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Pharmacotherapeutics for Advanced Nursing Practice – TWU | NURS 5663 Final Exam 2025.
- Which of the following correctly describes the mechanism of action of etanercept? a. TNF- alpha inhibitor
1. Which of the following DMARDs has(have) the action of binding to the tumor necrosis
factor (TNF) of inflammatory response:
a. Etanercept
b. Azathioprene
c. Auranofin
d. All of the above
2. A patient is beginning therapy with oral methotrexate for rheuma arthritis. You should teach this
patient about the importance of a. Having routine renal and hepatic test b. Taking the medication on a daily basis. c. Reporting alopecia and rash d. Limiting folic acid consumption.
3. You determine a serotonin/norepinephrine reuptake inhibitor (SNRI) will be prescribed for a patient
who is experiencing major depression. When conducting a pretreatment health history. You learn the patient has a recent history of alcohol abuse. Which SNRI would be contraindicated for this patient? a. Veniafaxine (Effexor XR) b. Lexapro c. Pristia d. Cymbalta
4. Which is the best option for treating an acute migraine in an 8 - year-old boy?
a. Aimotriptan b. Zolmitriptan c. Ibuprofen
5. Which of the following prophylactic treatments could potentially lead to the development of the
serotonin syndrome in a patient prescribed rizatriptan (Maxalt) for migraine headache? a. Inderall b. Topamax c. Dtexor XR d. Valprox acid
6. A 46 year old man started tramadol 100mg every 4 to 6 hours for back pain. Yesterday he had a
generalized tonic - clonic seizure. He has no prior history of seizures and his neurological exam is completely normal. His back pain is affecting his mood, and he feels depressed. Which of the following would be the best treatment option? a. Ultram b. Start Tegretol for the seizures c. Start welbutrin for depression d. Make no changes in medications and carefully monitor
7. Which of the following is the most important concept to teach a pt prescribed phenytoin for
epileptic seizures? a. Tell the pt to take the medication with meal b. Educate the patient about
8. You just started a 35 - year old woman on lamotrigine for newly diagnosed epilepsy. She is not taking
any medications except for acetaminophen for an occasional headache. Which of the following will be most important to monitor? a. Heart rhythm b. Vision c. Complete blood count d. Rash
9. A 26- year old female with a history of depression has been taking sertraline 200 mg /day for 12
weeks with no response. The patient has no other complications.Which of the following is the most reasonable treatment option? a. Change to veniafaxine b. Add fluoxetine c. Decrease the dose of sertraline d. Increase the sode of sertraline
10. Which of the following is recommend first for long term treatment of generalized anxiety disorder?
a. Escitalopram(Lexapro) b. aloprazolam(Xanax) c. buspirone(Buspar) d. Lmipramine(Tofraril)
11. PJ is 26 year old man with social anxiety disorder has been taking sertraline 100mg/day for the past
year. He reports to the clinic today with complaints of increased anxiety., agitation, and nausea. He reports taking sertraline most days but ran out 4 days ago. What is most likely going on with PJ? a. Neuroleptic malignant syndrome b. Serotonin syndrome c. SAD relapse d. Discontinuation syndrome
12. DP is a 50 year old man who presents with a complaints of difficulty initiating sleep. You rule out
other potential sleep disorders and want to start him on drug therapy for his insomnia. Which of the following would be the best treatment option? a. Amitriptyline 10 mg at bedtime b. Zalepion 5 mg at bedtime c. Flurazepam 15 mg at bedtime d. Zolpidem tartrate 3.75 mg SL at bedtime
13. A decrease in seizure threshold is an adverse effect associated with which of the following
medications used for the treatment of attention deficit hyperactivity disorder (ADHD)? a. Guanfacine b. Dextroamphetamine c. Atomoxetine d. Clonidine
a. Lisinopril(Zestrill) b. Rosuvastatin (Crestor) c. Metformin (Glucophage) d. Dapagliflozin (Farxigs)
21. Sodium glucose cotransporter- 2 inhibitors (SGLT inhibitors) can cause all of the following except:
a. Hypotension b. Increase the risk of genitourinary infection c. Weight loss d. Hypokalemia
22. What is the preferred laboratory test for monitoring levothyroxine( Synthroid) therapy in pt with
hypothyroidism? a. Serum free T4 test b. Thyrotropin- releasing hormone(TRH) c. Serum iodine level d. Thyroid- stimulating Hormone( TSH)
