NR 567 Exam 1 V1 | NR 567 Advanced
Pharmacology for the AGACNP | Actual
Q&A with Rationale (NR567 Exam 1) |
Chamberlain College of Nursing
1. A patient is taking a drug that is known to be a potent inducer of the Cytochrome P450
(CYP) enzyme system. How should the AGACNP anticipate adjusting the dosage of other
medications metabolized by the same system?
A. Increase the dose to maintain therapeutic levels.
B. Decrease the dose to avoid toxicity.
C. Keep the dose the same but monitor for side effects.
D. Administer the drug intravenously only.
Answer: A
Rationale: Inducers of the CYP system increase the rate of drug metabolism by
stimulating the production of enzymes. This leads to a faster breakdown of co-
administered drugs, often resulting in sub-therapeutic blood levels. Therefore, the
clinician must increase the dosage of the substrate drug to achieve the desired clinical
effect.
2. Which physiological changes in the elderly population significantly impact the distribution
of lipid-soluble drugs? (Select All That Apply)
A. Increased percentage of body fat
,B. Increased total body water
C. Decreased lean muscle mass
D. Decreased serum albumin levels
E. Increased glomerular filtration rate
F. Increased gastric pH
Answer: A, C, D
Rationale: Pharmacokinetic changes in geriatrics include an increase in body fat
which provides a larger reservoir for lipid-soluble drugs, potentially prolonging their
half-life. Decreased lean muscle mass and decreased total body water affect the
distribution of water-soluble drugs, while lower albumin levels increase the free
fraction of protein-bound drugs. These factors collectively necessitate cautious dosing
in the elderly to prevent accumulation and toxicity.
3. When evaluating the ‘First-Pass Effect,’ the AGACNP understands that this phenomenon
primarily occurs after which route of administration?
A. Sublingual
B. Intravenous
C. Oral
D. Intramuscular
Answer: C
, Rationale: The first-pass effect refers to the rapid hepatic metabolism of a drug that
occurs after it is absorbed from the gastrointestinal tract and delivered to the liver via
the portal vein. Drugs administered orally must pass through the liver before reaching
systemic circulation, which can significantly reduce their bioavailability. Other routes
like sublingual or IV bypass the liver initially, ensuring higher systemic concentrations.
4. A drug with a high therapeutic index (TI) is characterized by which of the following?
A. A wide margin of safety between the therapeutic dose and the lethal dose.
B. A narrow window between efficacy and toxicity.
C. The requirement for frequent therapeutic drug monitoring (TDM).
D. A high potential for addiction and abuse.
Answer: A
Rationale: The therapeutic index is a ratio that compares the blood concentration at
which a drug becomes toxic to the concentration at which the drug is effective. A high
TI indicates that the drug is relatively safe because the dose required to cause toxicity
is much higher than the dose needed for therapy. Conversely, drugs like warfarin or
digoxin have a low TI and require precise monitoring.
5. Which of the following describes the term ‘Pharmacodynamics’?
A. What the drug does to the body.
B. What the body does to the drug.
C. The movement of drugs through the body.
Pharmacology for the AGACNP | Actual
Q&A with Rationale (NR567 Exam 1) |
Chamberlain College of Nursing
1. A patient is taking a drug that is known to be a potent inducer of the Cytochrome P450
(CYP) enzyme system. How should the AGACNP anticipate adjusting the dosage of other
medications metabolized by the same system?
A. Increase the dose to maintain therapeutic levels.
B. Decrease the dose to avoid toxicity.
C. Keep the dose the same but monitor for side effects.
D. Administer the drug intravenously only.
Answer: A
Rationale: Inducers of the CYP system increase the rate of drug metabolism by
stimulating the production of enzymes. This leads to a faster breakdown of co-
administered drugs, often resulting in sub-therapeutic blood levels. Therefore, the
clinician must increase the dosage of the substrate drug to achieve the desired clinical
effect.
2. Which physiological changes in the elderly population significantly impact the distribution
of lipid-soluble drugs? (Select All That Apply)
A. Increased percentage of body fat
,B. Increased total body water
C. Decreased lean muscle mass
D. Decreased serum albumin levels
E. Increased glomerular filtration rate
F. Increased gastric pH
Answer: A, C, D
Rationale: Pharmacokinetic changes in geriatrics include an increase in body fat
which provides a larger reservoir for lipid-soluble drugs, potentially prolonging their
half-life. Decreased lean muscle mass and decreased total body water affect the
distribution of water-soluble drugs, while lower albumin levels increase the free
fraction of protein-bound drugs. These factors collectively necessitate cautious dosing
in the elderly to prevent accumulation and toxicity.
3. When evaluating the ‘First-Pass Effect,’ the AGACNP understands that this phenomenon
primarily occurs after which route of administration?
A. Sublingual
B. Intravenous
C. Oral
D. Intramuscular
Answer: C
, Rationale: The first-pass effect refers to the rapid hepatic metabolism of a drug that
occurs after it is absorbed from the gastrointestinal tract and delivered to the liver via
the portal vein. Drugs administered orally must pass through the liver before reaching
systemic circulation, which can significantly reduce their bioavailability. Other routes
like sublingual or IV bypass the liver initially, ensuring higher systemic concentrations.
4. A drug with a high therapeutic index (TI) is characterized by which of the following?
A. A wide margin of safety between the therapeutic dose and the lethal dose.
B. A narrow window between efficacy and toxicity.
C. The requirement for frequent therapeutic drug monitoring (TDM).
D. A high potential for addiction and abuse.
Answer: A
Rationale: The therapeutic index is a ratio that compares the blood concentration at
which a drug becomes toxic to the concentration at which the drug is effective. A high
TI indicates that the drug is relatively safe because the dose required to cause toxicity
is much higher than the dose needed for therapy. Conversely, drugs like warfarin or
digoxin have a low TI and require precise monitoring.
5. Which of the following describes the term ‘Pharmacodynamics’?
A. What the drug does to the body.
B. What the body does to the drug.
C. The movement of drugs through the body.
