NSG 5240 Advanced Pharmacology
Final Practice Exam: Questions with
Verified Answers and Rationales
Question 1
Which pharmacokinetic parameter primarily determines the duration of a
drug's effect?
A) Bioavailability
B) Half-life
C) Volume of distribution
D) Absorption rate
Answer: B
Rationale: The half-life determines how long a drug remains active in the
body before levels fall below the therapeutic range. While bioavailability
and absorption affect onset, and distribution determines spread, half-life
dictates duration .
Question 2
A patient with liver cirrhosis is prescribed a drug that normally undergoes
extensive first-pass metabolism. The nurse practitioner anticipates:
A) Decreased bioavailability
B) Significantly increased bioavailability
C) No change in drug levels
D) Increased first-pass metabolism
,Answer: B
Rationale: The first-pass effect occurs in the liver. Liver impairment means
less drug is metabolized before reaching systemic circulation, leading to
higher bioavailability and potential toxicity. This is a critical consideration
when prescribing to patients with hepatic dysfunction .
Question 3
A drug has a half-life of 12 hours. Approximately how many hours will it
take to reach steady state?
A) 24 hours
B) 36 hours
C) 48 hours
D) 60 hours
Answer: D
Rationale: Steady state is achieved after approximately 4-5 half-lives. 5 ×
12 hours = 60 hours. At 4 half-lives, approximately 94% of steady state is
reached; at 5 half-lives, approximately 97% is reached .
Question 4
Which route of administration bypasses the first-pass effect?
A) Oral
B) Sublingual
,C) Rectal
D) Both sublingual and rectal
Answer: D
Rationale: Sublingual and rectal (partially) routes allow drug absorption
directly into systemic circulation, avoiding portal circulation and hepatic
first-pass metabolism .
Question 5
The term "bioavailability" refers to:
A) The amount of drug that reaches systemic circulation unchanged
B) The rate at which a drug is metabolized by the liver
C) The volume of distribution of a drug
D) The time it takes for a drug to reach peak concentration
Answer: A
Rationale: Bioavailability (F) is the fraction of an administered dose of a
drug that reaches systemic circulation unchanged. IV drugs have 100%
bioavailability; oral drugs have lower bioavailability due to first-pass
metabolism .
Question 6
A drug with a high "volume of distribution" (Vd) indicates that the drug:
, A) Is concentrated in the plasma and does not distribute to tissues
B) Has extensively distributed to tissues (high tissue binding)
C) Is primarily excreted unchanged by the kidneys
D) Has a short half-life
Answer: B
Rationale: A high Vd (>0.6 L/kg) indicates that the drug has extensively
distributed into tissues (e.g., lipophilic drugs). Factors affecting Vd include
lipid solubility, protein binding, and tissue perfusion .
Question 7
A patient with impaired renal function is prescribed gentamicin. What
adjustment should the nurse anticipate?
A) Increase dose frequency
B) Decrease dose frequency
C) Switch to oral form
D) No change is needed
Answer: B
Rationale: Gentamicin is excreted renally. Reduced kidney function
prolongs its half-life, necessitating less frequent dosing to prevent toxicity .
Question 8
What is the mechanism of action of beta-blockers?
Final Practice Exam: Questions with
Verified Answers and Rationales
Question 1
Which pharmacokinetic parameter primarily determines the duration of a
drug's effect?
A) Bioavailability
B) Half-life
C) Volume of distribution
D) Absorption rate
Answer: B
Rationale: The half-life determines how long a drug remains active in the
body before levels fall below the therapeutic range. While bioavailability
and absorption affect onset, and distribution determines spread, half-life
dictates duration .
Question 2
A patient with liver cirrhosis is prescribed a drug that normally undergoes
extensive first-pass metabolism. The nurse practitioner anticipates:
A) Decreased bioavailability
B) Significantly increased bioavailability
C) No change in drug levels
D) Increased first-pass metabolism
,Answer: B
Rationale: The first-pass effect occurs in the liver. Liver impairment means
less drug is metabolized before reaching systemic circulation, leading to
higher bioavailability and potential toxicity. This is a critical consideration
when prescribing to patients with hepatic dysfunction .
Question 3
A drug has a half-life of 12 hours. Approximately how many hours will it
take to reach steady state?
A) 24 hours
B) 36 hours
C) 48 hours
D) 60 hours
Answer: D
Rationale: Steady state is achieved after approximately 4-5 half-lives. 5 ×
12 hours = 60 hours. At 4 half-lives, approximately 94% of steady state is
reached; at 5 half-lives, approximately 97% is reached .
Question 4
Which route of administration bypasses the first-pass effect?
A) Oral
B) Sublingual
,C) Rectal
D) Both sublingual and rectal
Answer: D
Rationale: Sublingual and rectal (partially) routes allow drug absorption
directly into systemic circulation, avoiding portal circulation and hepatic
first-pass metabolism .
Question 5
The term "bioavailability" refers to:
A) The amount of drug that reaches systemic circulation unchanged
B) The rate at which a drug is metabolized by the liver
C) The volume of distribution of a drug
D) The time it takes for a drug to reach peak concentration
Answer: A
Rationale: Bioavailability (F) is the fraction of an administered dose of a
drug that reaches systemic circulation unchanged. IV drugs have 100%
bioavailability; oral drugs have lower bioavailability due to first-pass
metabolism .
Question 6
A drug with a high "volume of distribution" (Vd) indicates that the drug:
, A) Is concentrated in the plasma and does not distribute to tissues
B) Has extensively distributed to tissues (high tissue binding)
C) Is primarily excreted unchanged by the kidneys
D) Has a short half-life
Answer: B
Rationale: A high Vd (>0.6 L/kg) indicates that the drug has extensively
distributed into tissues (e.g., lipophilic drugs). Factors affecting Vd include
lipid solubility, protein binding, and tissue perfusion .
Question 7
A patient with impaired renal function is prescribed gentamicin. What
adjustment should the nurse anticipate?
A) Increase dose frequency
B) Decrease dose frequency
C) Switch to oral form
D) No change is needed
Answer: B
Rationale: Gentamicin is excreted renally. Reduced kidney function
prolongs its half-life, necessitating less frequent dosing to prevent toxicity .
Question 8
What is the mechanism of action of beta-blockers?
