NURS 5334 Advanced Pharmacology 2026/2027 Final Exam Practice Test with
correct answers and rationales
1. Which pharmacokinetic process refers to the movement of a drug from the bloodstream
into body tissues?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: B. Distribution
Rationale: Distribution is the movement of a drug from the systemic circulation into tissues and
organs where it exerts its therapeutic effects.
2. Which organ is primarily responsible for drug metabolism?
A. Kidney
B. Liver
C. Pancreas
D. Spleen
Answer: B. Liver
Rationale: The liver is the primary site of drug metabolism through the cytochrome P450 enzyme
system.
3. Which patient taking lisinopril requires immediate evaluation?
A. Blood pressure 128/78 mmHg
B. Persistent dry cough and lip swelling
C. Mild headache
D. Heart rate 72 beats/min
Answer: B. Persistent dry cough and lip swelling
Rationale: Lip swelling suggests angioedema, a rare but life-threatening adverse effect of ACE
inhibitors that requires immediate discontinuation and medical evaluation.
,4. Which electrolyte should be monitored most closely in a patient taking furosemide?
A. Calcium
B. Potassium
C. Sodium only
D. Magnesium only
Answer: B. Potassium
Rationale: Loop diuretics increase urinary potassium loss, placing patients at risk for
hypokalemia.
5. Which antihypertensive medication should generally be avoided during pregnancy?
A. Labetalol
B. Methyldopa
C. Lisinopril
D. Nifedipine
Answer: C. Lisinopril
Rationale: ACE inhibitors are contraindicated in pregnancy because they can cause fetal renal
injury and other serious fetal complications.
6. Which laboratory test should be monitored routinely in a patient taking warfarin?
A. aPTT
B. INR
C. Troponin
D. HbA1c
Answer: B. INR
Rationale: The International Normalized Ratio (INR) is used to monitor the anticoagulant effect
of warfarin.
7. Which medication is the antidote for warfarin overdose?
A. Protamine sulfate
B. Vitamin K
,C. Naloxone
D. Flumazenil
Answer: B. Vitamin K
Rationale: Vitamin K reverses the anticoagulant effects of warfarin.
8. Which medication is the antidote for opioid overdose?
A. Atropine
B. Naloxone
C. Epinephrine
D. Glucagon
Answer: B. Naloxone
Rationale: Naloxone rapidly reverses opioid-induced respiratory depression.
9. Which insulin has the fastest onset of action?
A. Regular insulin
B. NPH insulin
C. Insulin lispro
D. Insulin glargine
Answer: C. Insulin lispro
Rationale: Lispro is a rapid-acting insulin that begins working within approximately 15 minutes.
10. Metformin is contraindicated in patients with:
A. Severe renal impairment
B. Hypertension
C. Hyperlipidemia
D. Seasonal allergies
Answer: A. Severe renal impairment
Rationale: Severe renal impairment increases the risk of metformin-associated lactic acidosis.
, 11. Which medication class is considered first-line therapy for Type 2 diabetes in most
patients?
A. Sulfonylureas
B. Biguanides
C. Thiazolidinediones
D. DPP-4 inhibitors
Answer: B. Biguanides
Rationale: Metformin, a biguanide, is generally recommended as first-line pharmacologic
therapy for Type 2 diabetes unless contraindicated.
12. Which medication should be taken on an empty stomach, 30–60 minutes before
breakfast?
A. Levothyroxine
B. Omeprazole
C. Metformin
D. Prednisone
Answer: A. Levothyroxine
Rationale: Food reduces levothyroxine absorption; taking it consistently on an empty stomach
improves effectiveness.
13. Long-term corticosteroid therapy increases the risk for:
A. Osteoporosis
B. Hypoglycemia
C. Bradycardia
D. Hyperkalemia
Answer: A. Osteoporosis
Rationale: Chronic glucocorticoid use decreases bone formation and increases bone resorption.
correct answers and rationales
1. Which pharmacokinetic process refers to the movement of a drug from the bloodstream
into body tissues?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: B. Distribution
Rationale: Distribution is the movement of a drug from the systemic circulation into tissues and
organs where it exerts its therapeutic effects.
2. Which organ is primarily responsible for drug metabolism?
A. Kidney
B. Liver
C. Pancreas
D. Spleen
Answer: B. Liver
Rationale: The liver is the primary site of drug metabolism through the cytochrome P450 enzyme
system.
3. Which patient taking lisinopril requires immediate evaluation?
A. Blood pressure 128/78 mmHg
B. Persistent dry cough and lip swelling
C. Mild headache
D. Heart rate 72 beats/min
Answer: B. Persistent dry cough and lip swelling
Rationale: Lip swelling suggests angioedema, a rare but life-threatening adverse effect of ACE
inhibitors that requires immediate discontinuation and medical evaluation.
,4. Which electrolyte should be monitored most closely in a patient taking furosemide?
A. Calcium
B. Potassium
C. Sodium only
D. Magnesium only
Answer: B. Potassium
Rationale: Loop diuretics increase urinary potassium loss, placing patients at risk for
hypokalemia.
5. Which antihypertensive medication should generally be avoided during pregnancy?
A. Labetalol
B. Methyldopa
C. Lisinopril
D. Nifedipine
Answer: C. Lisinopril
Rationale: ACE inhibitors are contraindicated in pregnancy because they can cause fetal renal
injury and other serious fetal complications.
6. Which laboratory test should be monitored routinely in a patient taking warfarin?
A. aPTT
B. INR
C. Troponin
D. HbA1c
Answer: B. INR
Rationale: The International Normalized Ratio (INR) is used to monitor the anticoagulant effect
of warfarin.
7. Which medication is the antidote for warfarin overdose?
A. Protamine sulfate
B. Vitamin K
,C. Naloxone
D. Flumazenil
Answer: B. Vitamin K
Rationale: Vitamin K reverses the anticoagulant effects of warfarin.
8. Which medication is the antidote for opioid overdose?
A. Atropine
B. Naloxone
C. Epinephrine
D. Glucagon
Answer: B. Naloxone
Rationale: Naloxone rapidly reverses opioid-induced respiratory depression.
9. Which insulin has the fastest onset of action?
A. Regular insulin
B. NPH insulin
C. Insulin lispro
D. Insulin glargine
Answer: C. Insulin lispro
Rationale: Lispro is a rapid-acting insulin that begins working within approximately 15 minutes.
10. Metformin is contraindicated in patients with:
A. Severe renal impairment
B. Hypertension
C. Hyperlipidemia
D. Seasonal allergies
Answer: A. Severe renal impairment
Rationale: Severe renal impairment increases the risk of metformin-associated lactic acidosis.
, 11. Which medication class is considered first-line therapy for Type 2 diabetes in most
patients?
A. Sulfonylureas
B. Biguanides
C. Thiazolidinediones
D. DPP-4 inhibitors
Answer: B. Biguanides
Rationale: Metformin, a biguanide, is generally recommended as first-line pharmacologic
therapy for Type 2 diabetes unless contraindicated.
12. Which medication should be taken on an empty stomach, 30–60 minutes before
breakfast?
A. Levothyroxine
B. Omeprazole
C. Metformin
D. Prednisone
Answer: A. Levothyroxine
Rationale: Food reduces levothyroxine absorption; taking it consistently on an empty stomach
improves effectiveness.
13. Long-term corticosteroid therapy increases the risk for:
A. Osteoporosis
B. Hypoglycemia
C. Bradycardia
D. Hyperkalemia
Answer: A. Osteoporosis
Rationale: Chronic glucocorticoid use decreases bone formation and increases bone resorption.
