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WGU D116 OBJECTIVE ASSESSMENT AND PRACTICE
EXAM NEWEST 2025 TEST BANK| D116 ADVANCED
PHARMACOLOGY OA FINAL WITH COMPLETE 500
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALEREADY
GRADED A+ (BRAND NEW!!)
An advanced practice registered nurse (APRN) is treating a 58-year-old male for peptic ulcers. The patient is taking cimetidine and is complaining about impotence. Which medication should the APRN use instead? A. Bismuth B. Tinidazole C. Metronidazole D. Ranitidine - ANSWER - Ranitidine A patient has been on a long-term regimen of NSAIDs and needs a medication that is approved to prevent gastric ulcers. Which medication should an advanced practice registered nurse prescribe for this patient? A. Metronidazole B. Misoprostol C. Tinidazole D. Ranitidine - ANSWER – Misoprostol
A 32-year-old female presents to an advanced practice registered nurse (APRN) with severe nausea and vomiting during pregnancy and requires pharmaceutical therapy. The APRN knows that some medication solutions should be avoided during pregnancy. Which medication falls into this category? A. Metoclopramide B. Chenodiol C. Prochlorperazine D. Ondansetron - ANSWER - Chenodiol A 53-year-old female who is para 2 and gravida 2 (P2G2) presents to a clinic for a consultation on management of hot flashes. She is interested in treatment to help manage her symptoms since they are affecting her quality of life and causing sleep difficulty. She has well-controlled hypertension and is currently taking lisinopril 10 mg qd. She denies any personal history of blood clots. Occasionally, the patient takes ibuprofen as needed for headaches and had a migraine with an aura one time when she was a teenager. She still has her uterus and ovaries. Which medication is the safest initial medication to use to manage this patient's symptoms? A. Zolpidem B. Escitalopram C. Clonazepam D. Estradiol - ANSWER - Escitalopram
A patient with Graves disease comes into a clinic to tell her advanced practice registered nurse (APRN) that she just found out that she has been pregnant for six weeks. Which medication should the APRN use for this patient? A. Propylthiouracil B. Iodine- 131 C. Methimazole D. Levothyroxine - ANSWER - Propylthiouracil An advanced practice registered nurse (APRN) is ordering levothyroxine and is scheduling an appointment to check a patient's plasma levels to determine the medication's effectiveness. When should the APRN request the follow-up for this testing? A. In one week B. In four weeks C. In six months D. In three months - ANSWER - In four weeks A 35-year-old female who is a nonsmoker is happy with her combined oral hormonal contraceptive; however, she often forgets to take her pills and would like to discuss other options. She would also prefer to avoid any contraceptive that must be inserted into her body. Which medication should be recommended for this patient? A. Spermicide B. Transdermal patch C. Subdermal implant
D. Vaginal IUD - ANSWER - Transdermal patch A 47-year-old female presents to a clinic to discuss the management of hot flashes. She had a hysterectomy three years ago but still has her ovaries. She tells an advanced practice registered nurse (APRN) that the hot flashes are extremely bothersome to her and would like to start estradiol because this medication worked well for her sister. She tells the APRN that she smokes occasionally but is trying to quit. Which medication is contraindicated for this patient? A. Escitalopram B. Oral estrogen C. Gabapentin D. Clonidine - ANSWER - Oral estrogen A 32-year-old female is discussing contraceptive options with an advanced practice registered nurse (APRN). The patient is currently taking an oral contraceptive pill and has no contraindications to estrogen therapy. She tells the APRN that she is happy with the pill because it helps her skin but really does not like having to take something every day. She is planning on getting pregnant in 10-12 months when she is done with her graduate degree. Which recommendation should the APRN make for this patient? A. Sub-dermal etonogestrel implant B. Intrauterine device C. Vaginal contraceptive ring D. Continue oral contraceptive pill - ANSWER - Vaginal contraceptive ring
C. Lorcaserin/bupropion D. Orlistat - ANSWER - Naltrexone/bupropion A 40-year-old female is diagnosed with acute pyelonephritis with symptoms of fever, chills, severe flank pain, dysuria, urinary frequency, and urinary urgency. The patient is prescribed levofloxacin for 14 days. Which bacterium is being treated in this patient? Pseudomonas aeruginosa Borrelia burgdorferi Staphylococcus aureus Escherichia coli - ANSWER - Escherichia coli A 20-year-old patient with cancer is admitted to a medical surgical floor with diarrhea. The stool cultures return positive for Clostridium difficile. Which antibiotic should be prescribed for this patient? Metronidazole Ciprofloxacin Doxycycline Gentamicin - ANSWER - Metronidazole A mother brings her one-year-old son to a routine checkup. It is almost flu season, and she wants to get a flu vaccine for her son. This will be his first flu vaccine. She is hoping the intranasal vaccine will be used so her son does not have to be poked with a needle. What are the flu vaccine options, if any, for this patient?
