NU 578 Unit 1 Exam University Of South Alabama
NU 578 Unit 1 Exam University Of South Alabama
Exam Coverage
1. Pharmacokinetics (Absorption, Distribution, Metabolism, Excretion)
2. Pharmacodynamics (Receptor Theory, Agonists, Antagonists, Dose-Response)
3. Drug Interactions (CYP450, P-Glycoprotein, Pharmacodynamic Interactions)
4. Adverse Drug Reactions and Toxicity
5. Pharmacogenomics and Individualized Therapy
6. Special Populations (Pediatrics, Geriatrics, Pregnancy, Renal/Hepatic
Impairment)
7. Prescribing Principles and Legal Considerations
8. Therapeutic Drug Monitoring and Narrow Therapeutic Index Drugs
, 9. Autonomic Nervous System Pharmacology (Cholinergic and Adrenergic)
10. Medication Safety, High-Alert Medications, and Error Prevention
NU 578 Unit 1 Exam University Of South Alabama
200 Multiple Choice Questions with Answers and
Rationales
1. A patient is prescribed a highly protein-bound medication while concurrently
receiving warfarin therapy. The advanced practice nurse recognizes that
displacement from albumin binding sites will most likely produce which clinical
consequence?
A. Decreased therapeutic effect of warfarin due to reduced free drug
concentration
B. Increased risk of warfarin toxicity due to elevated free drug levels in plasma
,C. No significant change because protein binding does not influence drug
activity
D. Enhanced renal elimination of warfarin resulting in subtherapeutic
anticoagulation
Answer: B
Rationale: When two highly protein-bound drugs compete for the same albumin
binding sites, one drug may displace the other, increasing the free (unbound)
fraction of the displaced drug. Only unbound drug is pharmacologically active.
This elevation in free warfarin increases its anticoagulant effect and risk of
bleeding complications.
2. A patient with decompensated heart failure and significant hepatic
congestion is prescribed a drug extensively metabolized by the liver. Which
pharmacokinetic alteration should the advanced practice nurse anticipate?
, A. Enhanced first-pass metabolism leading to reduced oral bioavailability
B. Decreased hepatic metabolism resulting in prolonged drug half-life and
accumulation
C. Increased renal clearance compensating for reduced hepatic function
D. Reduced volume of distribution requiring higher loading doses
Answer: B
Rationale: Hepatic congestion from heart failure impairs liver function and
reduces drug-metabolizing enzyme activity. This decreases the rate of hepatic
metabolism, prolongs drug half-life, and increases risk of accumulation and
toxicity for drugs dependent on hepatic clearance.
3. Which pharmacokinetic parameter describes the volume of plasma from
which a drug is completely removed per unit of time?
NU 578 Unit 1 Exam University Of South Alabama
Exam Coverage
1. Pharmacokinetics (Absorption, Distribution, Metabolism, Excretion)
2. Pharmacodynamics (Receptor Theory, Agonists, Antagonists, Dose-Response)
3. Drug Interactions (CYP450, P-Glycoprotein, Pharmacodynamic Interactions)
4. Adverse Drug Reactions and Toxicity
5. Pharmacogenomics and Individualized Therapy
6. Special Populations (Pediatrics, Geriatrics, Pregnancy, Renal/Hepatic
Impairment)
7. Prescribing Principles and Legal Considerations
8. Therapeutic Drug Monitoring and Narrow Therapeutic Index Drugs
, 9. Autonomic Nervous System Pharmacology (Cholinergic and Adrenergic)
10. Medication Safety, High-Alert Medications, and Error Prevention
NU 578 Unit 1 Exam University Of South Alabama
200 Multiple Choice Questions with Answers and
Rationales
1. A patient is prescribed a highly protein-bound medication while concurrently
receiving warfarin therapy. The advanced practice nurse recognizes that
displacement from albumin binding sites will most likely produce which clinical
consequence?
A. Decreased therapeutic effect of warfarin due to reduced free drug
concentration
B. Increased risk of warfarin toxicity due to elevated free drug levels in plasma
,C. No significant change because protein binding does not influence drug
activity
D. Enhanced renal elimination of warfarin resulting in subtherapeutic
anticoagulation
Answer: B
Rationale: When two highly protein-bound drugs compete for the same albumin
binding sites, one drug may displace the other, increasing the free (unbound)
fraction of the displaced drug. Only unbound drug is pharmacologically active.
This elevation in free warfarin increases its anticoagulant effect and risk of
bleeding complications.
2. A patient with decompensated heart failure and significant hepatic
congestion is prescribed a drug extensively metabolized by the liver. Which
pharmacokinetic alteration should the advanced practice nurse anticipate?
, A. Enhanced first-pass metabolism leading to reduced oral bioavailability
B. Decreased hepatic metabolism resulting in prolonged drug half-life and
accumulation
C. Increased renal clearance compensating for reduced hepatic function
D. Reduced volume of distribution requiring higher loading doses
Answer: B
Rationale: Hepatic congestion from heart failure impairs liver function and
reduces drug-metabolizing enzyme activity. This decreases the rate of hepatic
metabolism, prolongs drug half-life, and increases risk of accumulation and
toxicity for drugs dependent on hepatic clearance.
3. Which pharmacokinetic parameter describes the volume of plasma from
which a drug is completely removed per unit of time?
