NR 508 ADVANCED PHARMACOLOGY
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. A patient is prescribed a drug with a high first-pass effect. Which route of administration
would result in the lowest bioavailability?
A. Intravenous
B. Sublingual
C. Oral
D. Intramuscular
Answer: C
Conceptual Explanation: Drugs taken orally pass through the portal circulation to the
liver before reaching systemic circulation, where they may be extensively metabolized,
reducing bioavailability.
2. Which cytochrome P450 enzyme is responsible for the metabolism of approximately 50%
of all clinically used drugs?
A. CYP2D6
,B. CYP1A2
C. CYP3A4
D. CYP2C19
Answer: C
Conceptual Explanation: CYP3A4 is the most abundant CYP enzyme in the liver and is
involved in the metabolism of roughly half of all prescribed medications.
3. A patient with heart failure is prescribed an ACE inhibitor. Which electrolyte abnormality
should the provider monitor for most closely?
A. Hyponatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors reduce aldosterone secretion, which leads to
potassium retention, potentially resulting in hyperkalemia.
4. When prescribing a statin for hyperlipidemia, which laboratory test is essential to monitor
if the patient reports new-onset muscle pain?
A. Serum Creatinine
B. Creatine Kinase (CK)
, C. Alanine Aminotransferase (ALT)
D. C-Reactive Protein
Answer: B
Conceptual Explanation: Elevated CK levels can indicate myopathy or rhabdomyolysis, a
known serious side effect of statin therapy.
5. What is the primary mechanism of action of Metformin in the treatment of Type 2
Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells
B. Increasing glucose excretion via the kidneys
C. Decreasing hepatic glucose production
D. Inhibiting alpha-glucosidase in the intestine
Answer: C
Conceptual Explanation: Metformin primarily works by decreasing gluconeogenesis in
the liver and increasing peripheral insulin sensitivity.
6. Which class of antidepressants is associated with the highest risk of hypertensive crisis
when consumed with tyramine-rich foods?
A. SSRIs
B. SNRIs
C. MAOIs
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. A patient is prescribed a drug with a high first-pass effect. Which route of administration
would result in the lowest bioavailability?
A. Intravenous
B. Sublingual
C. Oral
D. Intramuscular
Answer: C
Conceptual Explanation: Drugs taken orally pass through the portal circulation to the
liver before reaching systemic circulation, where they may be extensively metabolized,
reducing bioavailability.
2. Which cytochrome P450 enzyme is responsible for the metabolism of approximately 50%
of all clinically used drugs?
A. CYP2D6
,B. CYP1A2
C. CYP3A4
D. CYP2C19
Answer: C
Conceptual Explanation: CYP3A4 is the most abundant CYP enzyme in the liver and is
involved in the metabolism of roughly half of all prescribed medications.
3. A patient with heart failure is prescribed an ACE inhibitor. Which electrolyte abnormality
should the provider monitor for most closely?
A. Hyponatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors reduce aldosterone secretion, which leads to
potassium retention, potentially resulting in hyperkalemia.
4. When prescribing a statin for hyperlipidemia, which laboratory test is essential to monitor
if the patient reports new-onset muscle pain?
A. Serum Creatinine
B. Creatine Kinase (CK)
, C. Alanine Aminotransferase (ALT)
D. C-Reactive Protein
Answer: B
Conceptual Explanation: Elevated CK levels can indicate myopathy or rhabdomyolysis, a
known serious side effect of statin therapy.
5. What is the primary mechanism of action of Metformin in the treatment of Type 2
Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells
B. Increasing glucose excretion via the kidneys
C. Decreasing hepatic glucose production
D. Inhibiting alpha-glucosidase in the intestine
Answer: C
Conceptual Explanation: Metformin primarily works by decreasing gluconeogenesis in
the liver and increasing peripheral insulin sensitivity.
6. Which class of antidepressants is associated with the highest risk of hypertensive crisis
when consumed with tyramine-rich foods?
A. SSRIs
B. SNRIs
C. MAOIs
