UTA CP2 NURS 5338 FINAL EXAM – 150 PRACTICE
QUESTIONS & ANSWERS Complete Study Guide |
University of Texas at Arlington | Latest 2025/2026 | 100%
Verified
This document contains practice questions and verified answers for the UTA CP2 NURS 5338
Advanced Pharmacology for APRNs Final Exam. The questions cover pharmacokinetics,
pharmacodynamics, cardiovascular pharmacology, endocrine pharmacology, CNS/psychiatric drugs,
antimicrobials, pain management, special populations, and evidence-based prescribing .
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS (Questions 1–20)
1. An APRN is prescribing a medication that is a weak acid with a pKa of 4.5. In which
body compartment will this drug primarily be absorbed?
A) Stomach (pH 1.5-2.0)
B) Small intestine (pH 6.0-7.5)
C) Blood (pH 7.35-7.45)
D) Urine (pH 5.0-8.0)
Answer: A
,Weak acids are non-ionized (lipid-soluble) and well absorbed in acidic environments
(stomach). Using the Henderson-Hasselbalch equation: pH = pKa + log([A-]/[HA]). When pH
< pKa, the acidic drug is predominantly non-ionized (HA), favoring absorption. Stomach pH
is below the pKa of 4.5, so the drug will be mostly non-ionized and well absorbed. Weak
bases are better absorbed in the intestine .
2. A patient is taking two drugs that are highly protein-bound (98% each). Which
pharmacokinetic phenomenon is most likely to occur?
A) Decreased drug half-life
B) Drug displacement and increased free drug concentration
C) Increased renal excretion
D) Decreased volume of distribution
Answer: B
When two highly protein-bound drugs are co-administered, they compete for binding sites
on plasma proteins (primarily albumin). Displacement of one drug by the other leads to an
increase in the free (unbound) fraction of the displaced drug, potentially leading to toxicity.
This is clinically significant with drugs like warfarin and sulfonamides .
3. A patient with liver cirrhosis is prescribed a medication that undergoes extensive
first-pass metabolism. Which pharmacokinetic parameter is most affected?
A) Absorption
B) Distribution
C) Metabolism (biotransformation)
D) Excretion
,Answer: C
The liver is the primary site of drug metabolism (Phase I and Phase II reactions). In
cirrhosis, hepatic blood flow and enzyme activity are reduced, leading to decreased
clearance and prolonged half-life of many drugs (e.g., benzodiazepines, opioids, warfarin).
Dose reduction is often required .
4. Drug X has a half-life of 4 hours. Approximately how long will it take for the drug to
reach steady state?
A) 8 hours
B) 12 hours
C) 20 hours
D) 40 hours
Answer: C
Steady state is reached after approximately 4-5 half-lives. For a drug with a 4-hour half-life:
4 half-lives = 16 hours; 5 half-lives = 20 hours. Therefore, steady state occurs in about 20
hours. This principle applies regardless of dosing interval, assuming consistent dosing .
5. A medication has a narrow therapeutic index (NTI). This means:
A) The drug has a wide margin of safety
B) Small changes in dose can lead to toxicity or inefficacy
C) The drug is only available intravenously
D) The drug has no side effects
Answer: B
, Narrow therapeutic index drugs have a small window between the minimum effective
concentration (MEC) and the minimum toxic concentration (MTC). Examples include
warfarin, digoxin, phenytoin, lithium, and aminoglycosides. Therapeutic drug monitoring
(TDM) is essential for NTI drugs to avoid toxicity while ensuring efficacy .
6. Which phase of drug metabolism involves conjugation reactions (e.g.,
glucuronidation, sulfation)?
A) Phase I (oxidation, reduction, hydrolysis)
B) Phase II (conjugation)
C) Phase III (excretion)
D) Absorption phase
Answer: B
Phase II metabolism involves conjugation reactions that add a polar group (glucuronide,
sulfate, glutathione, acetyl) to the drug or its Phase I metabolite, making it more water-
soluble and easier to excrete in urine or bile. Phase II reactions are generally catalyzed by
transferase enzymes (e.g., UGTs, SULTs, NATs) .
