• NUR 670 - APEA 09/09/2026
EXAM
NUR 670 - APEA PRETEST 1 TEST BANK
NEWEST 2026/2027 ACTUAL EXAM COMPLETE
680 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
1. The PMHNP knows that the study of how the body absorbs, distributes, metabolizes,
and excretes a medication is known as:
A. Breakdown
B. Pharmacokinetics
C. Pharmacodynamics
D. First-pass effect
P 1
, • NUR 670 - APEA 09/09/2026
EXAM
B. Pharmacokinetics
Answer B. Pharmacokinetics is the study of what the body does to a drug concerning
absorption, distribution, metabolism, and excretion (ADME). The breakdown is one
aspect of metabolism in which the drug is prepared for bodily excretion.
Pharmacodynamics is the study of the relationship between drug concentration and
effect on the body. First-pass effect is the uptake and conversion of the drug in the
liver after enteric absorption.
2. After a drug is absorbed the substrate binds to protein for transport. Which portion of
the drug is available for therapeutic effects?
A. Bound
B. Unbound
C. Metabolized
D. Excreted
B. Unbound
Answer B. Unbound drug is the portion of the drug available for therapeutic effects.
Bound is the part of the drug that binds to protein and fat in preparation for excretion.
Metabolization is the process in which a drug is prepared for excretion. Excretion is
the process in which a substance leaves the body.
3. A 19-year-old male is referred to the PMHNP by the student health office for alcohol
use disorder. The patient states that on one occasion he passed out much sooner
than he usually would with far less than he would usually drink. Upon further
interview, the patient reveals the time he passed out was during a fraternity hazing
in which he was butt-chugging (receiving a beer and vodka enema). What
pharmacokinetic process was bypassed by this rectal administration route?
A. Excretion
B. Absorption
C. Distribution
D. First-pass effect
D. First-pass effect
Answer D. The first-pass effect is the precirculation process of uptake and
conversion by which a substrate is significantly reduced through the CYP450
pathway. Nonenteric routes of administration bypass this effect. Excretion is the
process by which substances leave the body. Absorption is the movement of the drug
P 2
, • NUR 670 - APEA 09/09/2026
EXAM
into the bloodstream. Distribution is the movement of the drug through the
bloodstream to target receptors where protein binding occurs.
4. The PMHNP is monitoring a serum drug level for a medication with a 24-hour
half-life. How many hours will it take to reach steady state?
A. 48 hours
B. 72 hours
C. 96 hours
D. 120 hours
D. 120 hours
Answer D. 120 hours; steady state is achieved in five half-lives of the medication (5 × 24 = 120).
5. A patient with schizophrenia was discharged from the hospital on olanzapine 5 mg
twice a day. He immediately resumed smoking cigarettes and escalated to one pack
per day. Upon presenting for his 1-week follow-up appointment, the patient reports
he is having trouble sleeping and the voices have started to return. Which of the
following actions should the PMHNP take?
A. Send the patient to the ED for stabilization
B. Change to another antipsychotic medication, and refer to a psychiatrist
C. Increase his olanzapine, and schedule a follow-up visit in 2 days
D. Tell him to stop smoking and give him a nicotine patch
C. Increase his olanzapine, and schedule a follow-up visit in 2 days
Answer C. Increase his olanzapine and schedule a follow up visit because the
patient's symptoms are no longer controlled and smoking is a known inducer of the
CYP450 pathway. The patient has not indicated a threat of harm to self or others;
changing to another antipsychotic medication requires retitration and is not indicated.
Telling a patient to stop smoking may trigger a psychological paradox and can erode
therapeutic alliance.
6. A patient who has been stable on quetiapine (Seroquel XR) for 3 months has decided
to start to drink grapefruit juice twice daily because she has heard it helps with
weight loss. She calls to report that since her new diet she has been feeling fatigue
P 3
, • NUR 670 - APEA 09/09/2026
EXAM
and difficulty waking up in the morning. What is the best response by the PMHNP?
