Page 1 of 156
NSG 5240 Advanced Pharmacology Midterm Exam
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES JUST RELEASED
NSG 5240 Advanced Pharmacology Midterm Exam
MOST TESTED EXAM COVERAGE — 10 AREAS
1. Pharmacokinetics: absorption, distribution, protein binding, metabolism, cytochrome P450
enzymes, half-life, bioavailability, clearance, renal elimination, hepatic elimination, and factors
that change drug levels.
2. Pharmacodynamics: receptors, agonists, antagonists, partial agonists, dose-response
relationships, therapeutic effects, adverse effects, potency, efficacy, and drug interactions.
3. Autonomic Pharmacology: sympathetic and parasympathetic receptors, alpha and beta
receptors, cholinergic drugs, anticholinergic drugs, adrenergic agonists, adrenergic blockers, and
common clinical uses.
4. Cardiovascular Pharmacology: ACE inhibitors, ARBs, beta-blockers, calcium channel blockers,
diuretics, nitrates, heart-failure medications, antiarrhythmics, and important monitoring
parameters.
5. Anticoagulants, Antiplatelets, and Lipid Drugs: warfarin, heparins, direct oral anticoagulants,
aspirin, antiplatelet drugs, statins, bleeding risks, laboratory monitoring, and patient teaching.
6. CNS and Psychiatric Pharmacology: antidepressants, SSRIs, SNRIs, TCAs, MAO inhibitors,
antipsychotics, mood stabilizers, benzodiazepines, anticonvulsants, and major adverse effects.
7. Antimicrobial Pharmacology: penicillins, cephalosporins, macrolides, tetracyclines,
fluoroquinolones, aminoglycosides, antifungals, antivirals, resistance, adverse effects, and safe
administration.
8. Endocrine and Metabolic Pharmacology: insulin, oral diabetes medications, thyroid
medications, corticosteroids, osteoporosis medications, and recognition of common drug-
related metabolic problems.
9. Drug Safety and Special Populations: pregnancy, older adults, children, renal impairment,
hepatic impairment, allergies, adverse drug reactions, drug interactions, and medication
reconciliation.
10. Clinical Prescribing and Patient Monitoring: selecting appropriate medications,
contraindications, therapeutic monitoring, laboratory tests, patient education, adherence,
toxicity, and recognizing when a medication should be held or changed.
1.
, Page 2 of 156
A patient with severe kidney disease receives a medication that is mainly removed through the kidneys.
What change should the prescriber consider?
A. Increase the dose
B. Decrease the dose
C. Increase the frequency
D. Give the medication with food
Answer: B
Rationale: Reduced renal function can decrease drug clearance and cause medication accumulation, so
the dose may need to be reduced.
2.
A patient takes a highly protein-bound medication and develops severe hypoalbuminemia. What
pharmacologic change should the nurse expect?
A. Less free drug
B. More free drug
C. Less drug absorption
D. Faster gastric emptying
, Page 3 of 156
Answer: B
Rationale: Low albumin leaves fewer protein-binding sites, increasing the unbound portion of highly
protein-bound medications.
3.
A patient asks why a medication must be taken every day for several days before its full effect appears.
Which concept explains this response?
A. Drug tolerance
B. Steady state
C. First-pass effect
D. Protein binding
Answer: B
Rationale: Repeated dosing allows drug concentrations to gradually approach a steady state, depending
largely on the medication's half-life.
4.
, Page 4 of 156
A medication has a very short half-life and is prescribed several times each day. What is the main reason
for frequent dosing?
A. The medication is poorly absorbed
B. The medication is rapidly eliminated
C. The medication cannot enter tissues
D. The medication has no therapeutic effect
Answer: B
Rationale: Drugs with short half-lives are removed from the body relatively quickly and may require
more frequent dosing.
5.
A patient taking several medications develops a new adverse effect after starting a strong CYP450
enzyme inhibitor. What should the nurse understand?
