NURS 6521 ADVANCED
PHARMACOLOGY EXAM REVIEW
(VERIFIED ANSWERS) QUESTIONS
WITH ANSWERS: WALDEN
UNIVERSITY
1. A patient is prescribed a drug that has a narrow therapeutic index. Which action is most
important for the nurse practitioner to take?
A. Advise the patient that side effects are unlikely.
B. Instruct the patient to take the drug on an empty stomach.
C. Provide the patient with a larger starting dose.
D. Monitor the patient’s blood levels of the drug closely.
Answer: D
Conceptual Explanation: A narrow therapeutic index indicates that the difference
between a therapeutic dose and a toxic dose is small, requiring frequent blood monitoring
to ensure safety and efficacy.
2. When considering the pharmacokinetics of a drug, which process is primarily affected by
the first-pass effect?
A. Excretion
,B. Distribution
C. Metabolism
D. Absorption
Answer: C
Conceptual Explanation: The first-pass effect occurs when a drug is metabolized by the
liver before it reaches the systemic circulation, significantly reducing the concentration of
the active drug.
3. A patient with chronic kidney disease (CKD) requires an adjustment in drug dosing. This is
primarily due to changes in which pharmacokinetic phase?
A. Distribution
B. Metabolism
C. Excretion
D. Absorption
Answer: C
Conceptual Explanation: CKD affects the kidneys’ ability to filter and remove drugs from
the body, leading to decreased excretion and potential toxicity.
4. Which receptor activity is responsible for the bronchodilation effect of albuterol?
A. Alpha-1 adrenergic receptors
B. Beta-1 adrenergic receptors
, C. Beta-2 adrenergic receptors
D. Muscarinic receptors
Answer: C
Conceptual Explanation: Albuterol is a selective beta-2 adrenergic agonist, which causes
relaxation of bronchial smooth muscle and bronchodilation.
5. A patient taking an ACE inhibitor develops a dry, persistent cough. What is the
physiological mechanism behind this adverse effect?
A. Increased production of angiotensin II
B. Direct irritation of the pleural lining
C. Accumulation of bradykinin in the lungs
D. Inhibition of surfactant production
Answer: C
Conceptual Explanation: ACE inhibitors block the breakdown of bradykinin, leading to its
accumulation in the respiratory tract, which triggers a dry cough in some patients.
6. A patient is diagnosed with Digoxin toxicity. Which electrolyte imbalance most likely
predisposed the patient to this condition?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
PHARMACOLOGY EXAM REVIEW
(VERIFIED ANSWERS) QUESTIONS
WITH ANSWERS: WALDEN
UNIVERSITY
1. A patient is prescribed a drug that has a narrow therapeutic index. Which action is most
important for the nurse practitioner to take?
A. Advise the patient that side effects are unlikely.
B. Instruct the patient to take the drug on an empty stomach.
C. Provide the patient with a larger starting dose.
D. Monitor the patient’s blood levels of the drug closely.
Answer: D
Conceptual Explanation: A narrow therapeutic index indicates that the difference
between a therapeutic dose and a toxic dose is small, requiring frequent blood monitoring
to ensure safety and efficacy.
2. When considering the pharmacokinetics of a drug, which process is primarily affected by
the first-pass effect?
A. Excretion
,B. Distribution
C. Metabolism
D. Absorption
Answer: C
Conceptual Explanation: The first-pass effect occurs when a drug is metabolized by the
liver before it reaches the systemic circulation, significantly reducing the concentration of
the active drug.
3. A patient with chronic kidney disease (CKD) requires an adjustment in drug dosing. This is
primarily due to changes in which pharmacokinetic phase?
A. Distribution
B. Metabolism
C. Excretion
D. Absorption
Answer: C
Conceptual Explanation: CKD affects the kidneys’ ability to filter and remove drugs from
the body, leading to decreased excretion and potential toxicity.
4. Which receptor activity is responsible for the bronchodilation effect of albuterol?
A. Alpha-1 adrenergic receptors
B. Beta-1 adrenergic receptors
, C. Beta-2 adrenergic receptors
D. Muscarinic receptors
Answer: C
Conceptual Explanation: Albuterol is a selective beta-2 adrenergic agonist, which causes
relaxation of bronchial smooth muscle and bronchodilation.
5. A patient taking an ACE inhibitor develops a dry, persistent cough. What is the
physiological mechanism behind this adverse effect?
A. Increased production of angiotensin II
B. Direct irritation of the pleural lining
C. Accumulation of bradykinin in the lungs
D. Inhibition of surfactant production
Answer: C
Conceptual Explanation: ACE inhibitors block the breakdown of bradykinin, leading to its
accumulation in the respiratory tract, which triggers a dry cough in some patients.
6. A patient is diagnosed with Digoxin toxicity. Which electrolyte imbalance most likely
predisposed the patient to this condition?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
