NURS 5334 Final Exam V2 | NURS 5334
Advanced Pharmacology Guide 2026/2027 |
Actual Q&A with Rationale (NURS5334 Final
Exam) | The University of Texas at Arlington
1. The objective of drug therapy is to:
A. Use the newest medications available
B. Produce maximum benefit with minimum harm
C. Prescribe the lowest cost medication
D. Eliminate all side effects
Answer: B
Rationale: The therapeutic objective of drug therapy is to provide maximum benefit
with minimum harm. This principle guides all prescribing decisions in advanced practice
.
2. A 75-year-old patient with renal impairment is prescribed a medication that is
primarily renally excreted. What is the most likely pharmacokinetic parameter that
will be altered?
A. Absorption
B. Distribution
C. Clearance
D. Bioavailability
Answer: C
Rationale: The clearance (CL) of the drug will be decreased in renal impairment. The
clinical implication is that the drug may accumulate to toxic levels if the dose or dosing
interval is not adjusted. This increases the risk of adverse effects .
3. Define Pharmacokinetics.
,A. The study of drug-receptor interactions
B. The impact of the body on drugs and how much of an administered dose gets to its
sites of action
C. The study of drug side effects
D. The study of drug manufacturing
Answer: B
Rationale: Pharmacokinetics is defined as the impact of the body on drugs—how much
of an administered dose gets to its sites of action. The four major pharmacokinetic
processes are absorption, distribution, metabolism, and excretion (ADME) .
4. Define Pharmacodynamics.
A. The impact of the body on drugs
B. The study of drug absorption
C. The impact of drugs on the body and the study of drug-receptor interactions
D. The study of drug metabolism
Answer: C
Rationale: Pharmacodynamics is the study of the impact of drugs on the body—what
the drug does to the body. It includes drug-receptor interactions, dose-response
relationships, potency, and efficacy .
5. What is the first-pass effect, and how does it affect oral drug bioavailability?
A. The excretion of drug through the kidneys; it increases bioavailability
B. The extensive hepatic metabolism of a drug before it reaches systemic circulation; it
significantly reduces bioavailability
C. The absorption of drug through the stomach; it has no effect on bioavailability
D. The binding of drug to plasma proteins; it increases bioavailability
Answer: B
Rationale: The first-pass effect is the extensive metabolism of an oral drug by the liver
and gut wall before it reaches systemic circulation, significantly reducing its
bioavailability. This often requires higher oral doses or alternative routes (IV, sublingual,
transdermal, or rectal) to circumvent the effect .
,6. A drug that has an effect, but no matter how high of a dose, cannot produce a
full agonist effect is called:
A. An agonist
B. A partial agonist
C. An antagonist
D. An inverse agonist
Answer: B
Rationale: A partial agonist binds to the receptor but produces a submaximal response
even at full receptor occupancy. It has lower efficacy than a full agonist. Clinically, it can
act as an antagonist in the presence of a full agonist (e.g., buprenorphine in opioid use
disorder) .
7. Explain the concept of therapeutic index (TI) and its clinical significance.
A. The ratio of a drug's effective dose to its toxic dose; a high TI indicates a narrow
margin of safety
B. The ratio of a drug's toxic dose to its effective dose; a low TI indicates a narrow
margin of safety requiring close monitoring
C. The ratio of a drug's absorption to its excretion; it determines dosing frequency
D. The ratio of a drug's potency to its efficacy; it determines drug selection
Answer: B
Rationale: The Therapeutic Index (TI) is the ratio of a drug's toxic dose (TD50 or LD50)
to its effective dose (ED50). A low TI (e.g., digoxin, warfarin, lithium) indicates a narrow
margin of safety, requiring close therapeutic drug monitoring and patient assessment. A
high TI (e.g., penicillin) is generally safer .
8. What is the role of cytochrome P450 (CYP) enzymes in drug metabolism, and
why are genetic polymorphisms important?
A. CYP enzymes are the major catalysts for Phase II drug metabolism; polymorphisms
have no clinical significance
, B. CYP enzymes are the major catalysts for Phase I drug metabolism; genetic
polymorphisms can create "poor metabolizers" or "ultra-rapid metabolizers," leading to
dangerously high or subtherapeutic drug levels
C. CYP enzymes are responsible for drug excretion; polymorphisms affect only renal
clearance
D. CYP enzymes are involved in drug absorption; polymorphisms affect only oral
bioavailability
Answer: B
Rationale: Cytochrome P450 (CYP) enzymes are the major catalysts for Phase I drug
metabolism. Genetic polymorphisms can create "poor metabolizers" or "ultra-rapid
metabolizers," leading to dangerously high or subtherapeutic drug levels, respectively,
with standard dosing .
9. Which of the following is an example of a drug with zero-order kinetics?
A. Warfarin
B. Phenytoin
C. Digoxin
D. Metformin
Answer: B
Rationale: Zero-order kinetics means elimination at a constant rate regardless of drug
concentration. Drugs with zero-order kinetics include phenytoin, salicylate, ethanol
(ETOH), and theophylline .
10. How long does it typically take to eliminate a drug from the body (5 half-
lives)?
