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NR341 PHARMACOLOGY CJE
BENCHMARK PRACTICE EXAM —
QUESTIONS WITH VERIFIED ANSWERS
AND COMPLETE RATIONALES
## SECTION 1: PHARMACOKINETICS &
PHARMACODYNAMICS
**1. A patient with hepatic cirrhosis has reduced Phase I
metabolism. Which drug would be most affected?**
A. Lorazepam (Phase II glucuronidation)
B. Phenytoin (Phase I oxidation)
C. Digoxin (renal excretion)
D. Acetaminophen (Phase II conjugation)
**Correct answer:** B
**Rationale:** Phase I reactions (oxidation, reduction,
hydrolysis) are more significantly affected by cirrhosis than
Phase II conjugation. Phenytoin undergoes Phase I oxidation
and would require dose adjustment in hepatic impairment .
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**2. A patient is prescribed a drug that is 98% protein-bound.
Which condition would increase the risk of toxicity?**
A. Obesity
B. Hypoalbuminemia (low albumin)
C. Renal failure
D. Hepatic cirrhosis
**Correct answer:** B
**Rationale:** Low albumin increases the free (unbound)
fraction of highly protein-bound drugs, increasing
pharmacological effect and toxicity risk. Only the unbound
fraction is pharmacologically active .
--
**3. What is the therapeutic index of a drug?**
A. The dose that produces a therapeutic effect
B. The ratio of the toxic dose to the therapeutic dose
C. The time required for the drug to reach steady state
D. The volume of distribution
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**Correct answer:** B
**Rationale:** The therapeutic index is the ratio of the toxic
dose (TD50) to the effective dose (ED50). A larger therapeutic
index indicates a safer drug with a wider margin between
therapeutic and toxic doses .
--
**4. The half-life of a drug is 4 hours. Approximately how long
will it take to reach steady state?**
A. 8 hours
B. 12 hours
C. 16–20 hours
D. 24 hours
**Correct answer:** C
**Rationale:** Steady state is typically reached after
approximately 4–5 half-lives. With a half-life of 4 hours, steady
state is reached in approximately 16–20 hours .
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NR341 PHARMACOLOGY CJE
BENCHMARK PRACTICE EXAM —
QUESTIONS WITH VERIFIED ANSWERS
AND COMPLETE RATIONALES
## SECTION 1: PHARMACOKINETICS &
PHARMACODYNAMICS
**1. A patient with hepatic cirrhosis has reduced Phase I
metabolism. Which drug would be most affected?**
A. Lorazepam (Phase II glucuronidation)
B. Phenytoin (Phase I oxidation)
C. Digoxin (renal excretion)
D. Acetaminophen (Phase II conjugation)
**Correct answer:** B
**Rationale:** Phase I reactions (oxidation, reduction,
hydrolysis) are more significantly affected by cirrhosis than
Phase II conjugation. Phenytoin undergoes Phase I oxidation
and would require dose adjustment in hepatic impairment .
--
,2 | Page
**2. A patient is prescribed a drug that is 98% protein-bound.
Which condition would increase the risk of toxicity?**
A. Obesity
B. Hypoalbuminemia (low albumin)
C. Renal failure
D. Hepatic cirrhosis
**Correct answer:** B
**Rationale:** Low albumin increases the free (unbound)
fraction of highly protein-bound drugs, increasing
pharmacological effect and toxicity risk. Only the unbound
fraction is pharmacologically active .
--
**3. What is the therapeutic index of a drug?**
A. The dose that produces a therapeutic effect
B. The ratio of the toxic dose to the therapeutic dose
C. The time required for the drug to reach steady state
D. The volume of distribution
, 3 | Page
**Correct answer:** B
**Rationale:** The therapeutic index is the ratio of the toxic
dose (TD50) to the effective dose (ED50). A larger therapeutic
index indicates a safer drug with a wider margin between
therapeutic and toxic doses .
--
**4. The half-life of a drug is 4 hours. Approximately how long
will it take to reach steady state?**
A. 8 hours
B. 12 hours
C. 16–20 hours
D. 24 hours
**Correct answer:** C
**Rationale:** Steady state is typically reached after
approximately 4–5 half-lives. With a half-life of 4 hours, steady
state is reached in approximately 16–20 hours .
--