A. Drug levels may increase
B. Drug absorption will always decrease
C. Protein production will increase
D. Renal filtration will always increase
NSG 5240 Advanced Pharmacology Midterm Exam
QUESTIONS AND VERIFIED ANSWERS WITH
RATIONALES JUST RELEASED
NSG 5240 Advanced Pharmacology Midterm Exam
MOST TESTED EXAM COVERAGE — 10 AREAS
1. Pharmacokinetics: absorption, distribution, protein binding, metabolism, cytochrome P450
enzymes, half-life, bioavailability, clearance, renal elimination, hepatic elimination, and factors
that change drug levels.
2. Pharmacodynamics: receptors, agonists, antagonists, partial agonists, dose-response
relationships, therapeutic effects, adverse effects, potency, efficacy, and drug interactions.
3. Autonomic Pharmacology: sympathetic and parasympathetic receptors, alpha and beta
receptors, cholinergic drugs, anticholinergic drugs, adrenergic agonists, adrenergic blockers, and
common clinical uses.
4. Cardiovascular Pharmacology: ACE inhibitors, ARBs, beta-blockers, calcium channel blockers,
diuretics, nitrates, heart-failure medications, antiarrhythmics, and important monitoring
parameters.
5. Anticoagulants, Antiplatelets, and Lipid Drugs: warfarin, heparins, direct oral anticoagulants,
aspirin, antiplatelet drugs, statins, bleeding risks, laboratory monitoring, and patient teaching.
6. CNS and Psychiatric Pharmacology: antidepressants, SSRIs, SNRIs, TCAs, MAO inhibitors,
antipsychotics, mood stabilizers, benzodiazepines, anticonvulsants, and major adverse effects.
7. Antimicrobial Pharmacology: penicillins, cephalosporins, macrolides, tetracyclines,
fluoroquinolones, aminoglycosides, antifungals, antivirals, resistance, adverse effects, and safe
administration.
8. Endocrine and Metabolic Pharmacology: insulin, oral diabetes medications, thyroid
medications, corticosteroids, osteoporosis medications, and recognition of common drug-
related metabolic problems.
9. Drug Safety and Special Populations: pregnancy, older adults, children, renal impairment,
hepatic impairment, allergies, adverse drug reactions, drug interactions, and medication
reconciliation.
10. Clinical Prescribing and Patient Monitoring: selecting appropriate medications,
contraindications, therapeutic monitoring, laboratory tests, patient education, adherence,
toxicity, and recognizing when a medication should be held or changed.
1.
, Page 2 of 156
A patient with severe kidney disease receives a medication that is mainly removed through the kidneys.
What change should the prescriber consider?
A. Increase the dose
B. Decrease the dose
C. Increase the frequency
D. Give the medication with food
Answer: B
Rationale: Reduced renal function can decrease drug clearance and cause medication accumulation, so
the dose may need to be reduced.
2.
A patient takes a highly protein-bound medication and develops severe hypoalbuminemia. What
pharmacologic change should the nurse expect?
A. Less free drug
B. More free drug
C. Less drug absorption
D. Faster gastric emptying
, Page 3 of 156
Answer: B
Rationale: Low albumin leaves fewer protein-binding sites, increasing the unbound portion of highly
protein-bound medications.
3.
A patient asks why a medication must be taken every day for several days before its full effect appears.
Which concept explains this response?
A. Drug tolerance
B. Steady state
C. First-pass effect
D. Protein binding
Answer: B
Rationale: Repeated dosing allows drug concentrations to gradually approach a steady state, depending
largely on the medication's half-life.
4.
, Page 4 of 156
A medication has a very short half-life and is prescribed several times each day. What is the main reason
for frequent dosing?
A. The medication is poorly absorbed
B. The medication is rapidly eliminated
C. The medication cannot enter tissues
D. The medication has no therapeutic effect
Answer: B
Rationale: Drugs with short half-lives are removed from the body relatively quickly and may require
more frequent dosing.
5.
A patient taking several medications develops a new adverse effect after starting a strong CYP450
enzyme inhibitor. What should the nurse understand?
A. Drug levels may increase
B. Drug absorption will always decrease
C. Protein production will increase
D. Renal filtration will always increase
