
A provider has a routine order for sodium phosphate as a bowel cleanser before a patient’s colonoscopy. The lab report shows that the patient’s creatinine clearance and blood urea nitrogen are both elevated. What will the provider do in response to these lab results?
Prescribe polyethylene glycol and electrolytes (PEG-ELS) instead.
A patient reports taking an oral bisacodyl laxative for several years. What instructions will the provider give the patient to guide the discontinuation of the laxative?
Stop taking the laxative immediately and expect no stool for several days.
A patient with a history of chronic alcohol use has been admitted to the unit with a diagnosis of cirrhosis. Admission laboratory reports show that the patient’s ammonia level is elevated at 218 µg/dL. What medication will the provider prescribe to address the lab result?
Lactulose
A patient who has been taking senna for several days notes that the urine is yellowish brown. What response will the prescriber provide when the patient expresses concern about this change?
It is an expected, harmless effect of senna.
When ordering castor oil for a patient, what guidance will the provider share with the nurse?
Chill the medication and mix it with fruit juice.
A patient is prescribed ondansetron 30 minutes before initiation of chemotherapy. The patient reports that the ondansetron did not work as well as it had previously. What action will the prescriber take?
Prescribe dexamethasone to be given with the ondansetron.
A patient receives ondansetron and dexamethasone for chemotherapy-induced nausea and vomiting (CINV). The patient states that the drugs provide relief during and immediately after chemotherapy, but that significant nausea and vomiting occur several days after each chemotherapy treatment. What action will the prescriber take to address this outcome?
Suggest adding aprepitant to the medication regimen.
A patient who experiences motion sickness plans to go on a cruise. The prescriber orders transdermal scopolamine [Transderm Scop]. The patient asks why an oral agent is not ordered. What response will the provider give to explain that the benefit of a transdermal preparation?
This form has less intense anticholinergic effects than the oral form.
A patient plans to perform missionary work in a region with poor drinking water. The provider gives the patient a prescription for ciprofloxacin to take on the trip. What instructions will the prescriber discuss with this patient?
Use the drug if symptoms develop and are severe or do not improve in a few days.
A patient reports a 6-month history of daily episodes of recurrent, crampy abdominal pain followed by diarrhea that usually relieves the pain. The patient undergoes a colonoscopy, for which the findings are normal. What will the provider discuss with the patient?
Keeping a food, stress, and symptom diary
A provider discusses the use of immunosuppressants for the treatment of inflammatory bowel disease (IBD) with a patient. Which statement by the patient indicates understanding of the teaching?
“Cyclosporine can be used to induce remission of IBD.”
A patient with Crohn disease will receive an initial infusion of infliximab. The prescriber explains how this drug works to treat this disease. Which statement by the patient indicates a need for further teaching?
“This drug sometimes provides a complete cure of inflammatory bowel disease.”
Drugs that increase the risk of osteoporosis developing include:
Glucocorticosteroids
Selective estrogen receptor modifiers (SERMs) treat osteoporosis by selectively:
Selectively acting on certain estrogen receptors in the bones.
Mrs. Phillips has been diagnosed with osteoporosis and is asking about the “once a month” pill to treat her condition. How would the APRN describe how bisphosphonates treat osteoporosis?
By reducing bone resorption and inhibiting osteoclastic activity
What drug might the APRN prescribe for her patient, a 73-year-old Caucasian female, knowing that this drug is recommended as primary prevention of osteoporosis in women over age 70 years?
Alendronate (Fosamax)
The APRN has just prescribed a bisphosphonate drug for her patient. What should the APRN include in her patient education about this drug?
Requiring sitting erect for at least 30 minutes after taking the medication
The APRN knows that IV forms of bisphosphonates are used for all the following except:
Persons with advancing renal dysfunction
The APRN is providing patient education to a 42-year-old female African American patient about osteoporosis prevention. Risk factors for osteoporosis and resultant fractures include all the following except:
Alcohol intake ≤ two drinks per day
The APRN recommends vitamin D supplementation when serum levels are low because she knows that inadequate vitamin D intake can contribute to the development of osteoporosis by:
Decreasing calcium absorption from the intestine
A patient takes non-steroidal anti-inflammatory drugs (NSAIDs) for arthritis. What can the provider prescribe to prevent ulcers?
Proton pump inhibitors
A patient with a history of peptic ulcer disease takes ranitidine and sucralfate. The patient reports that discomfort is usually controlled but that symptoms occasionally flare-up. What action will the provider take to address the patient’s concern?
Discuss testing for H. pylori and an antibiotic.
A patient newly diagnosed with peptic ulcer disease (PUD) reports taking low-dose aspirin (ASA) for prevention of cardiovascular disease. The medical history determines that the patient drinks 2 to 3 cups of coffee each day, eats three meals a day, and has a glass of wine with dinner 3 or 4 nights per week. The provider will counsel this patient to what lifestyle action?
Change the meal pattern to five or six smaller meals per day.
When metronidazole is a component of the H. pylori treatment regimen, what guidance will the prescriber provide to the patient?
Avoid any alcoholic beverages.
A patient with gastroesophageal reflux disease (GERD) receives a prescription for a proton pump inhibitor (PPI). What information will the provider include when teaching the patient about this drug?
“You should report any fever and cough to your provider.”
Which new diagnosis would prompt the provider to discontinue a PRN order for magnesium hydroxide?
Renal failure
An older adult patient takes an opioid analgesic after a right hip open reduction internal fixation (ORIF). Which medication will the provider prescribe to prevent constipation?
Docusate sodium
A patient taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension tells the provider that she wants to become pregnant. What response will the provider give to the patient?
“Let’s discuss using methyldopa instead of the ACE inhibitor while you are pregnant.”
A patient with chronic hypertension is admitted to the hospital. During the admission assessment, the nurse notes a heart rate of 96 beats/minute, a blood pressure of 150/90 mm Hg bibasilar crackles, 2+ pitting edema of the ankles, and distention of the jugular veins. What will the provider order in response to this assessment data?
Furosemide
A patient with heart failure who takes an angiotensin-converting enzyme (ACE) inhibitor, a thiazide diuretic, and a Beta blocker for several months comes to the clinic for evaluation. As part of the ongoing assessment of this patient, the provider will focus on which evaluation?
Serum electrolyte levels
A patient diagnosed with heart failure (HF) and taking an angiotensin-converting enzyme (ACE) inhibitor, has developed fibrotic changes in the heart and vessels. Which type of medication will the provider order to counter this development?
Aldosterone antagonist
A prescriber considers ordering propranolol for a patient with recurrent ventricular tachycardia. What information in the patient’s medical history will be of greatest concerned to the prescriber?
Asthma
Azithromycin is prescribed for a patient who develops an infection. The patient’s only other medication is simvastatin. Which patient symptom will create the greatest concern for the provider?
Muscle pain
The provider is assessing a newly diagnosed patient for short-term complications of diabetes. What evaluation does this assessment include?
Serum blood sugar results for hyperglycemia
A patient with type 1 diabetes recently became pregnant. What blood glucose testing schedule will the provider recommended during the pregnancy?
Six or seven times a day
An adolescent had a serum glucose test at a health fair. The parent calls the clinic and says, “The level was 125 mg/dL. Does that mean my child has diabetes?” What is the provider’s most accurate response?
“Unless your child were fasting for longer than 8 hours, this does not necessarily indicate diabetes.”
What method will the provider consider the most reliable measure for assessing a patient’s diabetes control over the preceding 3-month period?
Glycosylated hemoglobin level (A1c)
Insulin glargine is prescribed by the provider for a hospitalized patient with type 1 diabetes. When will the provider order this medication to be administered?
Once daily at bedtime
A patient with type 1 diabetes reports taking propranolol for hypertension. What concern does this information present for the provider?
The β blocker can mask the symptoms of hypoglycemia.
An older adult patient with type 2 diabetes has a history of severe hypoglycemia. The patient’s partner asks the provider what A1c level they should strive to achieve. What guideline will the prescriber provide?
Below 8.0
A patient is admitted to the hospital and is prescribed levothyroxine. Assessment data show that the patient also takes warfarin. The provider will make what medication dosage-related change?
Reducing warfarin
A patient who takes oral levothyroxine for hypothyroidism is admitted to the hospital. After the provider determines the patient has myxedema, what action will the provider take?
Change to intravenous levothyroxine.
A provider teaches a patient who has been diagnosed with hypothyroidism about a new prescription for levothyroxine. Which statement by the patient indicates a need for further teaching?
“If I take calcium supplements, I may need to decrease my dose of levothyroxine.”
A pregnant patient recently began treatment for hypothyroidism. What response will the provider give when the patient shares that she does not want to take medications while she is pregnant?
“Your baby will likely be born with permanent neuropsychologic deficits if the condition is not treated.”
An admission history on an adult patient notes that the patient has a heart rate of 62 beats/minute, a blood pressure of 105/62 mm Hg, and a temperature of 96.20F. The patient appears pale and reports always feeling cold and tired. The provider and patient will discuss tests to rule out what possible cause of these signs symptoms?
