NUR 651 EXAM 2 (BRADLEY) NEWEST
2026 TEST BANK| NUR651 ADVANCED
PHARMACOLOGY I EXAM 2
Q1. Which of the following processes is NOT a component of pharmacokinetics?
A) Absorption
B) Distribution
C) Metabolism
D) Pharmacodynamics
Answer: D) Pharmacodynamics
Rationale: Pharmacokinetics encompasses the four processes of Absorption,
Distribution, Metabolism, and Excretion (ADME). Pharmacodynamics is the study
of what the drug does to the body (receptor binding, mechanism of action,
effects), not a component of pharmacokinetics .
Q2. A drug with a high first-pass effect would have which characteristic?
A) High oral bioavailability
B) Low oral bioavailability
C) Rapid renal excretion
D) Extensive protein binding
Answer: B) Low oral bioavailability
Rationale: First-pass effect refers to the metabolism of a drug by the liver before
it reaches systemic circulation. Drugs with high first-pass metabolism (e.g.,
propranolol, morphine, nitroglycerin) have low oral bioavailability and often
require higher oral doses or alternative routes (IV, sublingual, transdermal) .
Q3. The volume of distribution (Vd) of a drug represents:
,A) The volume of plasma that contains the total amount of drug in the body
B) The apparent volume in which the total amount of drug would need to be
uniformly distributed to produce the measured plasma concentration
C) The actual volume of body water
D) The volume of the central compartment only
Answer: B) The apparent volume in which the total amount of drug would need
to be uniformly distributed
Rationale: Vd is a theoretical concept that relates the total amount of drug in the
body to the plasma concentration. A high Vd (>42 L) indicates extensive tissue
distribution; a low Vd suggests confinement to the vascular compartment .
Q4. Drug X has a half-life of 4 hours. Approximately how many half-lives are
required to reach steady state?
A) 2-3 half-lives
B) 4-5 half-lives
C) 6-7 half-lives
D) 8-10 half-lives
Answer: B) 4-5 half-lives
Rationale: It takes approximately 4-5 half-lives to reach steady state. For a drug
with a 4-hour half-life, steady state is achieved in about 16-20 hours. Conversely,
it takes the same number of half-lives for a drug to be eliminated from the body
after discontinuation .
Q5. Which cytochrome P450 enzyme is responsible for metabolizing the largest
number of drugs?
A) CYP1A2
B) CYP2D6
C) CYP3A4
D) CYP2C9
Answer: C) CYP3A4
,Rationale: CYP3A4 metabolizes approximately 50% of all marketed drugs,
including statins, calcium channel blockers, and benzodiazepines .
Q6. A drug is highly protein-bound (95%). Which statement is correct?
A) 95% of the drug is free and pharmacologically active
B) Only 5% of the drug is free and pharmacologically active
C) Protein binding increases drug excretion
D) The drug cannot be displaced by other medications
Answer: B) Only 5% of the drug is free and pharmacologically active
Rationale: Only unbound drug can bind to receptors, cross membranes, and be
eliminated. Protein binding serves as a reservoir. Changes in protein levels or
displacement by other drugs can increase free drug levels and toxicity .
Q7. A patient with liver failure is prescribed a medication that undergoes
extensive first-pass metabolism. The nurse expects:
A) Decreased oral bioavailability
B) Increased oral bioavailability
C) No change in drug levels
D) Decreased half-life
Answer: B) Increased oral bioavailability
Rationale: First-pass metabolism occurs in the liver. Liver failure reduces first-pass
effect, increasing bioavailability and risk of toxicity. Dose adjustment may be
necessary .
Q8. Which route of administration has the fastest onset of action?
A) Oral
B) Subcutaneous
C) Intramuscular
D) Intravenous
, Answer: D) Intravenous
Rationale: IV administration delivers drug directly into bloodstream, bypassing
absorption barriers. Onset is immediate and bioavailability is 100% .
Q9. A drug with a narrow therapeutic index requires:
A) No special monitoring
B) Frequent monitoring of serum drug levels
C) Higher doses for efficacy
D) Less frequent dosing
Answer: B) Frequent monitoring of serum drug levels
Rationale: Narrow therapeutic index means small difference between therapeutic
and toxic doses (e.g., warfarin, digoxin, phenytoin, lithium). These drugs require
careful dosing and therapeutic drug monitoring because small changes in dose or
factors affecting drug levels can result in toxicity or therapeutic failure .
Q10. The term "bioavailability" refers to:
A) The speed at which a drug is absorbed
B) The fraction of an administered dose that reaches systemic circulation
unchanged
C) The amount of drug bound to plasma proteins
D) The volume of distribution
Answer: B) The fraction of an administered dose that reaches systemic
circulation unchanged
Rationale: Bioavailability (F) is the fraction of the administered dose that reaches
systemic circulation unchanged. By definition, IV drugs have 100% bioavailability.
Oral drugs may have lower bioavailability due to incomplete absorption and first-
pass metabolism .
