1|Page
NUR 615 MIDTERM EXAM (UTICA) NEWEST 2026/ 2027
ACTUAL EXAM TEST BANK| NUR615 ADVANCED
PHARMACOLOGY I MIDTERM EXAM REVIEW WITH
COMPLETE 300 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
A patient with atrial fibrillation takes a medication primarily eliminated
by the kidneys. Serum creatinine rises substantially after dehydration.
Which pharmacokinetic change creates the greatest toxicity concern?
A. Increased clearance
B. Decreased clearance
C. Increased absorption
D. Reduced protein binding - Correct Answer – B. Decreased clearance
Reduced renal function decreases elimination of renally cleared drugs,
increasing accumulation and toxicity risk.
A patient receiving an aminoglycoside develops increasing creatinine
and reduced urine output. Which additional finding would most strongly
support medication-related toxicity?
A. Improved hearing
B. Rising drug concentration
C. Reduced blood pressure only
D. Increased appetite - Correct Answer – B. Rising drug concentration
Aminoglycosides have concentration-dependent toxicity concerns and
are primarily renally eliminated; impaired renal clearance can increase
concentrations.
pg. 1
,2|Page
A patient taking lisinopril has potassium of 5.9 mEq/L. Which
pharmacologic effect most directly contributes?
A. Increased aldosterone activity
B. Reduced aldosterone activity
C. Increased sodium excretion from the distal nephron
D. Increased potassium secretion - Correct Answer – B. Reduced
aldosterone activity
RAAS blockade decreases aldosterone production, reducing renal
potassium excretion and potentially causing hyperkalemia.
A patient taking warfarin develops a markedly elevated INR after
starting trimethoprim-sulfamethoxazole. Which pharmacologic principle
best explains the increased anticoagulant effect?
A. Enzyme inhibition
B. Receptor downregulation
C. Renal induction
D. Protein synthesis - Correct Answer - A. Enzyme inhibition
Inhibition of warfarin metabolism can increase systemic exposure and
anticoagulant effect, resulting in an elevated INR.
A medication's volume of distribution is 20 L and the desired plasma
concentration is 4 mg/L. Assuming complete distribution and no
loading-dose adjustment, what loading dose is required?
A. 5 mg
B. 40 mg
C. 80 mg
D. 100 mg - Correct Answer – C. 80 mg
pg. 2
,3|Page
Loading dose = target concentration × Vd = 4 mg/L × 20 L = 80 mg.
A patient takes levothyroxine every morning with breakfast and
continues to have an elevated TSH despite an apparently adequate
prescribed dose. Which change is most appropriate to improve
absorption?
A. Take it with calcium
B. Take it with iron
C. Take it on an empty stomach
D. Take it immediately after a high-fiber meal - Correct Answer – C.
Take it on an empty stomach
Levothyroxine absorption is reduced by food and several interacting
substances; consistent administration on an empty stomach improves
predictable absorption.
A medication has a half-life of 6 hours. A patient receives 160 mg once.
Approximately how much remains after 18 hours?
A. 80 mg
B. 40 mg
C. 20 mg
D. 10 mg - Correct Answer - C - 20 mg
Three half-lives occur in 18 hours: 160 → 80 → 40 → 20 mg.
A patient taking a nonselective β-blocker develops wheezing shortly
after administration. Which pharmacologic property best explains the
reaction?
A. β2 blockade
pg. 3
, 4|Page
B. α2 stimulation
C. Muscarinic stimulation
D. Histamine blockade - Correct Answer – A. β2 blockade
Blocking β2 receptors in bronchial smooth muscle can promote
bronchoconstriction, particularly in susceptible patients.
A patient receiving an IV infusion is prescribed 1,350 units/hr. The
available solution contains 25,000 units in 500 mL. What pump rate is
required?
A. 13.5 mL/hr
B. 20 mL/hr
C. 27 mL/hr
D. 54 mL/hr - Correct Answer – C. 27 mL/hr
Concentration = 25,000 ÷ 500 = 50 units/mL. Then 1,350 ÷ 50 = 27
mL/hr.
A patient with heart failure takes furosemide and develops potassium of
2.8 mEq/L. Which additional medication would require particular
caution because hypokalemia increases its toxicity?
