MSN Pharmacology for Advanced Practice 2

Question 1

Which adverse effect is most associated with long-term corticosteroid use that an MSN-prepared NP should monitor?

Accepted Answer

Hyperglycemia, osteoporosis, adrenal suppression, and immunosuppression

Answer

Hypoglycemia and weight loss

Answer

Bradycardia and hyponatremia

Answer

Thrombocytopenia and bleeding

Question 2

A patient on metformin is scheduled for a contrast CT scan. What pharmacological precaution is required?

Accepted Answer

Hold metformin before and 48 hours after contrast administration due to risk of lactic acidosis

Answer

Increase the metformin dose before the procedure

Answer

Switch to insulin permanently

Answer

No precaution is needed with modern contrast agents

Question 3

Which mechanism explains why selective serotonin reuptake inhibitors (SSRIs) require 2–4 weeks to produce antidepressant effects?

Accepted Answer

Neuroadaptive changes in autoreceptor sensitivity and synaptic remodeling take weeks to develop

Answer

Slow hepatic metabolism delaying peak plasma levels

Answer

Blood-brain barrier takes weeks to allow drug entry

Answer

The drug must accumulate in fat stores before becoming active

Question 4

Aminoglycoside antibiotics are dosed using once-daily extended interval strategies primarily to maximize which pharmacodynamic property?

Accepted Answer

Concentration-dependent killing and post-antibiotic effect

Answer

Time-dependent killing (T>MIC)

Answer

Minimum inhibitory concentration at trough

Answer

Bioavailability-dependent bacteriostatic effect

Question 5

Which immunosuppressant used post-transplant inhibits calcineurin, thereby preventing T-cell cytokine production?

Accepted Answer

Cyclosporine and tacrolimus

Answer

Mycophenolate mofetil

Answer

Azathioprine

Answer

Sirolimus (rapamycin)

Question 6

A pregnant patient requires anticoagulation. Which agent is safe to use throughout pregnancy?

Accepted Answer

Unfractionated or low-molecular-weight heparin — does not cross the placenta

Answer

Warfarin — safe in all trimesters

Answer

Rivaroxaban — FDA Category B

Answer

Dabigatran — safest option in first trimester