A. "I will put in a new prescription for a lower dose of your medication."
B. "Stop drinking the grapefruit juice, and schedule an appointment to discuss the
matter further."
C. "I will prescribe you a stimulant, and see you in 2 weeks."
D. "You should make an appointment with your primary care provider for
evaluation."
B. "Stop drinking the grapefruit juice, and schedule an appointment to discuss the
matter further."
Answer B. Stop drinking the grapefruit juice and schedule an appointment to discuss
weight gain/weight loss. Grapefruit is a known inhibitor of the CYP450 pathway;
stopping this will reduce the sedation over time. It is not appropriate to prescribe this
patient a stimulant as the cause has not been determined. Deferring the patient to
primary care is not suitable as there is a potential psychotropic drug interaction.
7. A 79-year-old female with no past psychiatric history is admitted with new onset
auditory hallucinations. The patient states her most bothersome symptom is the
voices, which have kept her from sleeping through the night for the last 3 weeks,
and as a result, she is tired and irritable. Which medication should the PMHNP
order for bedtime for sleep?
A. Olanzapine 2.5 mg PO
B. Lorazepam 1 mg PO
C. Chlorpromazine 50 mg PO
D. Sertraline 50 mg PO
A. Olanzapine 2.5 mg PO
Answer A. Olanzapine is an atypical antipsychotic that can help the patient sleep. Because of the
patient's age, it is essential to start at a low dose and slowly titrate as tolerated. Benzodiazepines are
not preferred in the elderly as they increase risk especially at higher starting doses. Chlorpromazine
potentiates many anticholinergic effects particularly at high starting doses. Sertraline is not sedating,
and the dose should be started lower in the elderly.
B.
8. A 16-year-old male with a history of smoking cigarettes and marijuana is being
evaluated at the request of the school and parents. The child states that the reason
he smokes is it "helps calm me down" as he is anxious all the time. Which of the
following medications would be the best choice?
A. Fluoxetine 20 mg PO daily
B. Clonazepam 0.5 mg PO daily
P 4
EXAM
NUR 670 - APEA PRETEST 1 TEST BANK
NEWEST 2026/2027 ACTUAL EXAM COMPLETE
680 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
1. The PMHNP knows that the study of how the body absorbs, distributes, metabolizes,
and excretes a medication is known as:
A. Breakdown
B. Pharmacokinetics
C. Pharmacodynamics
D. First-pass effect
P 1
, • NUR 670 - APEA 09/09/2026
EXAM
B. Pharmacokinetics
Answer B. Pharmacokinetics is the study of what the body does to a drug concerning
absorption, distribution, metabolism, and excretion (ADME). The breakdown is one
aspect of metabolism in which the drug is prepared for bodily excretion.
Pharmacodynamics is the study of the relationship between drug concentration and
effect on the body. First-pass effect is the uptake and conversion of the drug in the
liver after enteric absorption.
2. After a drug is absorbed the substrate binds to protein for transport. Which portion of
the drug is available for therapeutic effects?
A. Bound
B. Unbound
C. Metabolized
D. Excreted
B. Unbound
Answer B. Unbound drug is the portion of the drug available for therapeutic effects.
Bound is the part of the drug that binds to protein and fat in preparation for excretion.
Metabolization is the process in which a drug is prepared for excretion. Excretion is
the process in which a substance leaves the body.
3. A 19-year-old male is referred to the PMHNP by the student health office for alcohol
use disorder. The patient states that on one occasion he passed out much sooner
than he usually would with far less than he would usually drink. Upon further
interview, the patient reveals the time he passed out was during a fraternity hazing
in which he was butt-chugging (receiving a beer and vodka enema). What
pharmacokinetic process was bypassed by this rectal administration route?
A. Excretion
B. Absorption
C. Distribution
D. First-pass effect
D. First-pass effect
Answer D. The first-pass effect is the precirculation process of uptake and
conversion by which a substrate is significantly reduced through the CYP450
pathway. Nonenteric routes of administration bypass this effect. Excretion is the
process by which substances leave the body. Absorption is the movement of the drug
P 2
, • NUR 670 - APEA 09/09/2026
EXAM
into the bloodstream. Distribution is the movement of the drug through the
bloodstream to target receptors where protein binding occurs.
