NUR 6011/NUR6011 Final Exam V1 |
Advance Pharmacology Q&A with
Rationale | William Paterson University
1. Which physiological factor is the primary determinant of the ‘first-pass effect’ in oral drug
administration?
A. Hepatic metabolism
B. Glomerular filtration rate
C. Gastric emptying time
D. Plasma protein binding
Correct Answer: A
Expert Explanation: Hepatic metabolism is the primary driver of the first-pass effect,
where drugs are metabolized by the liver before reaching systemic circulation. This
process significantly reduces the bioavailability of certain oral medications. Understanding
this effect is crucial for determining appropriate dosages for oral versus intravenous
routes.
2. A patient taking an ACE inhibitor develops a dry, non-productive cough. What is the
biochemical cause of this side effect?
A. Accumulation of bradykinin in the lungs
B. Increased production of Angiotensin II
,C. Decreased levels of substance P
D. Direct irritation of the bronchial mucosa
Correct Answer: A
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This accumulation triggers the sensory nerves in the
lungs, resulting in a persistent dry cough. Switching the patient to an Angiotensin II
Receptor Blocker (ARB) usually resolves this issue because ARBs do not affect bradykinin
levels.
3. When prescribing Warfarin, which laboratory value is used to monitor the therapeutic
effect and adjust the dose?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. Bleeding time
D. International Normalized Ratio (INR)
Correct Answer: D
Expert Explanation: The International Normalized Ratio (INR) is the standard
measurement used to monitor the effectiveness of Warfarin therapy. It provides a
consistent result regardless of the laboratory reagents used, ensuring safe anticoagulation
levels. Clinicians typically aim for an INR range of 2.0 to 3.0 for most indications like atrial
fibrillation.
, 4. Which antibiotic class is associated with a risk of tendon rupture, particularly in elderly
patients?
A. Fluoroquinolones
B. Macrolides
C. Tetracyclines
D. Aminoglycosides
Correct Answer: A
Expert Explanation: Fluoroquinolones, such as Ciprofloxacin and Levofloxacin, carry a
black box warning for increased risk of tendonitis and tendon rupture. This risk is notably
higher in patients over 60 years of age and those taking concomitant corticosteroids.
Healthcare providers must educate patients to report any new tendon pain or
inflammation immediately.
5. What is the mechanism of action for Metformin in the treatment of Type 2 Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells
B. Increasing hepatic glucose production
C. Inhibiting glucose absorption in the small intestine
D. Decreasing hepatic glucose production and improving insulin sensitivity
Correct Answer: D
Advance Pharmacology Q&A with
Rationale | William Paterson University
1. Which physiological factor is the primary determinant of the ‘first-pass effect’ in oral drug
administration?
A. Hepatic metabolism
B. Glomerular filtration rate
C. Gastric emptying time
D. Plasma protein binding
Correct Answer: A
Expert Explanation: Hepatic metabolism is the primary driver of the first-pass effect,
where drugs are metabolized by the liver before reaching systemic circulation. This
process significantly reduces the bioavailability of certain oral medications. Understanding
this effect is crucial for determining appropriate dosages for oral versus intravenous
routes.
2. A patient taking an ACE inhibitor develops a dry, non-productive cough. What is the
biochemical cause of this side effect?
A. Accumulation of bradykinin in the lungs
B. Increased production of Angiotensin II
,C. Decreased levels of substance P
D. Direct irritation of the bronchial mucosa
Correct Answer: A
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This accumulation triggers the sensory nerves in the
lungs, resulting in a persistent dry cough. Switching the patient to an Angiotensin II
Receptor Blocker (ARB) usually resolves this issue because ARBs do not affect bradykinin
levels.
3. When prescribing Warfarin, which laboratory value is used to monitor the therapeutic
effect and adjust the dose?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. Bleeding time
D. International Normalized Ratio (INR)
Correct Answer: D
Expert Explanation: The International Normalized Ratio (INR) is the standard
measurement used to monitor the effectiveness of Warfarin therapy. It provides a
consistent result regardless of the laboratory reagents used, ensuring safe anticoagulation
levels. Clinicians typically aim for an INR range of 2.0 to 3.0 for most indications like atrial
fibrillation.
, 4. Which antibiotic class is associated with a risk of tendon rupture, particularly in elderly
patients?
A. Fluoroquinolones
B. Macrolides
C. Tetracyclines
D. Aminoglycosides
Correct Answer: A
Expert Explanation: Fluoroquinolones, such as Ciprofloxacin and Levofloxacin, carry a
black box warning for increased risk of tendonitis and tendon rupture. This risk is notably
higher in patients over 60 years of age and those taking concomitant corticosteroids.
Healthcare providers must educate patients to report any new tendon pain or
inflammation immediately.
5. What is the mechanism of action for Metformin in the treatment of Type 2 Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells
B. Increasing hepatic glucose production
C. Inhibiting glucose absorption in the small intestine
D. Decreasing hepatic glucose production and improving insulin sensitivity
Correct Answer: D