2026 TEST BANK| NUR651 ADVANCED
PHARMACOLOGY I EXAM 2
Q1. Which of the following processes is NOT a component of pharmacokinetics?
A) Absorption
B) Distribution
C) Metabolism
D) Pharmacodynamics
Answer: D) Pharmacodynamics
Rationale: Pharmacokinetics encompasses the four processes of Absorption,
Distribution, Metabolism, and Excretion (ADME). Pharmacodynamics is the study
of what the drug does to the body (receptor binding, mechanism of action,
effects), not a component of pharmacokinetics .
Q2. A drug with a high first-pass effect would have which characteristic?
A) High oral bioavailability
B) Low oral bioavailability
C) Rapid renal excretion
D) Extensive protein binding
Answer: B) Low oral bioavailability
Rationale: First-pass effect refers to the metabolism of a drug by the liver before
it reaches systemic circulation. Drugs with high first-pass metabolism (e.g.,
propranolol, morphine, nitroglycerin) have low oral bioavailability and often
require higher oral doses or alternative routes (IV, sublingual, transdermal) .
Q3. The volume of distribution (Vd) of a drug represents:
,A) The volume of plasma that contains the total amount of drug in the body
B) The apparent volume in which the total amount of drug would need to be
uniformly distributed to produce the measured plasma concentration
C) The actual volume of body water
D) The volume of the central compartment only
Answer: B) The apparent volume in which the total amount of drug would need
to be uniformly distributed
Rationale: Vd is a theoretical concept that relates the total amount of drug in the
body to the plasma concentration. A high Vd (>42 L) indicates extensive tissue
distribution; a low Vd suggests confinement to the vascular compartment .
Q4. Drug X has a half-life of 4 hours. Approximately how many half-lives are
required to reach steady state?
A) 2-3 half-lives
B) 4-5 half-lives
C) 6-7 half-lives
D) 8-10 half-lives
Answer: B) 4-5 half-lives
Rationale: It takes approximately 4-5 half-lives to reach steady state. For a drug
with a 4-hour half-life, steady state is achieved in about 16-20 hours. Conversely,
it takes the same number of half-lives for a drug to be eliminated from the body
after discontinuation .
Q5. Which cytochrome P450 enzyme is responsible for metabolizing the largest
number of drugs?
A) CYP1A2
B) CYP2D6
C) CYP3A4
D) CYP2C9
Answer: C) CYP3A4
,Rationale: CYP3A4 metabolizes approximately 50% of all marketed drugs,
including statins, calcium channel blockers, and benzodiazepines .
Q6. A drug is highly protein-bound (95%). Which statement is correct?
A) 95% of the drug is free and pharmacologically active
B) Only 5% of the drug is free and pharmacologically active
C) Protein binding increases drug excretion
D) The drug cannot be displaced by other medications
Answer: B) Only 5% of the drug is free and pharmacologically active
Rationale: Only unbound drug can bind to receptors, cross membranes, and be
eliminated. Protein binding serves as a reservoir. Changes in protein levels or
displacement by other drugs can increase free drug levels and toxicity .
Q7. A patient with liver failure is prescribed a medication that undergoes
extensive first-pass metabolism. The nurse expects:
A) Decreased oral bioavailability
B) Increased oral bioavailability
C) No change in drug levels
D) Decreased half-life
Answer: B) Increased oral bioavailability
Rationale: First-pass metabolism occurs in the liver. Liver failure reduces first-pass
effect, increasing bioavailability and risk of toxicity. Dose adjustment may be
necessary .
Q8. Which route of administration has the fastest onset of action?
A) Oral
B) Subcutaneous
C) Intramuscular
D) Intravenous
, Answer: D) Intravenous
Rationale: IV administration delivers drug directly into bloodstream, bypassing
absorption barriers. Onset is immediate and bioavailability is 100% .
Q9. A drug with a narrow therapeutic index requires:
A) No special monitoring
B) Frequent monitoring of serum drug levels
C) Higher doses for efficacy
D) Less frequent dosing
Answer: B) Frequent monitoring of serum drug levels
Rationale: Narrow therapeutic index means small difference between therapeutic
and toxic doses (e.g., warfarin, digoxin, phenytoin, lithium). These drugs require
careful dosing and therapeutic drug monitoring because small changes in dose or
factors affecting drug levels can result in toxicity or therapeutic failure .
Q10. The term "bioavailability" refers to:
A) The speed at which a drug is absorbed
B) The fraction of an administered dose that reaches systemic circulation
unchanged
C) The amount of drug bound to plasma proteins
D) The volume of distribution
Answer: B) The fraction of an administered dose that reaches systemic
circulation unchanged
Rationale: Bioavailability (F) is the fraction of the administered dose that reaches
systemic circulation unchanged. By definition, IV drugs have 100% bioavailability.
Oral drugs may have lower bioavailability due to incomplete absorption and first-
pass metabolism .
