NURS 663 Exam 1 Questions | Verified Answers with Detailed
Rationales (2026/2027 Edition)
SOUTHERN UNIVERSITY SCHOOL OF NURSING
Subject: Advanced Pharmacology for Nurse Educators
Duration: 3 Hours
Total Marks: 100
Total Number of Questions: 50
Instructions:
1. This paper consists of THREE sections: Section A (Multiple Choice Questions),
Section B (Short Answer Questions), and Section C (Case Study Questions).
2. Answer ALL questions in ALL sections.
3. Write your student number and name clearly on the answer booklet.
4. For Section A, write the letter corresponding to the correct answer.
5. For Section B, answer in the spaces provided or on a separate sheet.
6. For Section C, provide detailed responses with clear rationales.
7. Non-programmable calculators are permitted.
8. No mobile phones or smart devices are allowed.
SECTION A: MULTIPLE CHOICE QUESTIONS
(30 Questions × 2 marks each = 60 marks)
Choose the ONE correct answer for each question.
Question 1:
A 72-year-old patient with chronic kidney disease is prescribed a medication primarily
eliminated by the kidneys. Which pharmacokinetic principle should the nurse educator
emphasize when teaching students about dosing adjustments in this patient?
A) The drug's volume of distribution will increase significantly
B) The drug's half-life will be prolonged, increasing risk of toxicity
C) The drug's bioavailability will decrease due to reduced first-pass metabolism
,D) The drug's protein binding will increase, reducing free drug concentration
Correct Answer: B
Marks: 2
Rationale:
In chronic kidney disease, renal clearance is reduced, leading to prolonged drug half-life
and accumulation of renally eliminated drugs. This increases the risk of toxicity and
necessitates dose reduction or extended dosing intervals. The concept being tested is
pharmacokinetics, specifically renal elimination and its clinical implications in special
populations.
Question 2:
Which pharmacodynamic concept explains why a patient taking warfarin experiences
increased bleeding when also prescribed aspirin?
A) Pharmacogenetic variation
B) Additive pharmacological effect
C) Competitive antagonism
D) Enzyme induction
Correct Answer: B
Marks: 2
Rationale:
Both warfarin and aspirin affect hemostasis through different mechanisms—warfarin
inhibits vitamin K-dependent clotting factors, while aspirin inhibits platelet aggregation.
Their combined effect on bleeding risk is additive. The concept being tested is
pharmacodynamic drug interactions and the principle of additive effects.
, Question 3:
A nurse educator is teaching about pharmacogenetics. Which statement correctly
describes the clinical significance of CYP2D6 poor metabolizer status?
A) Patients require higher doses of codeine for analgesic effect
B) Patients are at increased risk of toxicity from standard doses of tramadol
C) Patients cannot convert codeine to its active metabolite morphine, reducing
analgesia
D) Patients metabolize metoprolol more rapidly, requiring dose increases
Correct Answer: C
Marks: 2
Rationale:
CYP2D6 is responsible for converting the prodrug codeine into its active metabolite
morphine. Poor metabolizers lack this enzymatic activity, resulting in inadequate
analgesia from codeine. The concept being tested is pharmacogenetics and its impact
on prodrug activation and therapeutic outcomes.
Question 4:
Which factor is most likely to increase the volume of distribution of a lipophilic drug in
an elderly patient?
A) Decreased total body water
B) Increased adipose tissue mass
C) Decreased plasma albumin levels
D) Reduced hepatic blood flow
Correct Answer: B
Marks: 2
Rationale:
Rationales (2026/2027 Edition)
SOUTHERN UNIVERSITY SCHOOL OF NURSING
Subject: Advanced Pharmacology for Nurse Educators
Duration: 3 Hours
Total Marks: 100
Total Number of Questions: 50
Instructions:
1. This paper consists of THREE sections: Section A (Multiple Choice Questions),
Section B (Short Answer Questions), and Section C (Case Study Questions).
2. Answer ALL questions in ALL sections.
3. Write your student number and name clearly on the answer booklet.
4. For Section A, write the letter corresponding to the correct answer.
5. For Section B, answer in the spaces provided or on a separate sheet.
6. For Section C, provide detailed responses with clear rationales.
7. Non-programmable calculators are permitted.
8. No mobile phones or smart devices are allowed.
SECTION A: MULTIPLE CHOICE QUESTIONS
(30 Questions × 2 marks each = 60 marks)
Choose the ONE correct answer for each question.
Question 1:
A 72-year-old patient with chronic kidney disease is prescribed a medication primarily
eliminated by the kidneys. Which pharmacokinetic principle should the nurse educator
emphasize when teaching students about dosing adjustments in this patient?
A) The drug's volume of distribution will increase significantly
B) The drug's half-life will be prolonged, increasing risk of toxicity
C) The drug's bioavailability will decrease due to reduced first-pass metabolism
,D) The drug's protein binding will increase, reducing free drug concentration
Correct Answer: B
Marks: 2
Rationale:
In chronic kidney disease, renal clearance is reduced, leading to prolonged drug half-life
and accumulation of renally eliminated drugs. This increases the risk of toxicity and
necessitates dose reduction or extended dosing intervals. The concept being tested is
pharmacokinetics, specifically renal elimination and its clinical implications in special
populations.
Question 2:
Which pharmacodynamic concept explains why a patient taking warfarin experiences
increased bleeding when also prescribed aspirin?
A) Pharmacogenetic variation
B) Additive pharmacological effect
C) Competitive antagonism
D) Enzyme induction
Correct Answer: B
Marks: 2
Rationale:
Both warfarin and aspirin affect hemostasis through different mechanisms—warfarin
inhibits vitamin K-dependent clotting factors, while aspirin inhibits platelet aggregation.
Their combined effect on bleeding risk is additive. The concept being tested is
pharmacodynamic drug interactions and the principle of additive effects.
, Question 3:
A nurse educator is teaching about pharmacogenetics. Which statement correctly
describes the clinical significance of CYP2D6 poor metabolizer status?
A) Patients require higher doses of codeine for analgesic effect
B) Patients are at increased risk of toxicity from standard doses of tramadol
C) Patients cannot convert codeine to its active metabolite morphine, reducing
analgesia
D) Patients metabolize metoprolol more rapidly, requiring dose increases
Correct Answer: C
Marks: 2
Rationale:
CYP2D6 is responsible for converting the prodrug codeine into its active metabolite
morphine. Poor metabolizers lack this enzymatic activity, resulting in inadequate
analgesia from codeine. The concept being tested is pharmacogenetics and its impact
on prodrug activation and therapeutic outcomes.
Question 4:
Which factor is most likely to increase the volume of distribution of a lipophilic drug in
an elderly patient?
A) Decreased total body water
B) Increased adipose tissue mass
C) Decreased plasma albumin levels
D) Reduced hepatic blood flow
Correct Answer: B
Marks: 2
Rationale:
