NURS 6521 / NURS6521
Advanced Pharmacology
Midterm Exam | 100
Questions and Answers |
Latest 2025/2026 Update.
[DOCUMENT TITLE]
[Document subtitle]
,NURS 6521 Advanced Pharmacology – Comprehensive
Test Bank
Section 1: Pharmacokinetics & Pharmacodynamics
(Questions 1–15)
1. A patient with hepatic cirrhosis is prescribed a medication with high first-pass
metabolism. The advanced practice nurse anticipates which of the following?
A) Increased bioavailability requiring dose reduction
B) Decreased bioavailability requiring dose increase
C) No change in drug metabolism
D) Increased protein binding requiring dose adjustment
Answer: A
Rationale: Hepatic cirrhosis impairs first-pass metabolism, leading to increased
bioavailability of orally administered drugs that normally undergo extensive hepatic
metabolism. Dose reduction is often required to prevent toxicity.
2. Which of the following best describes the volume of distribution (Vd) of a
highly lipophilic drug?
A) Small Vd, primarily confined to the vascular space
B) Large Vd, extensive tissue distribution
C) Vd equal to total body water
D) Vd unaffected by protein binding
,Answer: B
Rationale: Highly lipophilic drugs readily cross cell membranes and distribute into
adipose and other tissues, resulting in a large volume of distribution.
3. A drug with a half-life of 24 hours is administered intravenously. Approximately
how long will it take to reach steady-state concentration?
A) 24 hours
B) 48 hours
C) 5 days
D) 10 days
Answer: C
Rationale: Steady-state is achieved after approximately 4–5 half-lives. With a 24-hour
half-life, steady-state is reached in about 4–5 days.
4. Which cytochrome P450 enzyme is most commonly involved in clinically
significant drug-drug interactions?
A) CYP1A2
B) CYP2C9
C) CYP2D6
D) CYP3A4
Answer: D
Rationale: CYP3A4 metabolizes approximately 50% of all drugs and is frequently
involved in drug-drug interactions through inhibition or induction.
, 5. A patient experiences a diminished therapeutic response to a medication after
prolonged use. This phenomenon is best described as:
A) Tachyphylaxis
B) Tolerance
C) Anaphylaxis
D) Idiosyncratic reaction
Answer: B
Rationale: Tolerance refers to a decreased response to a drug after repeated use, often
requiring dose escalation to achieve the same effect.
6. Which of the following pharmacokinetic processes is primarily responsible for
drug elimination?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Answer: D
Rationale: Excretion, primarily via the kidneys, is the main process by which drugs and
their metabolites are removed from the body.
7. A medication that acts as a competitive antagonist will:
Advanced Pharmacology
Midterm Exam | 100
Questions and Answers |
Latest 2025/2026 Update.
[DOCUMENT TITLE]
[Document subtitle]
,NURS 6521 Advanced Pharmacology – Comprehensive
Test Bank
Section 1: Pharmacokinetics & Pharmacodynamics
(Questions 1–15)
1. A patient with hepatic cirrhosis is prescribed a medication with high first-pass
metabolism. The advanced practice nurse anticipates which of the following?
A) Increased bioavailability requiring dose reduction
B) Decreased bioavailability requiring dose increase
C) No change in drug metabolism
D) Increased protein binding requiring dose adjustment
Answer: A
Rationale: Hepatic cirrhosis impairs first-pass metabolism, leading to increased
bioavailability of orally administered drugs that normally undergo extensive hepatic
metabolism. Dose reduction is often required to prevent toxicity.
2. Which of the following best describes the volume of distribution (Vd) of a
highly lipophilic drug?
A) Small Vd, primarily confined to the vascular space
B) Large Vd, extensive tissue distribution
C) Vd equal to total body water
D) Vd unaffected by protein binding
,Answer: B
Rationale: Highly lipophilic drugs readily cross cell membranes and distribute into
adipose and other tissues, resulting in a large volume of distribution.
3. A drug with a half-life of 24 hours is administered intravenously. Approximately
how long will it take to reach steady-state concentration?
A) 24 hours
B) 48 hours
C) 5 days
D) 10 days
Answer: C
Rationale: Steady-state is achieved after approximately 4–5 half-lives. With a 24-hour
half-life, steady-state is reached in about 4–5 days.
4. Which cytochrome P450 enzyme is most commonly involved in clinically
significant drug-drug interactions?
A) CYP1A2
B) CYP2C9
C) CYP2D6
D) CYP3A4
Answer: D
Rationale: CYP3A4 metabolizes approximately 50% of all drugs and is frequently
involved in drug-drug interactions through inhibition or induction.
, 5. A patient experiences a diminished therapeutic response to a medication after
prolonged use. This phenomenon is best described as:
A) Tachyphylaxis
B) Tolerance
C) Anaphylaxis
D) Idiosyncratic reaction
Answer: B
Rationale: Tolerance refers to a decreased response to a drug after repeated use, often
requiring dose escalation to achieve the same effect.
6. Which of the following pharmacokinetic processes is primarily responsible for
drug elimination?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Answer: D
Rationale: Excretion, primarily via the kidneys, is the main process by which drugs and
their metabolites are removed from the body.
7. A medication that acts as a competitive antagonist will:
