NURS 3209 PHARMACOLOGY FUNDAMENTALS EXAM PRACTICE
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES Q&A INSTANT DOWNLOAD PDF
150 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply pharmacokinetic and pharmacodynamic principles to predict drug behavior and interactions
2 Evaluate adverse drug reactions and toxicity management across major drug classes
3 Integrate patient-specific factors (e
4 Critically analyze complex clinical scenarios to make evidence-based pharmacological decisions
5 NURS 3209 Pharmacology Fundamentals Exam Practice Questions And Correct Answers
6 Verified Answers
7 Plus Rationales Q&A Instant Download Pdf
8 Foundations of Nursing Pharmacology
9 Applied Nursing Pharmacology
10 Advanced Nursing Pharmacology
11 Nursing Pharmacology Review
Page 1
,Q1 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
A patient on warfarin is started on metronidazole for an anaerobic infection. Three
days later, the INR is 5.2. What is the most likely mechanism for this interaction?
A. Metronidazole increases warfarin absorption from the gut.
B. Metronidazole inhibits CYP2C9, reducing warfarin metabolism. CORRECT
C. Metronidazole displaces warfarin from plasma albumin.
D. Metronidazole reduces vitamin K absorption from the colon.
RATIONALE: Metronidazole is a potent inhibitor of CYP2C9, the enzyme responsible for
metabolizing the S-enantiomer of warfarin. This inhibition leads to increased warfarin plasma
levels and enhanced anticoagulant effect, elevating INR. The other options are not mechanisms
of this interaction.
Q2 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
Which pharmacokinetic parameter would be most altered in a patient with
end-stage renal disease receiving a drug that is primarily eliminated unchanged by
the kidneys?
A. Bioavailability (F)
B. Volume of distribution (Vd)
C. Half-life (t1/2) CORRECT
D. Peak plasma concentration (Cmax)
RATIONALE: Renal impairment reduces the elimination rate constant (ke) for renally cleared
drugs, directly prolonging the half-life. While Vd and Cmax can be affected by fluid shifts or
protein binding changes, the primary effect on a renally eliminated drug is on half-life and
clearance. Bioavailability is more related to absorption and first-pass metabolism.
Page 2
,Q3 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
A patient on digoxin develops nausea, visual halos, and bradycardia. Which
laboratory value is most likely to be elevated, and what is the first-line treatment
for severe toxicity?
A. Potassium; administer lidocaine
B. Digoxin level; administer digoxin-specific Fab fragments CORRECT
C. Magnesium; administer magnesium sulfate
D. Calcium; administer calcium gluconate
RATIONALE: The symptoms are classic for digoxin toxicity. Elevated digoxin levels confirm the
diagnosis. The antidote is digoxin-specific Fab fragments (Digibind). While potassium
abnormalities may occur, the immediate treatment for life-threatening toxicity is Fab fragments.
Lidocaine is for ventricular arrhythmias but not first-line for toxicity itself. Calcium administration
is contraindicated because it can worsen digoxin toxicity.
Q4 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
Which statement correctly contrasts the mechanism of action of
low-molecular-weight heparin (LMWH) with unfractionated heparin (UFH)?
A. LMWH inhibits thrombin more effectively than factor Xa.
B. LMWH binds to antithrombin III but has reduced ability to inactivate thrombin. CORRECT
C. UFH has a more predictable pharmacokinetic profile than LMWH.
D. UFH requires antithrombin III, while LMWH does not.
RATIONALE: LMWH primarily inhibits factor Xa via antithrombin III, with less thrombin inhibition
due to its shorter chain length. UFH inactivates both thrombin and factor Xa. LMWH has more
predictable pharmacokinetics, allowing fixed dosing. Both require antithrombin III for their
anticoagulant effect.
Page 3
, Q5 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
A patient with type 2 diabetes has chronic kidney disease (eGFR 25 mL/min).
Which antidiabetic agent is most contraindicated due to an increased risk of lactic
acidosis?
A. Sitagliptin
B. Metformin CORRECT
C. Glipizide
D. Empagliflozin
RATIONALE: Metformin is contraindicated when eGFR is below 30 mL/min because of the risk of
lactic acidosis. Sitagliptin requires dose adjustment but is not contraindicated. Glipizide may be
used with caution. Empagliflozin may have benefits in CKD but is not associated with lactic
acidosis.
Q6 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
Which opioid analgesic is most likely to cause serotonin syndrome when
combined with an MAO inhibitor?
A. Morphine
B. Fentanyl
C. Meperidine CORRECT
D. Oxycodone
RATIONALE: Meperidine inhibits synaptic reuptake of serotonin and, when combined with MAO
inhibitors, can precipitate serotonin syndrome. Other opioids like morphine, fentanyl, and
oxycodone have much weaker serotonergic activity and are less likely to cause this interaction.
