NURS 676 Advanced Pharmacology Exam Review 2026-
2027 | Western Carolina University (WCU)
Midterm Practice Questions with Rationales
Question 1
A nurse is reviewing pharmacokinetics and understands that the process of drug
metabolism primarily occurs in which organ?
A. Kidneys
B. Liver
C. Heart
D. Lungs
Correct Answer✅:
B. Liver
Rationale:
The liver is the primary site of drug metabolism. Hepatic enzymes, especially the
cytochrome P450 system, modify medications to make them easier to eliminate
from the body. Changes in liver function can significantly affect medication levels
and toxicity risk.
,Question 2
Which statement best describes the difference between pharmacokinetics and
pharmacodynamics?
A. Pharmacokinetics describes how drugs affect the body, while
pharmacodynamics describes drug absorption
B. Pharmacokinetics describes what the body does to the drug, while
pharmacodynamics describes what the drug does to the body
C. Pharmacokinetics only applies to antibiotics, while pharmacodynamics applies
to all other medications
D. Pharmacokinetics and pharmacodynamics describe identical processes
Correct Answer✅:
B. Pharmacokinetics describes what the body does to the drug, while
pharmacodynamics describes what the drug does to the body
Rationale:
Pharmacokinetics includes absorption, distribution, metabolism, and elimination
(ADME). Pharmacodynamics focuses on medication effects, receptor interactions,
and physiological responses produced by the drug.
Question 3
A nurse is monitoring a patient receiving an ACE inhibitor. Which finding requires
immediate follow-up?
A. Mild headache during the first week of therapy
B. Dry cough
,C. Swelling of the lips and tongue
D. Slight decrease in blood pressure
Correct Answer✅:
C. Swelling of the lips and tongue
Rationale:
ACE inhibitors can cause angioedema, a potentially life-threatening reaction
involving swelling of the face, lips, tongue, and airway. Immediate intervention is
required because airway obstruction may occur.
Question 4
Which mechanism explains how beta-blocker medications lower blood pressure?
A. Increasing heart rate and cardiac output
B. Blocking beta-adrenergic receptors, reducing heart rate and cardiac workload
C. Increasing sodium retention by the kidneys
D. Stimulating sympathetic nervous system activity
Correct Answer✅:
B. Blocking beta-adrenergic receptors, reducing heart rate and cardiac
workload
Rationale:
Beta-blockers reduce sympathetic stimulation by blocking beta receptors. This
decreases heart rate, contractility, and cardiac workload, which lowers blood
pressure and reduces oxygen demand on the heart.
, Question 5
The nurse understands that insulin lowers blood glucose by:
A. Increasing glucose production in the liver
B. Promoting movement of glucose into cells for energy use
C. Preventing glucose absorption from the intestine
D. Increasing breakdown of stored glucose
Correct Answer✅:
B. Promoting movement of glucose into cells for energy use
Rationale:
Insulin allows glucose to enter muscle and fat cells, lowering blood glucose levels.
It also promotes storage of glucose as glycogen and reduces glucose production by
the liver.
Question 6
A patient taking warfarin requires monitoring of which laboratory value?
A. Hemoglobin A1C
B. International normalized ratio (INR)
C. Serum sodium level
D. Liver enzyme level only
Correct Answer✅:
B. International normalized ratio (INR)
Rationale:
Warfarin affects vitamin K-dependent clotting factors and requires INR monitoring
2027 | Western Carolina University (WCU)
Midterm Practice Questions with Rationales
Question 1
A nurse is reviewing pharmacokinetics and understands that the process of drug
metabolism primarily occurs in which organ?
A. Kidneys
B. Liver
C. Heart
D. Lungs
Correct Answer✅:
B. Liver
Rationale:
The liver is the primary site of drug metabolism. Hepatic enzymes, especially the
cytochrome P450 system, modify medications to make them easier to eliminate
from the body. Changes in liver function can significantly affect medication levels
and toxicity risk.
,Question 2
Which statement best describes the difference between pharmacokinetics and
pharmacodynamics?
A. Pharmacokinetics describes how drugs affect the body, while
pharmacodynamics describes drug absorption
B. Pharmacokinetics describes what the body does to the drug, while
pharmacodynamics describes what the drug does to the body
C. Pharmacokinetics only applies to antibiotics, while pharmacodynamics applies
to all other medications
D. Pharmacokinetics and pharmacodynamics describe identical processes
Correct Answer✅:
B. Pharmacokinetics describes what the body does to the drug, while
pharmacodynamics describes what the drug does to the body
Rationale:
Pharmacokinetics includes absorption, distribution, metabolism, and elimination
(ADME). Pharmacodynamics focuses on medication effects, receptor interactions,
and physiological responses produced by the drug.
Question 3
A nurse is monitoring a patient receiving an ACE inhibitor. Which finding requires
immediate follow-up?
A. Mild headache during the first week of therapy
B. Dry cough
,C. Swelling of the lips and tongue
D. Slight decrease in blood pressure
Correct Answer✅:
C. Swelling of the lips and tongue
Rationale:
ACE inhibitors can cause angioedema, a potentially life-threatening reaction
involving swelling of the face, lips, tongue, and airway. Immediate intervention is
required because airway obstruction may occur.
Question 4
Which mechanism explains how beta-blocker medications lower blood pressure?
A. Increasing heart rate and cardiac output
B. Blocking beta-adrenergic receptors, reducing heart rate and cardiac workload
C. Increasing sodium retention by the kidneys
D. Stimulating sympathetic nervous system activity
Correct Answer✅:
B. Blocking beta-adrenergic receptors, reducing heart rate and cardiac
workload
Rationale:
Beta-blockers reduce sympathetic stimulation by blocking beta receptors. This
decreases heart rate, contractility, and cardiac workload, which lowers blood
pressure and reduces oxygen demand on the heart.
, Question 5
The nurse understands that insulin lowers blood glucose by:
A. Increasing glucose production in the liver
B. Promoting movement of glucose into cells for energy use
C. Preventing glucose absorption from the intestine
D. Increasing breakdown of stored glucose
Correct Answer✅:
B. Promoting movement of glucose into cells for energy use
Rationale:
Insulin allows glucose to enter muscle and fat cells, lowering blood glucose levels.
It also promotes storage of glucose as glycogen and reduces glucose production by
the liver.
Question 6
A patient taking warfarin requires monitoring of which laboratory value?
A. Hemoglobin A1C
B. International normalized ratio (INR)
C. Serum sodium level
D. Liver enzyme level only
Correct Answer✅:
B. International normalized ratio (INR)
Rationale:
Warfarin affects vitamin K-dependent clotting factors and requires INR monitoring
