CEA NR568 / NR 568 Advanced
Pharmacology CEA Exam Prep Test Bank
150 Practice Questions with Verified
Answers & Detailed Rationales
Chamberlain University | 2026/2027
Update | A+ Graded
SECTION I: Pharmacokinetics & Pharmacodynamics (Questions 1-20)
1. Approximately how many days are required to achieve steady-state
warfarin levels?
A. 1 to 2 days
B. 24 hours
C. 7 to 9 days
D. 30 days
Correct Answer: C
Rationale: Steady state is reached after 4 to 5 half-lives. With a warfarin half-life
of about 36 to 42 hours, 5 half-lives equals 180 to 210 hours, or approximately 7.5
to 8 days. This is why warfarin requires bridging with heparin for acute
thromboembolism .
2. A patient is receiving a drug that undergoes zero-order kinetics (e.g.,
phenytoin at high doses). Which statement is correct?
,A. A constant fraction of drug is eliminated per unit time
B. Half-life remains constant regardless of dose
C. Drug accumulation does not occur
D. A constant amount of drug is eliminated per unit time, independent of
concentration
Correct Answer: D
Rationale: Zero-order kinetics means elimination rate is constant regardless of
concentration (e.g., phenytoin, ethanol). This leads to a concentration-dependent
half-life and risk of toxicity with dose increases .
3. A patient with a large amount of adipose tissue is started on a lipophilic
drug (e.g., diazepam). Compared to a lean patient, this patient will likely
have:
A. A smaller volume of distribution and shorter half-life
B. No difference in distribution
C. Faster elimination due to increased metabolism
D. A larger volume of distribution and prolonged half-life
Correct Answer: D
Rationale: Lipophilic drugs accumulate in adipose tissue, increasing the volume of
distribution (Vd) and prolonging elimination half-life. This is particularly relevant
in older adults with increased body fat percentage .
4. A patient is prescribed a drug that is a weak acid (pKa 4.5). In the acidic
environment of the stomach (pH 1.5), the drug will be:
A. Mostly ionized and not absorbed
B. Completely ionized and excreted
C. Precipitated as an insoluble salt
D. Mostly nonionized and absorbed rapidly
Correct Answer: D
,Rationale: Weak acids are nonionized (lipid-soluble) in acidic pH, favoring gastric
absorption. Weak bases are nonionized in alkaline environments, favoring
absorption in the small intestine .
5. A patient with renal impairment (CrCl 25 mL/min) requires a drug that is
90% renally excreted. The recommended dosing adjustment is to:
A. Increase the dose to achieve therapeutic levels
B. No adjustment needed
C. Double the loading dose
D. Reduce the dose or prolong the dosing interval proportionally to CrCl
Correct Answer: D
Rationale: When a drug is predominantly renally excreted, the dose should be
reduced or the interval prolonged proportionally to creatinine clearance to prevent
accumulation and toxicity .
6. A patient is prescribed a drug that follows one-compartment
pharmacokinetics. The drug is given intravenously. The elimination rate
constant (k) is 0.1 hr⁻¹. What is the half-life?
A. 0.693 hours
B. 1 hour
C. 10 hours
D. 6.93 hours
Correct Answer: D
Rationale: t½ = 0.693 / k = 0..1 = 6.93 hours. This relationship is
fundamental to pharmacokinetic calculations .
, 7. A patient is receiving an intravenous infusion of a drug that has reached
steady state. If the infusion rate is doubled, the new steady-state concentration
will be:
A. Halved
B. Unchanged
C. Increased by 50%
D. Doubled
Correct Answer: D
Rationale: Steady-state concentration is directly proportional to infusion rate (Css
= infusion rate / clearance). Doubling the infusion rate doubles the steady-state
concentration .
8. The provider notes that the bioavailability of propranolol is only about 25%
despite nearly complete gastrointestinal absorption. Which pharmacokinetic
phenomenon best explains the reduced bioavailability?
A. Plasma protein binding
B. Distribution into adipose tissue
C. Low oral absorption
D. First-pass hepatic metabolism
Correct Answer: D
Rationale: Propranolol undergoes extensive first-pass metabolism in the liver,
reducing its systemic bioavailability despite complete gastrointestinal absorption.
The liver metabolizes a significant portion of the drug before it reaches systemic
circulation .
9. A patient with cirrhosis and ascites has an increased volume of distribution
for hydrophilic drugs. Which drug would require a higher loading dose?
