, NR 566 Midterm Exam | Chamberlain Advanced
Pharmacology Actual Questions and Answers
1. A patient with liver disease is prescribed a medication primarily metabolized by
the liver. The NP anticipates which change in drug levels?
• A. Decreased drug levels
• B. Increased drug levels
• C. No change in drug levels
• D. Decreased drug half-life
Answer: B
Rationale: Impaired liver function reduces first-pass metabolism, leading to higher drug
levels and increased risk of toxicity .
2. A nurse practitioner is prescribing a medication that undergoes extensive first-
pass metabolism. Which route of administration would most effectively bypass
this effect?
• A. Oral
• B. Sublingual
• C. Intravenous
• D. Subcutaneous
Answer: C
Rationale: Intravenous administration delivers the medication directly into the
bloodstream, completely bypassing first-pass metabolism and providing 100%
bioavailability .
3. A patient is receiving a drug that is highly protein-bound (98%). Another highly
protein-bound drug is added. The NP should monitor for:
, • A. Decreased effectiveness of the first drug
• B. Increased risk of toxicity of the first drug
• C. No change in drug levels
• D. Faster elimination of both drugs
Answer: B
Rationale: Competition for protein-binding sites can displace the first drug, increasing
free (active) drug levels and risk of toxicity .
4. What is the primary organ responsible for drug excretion?
• A. Liver
• B. Kidneys
• C. Lungs
• D. Skin
Answer: B
Rationale: The kidneys are the primary organ for drug excretion. Impaired renal
function requires dosage adjustments to prevent accumulation and toxicity .
5. A patient with renal impairment is prescribed a drug excreted primarily by the
kidneys. The NP should:
• A. Prescribe a higher dose
• B. Prescribe a lower dose
• C. Prescribe the standard dose
• D. Avoid prescribing the drug
Answer: B
Rationale: Impaired renal function decreases drug excretion, leading to accumulation.
Lower doses or extended dosing intervals are required .
, 6. Which of the following describes a drug agonist?
• A. Binds to a receptor and blocks a response
• B. Binds to a receptor and produces a response
• C. Has no effect on receptors
• D. Enhances metabolism
Answer: B
Rationale: An agonist binds to a receptor and activates it, producing a response. An
antagonist binds but blocks the response .
7. The NP is prescribing a drug that is a CYP450 enzyme inducer. What effect will
this have on other drugs metabolized by the same enzyme?
• A. Increased metabolism and decreased effectiveness
• B. Decreased metabolism and increased toxicity
• C. No effect
• D. Increased absorption
Answer: A
Rationale: CYP450 inducers increase the metabolism of other drugs, potentially
decreasing their effectiveness. Examples include rifampin, phenytoin, and
carbamazepine .
8. A patient is taking warfarin and starts a new medication that is a CYP450
inhibitor. The NP should monitor for:
• A. Decreased INR
• B. Increased INR and bleeding risk
• C. No change in INR
Pharmacology Actual Questions and Answers
1. A patient with liver disease is prescribed a medication primarily metabolized by
the liver. The NP anticipates which change in drug levels?
• A. Decreased drug levels
• B. Increased drug levels
• C. No change in drug levels
• D. Decreased drug half-life
Answer: B
Rationale: Impaired liver function reduces first-pass metabolism, leading to higher drug
levels and increased risk of toxicity .
2. A nurse practitioner is prescribing a medication that undergoes extensive first-
pass metabolism. Which route of administration would most effectively bypass
this effect?
• A. Oral
• B. Sublingual
• C. Intravenous
• D. Subcutaneous
Answer: C
Rationale: Intravenous administration delivers the medication directly into the
bloodstream, completely bypassing first-pass metabolism and providing 100%
bioavailability .
3. A patient is receiving a drug that is highly protein-bound (98%). Another highly
protein-bound drug is added. The NP should monitor for:
, • A. Decreased effectiveness of the first drug
• B. Increased risk of toxicity of the first drug
• C. No change in drug levels
• D. Faster elimination of both drugs
Answer: B
Rationale: Competition for protein-binding sites can displace the first drug, increasing
free (active) drug levels and risk of toxicity .
4. What is the primary organ responsible for drug excretion?
• A. Liver
• B. Kidneys
• C. Lungs
• D. Skin
Answer: B
Rationale: The kidneys are the primary organ for drug excretion. Impaired renal
function requires dosage adjustments to prevent accumulation and toxicity .
5. A patient with renal impairment is prescribed a drug excreted primarily by the
kidneys. The NP should:
• A. Prescribe a higher dose
• B. Prescribe a lower dose
• C. Prescribe the standard dose
• D. Avoid prescribing the drug
Answer: B
Rationale: Impaired renal function decreases drug excretion, leading to accumulation.
Lower doses or extended dosing intervals are required .
, 6. Which of the following describes a drug agonist?
• A. Binds to a receptor and blocks a response
• B. Binds to a receptor and produces a response
• C. Has no effect on receptors
• D. Enhances metabolism
Answer: B
Rationale: An agonist binds to a receptor and activates it, producing a response. An
antagonist binds but blocks the response .
7. The NP is prescribing a drug that is a CYP450 enzyme inducer. What effect will
this have on other drugs metabolized by the same enzyme?
• A. Increased metabolism and decreased effectiveness
• B. Decreased metabolism and increased toxicity
• C. No effect
• D. Increased absorption
Answer: A
Rationale: CYP450 inducers increase the metabolism of other drugs, potentially
decreasing their effectiveness. Examples include rifampin, phenytoin, and
carbamazepine .
8. A patient is taking warfarin and starts a new medication that is a CYP450
inhibitor. The NP should monitor for:
• A. Decreased INR
• B. Increased INR and bleeding risk
• C. No change in INR
