NURS 6521 ADVANCED
PHARMACOLOGY COMPREHENSIVE
PRACTICE EXAM (VERIFIED
ANSWERS) QUESTIONS WITH
ANSWERS: WALDEN UNIVERSITY
1. A patient with chronic kidney disease (CKD) requires an adjustment in drug dosing. Which
pharmacokinetic process is most significantly impacted by a decrease in glomerular filtration
rate (GFR)?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: C
Conceptual Explanation: Excretion is the process primarily managed by the kidneys. A
decrease in GFR directly reduces the clearance of drugs excreted via urine, necessitating
dose adjustments to prevent toxicity.
2. A healthcare provider is considering prescribing a medication with a narrow therapeutic
index (NTI). What is the primary clinical implication of this classification?
A. The drug has a high safety margin.
,B. The drug does not require blood level monitoring.
C. Small differences in dose or blood concentration may lead to serious therapeutic failures
or adverse drug reactions.
D. The drug is metabolized strictly by the liver.
Answer: C
Conceptual Explanation: Narrow therapeutic index drugs have a very small window
between the effective dose and the toxic dose, requiring precise dosing and often
therapeutic drug monitoring.
3. When prescribing an ACE inhibitor such as Lisinopril, which electrolyte imbalance must the
clinician monitor for?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
Answer: B
Conceptual Explanation: ACE inhibitors block the conversion of Angiotensin I to
Angiotensin II, which leads to decreased aldosterone secretion, potentially causing
potassium retention and hyperkalemia.
, 4. A 65-year-old patient is started on Warfarin for atrial fibrillation. The patient is also taking
Amiodarone. What interaction should the provider anticipate?
A. Amiodarone increases the renal excretion of Warfarin.
B. Amiodarone induces CYP3A4, decreasing Warfarin levels.
C. Amiodarone inhibits CYP2C9, increasing Warfarin levels and INR.
D. There is no significant interaction between these two drugs.
Answer: C
Conceptual Explanation: Amiodarone is a potent inhibitor of the CYP450 system,
specifically CYP2C9, which metabolizes the S-isomer of Warfarin. This interaction increases
the anticoagulant effect.
5. Which of the following describes the mechanism of action of Metformin in treating Type 2
Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells.
B. Decreasing hepatic glucose production and improving insulin sensitivity.
C. Increasing glucose uptake in the kidneys.
D. Slowing the breakdown of complex carbohydrates in the gut.
Answer: B
PHARMACOLOGY COMPREHENSIVE
PRACTICE EXAM (VERIFIED
ANSWERS) QUESTIONS WITH
ANSWERS: WALDEN UNIVERSITY
1. A patient with chronic kidney disease (CKD) requires an adjustment in drug dosing. Which
pharmacokinetic process is most significantly impacted by a decrease in glomerular filtration
rate (GFR)?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: C
Conceptual Explanation: Excretion is the process primarily managed by the kidneys. A
decrease in GFR directly reduces the clearance of drugs excreted via urine, necessitating
dose adjustments to prevent toxicity.
2. A healthcare provider is considering prescribing a medication with a narrow therapeutic
index (NTI). What is the primary clinical implication of this classification?
A. The drug has a high safety margin.
,B. The drug does not require blood level monitoring.
C. Small differences in dose or blood concentration may lead to serious therapeutic failures
or adverse drug reactions.
D. The drug is metabolized strictly by the liver.
Answer: C
Conceptual Explanation: Narrow therapeutic index drugs have a very small window
between the effective dose and the toxic dose, requiring precise dosing and often
therapeutic drug monitoring.
3. When prescribing an ACE inhibitor such as Lisinopril, which electrolyte imbalance must the
clinician monitor for?
A. Hyponatremia
B. Hyperkalemia
C. Hypocalcemia
D. Hypermagnesemia
Answer: B
Conceptual Explanation: ACE inhibitors block the conversion of Angiotensin I to
Angiotensin II, which leads to decreased aldosterone secretion, potentially causing
potassium retention and hyperkalemia.
, 4. A 65-year-old patient is started on Warfarin for atrial fibrillation. The patient is also taking
Amiodarone. What interaction should the provider anticipate?
A. Amiodarone increases the renal excretion of Warfarin.
B. Amiodarone induces CYP3A4, decreasing Warfarin levels.
C. Amiodarone inhibits CYP2C9, increasing Warfarin levels and INR.
D. There is no significant interaction between these two drugs.
Answer: C
Conceptual Explanation: Amiodarone is a potent inhibitor of the CYP450 system,
specifically CYP2C9, which metabolizes the S-isomer of Warfarin. This interaction increases
the anticoagulant effect.
5. Which of the following describes the mechanism of action of Metformin in treating Type 2
Diabetes?
A. Stimulating insulin secretion from pancreatic beta cells.
B. Decreasing hepatic glucose production and improving insulin sensitivity.
C. Increasing glucose uptake in the kidneys.
D. Slowing the breakdown of complex carbohydrates in the gut.
Answer: B