A. Diazepam (lipophilic)
B. Fentanyl (lipophilic)
Pharmacology CEA Exam Prep Test Bank
150 Practice Questions with Verified
Answers & Detailed Rationales
Chamberlain University | 2026/2027
Update | A+ Graded
SECTION I: Pharmacokinetics & Pharmacodynamics (Questions 1-20)
1. Approximately how many days are required to achieve steady-state
warfarin levels?
A. 1 to 2 days
B. 24 hours
C. 7 to 9 days
D. 30 days
Correct Answer: C
Rationale: Steady state is reached after 4 to 5 half-lives. With a warfarin half-life
of about 36 to 42 hours, 5 half-lives equals 180 to 210 hours, or approximately 7.5
to 8 days. This is why warfarin requires bridging with heparin for acute
thromboembolism .
2. A patient is receiving a drug that undergoes zero-order kinetics (e.g.,
phenytoin at high doses). Which statement is correct?
,A. A constant fraction of drug is eliminated per unit time
B. Half-life remains constant regardless of dose
C. Drug accumulation does not occur
D. A constant amount of drug is eliminated per unit time, independent of
concentration
Correct Answer: D
Rationale: Zero-order kinetics means elimination rate is constant regardless of
concentration (e.g., phenytoin, ethanol). This leads to a concentration-dependent
half-life and risk of toxicity with dose increases .
3. A patient with a large amount of adipose tissue is started on a lipophilic
drug (e.g., diazepam). Compared to a lean patient, this patient will likely
have:
A. A smaller volume of distribution and shorter half-life
B. No difference in distribution
C. Faster elimination due to increased metabolism
D. A larger volume of distribution and prolonged half-life
Correct Answer: D
Rationale: Lipophilic drugs accumulate in adipose tissue, increasing the volume of
distribution (Vd) and prolonging elimination half-life. This is particularly relevant
in older adults with increased body fat percentage .
4. A patient is prescribed a drug that is a weak acid (pKa 4.5). In the acidic
environment of the stomach (pH 1.5), the drug will be:
A. Mostly ionized and not absorbed
B. Completely ionized and excreted
C. Precipitated as an insoluble salt
D. Mostly nonionized and absorbed rapidly
Correct Answer: D
,Rationale: Weak acids are nonionized (lipid-soluble) in acidic pH, favoring gastric
absorption. Weak bases are nonionized in alkaline environments, favoring
absorption in the small intestine .
5. A patient with renal impairment (CrCl 25 mL/min) requires a drug that is
90% renally excreted. The recommended dosing adjustment is to:
A. Increase the dose to achieve therapeutic levels
B. No adjustment needed
C. Double the loading dose
D. Reduce the dose or prolong the dosing interval proportionally to CrCl
Correct Answer: D
Rationale: When a drug is predominantly renally excreted, the dose should be
reduced or the interval prolonged proportionally to creatinine clearance to prevent
accumulation and toxicity .
6. A patient is prescribed a drug that follows one-compartment
pharmacokinetics. The drug is given intravenously. The elimination rate
constant (k) is 0.1 hr⁻¹. What is the half-life?
A. 0.693 hours
B. 1 hour
C. 10 hours
D. 6.93 hours
Correct Answer: D
Rationale: t½ = 0.693 / k = 0..1 = 6.93 hours. This relationship is
fundamental to pharmacokinetic calculations .
, 7. A patient is receiving an intravenous infusion of a drug that has reached
steady state. If the infusion rate is doubled, the new steady-state concentration
will be:
A. Halved
B. Unchanged
C. Increased by 50%
D. Doubled
Correct Answer: D
Rationale: Steady-state concentration is directly proportional to infusion rate (Css
= infusion rate / clearance). Doubling the infusion rate doubles the steady-state
concentration .
8. The provider notes that the bioavailability of propranolol is only about 25%
despite nearly complete gastrointestinal absorption. Which pharmacokinetic
phenomenon best explains the reduced bioavailability?
A. Plasma protein binding
B. Distribution into adipose tissue
C. Low oral absorption
D. First-pass hepatic metabolism
Correct Answer: D
Rationale: Propranolol undergoes extensive first-pass metabolism in the liver,
reducing its systemic bioavailability despite complete gastrointestinal absorption.
The liver metabolizes a significant portion of the drug before it reaches systemic
circulation .
9. A patient with cirrhosis and ascites has an increased volume of distribution
for hydrophilic drugs. Which drug would require a higher loading dose?
A. Diazepam (lipophilic)
B. Fentanyl (lipophilic)