Page 4
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES Q&A INSTANT DOWNLOAD PDF
150 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Apply pharmacokinetic and pharmacodynamic principles to predict drug behavior and interactions
2 Evaluate adverse drug reactions and toxicity management across major drug classes
3 Integrate patient-specific factors (e
4 Critically analyze complex clinical scenarios to make evidence-based pharmacological decisions
5 NURS 3209 Pharmacology Fundamentals Exam Practice Questions And Correct Answers
6 Verified Answers
7 Plus Rationales Q&A Instant Download Pdf
8 Foundations of Nursing Pharmacology
9 Applied Nursing Pharmacology
10 Advanced Nursing Pharmacology
11 Nursing Pharmacology Review
Page 1
,Q1 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
A patient on warfarin is started on metronidazole for an anaerobic infection. Three
days later, the INR is 5.2. What is the most likely mechanism for this interaction?
A. Metronidazole increases warfarin absorption from the gut.
B. Metronidazole inhibits CYP2C9, reducing warfarin metabolism. CORRECT
C. Metronidazole displaces warfarin from plasma albumin.
D. Metronidazole reduces vitamin K absorption from the colon.
RATIONALE: Metronidazole is a potent inhibitor of CYP2C9, the enzyme responsible for
metabolizing the S-enantiomer of warfarin. This inhibition leads to increased warfarin plasma
levels and enhanced anticoagulant effect, elevating INR. The other options are not mechanisms
of this interaction.
Q2 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
Which pharmacokinetic parameter would be most altered in a patient with
end-stage renal disease receiving a drug that is primarily eliminated unchanged by
the kidneys?
A. Bioavailability (F)
B. Volume of distribution (Vd)
C. Half-life (t1/2) CORRECT
D. Peak plasma concentration (Cmax)
RATIONALE: Renal impairment reduces the elimination rate constant (ke) for renally cleared
drugs, directly prolonging the half-life. While Vd and Cmax can be affected by fluid shifts or
protein binding changes, the primary effect on a renally eliminated drug is on half-life and
clearance. Bioavailability is more related to absorption and first-pass metabolism.
Page 2
,Q3 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
A patient on digoxin develops nausea, visual halos, and bradycardia. Which
laboratory value is most likely to be elevated, and what is the first-line treatment
for severe toxicity?
A. Potassium; administer lidocaine
B. Digoxin level; administer digoxin-specific Fab fragments CORRECT
C. Magnesium; administer magnesium sulfate
D. Calcium; administer calcium gluconate
RATIONALE: The symptoms are classic for digoxin toxicity. Elevated digoxin levels confirm the
diagnosis. The antidote is digoxin-specific Fab fragments (Digibind). While potassium
abnormalities may occur, the immediate treatment for life-threatening toxicity is Fab fragments.
Lidocaine is for ventricular arrhythmias but not first-line for toxicity itself. Calcium administration
is contraindicated because it can worsen digoxin toxicity.
Q4 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
Which statement correctly contrasts the mechanism of action of
low-molecular-weight heparin (LMWH) with unfractionated heparin (UFH)?
A. LMWH inhibits thrombin more effectively than factor Xa.
B. LMWH binds to antithrombin III but has reduced ability to inactivate thrombin. CORRECT
C. UFH has a more predictable pharmacokinetic profile than LMWH.
D. UFH requires antithrombin III, while LMWH does not.
RATIONALE: LMWH primarily inhibits factor Xa via antithrombin III, with less thrombin inhibition
due to its shorter chain length. UFH inactivates both thrombin and factor Xa. LMWH has more
predictable pharmacokinetics, allowing fixed dosing. Both require antithrombin III for their
anticoagulant effect.
Page 3
, Q5 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
A patient with type 2 diabetes has chronic kidney disease (eGFR 25 mL/min).
Which antidiabetic agent is most contraindicated due to an increased risk of lactic
acidosis?
A. Sitagliptin
B. Metformin CORRECT
C. Glipizide
D. Empagliflozin
RATIONALE: Metformin is contraindicated when eGFR is below 30 mL/min because of the risk of
lactic acidosis. Sitagliptin requires dose adjustment but is not contraindicated. Glipizide may be
used with caution. Empagliflozin may have benefits in CKD but is not associated with lactic
acidosis.
Q6 APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO PREDICT DRUG
BEHAVIOR AND INTERACTIONS
Which opioid analgesic is most likely to cause serotonin syndrome when
combined with an MAO inhibitor?
A. Morphine
B. Fentanyl
C. Meperidine CORRECT
D. Oxycodone
RATIONALE: Meperidine inhibits synaptic reuptake of serotonin and, when combined with MAO
inhibitors, can precipitate serotonin syndrome. Other opioids like morphine, fentanyl, and
oxycodone have much weaker serotonergic activity and are less likely to cause this interaction.
Page 4