23. Which of the following statement is true regarding levothyroxine( Synthroid)?
a. Potential side effects include hepatitis and agranulocytosis b. New steady state level of T4 are reached approximately 6 days after a dosage change c. It produces stable serum levels of both T4 and T d. Its absorption is unaffected by administration with food.
24. Which of the following antihistamine is considered to cause the least amount sedation?
a. Fexofenadine(allegra) b. Diphenhydramine(Benadryl) c. Cetirizine(Zyrtec) d. Hydroxyzine (Atarax)
25. Which of the following is an appropriate intervention for an anaphylactic reaction is an adult?
a. Subcutaneous epinephrine (1:1000) 0.6 mg then repeat every 5 min as needed b. Intramuscular epinephrine (1:1000) 0.3 mg then repeat every 5 min as needed c. Intramuscular epinephrine (1:1000) 0.15mg then repeat every15 min as needed d. Intravenous epinephrine 1 to 4 mcg/min and titrate to response
26. Which of the following is an appropriate option for HIV pre-exposure prophylaxix(PrEP) for a 63 kg
male with renal impairment? a. Lopinavir/ritonavir(kaletra) b. Emtricitabine (Emtriva) c. Emtricitabine/tenofovir disoproxil fumarate (Truvada) d. Emtricitabine /tenofovir alafenamide ( Descovy)
27. A 30 - year-old woman newly diagnosed with HIV is started on lamivudine (Epivir) alone. Which of the
following explains why this regiment is unlikely to be therapeutically effective? a. Lamivudine is not absorbed from the gastrointestinal tract. b. Resistance to HIV is likely to develop from the use of single agent c. Lamivudine is not active against HIV. d. Lamivudine is inactivated by hepatic cytochrome P450 isoenzymes.
28. An 70 year old man was admitted to hospital and diagnosed with an acute DVT. Treatment was
initiated with intravenous heparin. 12 hours later, his a PTT is greater than 150 seconds and he is
noted to have bright red blood per rectum. Which of the following is the best course action in the management of the patient? a. Hold heparin give recombinant
29. A 55 year- old woman with atrial fibrillation is prescribed dabigatran (Pradaxa). What is the
mechanism of action of the oral anticoagulant? a. It directly inhibits thrombin b. It indirectly inhibits factor Xa by activating antithrombin c. It blocks the synthesis of active clotting factors d. It directly inhibits factor Xa.
30. Which of the following is usually the preferred route of vitamin B12(cyanocobalamin) administration
for a patient with pernicious anemia? a. Oral b. There is no preferred route of administration c. Parenteral (either intramuscular or deep subcutaneous injection) d. Intranasal
31. What initial daily dose of folic acid is typically effective in treating anemia secondary to folic acid
deficiency? a. 1mg b. 1200mg c. 4ng d. 4000mcg
32. Which of the following immunizations are contraindicated immunosuppressed children?
a. MMR b. DTap c. Hepatitis B d. Influenza (inactive)
33. Which of the following is considered a contraindication to receiving the inactivated influenza
vaccine? a. Anaphylaxis to a previous influenza vaccine b. Pregnancy c. Intolerance to eating eggs d. Breast feeding
34. The spouse of a patient who smokes wonders why anyone would want to engage in such a
disgusting habit. Which response to the spouse is accurate? a. Nicotine lowers blood pressure. b. Nicotine settles the stomach and increased appetite c. Nicotine increases alertness and promotes dopamine release. d. Nicotine causes relaxation and helps with sleep.