7. A drug that is a strong CYP3A4 inducer would be expected to:
A) Increase the levels of other drugs metabolized by CYP3A4
B) Decrease the levels of other drugs metabolized by CYP3A4
C) Have no effect on drug metabolism
D) Increase its own metabolism only
Answer: B
QUESTIONS & ANSWERS Complete Study Guide |
University of Texas at Arlington | Latest 2025/2026 | 100%
Verified
This document contains practice questions and verified answers for the UTA CP2 NURS 5338
Advanced Pharmacology for APRNs Final Exam. The questions cover pharmacokinetics,
pharmacodynamics, cardiovascular pharmacology, endocrine pharmacology, CNS/psychiatric drugs,
antimicrobials, pain management, special populations, and evidence-based prescribing .
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS (Questions 1–20)
1. An APRN is prescribing a medication that is a weak acid with a pKa of 4.5. In which
body compartment will this drug primarily be absorbed?
A) Stomach (pH 1.5-2.0)
B) Small intestine (pH 6.0-7.5)
C) Blood (pH 7.35-7.45)
D) Urine (pH 5.0-8.0)
Answer: A
,Weak acids are non-ionized (lipid-soluble) and well absorbed in acidic environments
(stomach). Using the Henderson-Hasselbalch equation: pH = pKa + log([A-]/[HA]). When pH
< pKa, the acidic drug is predominantly non-ionized (HA), favoring absorption. Stomach pH
is below the pKa of 4.5, so the drug will be mostly non-ionized and well absorbed. Weak
bases are better absorbed in the intestine .
2. A patient is taking two drugs that are highly protein-bound (98% each). Which
pharmacokinetic phenomenon is most likely to occur?
A) Decreased drug half-life
B) Drug displacement and increased free drug concentration
C) Increased renal excretion
D) Decreased volume of distribution
Answer: B
When two highly protein-bound drugs are co-administered, they compete for binding sites
on plasma proteins (primarily albumin). Displacement of one drug by the other leads to an
increase in the free (unbound) fraction of the displaced drug, potentially leading to toxicity.
This is clinically significant with drugs like warfarin and sulfonamides .
3. A patient with liver cirrhosis is prescribed a medication that undergoes extensive
first-pass metabolism. Which pharmacokinetic parameter is most affected?
A) Absorption
B) Distribution
C) Metabolism (biotransformation)
D) Excretion
,Answer: C
The liver is the primary site of drug metabolism (Phase I and Phase II reactions). In
cirrhosis, hepatic blood flow and enzyme activity are reduced, leading to decreased
clearance and prolonged half-life of many drugs (e.g., benzodiazepines, opioids, warfarin).
Dose reduction is often required .
4. Drug X has a half-life of 4 hours. Approximately how long will it take for the drug to
reach steady state?
A) 8 hours
B) 12 hours
C) 20 hours
D) 40 hours
Answer: C
Steady state is reached after approximately 4-5 half-lives. For a drug with a 4-hour half-life:
4 half-lives = 16 hours; 5 half-lives = 20 hours. Therefore, steady state occurs in about 20
hours. This principle applies regardless of dosing interval, assuming consistent dosing .
5. A medication has a narrow therapeutic index (NTI). This means:
A) The drug has a wide margin of safety
B) Small changes in dose can lead to toxicity or inefficacy
C) The drug is only available intravenously
D) The drug has no side effects
Answer: B
, Narrow therapeutic index drugs have a small window between the minimum effective
concentration (MEC) and the minimum toxic concentration (MTC). Examples include
warfarin, digoxin, phenytoin, lithium, and aminoglycosides. Therapeutic drug monitoring
(TDM) is essential for NTI drugs to avoid toxicity while ensuring efficacy .
6. Which phase of drug metabolism involves conjugation reactions (e.g.,
glucuronidation, sulfation)?
A) Phase I (oxidation, reduction, hydrolysis)
B) Phase II (conjugation)
C) Phase III (excretion)
D) Absorption phase
Answer: B
Phase II metabolism involves conjugation reactions that add a polar group (glucuronide,
sulfate, glutathione, acetyl) to the drug or its Phase I metabolite, making it more water-
soluble and easier to excrete in urine or bile. Phase II reactions are generally catalyzed by
transferase enzymes (e.g., UGTs, SULTs, NATs) .
7. A drug that is a strong CYP3A4 inducer would be expected to:
A) Increase the levels of other drugs metabolized by CYP3A4
B) Decrease the levels of other drugs metabolized by CYP3A4
C) Have no effect on drug metabolism
D) Increase its own metabolism only
Answer: B
