NUR 6011 EXAM 1 – ADVANCED PHARMACOLOGY
William Paterson University | Complete 200-Question
Test Bank | NGN-Style Questions & Case Scenarios |
2026/2027 Edition | 100% Pass Guarantee
1. A patient is started on a new medication that undergoes extensive first-
pass metabolism. Which route of administration would avoid first-pass
effect?
A) Oral
B) Sublingual or IV
C) Rectal
D) Intramuscular
Answer B: Sublingual or IV
Rationale: Sublingual and IV routes bypass the hepatic portal system, avoiding
first-pass metabolism. Oral drugs undergo extensive first-pass.
2. The half-life of a drug is 6 hours. How many half-lives are needed to reach
steady state?
A) 2
B) 3
C) 4-5
D) 6
Answer C: 4-5
,Rationale: Steady state is achieved after approximately 4-5 half-lives. At that
point, drug accumulation and elimination are balanced.
3. A drug has a volume of distribution (Vd) of 50 L. This large Vd suggests
that the drug:
A) Is highly protein bound
B) Is extensively distributed into tissues
C) Has a short half-life
D) Is eliminated rapidly
Answer B: Is extensively distributed into tissues
Rationale: Large Vd indicates that the drug has left the plasma and is
concentrated in tissues. Small Vd suggests plasma binding.
4. Which of the following is an example of a competitive antagonist?
A) A drug that binds irreversibly to the receptor
B) A drug that binds reversibly to the same receptor site as the agonist
C) A drug that binds to a different receptor site
D) A drug that has intrinsic activity
Answer B: A drug that binds reversibly to the same receptor site as the
agonist
Rationale: Competitive antagonists bind reversibly to the same receptor site,
blocking agonist binding. They can be overcome by increasing agonist
concentration.
,5. The therapeutic index (TI) of a drug is defined as:
A) The dose required to produce a therapeutic effect
B) The ratio of the lethal dose (LD50) to the effective dose (ED50)
C) The amount of drug that reaches systemic circulation
D) The time required for half of the drug to be eliminated
Answer B: The ratio of the lethal dose (LD50) to the effective dose (ED50)
Rationale: TI = LD50/ED50. A larger TI indicates a safer drug. Narrow TI drugs
require monitoring.
6. A patient with renal impairment is prescribed a medication excreted
primarily via the kidneys. The nurse anticipates the provider will:
A) Increase the dose
B) Decrease the dose or lengthen the dosing interval
C) Administer the drug with food
D) Discontinue the drug
Answer B: Decrease the dose or lengthen the dosing interval
Rationale: Renal impairment reduces drug clearance, leading to accumulation and
toxicity. Dose adjustment or prolonged intervals are needed.
7. Which cytochrome P450 enzyme is responsible for the metabolism of most
drugs?
, A) CYP1A2
B) CYP3A4
C) CYP2D6
D) CYP2C9
Answer B: CYP3A4
Rationale: CYP3A4 metabolizes approximately 50% of all drugs, including many
statins, calcium channel blockers, and immunosuppressants.
8. A patient on warfarin is started on an antibiotic that inhibits CYP2C9. The
nurse should monitor for:
A) Decreased INR (clot risk)
B) Increased INR (bleeding risk)
C) No change
D) Increased platelet count
Answer B: Increased INR (bleeding risk)
Rationale: CYP2C9 inhibition reduces warfarin metabolism, increasing INR and
bleeding risk. Close monitoring is required.
9. A drug that is a weak acid will be ionized in which environment?
A) Acidic stomach (pH 2)
B) Alkaline environment (pH 8)
C) Both acidic and alkaline
D) Neither
William Paterson University | Complete 200-Question
Test Bank | NGN-Style Questions & Case Scenarios |
2026/2027 Edition | 100% Pass Guarantee
1. A patient is started on a new medication that undergoes extensive first-
pass metabolism. Which route of administration would avoid first-pass
effect?
A) Oral
B) Sublingual or IV
C) Rectal
D) Intramuscular
Answer B: Sublingual or IV
Rationale: Sublingual and IV routes bypass the hepatic portal system, avoiding
first-pass metabolism. Oral drugs undergo extensive first-pass.
2. The half-life of a drug is 6 hours. How many half-lives are needed to reach
steady state?
A) 2
B) 3
C) 4-5
D) 6
Answer C: 4-5
,Rationale: Steady state is achieved after approximately 4-5 half-lives. At that
point, drug accumulation and elimination are balanced.
3. A drug has a volume of distribution (Vd) of 50 L. This large Vd suggests
that the drug:
A) Is highly protein bound
B) Is extensively distributed into tissues
C) Has a short half-life
D) Is eliminated rapidly
Answer B: Is extensively distributed into tissues
Rationale: Large Vd indicates that the drug has left the plasma and is
concentrated in tissues. Small Vd suggests plasma binding.
4. Which of the following is an example of a competitive antagonist?
A) A drug that binds irreversibly to the receptor
B) A drug that binds reversibly to the same receptor site as the agonist
C) A drug that binds to a different receptor site
D) A drug that has intrinsic activity
Answer B: A drug that binds reversibly to the same receptor site as the
agonist
Rationale: Competitive antagonists bind reversibly to the same receptor site,
blocking agonist binding. They can be overcome by increasing agonist
concentration.
,5. The therapeutic index (TI) of a drug is defined as:
A) The dose required to produce a therapeutic effect
B) The ratio of the lethal dose (LD50) to the effective dose (ED50)
C) The amount of drug that reaches systemic circulation
D) The time required for half of the drug to be eliminated
Answer B: The ratio of the lethal dose (LD50) to the effective dose (ED50)
Rationale: TI = LD50/ED50. A larger TI indicates a safer drug. Narrow TI drugs
require monitoring.
6. A patient with renal impairment is prescribed a medication excreted
primarily via the kidneys. The nurse anticipates the provider will:
A) Increase the dose
B) Decrease the dose or lengthen the dosing interval
C) Administer the drug with food
D) Discontinue the drug
Answer B: Decrease the dose or lengthen the dosing interval
Rationale: Renal impairment reduces drug clearance, leading to accumulation and
toxicity. Dose adjustment or prolonged intervals are needed.
7. Which cytochrome P450 enzyme is responsible for the metabolism of most
drugs?
, A) CYP1A2
B) CYP3A4
C) CYP2D6
D) CYP2C9
Answer B: CYP3A4
Rationale: CYP3A4 metabolizes approximately 50% of all drugs, including many
statins, calcium channel blockers, and immunosuppressants.
8. A patient on warfarin is started on an antibiotic that inhibits CYP2C9. The
nurse should monitor for:
A) Decreased INR (clot risk)
B) Increased INR (bleeding risk)
C) No change
D) Increased platelet count
Answer B: Increased INR (bleeding risk)
Rationale: CYP2C9 inhibition reduces warfarin metabolism, increasing INR and
bleeding risk. Close monitoring is required.
9. A drug that is a weak acid will be ionized in which environment?
A) Acidic stomach (pH 2)
B) Alkaline environment (pH 8)
C) Both acidic and alkaline
D) Neither
