Page 1 of 161
NURS 5334 Advanced Pharmacology Final Exam
UPDATE THIS YEAR (2026-2027) ALL 300
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
1. A nurse practitioner is teaching a patient about a newly prescribed medication. Which
statement correctly distinguishes between pharmacokinetics and pharmacodynamics?
A) Pharmacokinetics is what the drug does to the body; pharmacodynamics is what the body
does to the drug.
B) Pharmacokinetics is the movement of drug across the cell membrane; pharmacodynamics is
the study of drug excretion.
C) Pharmacokinetics is what the body does to the drug; pharmacodynamics is what the drug
does to the body.
D) Pharmacokinetics only involves drug absorption; pharmacodynamics only involves drug
metabolism.
Answer: C
Pharmacokinetics refers to ADME (absorption, distribution, metabolism, excretion)—what the
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body does to the drug. Pharmacodynamics refers to the drug's biochemical and physiologic
effects—what the drug does to the body.
2. Which of the four major pharmacokinetic processes is the primary determinant of how
quickly a drug reaches its site of action?
A) Distribution
B) Metabolism
C) Excretion
D) Absorption
Answer: D
Absorption is the movement of a drug from its site of administration into systemic circulation;
the rate of absorption directly influences how quickly the drug reaches its target site and the
onset of action.
3. A drug with a high therapeutic index is considered:
A) More likely to cause toxicity
B) Safer than a drug with a low therapeutic index
C) Less effective than a drug with a low therapeutic index
D) More likely to cause allergic reactions
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Answer: B
A high therapeutic index indicates a wide margin between the therapeutic dose and the toxic
dose, making the drug safer. A low therapeutic index means the drug has a narrow margin of
safety.
4. What is bioavailability?
A) The amount of drug that is bound to plasma proteins
B) The fraction of an administered drug dose that reaches systemic circulation unchanged
C) The rate at which a drug is eliminated from the body
D) The time required for the drug concentration to decrease by half
Answer: B
Bioavailability is the fraction of an administered dose that reaches systemic circulation
unchanged and is available to produce an effect. IV drugs have 100% bioavailability; oral drugs
typically have lower bioavailability due to incomplete absorption and first-pass metabolism.
5. The first-pass effect occurs when:
A) A drug is excreted unchanged by the kidneys
B) An orally administered drug is metabolized by the liver before reaching systemic circulation
C) A drug binds extensively to plasma proteins
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D) A drug is administered via the intravenous route
Answer: B
The first-pass effect occurs when an orally administered drug is absorbed from the GI tract and
carried via the portal vein to the liver, where a significant portion is metabolized before reaching
systemic circulation.
6. A patient with hepatic impairment is prescribed a medication that is extensively metabolized
by the liver. What is the most appropriate action?
A) Administer a higher dose to achieve therapeutic effect
B) Administer the standard dose; hepatic impairment does not affect metabolism
C) Consider dose reduction or use of an alternative medication
D) Administer the medication via the oral route to bypass the liver
Answer: C
Reduced hepatic function decreases metabolism of drugs that rely on the liver for clearance,
leading to higher and more prolonged plasma concentrations. Dose reductions, extended
intervals, or avoidance of hepatically metabolized drugs may be necessary.
7. Which of the following factors can affect drug absorption when given orally?
A) Gastric pH and presence of food
4
NURS 5334 Advanced Pharmacology Final Exam
UPDATE THIS YEAR (2026-2027) ALL 300
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
1. A nurse practitioner is teaching a patient about a newly prescribed medication. Which
statement correctly distinguishes between pharmacokinetics and pharmacodynamics?
A) Pharmacokinetics is what the drug does to the body; pharmacodynamics is what the body
does to the drug.
B) Pharmacokinetics is the movement of drug across the cell membrane; pharmacodynamics is
the study of drug excretion.
C) Pharmacokinetics is what the body does to the drug; pharmacodynamics is what the drug
does to the body.
D) Pharmacokinetics only involves drug absorption; pharmacodynamics only involves drug
metabolism.
Answer: C
Pharmacokinetics refers to ADME (absorption, distribution, metabolism, excretion)—what the
1
, Page 2 of 161
body does to the drug. Pharmacodynamics refers to the drug's biochemical and physiologic
effects—what the drug does to the body.
2. Which of the four major pharmacokinetic processes is the primary determinant of how
quickly a drug reaches its site of action?
A) Distribution
B) Metabolism
C) Excretion
D) Absorption
Answer: D
Absorption is the movement of a drug from its site of administration into systemic circulation;
the rate of absorption directly influences how quickly the drug reaches its target site and the
onset of action.
3. A drug with a high therapeutic index is considered:
A) More likely to cause toxicity
B) Safer than a drug with a low therapeutic index
C) Less effective than a drug with a low therapeutic index
D) More likely to cause allergic reactions
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Answer: B
A high therapeutic index indicates a wide margin between the therapeutic dose and the toxic
dose, making the drug safer. A low therapeutic index means the drug has a narrow margin of
safety.
4. What is bioavailability?
A) The amount of drug that is bound to plasma proteins
B) The fraction of an administered drug dose that reaches systemic circulation unchanged
C) The rate at which a drug is eliminated from the body
D) The time required for the drug concentration to decrease by half
Answer: B
Bioavailability is the fraction of an administered dose that reaches systemic circulation
unchanged and is available to produce an effect. IV drugs have 100% bioavailability; oral drugs
typically have lower bioavailability due to incomplete absorption and first-pass metabolism.
5. The first-pass effect occurs when:
A) A drug is excreted unchanged by the kidneys
B) An orally administered drug is metabolized by the liver before reaching systemic circulation
C) A drug binds extensively to plasma proteins
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, Page 4 of 161
D) A drug is administered via the intravenous route
Answer: B
The first-pass effect occurs when an orally administered drug is absorbed from the GI tract and
carried via the portal vein to the liver, where a significant portion is metabolized before reaching
systemic circulation.
6. A patient with hepatic impairment is prescribed a medication that is extensively metabolized
by the liver. What is the most appropriate action?
A) Administer a higher dose to achieve therapeutic effect
B) Administer the standard dose; hepatic impairment does not affect metabolism
C) Consider dose reduction or use of an alternative medication
D) Administer the medication via the oral route to bypass the liver
Answer: C
Reduced hepatic function decreases metabolism of drugs that rely on the liver for clearance,
leading to higher and more prolonged plasma concentrations. Dose reductions, extended
intervals, or avoidance of hepatically metabolized drugs may be necessary.
7. Which of the following factors can affect drug absorption when given orally?
A) Gastric pH and presence of food
4