A. Digoxin
B. Acetaminophen
C. Amoxicillin
D. Levothyroxine - Correct Answer - A. Digoxin
Hypokalemia increases myocardial sensitivity to digoxin and raises the
risk of digoxin toxicity.
pg. 4
NUR 615 MIDTERM EXAM (UTICA) NEWEST 2026/ 2027
ACTUAL EXAM TEST BANK| NUR615 ADVANCED
PHARMACOLOGY I MIDTERM EXAM REVIEW WITH
COMPLETE 300 REAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS/ ALREADY GRADED
A+ (MOST RECENT!!)
A patient with atrial fibrillation takes a medication primarily eliminated
by the kidneys. Serum creatinine rises substantially after dehydration.
Which pharmacokinetic change creates the greatest toxicity concern?
A. Increased clearance
B. Decreased clearance
C. Increased absorption
D. Reduced protein binding - Correct Answer – B. Decreased clearance
Reduced renal function decreases elimination of renally cleared drugs,
increasing accumulation and toxicity risk.
A patient receiving an aminoglycoside develops increasing creatinine
and reduced urine output. Which additional finding would most strongly
support medication-related toxicity?
A. Improved hearing
B. Rising drug concentration
C. Reduced blood pressure only
D. Increased appetite - Correct Answer – B. Rising drug concentration
Aminoglycosides have concentration-dependent toxicity concerns and
are primarily renally eliminated; impaired renal clearance can increase
concentrations.
pg. 1
,2|Page
A patient taking lisinopril has potassium of 5.9 mEq/L. Which
pharmacologic effect most directly contributes?
A. Increased aldosterone activity
B. Reduced aldosterone activity
C. Increased sodium excretion from the distal nephron
D. Increased potassium secretion - Correct Answer – B. Reduced
aldosterone activity
RAAS blockade decreases aldosterone production, reducing renal
potassium excretion and potentially causing hyperkalemia.
A patient taking warfarin develops a markedly elevated INR after
starting trimethoprim-sulfamethoxazole. Which pharmacologic principle
best explains the increased anticoagulant effect?
A. Enzyme inhibition
B. Receptor downregulation
C. Renal induction
D. Protein synthesis - Correct Answer - A. Enzyme inhibition
Inhibition of warfarin metabolism can increase systemic exposure and
anticoagulant effect, resulting in an elevated INR.
A medication's volume of distribution is 20 L and the desired plasma
concentration is 4 mg/L. Assuming complete distribution and no
loading-dose adjustment, what loading dose is required?
A. 5 mg
B. 40 mg
C. 80 mg
D. 100 mg - Correct Answer – C. 80 mg
pg. 2
,3|Page
Loading dose = target concentration × Vd = 4 mg/L × 20 L = 80 mg.
A patient takes levothyroxine every morning with breakfast and
continues to have an elevated TSH despite an apparently adequate
prescribed dose. Which change is most appropriate to improve
absorption?
A. Take it with calcium
B. Take it with iron
C. Take it on an empty stomach
D. Take it immediately after a high-fiber meal - Correct Answer – C.
Take it on an empty stomach
Levothyroxine absorption is reduced by food and several interacting
substances; consistent administration on an empty stomach improves
predictable absorption.
A medication has a half-life of 6 hours. A patient receives 160 mg once.
Approximately how much remains after 18 hours?
A. 80 mg
B. 40 mg
C. 20 mg
D. 10 mg - Correct Answer - C - 20 mg
Three half-lives occur in 18 hours: 160 → 80 → 40 → 20 mg.
A patient taking a nonselective β-blocker develops wheezing shortly
after administration. Which pharmacologic property best explains the
reaction?
A. β2 blockade
pg. 3
, 4|Page
B. α2 stimulation
C. Muscarinic stimulation
D. Histamine blockade - Correct Answer – A. β2 blockade
Blocking β2 receptors in bronchial smooth muscle can promote
bronchoconstriction, particularly in susceptible patients.
A patient receiving an IV infusion is prescribed 1,350 units/hr. The
available solution contains 25,000 units in 500 mL. What pump rate is
required?
A. 13.5 mL/hr
B. 20 mL/hr
C. 27 mL/hr
D. 54 mL/hr - Correct Answer – C. 27 mL/hr
Concentration = 25,000 ÷ 500 = 50 units/mL. Then 1,350 ÷ 50 = 27
mL/hr.
A patient with heart failure takes furosemide and develops potassium of
2.8 mEq/L. Which additional medication would require particular
caution because hypokalemia increases its toxicity?
A. Digoxin
B. Acetaminophen
C. Amoxicillin
D. Levothyroxine - Correct Answer - A. Digoxin
Hypokalemia increases myocardial sensitivity to digoxin and raises the
risk of digoxin toxicity.
pg. 4
