NURS 5334 Advanced Pharmacology
Exam 2 UTA Actual Exam 2026/2027 –
Complete Exam-Style Questions | 100%
Verified – Pass Guaranteed – A+ Graded
Question 1
A patient with hepatic cirrhosis is prescribed a medication that undergoes
extensive first-pass metabolism. The nurse practitioner should anticipate:
A. Increased bioavailability of the drug
B. Decreased bioavailability of the drug
C. No change in drug bioavailability
D. Increased renal excretion of the drug
Correct Answer: A
Rationale: First-pass metabolism occurs in the liver. In patients with hepatic
cirrhosis, liver function is impaired, reducing first-pass metabolism and increasing
the bioavailability of orally administered drugs. This can lead to higher drug levels
and increased risk of toxicity.
Question 2
A patient is prescribed a drug with a half-life of 24 hours. Approximately how many
hours will it take for the drug to reach steady state?
A. 24 hours
B. 48 hours
,C. 96 hours
D. 120 hours
Correct Answer: D
Rationale: Steady state is reached after approximately 4-5 half-lives. With a half-
life of 24 hours, steady state is achieved in approximately 96-120 hours (4-5 days).
This is important for understanding when therapeutic effects will be fully
established.
Question 3
Which route of administration has the fastest onset of action?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
Correct Answer: D
Rationale: Intravenous administration delivers the drug directly into the
bloodstream, resulting in the fastest onset of action. Oral administration requires
absorption from the GI tract, which is slower. Subcutaneous and intramuscular
routes require absorption from the injection site.
Question 4
A patient with renal impairment is prescribed a medication that is primarily renally
excreted. The nurse practitioner should:
A. Increase the dose
,B. Decrease the dose or increase the dosing interval
C. Maintain the standard dose
D. Administer the medication intravenously
Correct Answer: B
Rationale: In renal impairment, drug excretion is decreased, leading to drug
accumulation and increased risk of toxicity. The dose should be decreased or the
dosing interval should be increased based on the patient's creatinine clearance and
glomerular filtration rate.
Question 5
Which term describes the movement of a drug from the site of administration into
the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
Correct Answer: C
Rationale: Absorption is the movement of a drug from the site of administration
into the bloodstream. Distribution is the movement of the drug from the
bloodstream to tissues. Metabolism is the biotransformation of the drug. Excretion
is the removal of the drug from the body.
Question 6
A drug with a narrow therapeutic index requires:
, A. Less frequent monitoring
B. More frequent monitoring of serum drug levels
C. No special monitoring
D. Only monitoring of vital signs
Correct Answer: B
Rationale: Drugs with a narrow therapeutic index have a small margin between
therapeutic and toxic doses. Examples include digoxin, lithium, warfarin, and
phenytoin. These drugs require frequent monitoring of serum drug levels to ensure
therapeutic efficacy and prevent toxicity.
Question 7
Which pharmacokinetic process is affected by first-pass metabolism?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: C
Rationale: First-pass metabolism is a process of drug metabolism that occurs in
the liver before the drug reaches systemic circulation. Orally administered drugs
are absorbed from the GI tract and transported to the liver via the portal circulation,
where they may be metabolized before reaching the systemic circulation.
Question 8
A patient is prescribed a medication that is 95% protein-bound. What is the clinical
Exam 2 UTA Actual Exam 2026/2027 –
Complete Exam-Style Questions | 100%
Verified – Pass Guaranteed – A+ Graded
Question 1
A patient with hepatic cirrhosis is prescribed a medication that undergoes
extensive first-pass metabolism. The nurse practitioner should anticipate:
A. Increased bioavailability of the drug
B. Decreased bioavailability of the drug
C. No change in drug bioavailability
D. Increased renal excretion of the drug
Correct Answer: A
Rationale: First-pass metabolism occurs in the liver. In patients with hepatic
cirrhosis, liver function is impaired, reducing first-pass metabolism and increasing
the bioavailability of orally administered drugs. This can lead to higher drug levels
and increased risk of toxicity.
Question 2
A patient is prescribed a drug with a half-life of 24 hours. Approximately how many
hours will it take for the drug to reach steady state?
A. 24 hours
B. 48 hours
,C. 96 hours
D. 120 hours
Correct Answer: D
Rationale: Steady state is reached after approximately 4-5 half-lives. With a half-
life of 24 hours, steady state is achieved in approximately 96-120 hours (4-5 days).
This is important for understanding when therapeutic effects will be fully
established.
Question 3
Which route of administration has the fastest onset of action?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
Correct Answer: D
Rationale: Intravenous administration delivers the drug directly into the
bloodstream, resulting in the fastest onset of action. Oral administration requires
absorption from the GI tract, which is slower. Subcutaneous and intramuscular
routes require absorption from the injection site.
Question 4
A patient with renal impairment is prescribed a medication that is primarily renally
excreted. The nurse practitioner should:
A. Increase the dose
,B. Decrease the dose or increase the dosing interval
C. Maintain the standard dose
D. Administer the medication intravenously
Correct Answer: B
Rationale: In renal impairment, drug excretion is decreased, leading to drug
accumulation and increased risk of toxicity. The dose should be decreased or the
dosing interval should be increased based on the patient's creatinine clearance and
glomerular filtration rate.
Question 5
Which term describes the movement of a drug from the site of administration into
the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
Correct Answer: C
Rationale: Absorption is the movement of a drug from the site of administration
into the bloodstream. Distribution is the movement of the drug from the
bloodstream to tissues. Metabolism is the biotransformation of the drug. Excretion
is the removal of the drug from the body.
Question 6
A drug with a narrow therapeutic index requires:
, A. Less frequent monitoring
B. More frequent monitoring of serum drug levels
C. No special monitoring
D. Only monitoring of vital signs
Correct Answer: B
Rationale: Drugs with a narrow therapeutic index have a small margin between
therapeutic and toxic doses. Examples include digoxin, lithium, warfarin, and
phenytoin. These drugs require frequent monitoring of serum drug levels to ensure
therapeutic efficacy and prevent toxicity.
Question 7
Which pharmacokinetic process is affected by first-pass metabolism?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: C
Rationale: First-pass metabolism is a process of drug metabolism that occurs in
the liver before the drug reaches systemic circulation. Orally administered drugs
are absorbed from the GI tract and transported to the liver via the portal circulation,
where they may be metabolized before reaching the systemic circulation.
Question 8
A patient is prescribed a medication that is 95% protein-bound. What is the clinical