4. The PMHNP is monitoring a serum drug level for a medication with a 24-hour
half-life. How many hours will it take to reach steady state?
A. 48 hours
B. 72 hours
C. 96 hours
D. 120 hours
D. 120 hours
Answer D. 120 hours; steady state is achieved in five half-lives of the medication (5 × 24 = 120).
5. A patient with schizophrenia was discharged from the hospital on olanzapine 5 mg
twice a day. He immediately resumed smoking cigarettes and escalated to one pack
per day. Upon presenting for his 1-week follow-up appointment, the patient reports
he is having trouble sleeping and the voices have started to return. Which of the
following actions should the PMHNP take?
A. Send the patient to the ED for stabilization
B. Change to another antipsychotic medication, and refer to a psychiatrist
C. Increase his olanzapine, and schedule a follow-up visit in 2 days
D. Tell him to stop smoking and give him a nicotine patch
C. Increase his olanzapine, and schedule a follow-up visit in 2 days
Answer C. Increase his olanzapine and schedule a follow up visit because the
patient's symptoms are no longer controlled and smoking is a known inducer of the
CYP450 pathway. The patient has not indicated a threat of harm to self or others;
changing to another antipsychotic medication requires retitration and is not indicated.
Telling a patient to stop smoking may trigger a psychological paradox and can erode
therapeutic alliance.
6. A patient who has been stable on quetiapine (Seroquel XR) for 3 months has decided
to start to drink grapefruit juice twice daily because she has heard it helps with
weight loss. She calls to report that since her new diet she has been feeling fatigue
P 3
, • NUR 670 - APEA 09/09/2026
EXAM
and difficulty waking up in the morning. What is the best response by the PMHNP?
A. "I will put in a new prescription for a lower dose of your medication."
B. "Stop drinking the grapefruit juice, and schedule an appointment to discuss the
matter further."
C. "I will prescribe you a stimulant, and see you in 2 weeks."
D. "You should make an appointment with your primary care provider for
evaluation."
B. "Stop drinking the grapefruit juice, and schedule an appointment to discuss the
matter further."
Answer B. Stop drinking the grapefruit juice and schedule an appointment to discuss
weight gain/weight loss. Grapefruit is a known inhibitor of the CYP450 pathway;
stopping this will reduce the sedation over time. It is not appropriate to prescribe this
patient a stimulant as the cause has not been determined. Deferring the patient to
primary care is not suitable as there is a potential psychotropic drug interaction.
7. A 79-year-old female with no past psychiatric history is admitted with new onset
auditory hallucinations. The patient states her most bothersome symptom is the
voices, which have kept her from sleeping through the night for the last 3 weeks,
and as a result, she is tired and irritable. Which medication should the PMHNP
order for bedtime for sleep?
A. Olanzapine 2.5 mg PO
B. Lorazepam 1 mg PO
C. Chlorpromazine 50 mg PO
D. Sertraline 50 mg PO
A. Olanzapine 2.5 mg PO
Answer A. Olanzapine is an atypical antipsychotic that can help the patient sleep. Because of the
patient's age, it is essential to start at a low dose and slowly titrate as tolerated. Benzodiazepines are
not preferred in the elderly as they increase risk especially at higher starting doses. Chlorpromazine
potentiates many anticholinergic effects particularly at high starting doses. Sertraline is not sedating,
and the dose should be started lower in the elderly.
B.
8. A 16-year-old male with a history of smoking cigarettes and marijuana is being
evaluated at the request of the school and parents. The child states that the reason
he smokes is it "helps calm me down" as he is anxious all the time. Which of the
following medications would be the best choice?
A. Fluoxetine 20 mg PO daily
B. Clonazepam 0.5 mg PO daily
P 4
