NUR612/NUR612 Final Exam V2 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. Which pharmacokinetic process is primarily affected by a drug’s volume of distribution
(Vd)?
A. Metabolism
B. Absorption
C. Excretion
D. Distribution
Answer: D
Rationale: The volume of distribution represents the theoretical volume that would be
necessary to contain the total amount of an administered drug at the same concentration
that it is observed in the blood plasma. It helps clinicians understand how extensively a
drug is dispersed throughout the body tissues versus staying in the circulation. A high Vd
indicates that the drug is highly tissue-bound or lipid-soluble.
2. A patient is prescribed an ACE inhibitor and develops a persistent dry cough. What is the
physiological cause of this side effect?
A. Decreased levels of angiotensin II
B. Increased levels of bradykinin
,C. Increased sodium retention
D. Bronchoconstriction from histamine release
Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This accumulation irritates the airways and triggers a
non-productive, persistent cough in approximately 10-20% of patients. If the cough
becomes intolerable, patients are typically switched to an Angiotensin II Receptor Blocker
(ARB) which does not affect bradykinin levels.
3. Which of the following is a significant concern when administering aminoglycoside
antibiotics?
A. Hepatotoxicity
B. Ototoxicity
C. Gingival hyperplasia
D. Peripheral neuropathy
Answer: B
Rationale: Aminoglycosides are well-known for their narrow therapeutic index and risk of
permanent ototoxicity and nephrotoxicity. Ototoxicity can manifest as hearing loss or
vestibular dysfunction, often requiring baseline and periodic auditory testing. Close
monitoring of serum drug levels, particularly troughs, is essential to minimize these risks.
, 4. A patient with a history of asthma requires a beta-blocker for hypertension. Which agent is
most appropriate to use?
A. Propranolol
B. Metoprolol
C. Nadolol
D. Timolol
Answer: B
Rationale: Metoprolol is a cardioselective beta-1 blocker, meaning it primarily targets the
heart and has less effect on the beta-2 receptors in the lungs. Non-selective beta-blockers
like propranolol can cause bronchoconstriction by blocking beta-2 receptors, which is
dangerous for asthma patients. Even with cardioselective agents, caution must be exercised
as selectivity is lost at higher doses.
5. What is the primary mechanism of action of Warfarin?
A. Inhibition of Thrombin (Factor IIa)
B. Inhibition of Vitamin K epoxide reductase
C. Activation of Antithrombin III
D. Inhibition of Factor Xa
Answer: B
Pharmacology Q&A with Rationale |
William Paterson University
1. Which pharmacokinetic process is primarily affected by a drug’s volume of distribution
(Vd)?
A. Metabolism
B. Absorption
C. Excretion
D. Distribution
Answer: D
Rationale: The volume of distribution represents the theoretical volume that would be
necessary to contain the total amount of an administered drug at the same concentration
that it is observed in the blood plasma. It helps clinicians understand how extensively a
drug is dispersed throughout the body tissues versus staying in the circulation. A high Vd
indicates that the drug is highly tissue-bound or lipid-soluble.
2. A patient is prescribed an ACE inhibitor and develops a persistent dry cough. What is the
physiological cause of this side effect?
A. Decreased levels of angiotensin II
B. Increased levels of bradykinin
,C. Increased sodium retention
D. Bronchoconstriction from histamine release
Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This accumulation irritates the airways and triggers a
non-productive, persistent cough in approximately 10-20% of patients. If the cough
becomes intolerable, patients are typically switched to an Angiotensin II Receptor Blocker
(ARB) which does not affect bradykinin levels.
3. Which of the following is a significant concern when administering aminoglycoside
antibiotics?
A. Hepatotoxicity
B. Ototoxicity
C. Gingival hyperplasia
D. Peripheral neuropathy
Answer: B
Rationale: Aminoglycosides are well-known for their narrow therapeutic index and risk of
permanent ototoxicity and nephrotoxicity. Ototoxicity can manifest as hearing loss or
vestibular dysfunction, often requiring baseline and periodic auditory testing. Close
monitoring of serum drug levels, particularly troughs, is essential to minimize these risks.
, 4. A patient with a history of asthma requires a beta-blocker for hypertension. Which agent is
most appropriate to use?
A. Propranolol
B. Metoprolol
C. Nadolol
D. Timolol
Answer: B
Rationale: Metoprolol is a cardioselective beta-1 blocker, meaning it primarily targets the
heart and has less effect on the beta-2 receptors in the lungs. Non-selective beta-blockers
like propranolol can cause bronchoconstriction by blocking beta-2 receptors, which is
dangerous for asthma patients. Even with cardioselective agents, caution must be exercised
as selectivity is lost at higher doses.
5. What is the primary mechanism of action of Warfarin?
A. Inhibition of Thrombin (Factor IIa)
B. Inhibition of Vitamin K epoxide reductase
C. Activation of Antithrombin III
D. Inhibition of Factor Xa
Answer: B
