NR 565 - advanced pharmacology midterm – Chamberlain ALL
QUESTIONS AND 100% CORRECT ANSWERS ALREADY GRADED A+ - LATEST
UPDATE 2026
NR 565 ADVANCED PHARMACOLOGY –
MIDTERM PRACTICE
1. Which phase of pharmacokinetics involves drug metabolism?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: C
Rationale: Metabolism primarily occurs in the liver via CYP450 enzymes.
2. First-pass metabolism occurs primarily in the
A. Kidneys
B. Liver
C. Lungs
D. Intestines
Answer: B
Rationale: Oral drugs are metabolized in the liver before systemic circulation.
3. Which route avoids first-pass metabolism?
A. Oral
B. Rectal
C. Sublingual
D. Enteral feeding tube
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Answer: C
Rationale: Sublingual drugs enter systemic circulation directly.
4. A drug that is highly protein-bound will have
A. Increased free drug
B. Decreased half-life
C. Decreased therapeutic effect
D. Potential drug–drug interactions
Answer: D
Rationale: Competition for protein-binding sites increases toxicity risk.
5. Albumin binds primarily to
A. Water-soluble drugs
B. Acidic drugs
C. Basic drugs
D. Lipid-soluble drugs
Answer: B
Rationale: Acidic drugs preferentially bind albumin.
6. Cytochrome P450 enzyme induction will
A. Increase drug levels
B. Decrease drug metabolism
C. Decrease drug levels
D. Cause toxicity
Answer: C
Rationale: Inducers increase metabolism → lower drug concentrations.
7. Which drug is a CYP450 inhibitor?
A. Rifampin
B. Carbamazepine
C. Erythromycin
D. Phenytoin
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Answer: C
Rationale: Erythromycin inhibits CYP enzymes, increasing drug levels.
8. Older adults are at higher risk for adverse drug effects due to
A. Increased renal clearance
B. Increased hepatic blood flow
C. Decreased renal function
D. Increased albumin levels
Answer: C
Rationale: Renal decline increases drug accumulation.
9. Which parameter best evaluates renal drug clearance?
A. Serum creatinine
B. BUN
C. Creatinine clearance
D. Urine output
Answer: C
Rationale: CrCl best reflects renal drug elimination.
10. A partial agonist will
A. Produce maximal receptor response
B. Block receptor activation
C. Produce less than maximal response
D. Have no intrinsic activity
Answer: C
Rationale: Partial agonists activate receptors but with lower efficacy.
11. A competitive antagonist
A. Permanently binds receptors
B. Can be overcome by higher agonist doses
C. Increases efficacy
D. Decreases potency only
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Answer: B
Rationale: Competitive antagonists compete at the same receptor site.
12. Therapeutic index (TI) indicates
A. Drug potency
B. Drug efficacy
C. Drug safety margin
D. Drug metabolism
Answer: C
Rationale: Narrow TI drugs require close monitoring.
13. Which drug has a narrow therapeutic index?
A. Acetaminophen
B. Digoxin
C. Amoxicillin
D. Ibuprofen
Answer: B
Rationale: Small dose changes can cause toxicity.
14. Which antihypertensive is contraindicated in pregnancy?
A. Methyldopa
B. Labetalol
C. ACE inhibitors
D. Nifedipine
Answer: C
Rationale: ACE inhibitors cause fetal renal damage.
15. A patient on ACE inhibitors should be monitored for
A. Hypokalemia
B. Hyperkalemia
C. Hypoglycemia
D. Hypernatremia
UPDATED exam 2026