NURS 6521 Advanced Pharmacology
Midterm Exam
150 Practice Questions with Detailed
Rationales
Latest Update – Walden University
This comprehensive practice exam reflects the NURS
6521 Advanced Pharmacology midterm format,
covering pharmacokinetics, pharmacodynamics,
antimicrobial agents, cardiovascular pharmacology,
endocrine drugs, CNS medications, and special
population considerations .
SECTION 1: PHARMACOKINETICS &
PHARMACODYNAMICS (Questions 1-25)
A) Kidneys
B) Lungs
, C) Liver
D) Intestines
First-pass metabolism occurs when a drug is
metabolized in the liver before reaching systemic
circulation, reducing its bioavailability . Drugs administered
orally pass through the hepatic portal system and undergo
metabolism by hepatic enzymes, particularly the CYP450
system . This is why some drugs require higher oral doses
than intravenous doses to achieve therapeutic effects.
A) Kidneys are responsible for drug excretion, not first-
pass metabolism.
B) Lungs are involved in elimination of volatile drugs but
not primary first-pass metabolism.
D) Intestinal metabolism occurs to a lesser extent through
enteric enzymes and gut microbiome, but the liver is the
primary site .
A) The distribution of a drug to target tissues
B) The amount of active drug that reaches systemic
,circulation
C) The rate at which a drug is metabolized
D) The time required for drug excretion
Bioavailability is the fraction of the
administered drug dose that reaches systemic circulation
in its unchanged, active form . Intravenous administration
has 100% bioavailability because the drug bypasses
absorption barriers. Oral bioavailability is affected by first-
pass metabolism, drug solubility, and formulation factors .
A) Its potency at receptor sites
B) Its duration of action and dosing interval
C) The rate of drug absorption
D) The extent of protein binding
Half-life (t½) is the time required for plasma
concentration to decrease by 50%. It determines dosing
frequency and time to reach steady state . Drugs with
, shorter half-lives require more frequent dosing, while
longer half-lives allow once-daily or extended-interval
dosing .
A) Less frequent dosing
B) More frequent dosing to maintain therapeutic levels
C) No maintenance dosing
D) A loading dose only
Drugs with short half-lives are eliminated
rapidly, requiring frequent dosing to maintain
concentrations within the therapeutic range . Examples
include morphine (t½ 2-4 hours), requiring q4h dosing .
A) Increased renal clearance
B) Increased hepatic metabolism
Midterm Exam
150 Practice Questions with Detailed
Rationales
Latest Update – Walden University
This comprehensive practice exam reflects the NURS
6521 Advanced Pharmacology midterm format,
covering pharmacokinetics, pharmacodynamics,
antimicrobial agents, cardiovascular pharmacology,
endocrine drugs, CNS medications, and special
population considerations .
SECTION 1: PHARMACOKINETICS &
PHARMACODYNAMICS (Questions 1-25)
A) Kidneys
B) Lungs
, C) Liver
D) Intestines
First-pass metabolism occurs when a drug is
metabolized in the liver before reaching systemic
circulation, reducing its bioavailability . Drugs administered
orally pass through the hepatic portal system and undergo
metabolism by hepatic enzymes, particularly the CYP450
system . This is why some drugs require higher oral doses
than intravenous doses to achieve therapeutic effects.
A) Kidneys are responsible for drug excretion, not first-
pass metabolism.
B) Lungs are involved in elimination of volatile drugs but
not primary first-pass metabolism.
D) Intestinal metabolism occurs to a lesser extent through
enteric enzymes and gut microbiome, but the liver is the
primary site .
A) The distribution of a drug to target tissues
B) The amount of active drug that reaches systemic
,circulation
C) The rate at which a drug is metabolized
D) The time required for drug excretion
Bioavailability is the fraction of the
administered drug dose that reaches systemic circulation
in its unchanged, active form . Intravenous administration
has 100% bioavailability because the drug bypasses
absorption barriers. Oral bioavailability is affected by first-
pass metabolism, drug solubility, and formulation factors .
A) Its potency at receptor sites
B) Its duration of action and dosing interval
C) The rate of drug absorption
D) The extent of protein binding
Half-life (t½) is the time required for plasma
concentration to decrease by 50%. It determines dosing
frequency and time to reach steady state . Drugs with
, shorter half-lives require more frequent dosing, while
longer half-lives allow once-daily or extended-interval
dosing .
A) Less frequent dosing
B) More frequent dosing to maintain therapeutic levels
C) No maintenance dosing
D) A loading dose only
Drugs with short half-lives are eliminated
rapidly, requiring frequent dosing to maintain
concentrations within the therapeutic range . Examples
include morphine (t½ 2-4 hours), requiring q4h dosing .
A) Increased renal clearance
B) Increased hepatic metabolism
