NUR2474 MIDTERM EXAM:
PHARMACOLOGY ADVANCED STUDY
GUIDE QUESTIONS AND VERIFIED
ANSWERS | 100% CORRECT | GRADE A+
1. A patient is prescribed a drug that undergoes significant first-pass metabolism. Which
route of administration would most likely require the highest dose to achieve a therapeutic
effect?
A. Oral
B. Sublingual
C. Intravenous
D. Intramuscular
Answer: A
Conceptual Explanation: Oral medications are absorbed in the GI tract and travel to the
liver via the portal vein, where they are metabolized before reaching systemic circulation
(first-pass effect). IV, sublingual, and IM routes bypass the first-pass effect.
2. A nurse is caring for a patient with hypoalbuminemia. How does this condition affect the
pharmacokinetics of highly protein-bound drugs?
A. It decreases the risk of drug toxicity.
,B. It increases the concentration of free, active drug in the bloodstream.
C. It increases the rate of drug excretion by the kidneys.
D. It has no effect on drug distribution.
Answer: B
Conceptual Explanation: Low albumin levels mean fewer binding sites for highly protein-
bound drugs, leading to more free (unbound) drug, which increases the risk of toxicity.
3. A drug has a half-life of 4 hours. If a patient receives a dose of 400 mg at 08:00, how much
drug will remain in the patient’s system at 20:00?
A. 100 mg
B. 200 mg
C. 50 mg
D. 25 mg
Answer: C
Conceptual Explanation: From 08:00 to 20:00 is 12 hours (3 half-lives). 400mg -> 200mg
(1st) -> 100mg (2nd) -> 50mg (3rd).
4. Which pharmacokinetic process is primarily affected by a patient’s genetic polymorphism
of the Cytochrome P450 (CYP450) enzyme system?
A. Absorption
B. Excretion
, C. Distribution
D. Metabolism
Answer: D
Conceptual Explanation: The CYP450 system is the major enzyme family responsible for
the hepatic metabolism of drugs.
5. When administering an agonist medication, the nurse understands that the drug will:
A. Block the receptor from activation by endogenous substances.
B. Bind to a receptor and mimic the body’s own regulatory molecules.
C. Decrease the affinity of the receptor for other drugs.
D. Permanently damage the receptor site.
Answer: B
Conceptual Explanation: Agonists are molecules that activate receptors; antagonists
prevent receptor activation.
6. A patient is receiving Digoxin. The nurse monitors for toxicity because Digoxin has a:
A. Wide therapeutic index.
B. Narrow therapeutic index.
C. Short half-life.
D. Low affinity for receptors.
PHARMACOLOGY ADVANCED STUDY
GUIDE QUESTIONS AND VERIFIED
ANSWERS | 100% CORRECT | GRADE A+
1. A patient is prescribed a drug that undergoes significant first-pass metabolism. Which
route of administration would most likely require the highest dose to achieve a therapeutic
effect?
A. Oral
B. Sublingual
C. Intravenous
D. Intramuscular
Answer: A
Conceptual Explanation: Oral medications are absorbed in the GI tract and travel to the
liver via the portal vein, where they are metabolized before reaching systemic circulation
(first-pass effect). IV, sublingual, and IM routes bypass the first-pass effect.
2. A nurse is caring for a patient with hypoalbuminemia. How does this condition affect the
pharmacokinetics of highly protein-bound drugs?
A. It decreases the risk of drug toxicity.
,B. It increases the concentration of free, active drug in the bloodstream.
C. It increases the rate of drug excretion by the kidneys.
D. It has no effect on drug distribution.
Answer: B
Conceptual Explanation: Low albumin levels mean fewer binding sites for highly protein-
bound drugs, leading to more free (unbound) drug, which increases the risk of toxicity.
3. A drug has a half-life of 4 hours. If a patient receives a dose of 400 mg at 08:00, how much
drug will remain in the patient’s system at 20:00?
A. 100 mg
B. 200 mg
C. 50 mg
D. 25 mg
Answer: C
Conceptual Explanation: From 08:00 to 20:00 is 12 hours (3 half-lives). 400mg -> 200mg
(1st) -> 100mg (2nd) -> 50mg (3rd).
4. Which pharmacokinetic process is primarily affected by a patient’s genetic polymorphism
of the Cytochrome P450 (CYP450) enzyme system?
A. Absorption
B. Excretion
, C. Distribution
D. Metabolism
Answer: D
Conceptual Explanation: The CYP450 system is the major enzyme family responsible for
the hepatic metabolism of drugs.
5. When administering an agonist medication, the nurse understands that the drug will:
A. Block the receptor from activation by endogenous substances.
B. Bind to a receptor and mimic the body’s own regulatory molecules.
C. Decrease the affinity of the receptor for other drugs.
D. Permanently damage the receptor site.
Answer: B
Conceptual Explanation: Agonists are molecules that activate receptors; antagonists
prevent receptor activation.
6. A patient is receiving Digoxin. The nurse monitors for toxicity because Digoxin has a:
A. Wide therapeutic index.
B. Narrow therapeutic index.
C. Short half-life.
D. Low affinity for receptors.
