WGU D116 Advanced Pharmacology OA Exam 2026/2027 Actual
Exam - Questions with Detailed Rationales | 100% Verified Graded A+
Pass Guaranteed - A+ Graded 200
Questions 1–200
1. A patient is prescribed a drug that is a weak base with a pKa of
8.5. Which condition would increase its renal excretion?
A) Alkalinization of the urine
B) Acidification of the urine
C) Increased protein binding
D) Decreased renal blood flow
Answer B: Acidification of the urine
,Rationale: Weak bases are ionized and trapped in acidic urine,
enhancing excretion.
2. A patient with a genetic polymorphism resulting in CYP2D6 poor
metabolizer phenotype is prescribed codeine. What is the most
likely outcome?
A) Increased risk of respiratory depression
B) Little to no analgesic effect
C) Prolonged half-life of codeine
D) Increased risk of serotonin syndrome
Answer B: Little to no analgesic effect
Rationale: CYP2D6 is required to convert codeine to active morphine;
poor metabolizers have reduced analgesia.
3. A patient is prescribed a drug that is 98% protein-bound. Which
condition would increase the risk of toxicity?
A) Obesity
B) Hypoalbuminemia (low albumin)
C) Renal failure
,D) Hepatic cirrhosis
Answer B: Hypoalbuminemia (low albumin)
Rationale: Low albumin increases the free fraction of highly protein-
bound drugs, increasing effect and toxicity risk.
4. A patient is receiving a drug that is a P-glycoprotein (P-gp)
substrate. Which co-administered drug would increase its oral
bioavailability?
A) Rifampin (P-gp inducer)
B) Ketoconazole (P-gp inhibitor)
C) Phenytoin (P-gp inducer)
D) St. John's wort (P-gp inducer)
Answer B: Ketoconazole (P-gp inhibitor)
Rationale: P-gp inhibitors decrease drug efflux from intestinal cells,
increasing absorption and bioavailability.
5. A patient with hepatic cirrhosis has reduced phase I metabolism.
Which drug would be most affected?
A) Lorazepam (phase II glucuronidation)
, B) Phenytoin (phase I oxidation)
C) Digoxin (renal excretion)
D) Acetaminophen (phase II conjugation)
Answer B: Phenytoin (phase I oxidation)
Rationale: Phase I reactions (oxidation) are more affected by
cirrhosis than phase II.
6. A patient on warfarin develops a supratherapeutic INR. Which
vitamin is the antidote?
A) Vitamin A
B) Vitamin K
C) Vitamin D
D) Vitamin E
Answer B: Vitamin K
Rationale: Vitamin K reverses warfarin's anticoagulant effect.
7. A patient with atrial fibrillation is prescribed warfarin. Which
drug interaction would increase the INR?
A) Rifampin
Exam - Questions with Detailed Rationales | 100% Verified Graded A+
Pass Guaranteed - A+ Graded 200
Questions 1–200
1. A patient is prescribed a drug that is a weak base with a pKa of
8.5. Which condition would increase its renal excretion?
A) Alkalinization of the urine
B) Acidification of the urine
C) Increased protein binding
D) Decreased renal blood flow
Answer B: Acidification of the urine
,Rationale: Weak bases are ionized and trapped in acidic urine,
enhancing excretion.
2. A patient with a genetic polymorphism resulting in CYP2D6 poor
metabolizer phenotype is prescribed codeine. What is the most
likely outcome?
A) Increased risk of respiratory depression
B) Little to no analgesic effect
C) Prolonged half-life of codeine
D) Increased risk of serotonin syndrome
Answer B: Little to no analgesic effect
Rationale: CYP2D6 is required to convert codeine to active morphine;
poor metabolizers have reduced analgesia.
3. A patient is prescribed a drug that is 98% protein-bound. Which
condition would increase the risk of toxicity?
A) Obesity
B) Hypoalbuminemia (low albumin)
C) Renal failure
,D) Hepatic cirrhosis
Answer B: Hypoalbuminemia (low albumin)
Rationale: Low albumin increases the free fraction of highly protein-
bound drugs, increasing effect and toxicity risk.
4. A patient is receiving a drug that is a P-glycoprotein (P-gp)
substrate. Which co-administered drug would increase its oral
bioavailability?
A) Rifampin (P-gp inducer)
B) Ketoconazole (P-gp inhibitor)
C) Phenytoin (P-gp inducer)
D) St. John's wort (P-gp inducer)
Answer B: Ketoconazole (P-gp inhibitor)
Rationale: P-gp inhibitors decrease drug efflux from intestinal cells,
increasing absorption and bioavailability.
5. A patient with hepatic cirrhosis has reduced phase I metabolism.
Which drug would be most affected?
A) Lorazepam (phase II glucuronidation)
, B) Phenytoin (phase I oxidation)
C) Digoxin (renal excretion)
D) Acetaminophen (phase II conjugation)
Answer B: Phenytoin (phase I oxidation)
Rationale: Phase I reactions (oxidation) are more affected by
cirrhosis than phase II.
6. A patient on warfarin develops a supratherapeutic INR. Which
vitamin is the antidote?
A) Vitamin A
B) Vitamin K
C) Vitamin D
D) Vitamin E
Answer B: Vitamin K
Rationale: Vitamin K reverses warfarin's anticoagulant effect.
7. A patient with atrial fibrillation is prescribed warfarin. Which
drug interaction would increase the INR?
A) Rifampin
