NR 508 ADVANCED PHARMACOLOGY
PRACTICE EXAM QUESTION AND
ANSWERS
1. A patient is prescribed a drug that is a known CYP450 enzyme inducer. What effect will this
have on a co-administered drug that is metabolized by the same enzyme path?
A. The plasma concentration of the second drug will decrease.
B. The plasma concentration of the second drug will increase.
C. The half-life of the second drug will be prolonged.
D. There will be no change in the metabolic rate of the second drug.
Answer: A
Conceptual Explanation: Enzyme inducers increase the metabolic activity of CYP450
enzymes, leading to faster breakdown and lower plasma levels of drugs metabolized by
those enzymes.
,2. Which of the following describes the ‘first-pass effect’ in pharmacology?
A. The rapid distribution of a drug to the brain.
B. The excretion of a drug through the kidneys on the first cycle.
C. The binding of a drug to plasma proteins upon administration.
D. The metabolism of a drug in the liver before it reaches systemic circulation.
Answer: D
Conceptual Explanation: The first-pass effect occurs when an oral drug is absorbed from
the GI tract and carried to the liver via the portal vein, where it is extensively metabolized
before reaching the rest of the body.
3. An elderly patient is being prescribed a new medication. Which physiological change
associated with aging most significantly impacts drug distribution?
A. Increased total body water.
B. Decreased serum albumin levels.
C. Decreased percentage of body fat.
D. Increased glomerular filtration rate.
Answer: B
Conceptual Explanation: Aging often leads to decreased serum albumin, which increases
the free fraction of protein-bound drugs, potentially leading to toxicity.
, 4. Which class of antihypertensive medications is contraindicated in a patient with a history
of angioedema?
A. Calcium Channel Blockers
B. Thiazide Diuretics
C. ACE Inhibitors
D. Beta-Blockers
Answer: C
Conceptual Explanation: ACE inhibitors increase bradykinin levels, which can trigger life-
threatening angioedema. A history of this reaction is an absolute contraindication.
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. Delaying the absorption of carbohydrates in the small intestine.
D. Decreasing hepatic glucose production and improving insulin sensitivity.
Answer: D
Conceptual Explanation: Metformin primarily works by reducing gluconeogenesis in the
liver and increasing peripheral glucose uptake by improving insulin sensitivity.
PRACTICE EXAM QUESTION AND
ANSWERS
1. A patient is prescribed a drug that is a known CYP450 enzyme inducer. What effect will this
have on a co-administered drug that is metabolized by the same enzyme path?
A. The plasma concentration of the second drug will decrease.
B. The plasma concentration of the second drug will increase.
C. The half-life of the second drug will be prolonged.
D. There will be no change in the metabolic rate of the second drug.
Answer: A
Conceptual Explanation: Enzyme inducers increase the metabolic activity of CYP450
enzymes, leading to faster breakdown and lower plasma levels of drugs metabolized by
those enzymes.
,2. Which of the following describes the ‘first-pass effect’ in pharmacology?
A. The rapid distribution of a drug to the brain.
B. The excretion of a drug through the kidneys on the first cycle.
C. The binding of a drug to plasma proteins upon administration.
D. The metabolism of a drug in the liver before it reaches systemic circulation.
Answer: D
Conceptual Explanation: The first-pass effect occurs when an oral drug is absorbed from
the GI tract and carried to the liver via the portal vein, where it is extensively metabolized
before reaching the rest of the body.
3. An elderly patient is being prescribed a new medication. Which physiological change
associated with aging most significantly impacts drug distribution?
A. Increased total body water.
B. Decreased serum albumin levels.
C. Decreased percentage of body fat.
D. Increased glomerular filtration rate.
Answer: B
Conceptual Explanation: Aging often leads to decreased serum albumin, which increases
the free fraction of protein-bound drugs, potentially leading to toxicity.
, 4. Which class of antihypertensive medications is contraindicated in a patient with a history
of angioedema?
A. Calcium Channel Blockers
B. Thiazide Diuretics
C. ACE Inhibitors
D. Beta-Blockers
Answer: C
Conceptual Explanation: ACE inhibitors increase bradykinin levels, which can trigger life-
threatening angioedema. A history of this reaction is an absolute contraindication.
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. Delaying the absorption of carbohydrates in the small intestine.
D. Decreasing hepatic glucose production and improving insulin sensitivity.
Answer: D
Conceptual Explanation: Metformin primarily works by reducing gluconeogenesis in the
liver and increasing peripheral glucose uptake by improving insulin sensitivity.
