NURS 6521 Advanced Pharmacology – Final
Exam Review (100 Questions with Answers &
Rationales)
Pharmacokinetics & Pharmacodynamics (Q1–10)
Q1. The term bioavailability refers to:
A. Fraction of drug reaching systemic circulation unchanged
B. Drug’s distribution in tissues
C. Drug’s binding to plasma proteins
D. Drug’s metabolism in the liver
Answer: A
Rationale: Bioavailability is the proportion of a drug that enters the systemic circulation intact
and can exert its effect.
Q2. A patient is prescribed Drug X with a half-life of 8 hours. How long will it take to reach
steady state?
A. 8 hours
B. 24 hours
C. 40 hours
D. 3–5 half-lives
Answer: D (3–5 half-lives, ~24–40 hours)
Rationale: It generally takes 4–5 half-lives for a drug to reach steady state.
Q3. Which statement correctly defines potency?
A. Maximum effect a drug can achieve
B. The dose required to produce an effect
C. The fraction of drug eliminated per unit time
D. The time taken for drug absorption
Answer: B
Rationale: Potency = the amount of drug required to produce a given effect.
,Q4. A competitive antagonist can be overcome by:
A. Increasing agonist concentration
B. Adding another antagonist
C. Decreasing drug metabolism
D. Blocking elimination pathways
Answer: A
Rationale: Competitive antagonism is reversible and can be overcome with higher agonist
doses.
Q5. Which type of receptor response is all-or-nothing?
A. Graded response
B. Quantal response
C. Partial agonist
D. Dose-response curve
Answer: B
Rationale: Quantal responses measure binary outcomes (e.g., seizure prevention vs not).
Q6. The therapeutic index (TI) is defined as:
A. LD50 / ED50
B. ED50 / LD50
C. The difference between peak and trough
D. The bioavailability of a drug
Answer: A
Rationale: TI = ratio of lethal dose (50%) to effective dose (50%). Larger TI = safer drug.
Q7. A drug metabolized by CYP3A4 is co-administered with ketoconazole. What happens?
A. Increased metabolism, decreased effect
B. Decreased metabolism, increased toxicity
C. No effect
D. Faster clearance
Answer: B
Rationale: Ketoconazole is a CYP3A4 inhibitor → decreased metabolism → higher drug levels.
, Q8. The first-pass effect refers to:
A. Renal excretion of drug
B. Hepatic metabolism before systemic circulation
C. Rapid IV administration
D. Drug binding to albumin
Answer: B
Rationale: Drugs absorbed orally may undergo significant metabolism in the liver before
reaching systemic circulation.
Q9. Which pharmacokinetic change occurs in elderly patients?
A. Increased renal clearance
B. Increased hepatic metabolism
C. Decreased renal clearance
D. Increased first-pass metabolism
Answer: C
Rationale: Aging is associated with decreased renal clearance and sometimes reduced hepatic
metabolism.
Q10. Which drug property allows it to cross the blood-brain barrier easily?
A. Polar and hydrophilic
B. Large molecular size
C. Lipophilic and non-ionized
D. Protein-bound
Answer: C
Rationale: Lipid-soluble, non-ionized drugs cross the BBB more readily.
Drug Interactions & Adverse Effects (Q11–22)
Q11. Grapefruit juice is most likely to:
A. Induce CYP3A4 metabolism
B. Inhibit CYP3A4 metabolism
C. Increase renal clearance
D. Reduce drug half-life
Answer: B
Rationale: Grapefruit juice inhibits intestinal CYP3A4, leading to higher plasma drug levels.
Exam Review (100 Questions with Answers &
Rationales)
Pharmacokinetics & Pharmacodynamics (Q1–10)
Q1. The term bioavailability refers to:
A. Fraction of drug reaching systemic circulation unchanged
B. Drug’s distribution in tissues
C. Drug’s binding to plasma proteins
D. Drug’s metabolism in the liver
Answer: A
Rationale: Bioavailability is the proportion of a drug that enters the systemic circulation intact
and can exert its effect.
Q2. A patient is prescribed Drug X with a half-life of 8 hours. How long will it take to reach
steady state?
A. 8 hours
B. 24 hours
C. 40 hours
D. 3–5 half-lives
Answer: D (3–5 half-lives, ~24–40 hours)
Rationale: It generally takes 4–5 half-lives for a drug to reach steady state.
Q3. Which statement correctly defines potency?
A. Maximum effect a drug can achieve
B. The dose required to produce an effect
C. The fraction of drug eliminated per unit time
D. The time taken for drug absorption
Answer: B
Rationale: Potency = the amount of drug required to produce a given effect.
,Q4. A competitive antagonist can be overcome by:
A. Increasing agonist concentration
B. Adding another antagonist
C. Decreasing drug metabolism
D. Blocking elimination pathways
Answer: A
Rationale: Competitive antagonism is reversible and can be overcome with higher agonist
doses.
Q5. Which type of receptor response is all-or-nothing?
A. Graded response
B. Quantal response
C. Partial agonist
D. Dose-response curve
Answer: B
Rationale: Quantal responses measure binary outcomes (e.g., seizure prevention vs not).
Q6. The therapeutic index (TI) is defined as:
A. LD50 / ED50
B. ED50 / LD50
C. The difference between peak and trough
D. The bioavailability of a drug
Answer: A
Rationale: TI = ratio of lethal dose (50%) to effective dose (50%). Larger TI = safer drug.
Q7. A drug metabolized by CYP3A4 is co-administered with ketoconazole. What happens?
A. Increased metabolism, decreased effect
B. Decreased metabolism, increased toxicity
C. No effect
D. Faster clearance
Answer: B
Rationale: Ketoconazole is a CYP3A4 inhibitor → decreased metabolism → higher drug levels.
, Q8. The first-pass effect refers to:
A. Renal excretion of drug
B. Hepatic metabolism before systemic circulation
C. Rapid IV administration
D. Drug binding to albumin
Answer: B
Rationale: Drugs absorbed orally may undergo significant metabolism in the liver before
reaching systemic circulation.
Q9. Which pharmacokinetic change occurs in elderly patients?
A. Increased renal clearance
B. Increased hepatic metabolism
C. Decreased renal clearance
D. Increased first-pass metabolism
Answer: C
Rationale: Aging is associated with decreased renal clearance and sometimes reduced hepatic
metabolism.
Q10. Which drug property allows it to cross the blood-brain barrier easily?
A. Polar and hydrophilic
B. Large molecular size
C. Lipophilic and non-ionized
D. Protein-bound
Answer: C
Rationale: Lipid-soluble, non-ionized drugs cross the BBB more readily.
Drug Interactions & Adverse Effects (Q11–22)
Q11. Grapefruit juice is most likely to:
A. Induce CYP3A4 metabolism
B. Inhibit CYP3A4 metabolism
C. Increase renal clearance
D. Reduce drug half-life
Answer: B
Rationale: Grapefruit juice inhibits intestinal CYP3A4, leading to higher plasma drug levels.
