,NUR 600 Exam 2 – Advanced Clinical
Pharmacology Exam – NGN Questions
and Case Scenarios (Guarantee Pass)
1. A patient with hepatic cirrhosis is prescribed a drug
with a high first-pass metabolism. Which
pharmacokinetic change is most likely to occur?
A) Decreased oral bioavailability
B) Increased oral bioavailability
C) Decreased volume of distribution
D) Increased renal clearance
Answer: B) Increased oral bioavailability
Rationale: In hepatic cirrhosis, liver function is impaired,
reducing first-pass metabolism. Drugs that normally
undergo extensive hepatic metabolism will have less
degradation during their first pass through the liver,
resulting in increased systemic availability when taken
orally .
2. A drug that is highly protein-bound is administered to
a patient with severe hypoalbuminemia. What is the
most likely pharmacokinetic consequence?
,A) Decreased free drug concentration
B) Increased free drug concentration
C) Decreased elimination half-life
D) Reduced drug efficacy
Answer: B) Increased free drug concentration
Rationale: Low albumin levels reduce available binding
sites for drugs. This increases the fraction of unbound
(active) drug in plasma, which can enhance
pharmacologic effects and increase the risk of toxicity .
3. A medication follows zero-order kinetics. Which
statement best describes its elimination?
A) A constant percentage of the drug is eliminated per
unit time
B) Elimination depends on renal perfusion
C) A constant amount of the drug is eliminated per unit
time
D) Elimination rate decreases as concentration increases
Answer: C) A constant amount of the drug is eliminated
per unit time
Rationale: Zero-order elimination means a constant
amount of drug is metabolized per unit time, regardless
, of concentration (e.g., phenytoin, high-dose aspirin). This
leads to a variable half-life and potential for toxicity .
4. A patient is given a drug that acts as a partial agonist
at a receptor. Which outcome is most likely when this
drug is administered alongside a full agonist?
A) It produces a greater maximal response than the full
agonist
B) It reduces the effect of the full agonist
C) It has no effect on the full agonist's activity
D) It irreversibly binds to the receptor
Answer: B) It reduces the effect of the full agonist
Rationale: Partial agonists have lower intrinsic activity
compared to full agonists. When both compete for the
same receptor, the partial agonist occupies receptors but
produces a weaker response, thereby diminishing the
overall effect of the full agonist .
5. A drug has a half-life of 8 hours. Approximately how
long will it take to reach steady state?
A) 8 hours
B) 16 hours
C) 24 hours
D) 40 hours
Pharmacology Exam – NGN Questions
and Case Scenarios (Guarantee Pass)
1. A patient with hepatic cirrhosis is prescribed a drug
with a high first-pass metabolism. Which
pharmacokinetic change is most likely to occur?
A) Decreased oral bioavailability
B) Increased oral bioavailability
C) Decreased volume of distribution
D) Increased renal clearance
Answer: B) Increased oral bioavailability
Rationale: In hepatic cirrhosis, liver function is impaired,
reducing first-pass metabolism. Drugs that normally
undergo extensive hepatic metabolism will have less
degradation during their first pass through the liver,
resulting in increased systemic availability when taken
orally .
2. A drug that is highly protein-bound is administered to
a patient with severe hypoalbuminemia. What is the
most likely pharmacokinetic consequence?
,A) Decreased free drug concentration
B) Increased free drug concentration
C) Decreased elimination half-life
D) Reduced drug efficacy
Answer: B) Increased free drug concentration
Rationale: Low albumin levels reduce available binding
sites for drugs. This increases the fraction of unbound
(active) drug in plasma, which can enhance
pharmacologic effects and increase the risk of toxicity .
3. A medication follows zero-order kinetics. Which
statement best describes its elimination?
A) A constant percentage of the drug is eliminated per
unit time
B) Elimination depends on renal perfusion
C) A constant amount of the drug is eliminated per unit
time
D) Elimination rate decreases as concentration increases
Answer: C) A constant amount of the drug is eliminated
per unit time
Rationale: Zero-order elimination means a constant
amount of drug is metabolized per unit time, regardless
, of concentration (e.g., phenytoin, high-dose aspirin). This
leads to a variable half-life and potential for toxicity .
4. A patient is given a drug that acts as a partial agonist
at a receptor. Which outcome is most likely when this
drug is administered alongside a full agonist?
A) It produces a greater maximal response than the full
agonist
B) It reduces the effect of the full agonist
C) It has no effect on the full agonist's activity
D) It irreversibly binds to the receptor
Answer: B) It reduces the effect of the full agonist
Rationale: Partial agonists have lower intrinsic activity
compared to full agonists. When both compete for the
same receptor, the partial agonist occupies receptors but
produces a weaker response, thereby diminishing the
overall effect of the full agonist .
5. A drug has a half-life of 8 hours. Approximately how
long will it take to reach steady state?
A) 8 hours
B) 16 hours
C) 24 hours
D) 40 hours