Hypothyroidism
A patient has a free T4 level of 0.6 ng/dL and a free T3 level of 220 pg/dL. When asked by the patient what these laboratory values mean, how will the provider respond?
“We will need to obtain a TSH level to better evaluate your diagnosis.”
For which patient situation will a provider select combination estrogen and progestin therapy over estrogen only therapy for management of menopausal symptoms?
Has never had surgery
A patient with osteopenia asks about the benefits of hormone therapy in preventing osteoporosis. Which statement by the provider is correct?
“When hormone therapy is discontinued, bone loss resumes.”
The patient who reports vaginal dryness and pain with intercourse is opposed to using lubricants but is concerned about hormonal adverse effects. Which hormone formulation will the provider choose to decrease systemic estrogen effects?
A vaginal conjugated estrogen
A prescriber provides teaching to a patient about the risks and benefits of estrogen therapy (ET) in the peri-menopausal period. Which statement by the patient indicates understanding of the teaching?
“Estrogen therapy is the most effective drug for suppression of menopausal symptoms.”
A 50-year-old postmenopausal patient who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy (ET) with the provider. When the patient expresses concerns about adverse effects of ET, what information will the provider share with her?
Transdermal preparations have fewer side effects.
A child with allergic rhinitis has used budesonide for several years. The parents are concerned that the child’s rate of growth has slowed. What action will the provider take to address the parent’s concerns?
Discuss changing to fluticasone with the parents.
A patient with seasonal and perennial rhinitis requests a prescription for the most effective drug for treating this condition. Which medication will the provider recommend?
Fluticasone propionate
A patient with a cold used phenylephrine nasal spray, 2 sprays every 4 hours, for a week. Since then it has become impossible to discontinue the medication because the nasal congestion has increased. What action will the provider take?
Order an intranasal glucocorticoid to be used while the phenylephrine is withdrawn.
A patient requests medication for insomnia. The provider notes that the patient is restless and anxious with a heart rate of 90 beats/minute, and blood pressure of 130/85 mm Hg. Current medications are the combination product loratadine/pseudoephedrine every 12 hours for allergic rhinitis. What action will the provider take?
Discuss changing to an intranasal glucocorticoid and loratadine.
A patient with a cough has been advised to use guaifenesin. When the patient asks why this particular drug, what response will the provider provide?
“It stimulates the flow of secretions so they are easier to cough up.
A child with perennial allergic rhinitis has been using an intranasal glucocorticoid. After the child develops frequent nosebleeds, the provider orders montelukast to replace the inhaler. What statement will the provider include when teaching the child’s parents about montelukast?
“This drug will help prevent inflammation without causing nosebleeds.”
A patient who recently recovered from acute bronchitis reports a lingering dry cough that prevents sleep. Which over-the-counter medication will the provider recommend to best manage the symptoms?
Diphenhydramine
Which medication for asthma can a provider prescribe off-label to treat allergic rhinitis?
Omalizumab
A provider prescribes montelukast for a child with asthma. Which statement by the child’s parent indicates understanding of this medication?
“I may notice mood changes in my child.”
A patient develops an asthma exacerbation. The patient’s medication history lists an inhaled glucocorticoid, montelukast, and a short acting β2 agonist as needed via metered-dose inhaler (MDI). The patient’s respiratory rate is 18 breaths/minute, heart rate is 96 beats/minute, and an oxygen saturation is 95%. The provider auscultates mild expiratory wheezes bilaterally. What action will the provider take first?
Question the patient about how much albuterol has been used.
A patient takes oral theophylline twice daily for chronic stable asthma. After developing an infection, the patient went to an after-hours clinic where ciprofloxacin was prescribed. What action will the patient’s primary provider take when the patient follows up the next day?
Reduce the theophylline dose.
A patient with asthma reports daily symptoms requiring a short-acting β2-agonist for relief. The patient has used oral glucocorticoids three times in the past 3 months and reports awakening at night with symptoms about once a week. The patient’s forced expiratory volume in 1 second (FEV1) is 75% of predicted values. Which regimen does the provider determine is best for this patient?
Daily low-dose inhaled glucocorticoid/LABA with a SABA as needed
Which medication will a provider prescribe for an asthma patient as part of step 1 management?
Short-acting β2 agonists
A patient with stable COPD is prescribed a bronchodilator by the provider. Which type of bronchodilator is preferred for this patient?
A long-acting inhaled β2 agonist (LABA)