NURS 5334 ADVANCED
PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS
1. Which phase of pharmacokinetics is most significantly impacted by the first-pass effect
when a drug is administered orally?
A. Distribution
B. Metabolism
C. Excretion
D. Absorption
Answer: B
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of an
orally administered drug before it reaches the systemic circulation.
2. A patient is prescribed a drug that is a known CYP450 inducer. How will this affect a co-
administered drug that is a substrate of the same enzyme?
A. Decreased plasma concentration of the substrate
B. Increased risk of toxicity of the substrate
C. Increased therapeutic effect of the substrate
,D. No change in the substrate’s metabolism
Answer: A
Conceptual Explanation: CYP450 inducers increase the rate of drug metabolism, leading
to decreased plasma concentrations and reduced therapeutic effects of substrate drugs.
3. What is the primary mechanism of action of ACE inhibitors in the treatment of
hypertension?
A. Promoting the excretion of potassium in the distal tubule
B. Directly inhibiting the release of renin
C. Antagonizing Angiotensin II receptors
D. Blocking the conversion of Angiotensin I to Angiotensin II
Answer: D
Conceptual Explanation: ACE inhibitors work by inhibiting the Angiotensin-Converting
Enzyme, which prevents the conversion of Angiotensin I to the potent vasoconstrictor
Angiotensin II.
4. Which electrolyte abnormality is a patient most at risk for when taking a potassium-sparing
diuretic like Spironolactone?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
, D. Hyperkalemia
Answer: D
Conceptual Explanation: Spironolactone blocks aldosterone receptors, leading to the
retention of potassium and excretion of sodium and water.
5. A patient on Warfarin therapy has an INR of 5.0 with no signs of active bleeding. What is
the most appropriate initial intervention?
A. Hold the next dose of Warfarin and monitor
B. Give a dose of Protamine Sulfate
C. Administer Vitamin K intravenously immediately
D. Administer Fresh Frozen Plasma (FFP)
Answer: A
Conceptual Explanation: For an elevated INR without bleeding, holding the dose is often
the first step; Vitamin K is reserved for higher INRs or bleeding risk.
6. Which medication is considered the first-line treatment for Type 2 Diabetes unless
contraindicated?
A. Glipizide
B. Sitagliptin
C. Pioglitazone
D. Metformin
PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS
1. Which phase of pharmacokinetics is most significantly impacted by the first-pass effect
when a drug is administered orally?
A. Distribution
B. Metabolism
C. Excretion
D. Absorption
Answer: B
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of an
orally administered drug before it reaches the systemic circulation.
2. A patient is prescribed a drug that is a known CYP450 inducer. How will this affect a co-
administered drug that is a substrate of the same enzyme?
A. Decreased plasma concentration of the substrate
B. Increased risk of toxicity of the substrate
C. Increased therapeutic effect of the substrate
,D. No change in the substrate’s metabolism
Answer: A
Conceptual Explanation: CYP450 inducers increase the rate of drug metabolism, leading
to decreased plasma concentrations and reduced therapeutic effects of substrate drugs.
3. What is the primary mechanism of action of ACE inhibitors in the treatment of
hypertension?
A. Promoting the excretion of potassium in the distal tubule
B. Directly inhibiting the release of renin
C. Antagonizing Angiotensin II receptors
D. Blocking the conversion of Angiotensin I to Angiotensin II
Answer: D
Conceptual Explanation: ACE inhibitors work by inhibiting the Angiotensin-Converting
Enzyme, which prevents the conversion of Angiotensin I to the potent vasoconstrictor
Angiotensin II.
4. Which electrolyte abnormality is a patient most at risk for when taking a potassium-sparing
diuretic like Spironolactone?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
, D. Hyperkalemia
Answer: D
Conceptual Explanation: Spironolactone blocks aldosterone receptors, leading to the
retention of potassium and excretion of sodium and water.
5. A patient on Warfarin therapy has an INR of 5.0 with no signs of active bleeding. What is
the most appropriate initial intervention?
A. Hold the next dose of Warfarin and monitor
B. Give a dose of Protamine Sulfate
C. Administer Vitamin K intravenously immediately
D. Administer Fresh Frozen Plasma (FFP)
Answer: A
Conceptual Explanation: For an elevated INR without bleeding, holding the dose is often
the first step; Vitamin K is reserved for higher INRs or bleeding risk.
6. Which medication is considered the first-line treatment for Type 2 Diabetes unless
contraindicated?
A. Glipizide
B. Sitagliptin
C. Pioglitazone
D. Metformin