35. A patient who wants to quit smoking has a prescription for varenicline(Chantix), which will be used
with a nicotine patch. The patient asks why the varenicline is necessary. Which statement is correct? a. It helps reduce anxiety and other withdrawal symptoms b. It will help reduce the likelihood of addiction to the patch. c. It helps patients experiencing withdrawal to sleep better d. The drug blocks nicotine access to pleasure receptors
a. Decrease her risk of endometrial cancer. b. Prevent deep vein thrombosis(DVT) c. Increase bone resorption to prevent fractures d. Lower her risk of myocardial infarction(MI)
41. A 50 - year-old postmenopausal patient who has a hysterectomy has moderate to severe vasomotor
symptoms and is discussing estrogen therapy(ET) with you. The patient is concerned about adverse effects of ET. You explained to her that: a. An estrogen-progesterone product will reduce side effects. b. Transdermal preparations have fewer side effects. c. Side effects of ET are uncommon among women of her age. d. An intravaginal preparation may be best for her.
42. A patient taking risedronate (Actonel) for osteoporosis reports experiencing diarrhea and
headaches. What should you tell this patient? a. These symptoms indicate serious toxicity. b. The medication should be taken after a meal to reduce symptoms. c. You are probably not taking the drug correctly. d. These are common side effects of this drug.
43. A patient has developed postmenopausal osteoporosis and will begin taking alendronate (Fosamax).
You should teach the patient to take the drug: a. For a maximum of 1 to 2 years. b. While sitting upright with plenty of water. c. With coffee or orange juice to increase absorption. d. At bedtime to minimize adverse effects.
44. A female patient has come to the STD clinic and has been diagnosed with a Trichomonas vaginalis
infection. What education should be provided to this patient? a. The medication should be taken twice daily for 2 weeks. b. The applicator for the vaginal gel should be washed after each application. c. Male partners should always be treated even if they are asymptomatic. d. The infection is not completely eliminated with the medication.
45. A patient admitted to the hospital is using metronidazole 0.75% vaginal gel (Metrogel). Which
condition is this agent used to treat? a. Haemophilus ducreyi b. Gardnerella vaginalis c. Trichomonas vaginalis d. Chlamydia trachomotis
46. Match the following pharmacoeconomic study designs with their correct description.
Cost - Benefit Analysis / Used to determine the overall Cost-Minimization Analysis / evaluates the cost of two or Cost- Effectiveness Analysis/ determine the best program Cost- Utility Analysis /measure data in terms of
47. Which of the following directions has the least potential to result in an error and significant patient
harm? a. Inject 10 units subcutaneously daily b. Inject 10 units SQ daily
c. Inject 10 units subcutaneously daily d. Inject 10 U daily
48. A patient has three gouty flare-ups in the past year. Which of the following should you consider for
treating this patient? a. Nonsteroidal anti-inflammatory drugs b. Colchicine c. Urate-lowering drugs d. Glucocorticoids
49. Nancy is a pregnant 33 - year old gymnast with a history of chronic joint discomfort of the knees. You
suspect Osteoarthritis from the wear and tear during her 10 - year gymnastic competition career. She is 15 week gestation. Which of the following is contraindicated in this patient? a. indomethacin(indocin) b. acetaminophen (Tylenol) c. Intraarticular steroid injections d. Warm moist heat
50. A 56 year old male patient with chronic renal insufficiency and hypertension presents with a chief
complaint of a swollen, painful right toe. Labs reveal a uric acid level of 13 mg /dL and CrCl- 30mL/ min. Which of the following is the best treatment option for his acute gout attack? a. Probenecid (Benemid) 500mg twice daily b. Colchicine 1.2mg now. Then 0.6mg one hour later if no relief c. Allopurinol 300mg twice daily d. Indomethacin 100 mg twice daily