A. 1-2 half-lives
B. 3-4 half-lives
C. 5 half-lives
D. 10 half-lives
Advanced Pharmacology Guide 2026/2027 |
Actual Q&A with Rationale (NURS5334 Final
Exam) | The University of Texas at Arlington
1. The objective of drug therapy is to:
A. Use the newest medications available
B. Produce maximum benefit with minimum harm
C. Prescribe the lowest cost medication
D. Eliminate all side effects
Answer: B
Rationale: The therapeutic objective of drug therapy is to provide maximum benefit
with minimum harm. This principle guides all prescribing decisions in advanced practice
.
2. A 75-year-old patient with renal impairment is prescribed a medication that is
primarily renally excreted. What is the most likely pharmacokinetic parameter that
will be altered?
A. Absorption
B. Distribution
C. Clearance
D. Bioavailability
Answer: C
Rationale: The clearance (CL) of the drug will be decreased in renal impairment. The
clinical implication is that the drug may accumulate to toxic levels if the dose or dosing
interval is not adjusted. This increases the risk of adverse effects .
3. Define Pharmacokinetics.
,A. The study of drug-receptor interactions
B. The impact of the body on drugs and how much of an administered dose gets to its
sites of action
C. The study of drug side effects
D. The study of drug manufacturing
Answer: B
Rationale: Pharmacokinetics is defined as the impact of the body on drugs—how much
of an administered dose gets to its sites of action. The four major pharmacokinetic
processes are absorption, distribution, metabolism, and excretion (ADME) .
4. Define Pharmacodynamics.
A. The impact of the body on drugs
B. The study of drug absorption
C. The impact of drugs on the body and the study of drug-receptor interactions
D. The study of drug metabolism
Answer: C
Rationale: Pharmacodynamics is the study of the impact of drugs on the body—what
the drug does to the body. It includes drug-receptor interactions, dose-response
relationships, potency, and efficacy .
5. What is the first-pass effect, and how does it affect oral drug bioavailability?
A. The excretion of drug through the kidneys; it increases bioavailability
B. The extensive hepatic metabolism of a drug before it reaches systemic circulation; it
significantly reduces bioavailability
C. The absorption of drug through the stomach; it has no effect on bioavailability
D. The binding of drug to plasma proteins; it increases bioavailability
Answer: B
Rationale: The first-pass effect is the extensive metabolism of an oral drug by the liver
and gut wall before it reaches systemic circulation, significantly reducing its
bioavailability. This often requires higher oral doses or alternative routes (IV, sublingual,
transdermal, or rectal) to circumvent the effect .
,6. A drug that has an effect, but no matter how high of a dose, cannot produce a
full agonist effect is called:
A. An agonist
B. A partial agonist
C. An antagonist
D. An inverse agonist
Answer: B
Rationale: A partial agonist binds to the receptor but produces a submaximal response
even at full receptor occupancy. It has lower efficacy than a full agonist. Clinically, it can
act as an antagonist in the presence of a full agonist (e.g., buprenorphine in opioid use
disorder) .
7. Explain the concept of therapeutic index (TI) and its clinical significance.
A. The ratio of a drug's effective dose to its toxic dose; a high TI indicates a narrow
margin of safety
B. The ratio of a drug's toxic dose to its effective dose; a low TI indicates a narrow
margin of safety requiring close monitoring
C. The ratio of a drug's absorption to its excretion; it determines dosing frequency
D. The ratio of a drug's potency to its efficacy; it determines drug selection
Answer: B
Rationale: The Therapeutic Index (TI) is the ratio of a drug's toxic dose (TD50 or LD50)
to its effective dose (ED50). A low TI (e.g., digoxin, warfarin, lithium) indicates a narrow
margin of safety, requiring close therapeutic drug monitoring and patient assessment. A
high TI (e.g., penicillin) is generally safer .
8. What is the role of cytochrome P450 (CYP) enzymes in drug metabolism, and
why are genetic polymorphisms important?
A. CYP enzymes are the major catalysts for Phase II drug metabolism; polymorphisms
have no clinical significance
, B. CYP enzymes are the major catalysts for Phase I drug metabolism; genetic
polymorphisms can create "poor metabolizers" or "ultra-rapid metabolizers," leading to
dangerously high or subtherapeutic drug levels
C. CYP enzymes are responsible for drug excretion; polymorphisms affect only renal
clearance
D. CYP enzymes are involved in drug absorption; polymorphisms affect only oral
bioavailability
Answer: B
Rationale: Cytochrome P450 (CYP) enzymes are the major catalysts for Phase I drug
metabolism. Genetic polymorphisms can create "poor metabolizers" or "ultra-rapid
metabolizers," leading to dangerously high or subtherapeutic drug levels, respectively,
with standard dosing .
9. Which of the following is an example of a drug with zero-order kinetics?
A. Warfarin
B. Phenytoin
C. Digoxin
D. Metformin
Answer: B
Rationale: Zero-order kinetics means elimination at a constant rate regardless of drug
concentration. Drugs with zero-order kinetics include phenytoin, salicylate, ethanol
(ETOH), and theophylline .
10. How long does it typically take to eliminate a drug from the body (5 half-
lives)?
A. 1-2 half-lives
B. 3-4 half-lives
C. 5 half-lives
D. 10 half-lives
