Pharmacology 5334 – Quiz 1 Actual Exam
2026/2027 Exam Questions and Answers
Guaranteed Pass Solutions Detailed Rationales
- Pass Guaranteed - A+ Graded
Section 1: Pharmacokinetics (Absorption, Distribution, Metabolism, Excretion)
Q1: A nurse understands that intravenous medications have 100% bioavailability
because:
A. They bypass the liver completely
B. They are administered directly into the bloodstream [CORRECT]
C. They avoid protein binding in plasma
D. They have no half-life
Rationale: Correct — IV administration delivers drug directly into systemic circulation,
eliminating absorption barriers and first-pass metabolism, resulting in 100%
bioavailability. Distractor A is incorrect because IV drugs still pass through the liver, but
bioavailability refers to the fraction reaching circulation unchanged, which is complete
with IV. (Pharmacology 5334: Pharmacokinetics – Bioavailability)
Q2: A patient with angina is prescribed nitroglycerin. The provider orders sublingual
tablets rather than oral capsules because:
,A. Sublingual administration bypasses first-pass hepatic metabolism [CORRECT]
B. Oral nitroglycerin is incompatible with gastric pH
C. Sublingual absorption is slower for prolonged effect
D. Oral formulations cause immediate toxicity
Rationale: Correct — Nitroglycerin undergoes extensive first-pass metabolism (95%
metabolized by liver), making oral bioavailability very low; sublingual administration
allows direct absorption into systemic circulation via sublingual veins, bypassing the
portal system. Distractor C is incorrect because sublingual absorption is actually faster
than oral, not slower. (Pharmacology 5334: Pharmacokinetics – First-Pass Effect)
Q3: A patient with liver cirrhosis has low serum albumin. The nurse anticipates which
effect regarding highly protein-bound drugs like phenytoin?
A. Decreased free drug and decreased therapeutic effect
B. Increased free drug and increased risk of toxicity [CORRECT]
C. Increased absorption from the GI tract
D. Decreased volume of distribution
Rationale: Correct — With low albumin, fewer drug binding sites are available, increasing
the fraction of unbound (free) active drug, potentially leading to toxicity despite normal
total drug levels. Distractor A incorrectly reverses the effect. (Pharmacology 5334:
Pharmacokinetics – Distribution)
Q4: A patient taking oral contraceptives is started on rifampin for tuberculosis. The
nurse should teach the patient that:
, A. The contraceptive effectiveness may decrease due to increased metabolism
[CORRECT]
B. Rifampin will increase estrogen levels causing toxicity
C. They should take the medications simultaneously for better absorption
D. Rifampin inhibits contraceptive metabolism
Rationale: Correct — Rifampin induces CYP450 enzymes, increasing metabolism of
ethinyl estradiol and progestins in oral contraceptives, potentially reducing
contraceptive efficacy and requiring backup methods. Distractor D is incorrect because
rifampin induces (speeds up) rather than inhibits metabolism. (Pharmacology 5334:
Pharmacokinetics – Metabolism/Interactions)
Q5: A patient taking simvastatin is prescribed clarithromycin for an infection. Which
complication is the nurse monitoring for?
A. Rhabdomyolysis due to increased statin levels [CORRECT]
B. Hepatotoxicity from decreased statin metabolism
C. Myopathy from CYP450 induction
D. Bleeding risk from protein displacement
Rationale: Correct — Clarithromycin inhibits CYP3A4, decreasing simvastatin
metabolism and increasing blood levels, raising the risk of statin-induced myopathy and
rhabdomyolysis. Distractor C incorrectly states induction rather than inhibition.
(Pharmacology 5334: Pharmacokinetics – Metabolism/Interactions)
Q6: How many half-lives are required to reach steady-state concentration with
continuous drug administration?
2026/2027 Exam Questions and Answers
Guaranteed Pass Solutions Detailed Rationales
- Pass Guaranteed - A+ Graded
Section 1: Pharmacokinetics (Absorption, Distribution, Metabolism, Excretion)
Q1: A nurse understands that intravenous medications have 100% bioavailability
because:
A. They bypass the liver completely
B. They are administered directly into the bloodstream [CORRECT]
C. They avoid protein binding in plasma
D. They have no half-life
Rationale: Correct — IV administration delivers drug directly into systemic circulation,
eliminating absorption barriers and first-pass metabolism, resulting in 100%
bioavailability. Distractor A is incorrect because IV drugs still pass through the liver, but
bioavailability refers to the fraction reaching circulation unchanged, which is complete
with IV. (Pharmacology 5334: Pharmacokinetics – Bioavailability)
Q2: A patient with angina is prescribed nitroglycerin. The provider orders sublingual
tablets rather than oral capsules because:
,A. Sublingual administration bypasses first-pass hepatic metabolism [CORRECT]
B. Oral nitroglycerin is incompatible with gastric pH
C. Sublingual absorption is slower for prolonged effect
D. Oral formulations cause immediate toxicity
Rationale: Correct — Nitroglycerin undergoes extensive first-pass metabolism (95%
metabolized by liver), making oral bioavailability very low; sublingual administration
allows direct absorption into systemic circulation via sublingual veins, bypassing the
portal system. Distractor C is incorrect because sublingual absorption is actually faster
than oral, not slower. (Pharmacology 5334: Pharmacokinetics – First-Pass Effect)
Q3: A patient with liver cirrhosis has low serum albumin. The nurse anticipates which
effect regarding highly protein-bound drugs like phenytoin?
A. Decreased free drug and decreased therapeutic effect
B. Increased free drug and increased risk of toxicity [CORRECT]
C. Increased absorption from the GI tract
D. Decreased volume of distribution
Rationale: Correct — With low albumin, fewer drug binding sites are available, increasing
the fraction of unbound (free) active drug, potentially leading to toxicity despite normal
total drug levels. Distractor A incorrectly reverses the effect. (Pharmacology 5334:
Pharmacokinetics – Distribution)
Q4: A patient taking oral contraceptives is started on rifampin for tuberculosis. The
nurse should teach the patient that:
, A. The contraceptive effectiveness may decrease due to increased metabolism
[CORRECT]
B. Rifampin will increase estrogen levels causing toxicity
C. They should take the medications simultaneously for better absorption
D. Rifampin inhibits contraceptive metabolism
Rationale: Correct — Rifampin induces CYP450 enzymes, increasing metabolism of
ethinyl estradiol and progestins in oral contraceptives, potentially reducing
contraceptive efficacy and requiring backup methods. Distractor D is incorrect because
rifampin induces (speeds up) rather than inhibits metabolism. (Pharmacology 5334:
Pharmacokinetics – Metabolism/Interactions)
Q5: A patient taking simvastatin is prescribed clarithromycin for an infection. Which
complication is the nurse monitoring for?
A. Rhabdomyolysis due to increased statin levels [CORRECT]
B. Hepatotoxicity from decreased statin metabolism
C. Myopathy from CYP450 induction
D. Bleeding risk from protein displacement
Rationale: Correct — Clarithromycin inhibits CYP3A4, decreasing simvastatin
metabolism and increasing blood levels, raising the risk of statin-induced myopathy and
rhabdomyolysis. Distractor C incorrectly states induction rather than inhibition.
(Pharmacology 5334: Pharmacokinetics – Metabolism/Interactions)
Q6: How many half-lives are required to reach steady-state concentration with
continuous drug administration?
