NURS 5334 Advanced Pharmacology: Recommended Exam-Style
Questions with Answers and Rationales – Comprehensive Study
Guide for Advanced Practice Nursing | pdf
Section 1: Pharmacokinetics & Pharmacodynamics
Q1: A patient with renal impairment is prescribed a drug excreted primarily by the
kidneys. Which adjustment is most appropriate?
A) Increase dose
B) Decrease dose
C) No change
D) Switch to oral form
Answer: B) Decrease dose
Rationale: Renal impairment reduces drug clearance; dose reduction prevents
toxicity.
Q2: The time it takes for a drug to reach half of its plasma concentration is called:
A) Bioavailability
B) Half-life
C) Therapeutic index
D) Onset
Answer: B) Half-life
Rationale: Half-life determines dosing intervals and accumulation risk.
Q3: A patient taking multiple drugs experiences unexpected side effects due to
CYP450 inhibition. This is an example of:
A) Pharmacokinetics interaction
B) Pharmacodynamics interaction
,C) Idiosyncratic reaction
D) Placebo effect
Answer: A) Pharmacokinetics interaction
Rationale: CYP450 inhibition alters drug metabolism, affecting plasma levels.
Q4: Which route avoids first-pass metabolism?
A) Oral
B) Sublingual
C) Rectal
D) Gastrostomy tube
Answer: B) Sublingual
Rationale: Sublingual absorption enters systemic circulation directly, bypassing
liver.
Q5: A patient develops toxicity from a narrow therapeutic index drug. Which
measure is essential?
A) Monitor vital signs
B) Monitor drug serum levels
C) Advise hydration
D) Encourage rest
Answer: B) Monitor drug serum levels
Rationale: Monitoring ensures drug stays within therapeutic range.
Q6: A high protein-bound drug may interact with another drug by:
A) Increasing absorption
B) Displacing protein binding
C) Decreasing metabolism
D) Slowing excretion
Answer: B) Displacing protein binding
Rationale: Competition for protein binding increases free drug levels, risking
toxicity.
Q7: Bioavailability of a drug given intravenously is:
A) 0%
B) 50%
, C) 100%
D) Variable
Answer: C) 100%
Rationale: IV administration delivers the full dose directly into circulation.
Q8: Which factor can alter pharmacodynamics?
A) Age
B) Genetic variations
C) Drug interactions
D) All of the above
Answer: D) All of the above
Rationale: Multiple factors influence drug response, including receptor sensitivity.
Q9: The dose-response curve shows:
A) Toxicity only
B) Relationship between drug dose and effect
C) Drug half-life
D) Excretion rate
Answer: B) Relationship between drug dose and effect
Rationale: It helps identify minimum effective dose and maximum response.
Q10: A patient has liver disease. Which pharmacokinetic change is expected?
A) Increased metabolism
B) Decreased metabolism
C) Increased excretion
D) Decreased absorption
Answer: B) Decreased metabolism
Rationale: Impaired hepatic function reduces metabolism, increasing drug levels.
Section 2: Cardiovascular Pharmacology
Q11: Which drug class reduces afterload by blocking angiotensin II?
A) Beta-blockers
Questions with Answers and Rationales – Comprehensive Study
Guide for Advanced Practice Nursing | pdf
Section 1: Pharmacokinetics & Pharmacodynamics
Q1: A patient with renal impairment is prescribed a drug excreted primarily by the
kidneys. Which adjustment is most appropriate?
A) Increase dose
B) Decrease dose
C) No change
D) Switch to oral form
Answer: B) Decrease dose
Rationale: Renal impairment reduces drug clearance; dose reduction prevents
toxicity.
Q2: The time it takes for a drug to reach half of its plasma concentration is called:
A) Bioavailability
B) Half-life
C) Therapeutic index
D) Onset
Answer: B) Half-life
Rationale: Half-life determines dosing intervals and accumulation risk.
Q3: A patient taking multiple drugs experiences unexpected side effects due to
CYP450 inhibition. This is an example of:
A) Pharmacokinetics interaction
B) Pharmacodynamics interaction
,C) Idiosyncratic reaction
D) Placebo effect
Answer: A) Pharmacokinetics interaction
Rationale: CYP450 inhibition alters drug metabolism, affecting plasma levels.
Q4: Which route avoids first-pass metabolism?
A) Oral
B) Sublingual
C) Rectal
D) Gastrostomy tube
Answer: B) Sublingual
Rationale: Sublingual absorption enters systemic circulation directly, bypassing
liver.
Q5: A patient develops toxicity from a narrow therapeutic index drug. Which
measure is essential?
A) Monitor vital signs
B) Monitor drug serum levels
C) Advise hydration
D) Encourage rest
Answer: B) Monitor drug serum levels
Rationale: Monitoring ensures drug stays within therapeutic range.
Q6: A high protein-bound drug may interact with another drug by:
A) Increasing absorption
B) Displacing protein binding
C) Decreasing metabolism
D) Slowing excretion
Answer: B) Displacing protein binding
Rationale: Competition for protein binding increases free drug levels, risking
toxicity.
Q7: Bioavailability of a drug given intravenously is:
A) 0%
B) 50%
, C) 100%
D) Variable
Answer: C) 100%
Rationale: IV administration delivers the full dose directly into circulation.
Q8: Which factor can alter pharmacodynamics?
A) Age
B) Genetic variations
C) Drug interactions
D) All of the above
Answer: D) All of the above
Rationale: Multiple factors influence drug response, including receptor sensitivity.
Q9: The dose-response curve shows:
A) Toxicity only
B) Relationship between drug dose and effect
C) Drug half-life
D) Excretion rate
Answer: B) Relationship between drug dose and effect
Rationale: It helps identify minimum effective dose and maximum response.
Q10: A patient has liver disease. Which pharmacokinetic change is expected?
A) Increased metabolism
B) Decreased metabolism
C) Increased excretion
D) Decreased absorption
Answer: B) Decreased metabolism
Rationale: Impaired hepatic function reduces metabolism, increasing drug levels.
Section 2: Cardiovascular Pharmacology
Q11: Which drug class reduces afterload by blocking angiotensin II?
A) Beta-blockers
