NURS 5334 ADVANCED PHARMACOLOGY FINAL EXAM |
SIMULATION (PART 1: QUESTIONS 1–30) 2026 UPDATE
1. A drug with a narrow therapeutic index requires: A. Less monitoring B. Frequent monitoring C.
No dose adjustment D. Increased absorption
Answer: B
Rationale: Small changes in serum concentration can cause toxicity or loss of efficacy.
2. Bioavailability refers to: A. Drug metabolism B. Amount of drug reaching systemic circulation C.
Protein binding D. Drug elimination
Answer: B
Rationale: Bioavailability measures the fraction of administered drug that reaches circulation.
3. Which route bypasses first-pass metabolism? A. Oral B. Rectal C. Sublingual D. Enteral
Answer: C
Rationale: Sublingual administration enters systemic circulation directly.
4. The liver primarily performs: A. Excretion B. Filtration C. Metabolism D. Absorption
Answer: C
Rationale: Hepatic enzymes transform drugs into metabolites.
5. A drug antagonist: A. Activates receptors B. Enhances response C. Blocks receptor activation D.
Increases efficacy
Answer: C
Rationale: Antagonists occupy receptors without activating them.
6. Steady-state concentration is generally achieved after: A. 1 half-life B. 2 half-lives C. 4–5
half-lives D. 10 half-lives
Answer: C
Rationale: Most drugs reach steady state after approximately 4–5 half-lives.
7. Which factor decreases renal drug clearance? A. Increased GFR B. Dehydration C. Young age
D. Hyperthyroidism
Answer: B
Rationale: Reduced kidney perfusion decreases elimination.
8. Drug distribution is most affected by: A. Protein binding B. Hair color C. Vision D. Height
Answer: A
Rationale: Highly protein-bound drugs have less free drug available.
9. A loading dose is used to: A. Prevent elimination B. Reach therapeutic level rapidly C. Reduce
toxicity D. Decrease absorption
Answer: B
Rationale: A loading dose rapidly achieves therapeutic concentration.
, 10. The half-life of a drug determines: A. Drug color B. Time for 50% elimination C. Protein binding
D. Absorption rate
Answer: B
Rationale: Half-life is the time required for 50% of the drug to be eliminated.
11. Before prescribing, the NP should first: A. Check insurance B. Obtain medication history C.
Schedule follow-up D. Print prescription
Answer: B
Rationale: Medication history helps prevent interactions and errors.
12. Polypharmacy increases risk of: A. Drug interactions B. Better outcomes C. Less monitoring D.
Reduced side effects
Answer: A
Rationale: Multiple medications increase interaction risk.
13. The Beers Criteria applies to: A. Pediatrics B. Pregnancy C. Older adults D. Athletes
Answer: C
Rationale: It identifies potentially inappropriate medications in older adults.
14. Controlled substances require: A. No documentation B. Careful prescribing and monitoring C.
Automatic refills D. Verbal orders only
Answer: B
Rationale: Controlled substances require legal and clinical oversight.
15. Which factor is most important in pediatric dosing? A. Weight B. Occupation C. Marital status D.
Education
Answer: A
Rationale: Most pediatric doses are weight-based.
16. Which schedule has accepted medical use but high abuse potential? A. I B. II C. III D. V
Answer: B
Rationale: Schedule II substances have accepted medical use and high abuse potential.
17. The safest approach when starting an elderly patient on medication is: A. Start high, go high B.
Start low, go slow C. Standard adult dose D. Double dose
Answer: B
Rationale: Older adults are more susceptible to adverse effects.
18. Medication reconciliation aims to: A. Increase prescriptions B. Prevent medication errors C.
Improve billing D. Reduce visits
Answer: B
Rationale: It ensures accurate medication records.
19. Informed consent includes: A. Risks and benefits discussion B. Billing explanation only C.
Pharmacy selection D. Lab ordering
Answer: A
Rationale: Patients should understand risks, benefits, and alternatives.