Intradermal influenza vaccines are the only recommended formulations for children four years and younger. The intranasal vaccine is recommended as first choice for children six months and older. Influenza vaccines are only available for children two years and older. For patients six months old to two years old, the influenza vaccine administered intramuscularly is the only recommended option. - ANSWER - For patients six months old to two years old, the influenza vaccine administered intramuscularly is the only recommended option. An adult female patient was placed on doxycycline. The patient states it has made her stomach upset, and she wants to know if there are any problems with her taking it with meals. Which advice should be provided? Milk will help with the absorption of doxycycline and will protect the stomach from being upset. Doxycycline may be given with food to decrease the upset stomach and will only slightly decrease absorption of the drug. An over-the-counter antacid may be taken with doxycycline to protect the stomach from being upset and will have little effect on the absorption of doxycycline. Iron supplements will be helpful in decreasing the upset stomach and will not affect absorption of doxycycline. - ANSWER - Doxycycline may be given with food to decrease the upset stomach and will only slightly decrease absorption of the drug.
Fexofenadine Desloratadine Promethazine Cetirizine - ANSWER - Promethazine A patient presents with complaint of pain and swelling of the big left toe. The patient has never experienced this problem before. It is determined that the patient is having an acute gouty attack. The patient's history is significant for an allergy to ibuprofen that results in a rash. Which treatment is appropriate for this patient? Allopurinol Indomethacin Naproxen Colchicine - ANSWER - Colchicine An adult patient with rheumatoid arthritis is being treated with methotrexate, folic acid, hydroxychloroquine, etanercept, and aspirin. Liver and kidney function tests, complete blood count (CBC), and platelet count are requested regularly. Which additional procedure should be included to assess for adverse effects of the drug regimen? Lipid panel Thyroid-stimulating hormone (TSH) Ophthalmic exam Hemoglobin A1c - ANSWER - Ophthalmic exam
Neuropharmacology - ANSWER - Studies how drugs influence the nervous system to modify behavior, cognition, and physiological function. Molecular Neuropharmacology - ANSWER - Interactions at receptor and signaling level. Behavioral Neuropharmacology - ANSWER - How drugs affect behavior and mental states. Acetylcholine (ACh) - ANSWER - Major neurotransmitter involved in memory, attention, and autonomic regulation. Dopamine (DA) - ANSWER - Major neurotransmitter involved in reward, motivation, and motor control. Serotonin (5-HT) - ANSWER - Major neurotransmitter involved in mood, sleep, pain, and gastrointestinal function. Norepinephrine (NE) - ANSWER - Major neurotransmitter involved in arousal, stress, attention, and blood pressure. GABA (γ-aminobutyric acid) - ANSWER - Major neurotransmitter providing inhibitory tone and seizure control.
Epilepsy - ANSWER - Characterized by excess neuronal firing, treated with GABA enhancers and sodium channel blockers. Depression - ANSWER - Characterized by decreased monoamines (5- HT, NE, DA), treated with SSRIs and SNRIs. Anxiety - ANSWER - Characterized by a hyperactive limbic system, treated with SSRIs and benzodiazepines. Schizophrenia - ANSWER - Characterized by increased dopamine in the mesolimbic pathway, treated with D2 antagonists. Migraine - ANSWER - Characterized by vascular and serotonin dysregulation, treated with triptans and beta blockers. Multiple Sclerosis - ANSWER - Characterized by autoimmune demyelination, treated with immunomodulators and steroids. Antipsychotics - ANSWER - Watch for extrapyramidal symptoms, QT prolongation, and increased prolactin. SSRIs/SNRIs - ANSWER - Watch for sexual dysfunction and serotonin syndrome. MAOIs - ANSWER - Watch for hypertensive crisis when consuming tyramine foods.
