WGU D116 Advanced Pharmacology
Final Exam Objective Assessment
Questions and Answers
Question 1. Which route of administration provides 100%
bioavailability?
A. Oral
B. Sublingual
C. Intravenous
D. Rectal
Answer: C. Intravenous
Rationale: IV administration places the drug directly into the systemic
circulation, so there is no absorption phase and no first-pass loss. Every
other route carries some potential for incomplete absorption or presystemic
metabolism.
D116 Questions | Page 1
,Question 2. Nitroglycerin is given sublingually for acute angina
primarily because this route:
A. Increases plasma protein binding
B. Slows renal elimination
C. Converts the drug to an active prodrug
D. Bypasses extensive hepatic first-pass metabolism
Answer: D. Bypasses extensive hepatic first-pass metabolism
Rationale: Oral nitroglycerin is almost completely metabolized on its first
pass through the liver. Sublingual absorption delivers the drug straight into
the systemic circulation, giving rapid onset.
Question 3. A drug has an apparent volume of distribution of 400 L in
a 70-kg adult. This most likely indicates:
A. Confinement to the vascular compartment
B. Extensive distribution into tissues outside the plasma
C. Very rapid renal elimination
D. Very high binding to plasma albumin
Answer: B. Extensive distribution into tissues outside the plasma
Rationale: A Vd far greater than total body water (about 42 L) means the
drug is sequestered in tissues such as fat or muscle, leaving little in plasma.
Drugs confined to plasma have a Vd of roughly 3 to 5 L.
D116 Questions | Page 2
,Question 4. A drug has an elimination half-life of 8 hours and is given
without a loading dose. About how long until steady state is reached?
A. 32 to 40 hours
B. 8 hours
C. 16 hours
D. 80 to 100 hours
Answer: A. 32 to 40 hours
Rationale: Steady state is reached after about 4 to 5 half-lives (8 h x 4 to 5
= 32 to 40 h). The size of the dose changes the concentration achieved,
not the time needed to reach steady state.
Question 5. The loading dose of a drug is determined primarily by its:
A. Clearance
B. Elimination half-life alone
C. Volume of distribution
D. Renal function alone
Answer: C. Volume of distribution
Rationale: Loading dose = (target concentration x Vd) / bioavailability. It
fills the distribution space quickly. Clearance governs the maintenance
dose.
D116 Questions | Page 3
, Question 6. To maintain a target steady-state concentration, the
maintenance dosing rate is determined primarily by:
A. Clearance
B. Volume of distribution
C. Time to peak concentration
D. Receptor affinity
Answer: A. Clearance
Rationale: Maintenance dose rate = (clearance x target concentration) /
bioavailability. At steady state the rate of drug input equals the rate of
elimination, and clearance defines the elimination rate.
Question 7. Which drug exhibits saturable (zero-order, Michaelis-
Menten) kinetics within its therapeutic range?
A. Lisinopril
B. Amoxicillin
C. Atenolol
D. Phenytoin
Answer: D. Phenytoin
Rationale: Phenytoin's metabolizing enzymes saturate at therapeutic
concentrations, so a small dose increase can produce a disproportionately
large rise in serum level and toxicity (nystagmus, ataxia, confusion).
D116 Questions | Page 4
Final Exam Objective Assessment
Questions and Answers
Question 1. Which route of administration provides 100%
bioavailability?
A. Oral
B. Sublingual
C. Intravenous
D. Rectal
Answer: C. Intravenous
Rationale: IV administration places the drug directly into the systemic
circulation, so there is no absorption phase and no first-pass loss. Every
other route carries some potential for incomplete absorption or presystemic
metabolism.
D116 Questions | Page 1
,Question 2. Nitroglycerin is given sublingually for acute angina
primarily because this route:
A. Increases plasma protein binding
B. Slows renal elimination
C. Converts the drug to an active prodrug
D. Bypasses extensive hepatic first-pass metabolism
Answer: D. Bypasses extensive hepatic first-pass metabolism
Rationale: Oral nitroglycerin is almost completely metabolized on its first
pass through the liver. Sublingual absorption delivers the drug straight into
the systemic circulation, giving rapid onset.
Question 3. A drug has an apparent volume of distribution of 400 L in
a 70-kg adult. This most likely indicates:
A. Confinement to the vascular compartment
B. Extensive distribution into tissues outside the plasma
C. Very rapid renal elimination
D. Very high binding to plasma albumin
Answer: B. Extensive distribution into tissues outside the plasma
Rationale: A Vd far greater than total body water (about 42 L) means the
drug is sequestered in tissues such as fat or muscle, leaving little in plasma.
Drugs confined to plasma have a Vd of roughly 3 to 5 L.
D116 Questions | Page 2
,Question 4. A drug has an elimination half-life of 8 hours and is given
without a loading dose. About how long until steady state is reached?
A. 32 to 40 hours
B. 8 hours
C. 16 hours
D. 80 to 100 hours
Answer: A. 32 to 40 hours
Rationale: Steady state is reached after about 4 to 5 half-lives (8 h x 4 to 5
= 32 to 40 h). The size of the dose changes the concentration achieved,
not the time needed to reach steady state.
Question 5. The loading dose of a drug is determined primarily by its:
A. Clearance
B. Elimination half-life alone
C. Volume of distribution
D. Renal function alone
Answer: C. Volume of distribution
Rationale: Loading dose = (target concentration x Vd) / bioavailability. It
fills the distribution space quickly. Clearance governs the maintenance
dose.
D116 Questions | Page 3
, Question 6. To maintain a target steady-state concentration, the
maintenance dosing rate is determined primarily by:
A. Clearance
B. Volume of distribution
C. Time to peak concentration
D. Receptor affinity
Answer: A. Clearance
Rationale: Maintenance dose rate = (clearance x target concentration) /
bioavailability. At steady state the rate of drug input equals the rate of
elimination, and clearance defines the elimination rate.
Question 7. Which drug exhibits saturable (zero-order, Michaelis-
Menten) kinetics within its therapeutic range?
A. Lisinopril
B. Amoxicillin
C. Atenolol
D. Phenytoin
Answer: D. Phenytoin
Rationale: Phenytoin's metabolizing enzymes saturate at therapeutic
concentrations, so a small dose increase can produce a disproportionately
large rise in serum level and toxicity (nystagmus, ataxia, confusion).
D116 Questions | Page 4
