NR566 Week 8: Final Exam (Dec-2025)

An adult patient has been taking a hypnotic nightly for 3 months to manage insomnia. The patient reports that the medication has become less effective and asks if the dose can be doubled. What is the MOST appropriate response by the nurse practitioner?

A Advise increasing the hypnotic dose gradually until sleep improves, since tolerance is expected with long-term use of these drugs
B. Transition the patient to barbiturates, since they have a lower risk of drug-dependency insomnia when used long term
C. ✅ Recommend interrupting hypnotic therapy temporarily to reduce tolerance and then resume at the previous effective dosage if needed
D. Suggest continuing the current dose indefinitely, because tolerance will resolve naturally without changes to the treatment plan

Before initiating ustekinumab for a patient with moderate to severe psoriasis, which of the following actions should the nurse practitioner take?

A Begin therapy without delay because infection risk is minimal
B. Avoid all vaccinations during therapy and for one year afterward
C. Initiate prophylactic antibiotic therapy to prevent local infections
D. ✅ Screen for latent tuberculosis infection before starting therapy

The NP should monitor for which adverse effect when taking phentermine/topiramate?

A Hypertension
B. Hypoglycemia
C. Bradycardia
✅ D. Acidosis ✔️

Which statement BEST explains safe prescribing considerations for antihistamines?

Answers: A – D

A. Antihistamines relieve mild to moderate allergic symptoms and may cause sedation, which can be reduced by taking the dose at night or using a second-generation agent ✅
B. Antihistamines should always be taken on an empty stomach, since food reduces effectiveness and increases adverse effects
C. Antihistamines prevent severe allergic reactions such as anaphylaxis and require frequent laboratory monitoring for safety and effectiveness
D. Antihistamines have no risk in children or older adults and are considered safe in patients with asthma, glaucoma, or urinary retention

A 6-year-old child with no significant medical history presents for routine immunizations. The parent asks why the varicella vaccine is recommended. Which explanation by the nurse practitioner is MOST appropriate?

Answers: A – D

A. The varicella vaccine provides nearly complete protection, and breakthrough infections are mild with fewer lesions and faster recovery ✅
B. The varicella vaccine is rarely used in healthy children because adverse effects are severe and transmission to others is common
C. The varicella vaccine is only effective when combined with MMR, since the single formulation does not provide strong immunity
D. The varicella vaccine prevents all cases of chickenpox and eliminates any risk of herpes zoster in adulthood…………………………………………….$60