SIMULATION (PART 1: QUESTIONS 1–30) 2026 UPDATE
1. A drug with a narrow therapeutic index requires: A. Less monitoring B. Frequent monitoring C.
No dose adjustment D. Increased absorption
Answer: B
Rationale: Small changes in serum concentration can cause toxicity or loss of efficacy.
2. Bioavailability refers to: A. Drug metabolism B. Amount of drug reaching systemic circulation C.
Protein binding D. Drug elimination
Answer: B
Rationale: Bioavailability measures the fraction of administered drug that reaches circulation.
3. Which route bypasses first-pass metabolism? A. Oral B. Rectal C. Sublingual D. Enteral
Answer: C
Rationale: Sublingual administration enters systemic circulation directly.
4. The liver primarily performs: A. Excretion B. Filtration C. Metabolism D. Absorption
Answer: C
Rationale: Hepatic enzymes transform drugs into metabolites.
5. A drug antagonist: A. Activates receptors B. Enhances response C. Blocks receptor activation D.
Increases efficacy
Answer: C
Rationale: Antagonists occupy receptors without activating them.
6. Steady-state concentration is generally achieved after: A. 1 half-life B. 2 half-lives C. 4–5
half-lives D. 10 half-lives
Answer: C
Rationale: Most drugs reach steady state after approximately 4–5 half-lives.
7. Which factor decreases renal drug clearance? A. Increased GFR B. Dehydration C. Young age
D. Hyperthyroidism
Answer: B
Rationale: Reduced kidney perfusion decreases elimination.
8. Drug distribution is most affected by: A. Protein binding B. Hair color C. Vision D. Height
Answer: A
Rationale: Highly protein-bound drugs have less free drug available.
9. A loading dose is used to: A. Prevent elimination B. Reach therapeutic level rapidly C. Reduce
toxicity D. Decrease absorption
Answer: B
Rationale: A loading dose rapidly achieves therapeutic concentration.
, 10. The half-life of a drug determines: A. Drug color B. Time for 50% elimination C. Protein binding
D. Absorption rate
Answer: B
Rationale: Half-life is the time required for 50% of the drug to be eliminated.
11. Before prescribing, the NP should first: A. Check insurance B. Obtain medication history C.
Schedule follow-up D. Print prescription
Answer: B
Rationale: Medication history helps prevent interactions and errors.
12. Polypharmacy increases risk of: A. Drug interactions B. Better outcomes C. Less monitoring D.
Reduced side effects
Answer: A
Rationale: Multiple medications increase interaction risk.
13. The Beers Criteria applies to: A. Pediatrics B. Pregnancy C. Older adults D. Athletes
Answer: C
Rationale: It identifies potentially inappropriate medications in older adults.
14. Controlled substances require: A. No documentation B. Careful prescribing and monitoring C.
Automatic refills D. Verbal orders only
Answer: B
Rationale: Controlled substances require legal and clinical oversight.
15. Which factor is most important in pediatric dosing? A. Weight B. Occupation C. Marital status D.
Education
Answer: A
Rationale: Most pediatric doses are weight-based.
16. Which schedule has accepted medical use but high abuse potential? A. I B. II C. III D. V
Answer: B
Rationale: Schedule II substances have accepted medical use and high abuse potential.
17. The safest approach when starting an elderly patient on medication is: A. Start high, go high B.
Start low, go slow C. Standard adult dose D. Double dose
Answer: B
Rationale: Older adults are more susceptible to adverse effects.
18. Medication reconciliation aims to: A. Increase prescriptions B. Prevent medication errors C.
Improve billing D. Reduce visits
Answer: B
Rationale: It ensures accurate medication records.
19. Informed consent includes: A. Risks and benefits discussion B. Billing explanation only C.
Pharmacy selection D. Lab ordering
Answer: A
Rationale: Patients should understand risks, benefits, and alternatives.