Anticholinergics - ANSWER - Watch for dry mouth, urinary retention, and confusion, especially in the elderly. Levodopa - ANSWER - Watch for dyskinesias and hallucinations. Benzodiazepines - ANSWER - Watch for dependence, withdrawal, and sedation. BALSA - ANSWER - Mnemonic for Parkinson's: Bromocriptine, Amantadine, Levodopa, Selegiline, Antimuscarinics BAD TRIP - ANSWER - Mnemonic for serotonin syndrome: Benzos, Agitation, Diaphoresis, Tachycardia, Reflexes ↑, Incoordination, Pyrexia Direct Muscarinic Agonists - ANSWER - Drugs that bind directly to muscarinic receptors and activate them. Pilocarpine - ANSWER - Used for glaucoma and xerostomia (dry mouth). Bethanechol - ANSWER - Used for urinary retention and postoperative ileus. Carbachol - ANSWER - Used for glaucoma (rarely used).
Edrophonium - ANSWER - Historically used in diagnosis of myasthenia gravis. Key Muscarinic Effects - ANSWER - SLUDGE-M: Salivation, Lacrimation, Urination, Diarrhea, Gastrointestinal motility, Emesis, Miosis (pupil constriction), bradycardia, bronchoconstriction. Anticholinergic Drugs - ANSWER - Medications that block the action of acetylcholine (ACh) at muscarinic receptors. Mechanism of Action of Anticholinergics - ANSWER - Most are muscarinic antagonists that competitively inhibit ACh at muscarinic receptors (M1-M5). Benztropine - ANSWER - Used for Parkinson's disease and drug- induced EPS. Trihexyphenidyl - ANSWER - Used for Parkinson's disease. Scopolamine - ANSWER - Used for motion sickness (transdermal patch). Ipratropium - ANSWER - Used for COPD and asthma (short-acting). Tiotropium - ANSWER - Used for COPD (long-acting).
Aclidinium - ANSWER - Used for COPD. Umeclidinium - ANSWER - Used for COPD. Oxybutynin - ANSWER - Used for overactive bladder and urinary incontinence. Tolterodine - ANSWER - Used for overactive bladder. Solifenacin - ANSWER - Used for overactive bladder. Dicyclomine - ANSWER - Used for irritable bowel syndrome (IBS). Hyoscyamine - ANSWER - Used for GI spasms. Atropine - ANSWER - Used for bradycardia, organophosphate poisoning, and pre-op secretion reduction. Anticholinergic Syndrome - ANSWER - High doses or overdose can cause toxicity: 'Dry as a bone', 'Blind as a bat', 'Hot as a hare', 'Red as a beet', 'Mad as a hatter', 'Full as a flask'. Direct-Acting Cholinergic Agonists - ANSWER - Drugs that bind directly to and activate cholinergic receptors.
Galantamine - ANSWER - Alzheimer's disease Organophosphates - ANSWER - Insecticides (e.g., malathion) - Irreversible AChE inhibitors Nerve gases - ANSWER - Sarin, VX - Military nerve agents Antidote - ANSWER - Atropine + Pralidoxime (2-PAM) Caffeine - ANSWER - Alertness, migraine Amphetamines - ANSWER - ADHD, narcolepsy Methylphenidate - ANSWER - ADHD Modafinil - ANSWER - Narcolepsy, shift work sleep disorder Barbiturates - ANSWER - Seizures, sedation (e.g., phenobarbital) Ethanol - ANSWER - CNS depressant Propofol - ANSWER - Anesthesia
Morphine - ANSWER - Pain (limited BBB penetration) Fentanyl - ANSWER - Pain, anesthesia (high BBB penetration) Heroin - ANSWER - Illicit drug (rapid CNS effect) SSRIs - ANSWER - Examples include fluoxetine, sertraline, citalopram SNRIs - ANSWER - Examples include venlafaxine, duloxetine TCAs - ANSWER - Examples include amitriptyline, nortriptyline Haloperidol - ANSWER - Typical antipsychotic Olanzapine - ANSWER - Atypical antipsychotic Risperidone - ANSWER - Atypical antipsychotic Clozapine - ANSWER - Atypical antipsychotic Phenytoin - ANSWER - Lipophilic, crosses BBB Valproic acid - ANSWER - Broad-spectrum anticonvulsant
