NR 565 Advanced Pharmacology
Final Exam Practice Questions
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS
1. A 65-year-old male with cirrhosis is prescribed a medication that
undergoes extensive first-pass hepatic metabolism. The nurse practitioner
understands that the bioavailability of this medication will be significantly
affected by which pharmacokinetic alteration?
A. Decreased absorption from the GI tract
B. Reduced first-pass metabolism leading to increased bioavailability
C. Enhanced renal elimination compensating for hepatic impairment
D. Increased protein binding reducing free drug concentration
Correct Answer: B
Rationale: In cirrhosis, first-pass hepatic metabolism is reduced due to
damaged hepatocytes and portosystemic shunting, leading to increased
bioavailability of drugs that normally undergo extensive first-pass
metabolism. This requires dose reduction to avoid toxicity .
2. A patient asks how a medication taken by mouth produces an effect in
the body. The APRN explains that the process by which a drug is absorbed,
distributed, metabolized, and excreted is known as:
,A. Pharmacodynamics
B. Pharmacotherapeutics
C. Pharmacokinetics
D. Pharmacogenomics
Correct Answer: C
Rationale: Pharmacokinetics is the study of drug movement throughout the
body, including absorption, distribution, metabolism, and excretion (ADME).
Pharmacodynamics is what the drug does to the body .
3. A drug that binds to a receptor and produces a response that is less than
that of a full agonist, even at maximal concentrations, is known as a:
A. Partial agonist
B. Inverse agonist
C. Competitive antagonist
D. Noncompetitive antagonist
Correct Answer: A
Rationale: A partial agonist has lower efficacy than a full agonist. It binds to
and activates a receptor but cannot produce a maximal response, even
when all receptors are occupied .
4. The half-life of a drug is defined as the:
A. Time required for the drug to reach peak concentration
B. Time required for the plasma concentration to decrease by 50%
C. Time required for the drug to be completely eliminated
D. Time required for the drug to be fully absorbed
, Correct Answer: B
Rationale: Half-life (t½) is the time required for the plasma concentration of
a drug to decrease by 50%. It determines dosing interval and time to reach
steady state (approximately 4-5 half-lives) .
5. A patient with cirrhosis of the liver is prescribed a medication that
undergoes extensive first-pass metabolism. The nurse anticipates that the
bioavailability of this medication will be:
A. Increased due to reduced hepatic function
B. Decreased due to impaired absorption
C. Unchanged because first-pass metabolism occurs in the intestines
D. Variable depending on renal function
Correct Answer: A
Rationale: Cirrhosis reduces liver function, decreasing first-pass metabolism
and increasing bioavailability. This can lead to higher drug levels and
increased risk of toxicity, potentially requiring dose adjustment .
6. Which factor most significantly influences a drug's ability to cross cell
membranes?
A. Molecular weight
B. Lipid solubility
C. Route of administration
D. Protein binding
Correct Answer: B
Final Exam Practice Questions
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS
1. A 65-year-old male with cirrhosis is prescribed a medication that
undergoes extensive first-pass hepatic metabolism. The nurse practitioner
understands that the bioavailability of this medication will be significantly
affected by which pharmacokinetic alteration?
A. Decreased absorption from the GI tract
B. Reduced first-pass metabolism leading to increased bioavailability
C. Enhanced renal elimination compensating for hepatic impairment
D. Increased protein binding reducing free drug concentration
Correct Answer: B
Rationale: In cirrhosis, first-pass hepatic metabolism is reduced due to
damaged hepatocytes and portosystemic shunting, leading to increased
bioavailability of drugs that normally undergo extensive first-pass
metabolism. This requires dose reduction to avoid toxicity .
2. A patient asks how a medication taken by mouth produces an effect in
the body. The APRN explains that the process by which a drug is absorbed,
distributed, metabolized, and excreted is known as:
,A. Pharmacodynamics
B. Pharmacotherapeutics
C. Pharmacokinetics
D. Pharmacogenomics
Correct Answer: C
Rationale: Pharmacokinetics is the study of drug movement throughout the
body, including absorption, distribution, metabolism, and excretion (ADME).
Pharmacodynamics is what the drug does to the body .
3. A drug that binds to a receptor and produces a response that is less than
that of a full agonist, even at maximal concentrations, is known as a:
A. Partial agonist
B. Inverse agonist
C. Competitive antagonist
D. Noncompetitive antagonist
Correct Answer: A
Rationale: A partial agonist has lower efficacy than a full agonist. It binds to
and activates a receptor but cannot produce a maximal response, even
when all receptors are occupied .
4. The half-life of a drug is defined as the:
A. Time required for the drug to reach peak concentration
B. Time required for the plasma concentration to decrease by 50%
C. Time required for the drug to be completely eliminated
D. Time required for the drug to be fully absorbed
, Correct Answer: B
Rationale: Half-life (t½) is the time required for the plasma concentration of
a drug to decrease by 50%. It determines dosing interval and time to reach
steady state (approximately 4-5 half-lives) .
5. A patient with cirrhosis of the liver is prescribed a medication that
undergoes extensive first-pass metabolism. The nurse anticipates that the
bioavailability of this medication will be:
A. Increased due to reduced hepatic function
B. Decreased due to impaired absorption
C. Unchanged because first-pass metabolism occurs in the intestines
D. Variable depending on renal function
Correct Answer: A
Rationale: Cirrhosis reduces liver function, decreasing first-pass metabolism
and increasing bioavailability. This can lead to higher drug levels and
increased risk of toxicity, potentially requiring dose adjustment .
6. Which factor most significantly influences a drug's ability to cross cell
membranes?
A. Molecular weight
B. Lipid solubility
C. Route of administration
D. Protein binding
Correct Answer: B
