,NU 578 U1 Exam | Pharm for Adv Practice Nurses (2026/2027) Q&A | U South
Alabama
1. A nurse practitioner is reviewing the mechanism of action of a new medication. Which
term best describes the study of what the drug does to the body?
A) Pharmacokinetics
B) Pharmacodynamics
C) Pharmacotherapeutics
D) Pharmacogenomics
Correct Answer: Pharmacodynamics
Rationale: Pharmacodynamics is the study of the biochemical and physiological effects of
drugs on the body, including receptor binding and post-receptor effects. Pharmacokinetics
describes what the body does to the drug (absorption, distribution, metabolism, excretion).
Pharmacotherapeutics is the use of drugs to treat disease. Pharmacogenomics studies how
genes affect drug response.
2. A patient with severe liver cirrhosis is prescribed a medication that undergoes extensive
first-pass metabolism. What should the prescriber anticipate?
A) Decreased oral bioavailability
B) Increased oral bioavailability
C) No change in bioavailability
D) Increased renal excretion
Correct Answer: Increased oral bioavailability
Rationale: First-pass metabolism occurs in the liver. In severe liver disease, hepatic
extraction is reduced, allowing more of the drug to reach systemic circulation. This results in
increased oral bioavailability. Providers must anticipate the need for dose reduction to
prevent toxicity.
,3. A drug has a volume of distribution (Vd) of 0.2 L/kg. This indicates that the drug is
primarily:
A) Widely distributed into tissues
B) Confined to the plasma compartment
C) Accumulated in fat tissue
D) Bound extensively to tissues
Correct Answer: Confined to the plasma compartment
Rationale: A Vd of 0.05-0.2 L/kg indicates the drug remains primarily in the plasma
compartment. Total body water Vd is approximately 0.5 L/kg. High tissue binding would
increase Vd significantly. Lipid-soluble drugs that accumulate in fat have much larger Vd
values.
4. Which property of an ideal drug refers to its ability to elicit only the response for which it
is given?
A) Effectiveness
B) Safety
C) Selectivity
D) Reversible action
Correct Answer: Selectivity
Rationale: Selectivity is the ability of a drug to elicit only the response for which it is given,
minimizing unintended effects. Effectiveness refers to the drug producing the intended
therapeutic response. Safety means the drug does not produce harmful effects. Reversible
action means the drug's effects can be reversed.
5. A nurse is preparing to administer an oral medication that undergoes extensive first-pass
metabolism. Which route would bypass this effect?
A) Oral
B) Sublingual
, C) Rectal
D) Intravenous
Correct Answer: Intravenous
Rationale: First-pass effect refers to rapid hepatic inactivation of certain oral drugs as they
pass through the gut wall and liver via the portal circulation. IV administration bypasses the
hepatic portal system entirely, allowing the drug to reach systemic circulation before hepatic
metabolism.
6. A drug that is a weak acid with a pKa of 4.5 is administered orally. In the stomach (pH 2),
the drug will be:
A) Mostly ionized
B) Mostly non-ionized
C) Equally ionized and non-ionized
D) Precipitated
Correct Answer: Mostly non-ionized
Rationale: Weak acids are non-ionized (lipophilic) in acidic environments and ionized
(hydrophilic) in basic environments. Non-ionized drugs are more readily absorbed across cell
membranes. The Henderson-Hasselbalch equation explains this relationship.
7. A patient with liver cirrhosis is prescribed a highly protein-bound medication. Due to
decreased albumin levels, the nurse expects:
A) Decreased free drug concentration
B) Increased free drug concentration
C) No change in drug concentration
D) Decreased drug absorption
Correct Answer: Increased free drug concentration
Alabama
1. A nurse practitioner is reviewing the mechanism of action of a new medication. Which
term best describes the study of what the drug does to the body?
A) Pharmacokinetics
B) Pharmacodynamics
C) Pharmacotherapeutics
D) Pharmacogenomics
Correct Answer: Pharmacodynamics
Rationale: Pharmacodynamics is the study of the biochemical and physiological effects of
drugs on the body, including receptor binding and post-receptor effects. Pharmacokinetics
describes what the body does to the drug (absorption, distribution, metabolism, excretion).
Pharmacotherapeutics is the use of drugs to treat disease. Pharmacogenomics studies how
genes affect drug response.
2. A patient with severe liver cirrhosis is prescribed a medication that undergoes extensive
first-pass metabolism. What should the prescriber anticipate?
A) Decreased oral bioavailability
B) Increased oral bioavailability
C) No change in bioavailability
D) Increased renal excretion
Correct Answer: Increased oral bioavailability
Rationale: First-pass metabolism occurs in the liver. In severe liver disease, hepatic
extraction is reduced, allowing more of the drug to reach systemic circulation. This results in
increased oral bioavailability. Providers must anticipate the need for dose reduction to
prevent toxicity.
,3. A drug has a volume of distribution (Vd) of 0.2 L/kg. This indicates that the drug is
primarily:
A) Widely distributed into tissues
B) Confined to the plasma compartment
C) Accumulated in fat tissue
D) Bound extensively to tissues
Correct Answer: Confined to the plasma compartment
Rationale: A Vd of 0.05-0.2 L/kg indicates the drug remains primarily in the plasma
compartment. Total body water Vd is approximately 0.5 L/kg. High tissue binding would
increase Vd significantly. Lipid-soluble drugs that accumulate in fat have much larger Vd
values.
4. Which property of an ideal drug refers to its ability to elicit only the response for which it
is given?
A) Effectiveness
B) Safety
C) Selectivity
D) Reversible action
Correct Answer: Selectivity
Rationale: Selectivity is the ability of a drug to elicit only the response for which it is given,
minimizing unintended effects. Effectiveness refers to the drug producing the intended
therapeutic response. Safety means the drug does not produce harmful effects. Reversible
action means the drug's effects can be reversed.
5. A nurse is preparing to administer an oral medication that undergoes extensive first-pass
metabolism. Which route would bypass this effect?
A) Oral
B) Sublingual
, C) Rectal
D) Intravenous
Correct Answer: Intravenous
Rationale: First-pass effect refers to rapid hepatic inactivation of certain oral drugs as they
pass through the gut wall and liver via the portal circulation. IV administration bypasses the
hepatic portal system entirely, allowing the drug to reach systemic circulation before hepatic
metabolism.
6. A drug that is a weak acid with a pKa of 4.5 is administered orally. In the stomach (pH 2),
the drug will be:
A) Mostly ionized
B) Mostly non-ionized
C) Equally ionized and non-ionized
D) Precipitated
Correct Answer: Mostly non-ionized
Rationale: Weak acids are non-ionized (lipophilic) in acidic environments and ionized
(hydrophilic) in basic environments. Non-ionized drugs are more readily absorbed across cell
membranes. The Henderson-Hasselbalch equation explains this relationship.
7. A patient with liver cirrhosis is prescribed a highly protein-bound medication. Due to
decreased albumin levels, the nurse expects:
A) Decreased free drug concentration
B) Increased free drug concentration
C) No change in drug concentration
D) Decreased drug absorption
Correct Answer: Increased free drug concentration
