Newest 2026/2027 NR 565 – Advanced Pharmacology Midterm exam verified with
correct answers and rationales
1. Which phase of pharmacokinetics describes the movement of a drug from the
site of administration into the bloodstream?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: A
Rationale: Absorption is the process by which a drug enters the systemic circulation after
administration.
2. Which organ is primarily responsible for drug metabolism?
A. Liver
B. Kidney
C. Lung
D. Pancreas
Correct Answer: A
Rationale: The liver is the principal site of drug metabolism through Phase I and Phase II
enzymatic reactions.
3. Which organ is primarily responsible for eliminating most medications from
the body?
A. Kidney
B. Heart
C. Stomach
D. Spleen
Correct Answer: A
Rationale: Most drugs and their metabolites are eliminated by the kidneys through filtration,
secretion, and reabsorption.
,4. A medication with a narrow therapeutic index requires:
A. Careful monitoring to avoid toxicity or subtherapeutic effects
B. Less frequent monitoring
C. Larger doses to improve effectiveness
D. No laboratory monitoring
Correct Answer: A
Rationale: Drugs with a narrow therapeutic index have a small margin between effective and
toxic doses.
5. Which factor most commonly affects drug metabolism in older adults?
A. Reduced hepatic blood flow and liver function
B. Increased liver size
C. Faster gastrointestinal motility
D. Increased muscle mass
Correct Answer: A
Rationale: Aging commonly decreases hepatic blood flow and metabolic capacity, increasing the
risk of adverse drug effects.
6. Which medication class is considered first-line therapy for uncomplicated
hypertension in many adults?
A. Thiazide diuretics
B. Opioids
C. Antihistamines
D. Antacids
Correct Answer: A
Rationale: Thiazide diuretics are among the recommended first-line antihypertensive agents
depending on patient characteristics.
7. Which adverse effect is commonly associated with ACE inhibitors?
,A. Persistent dry cough
B. Bradycardia
C. Hyperthyroidism
D. Constipation
Correct Answer: A
Rationale: ACE inhibitors may increase bradykinin levels, leading to a persistent dry cough.
8. Which electrolyte abnormality may occur with ACE inhibitor therapy?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: A
Rationale: ACE inhibitors reduce aldosterone secretion, which may increase serum potassium.
9. Which antihypertensive medication class should generally be avoided during
pregnancy?
A. ACE inhibitors
B. Calcium channel blockers
C. Methyldopa
D. Labetalol
Correct Answer: A
Rationale: ACE inhibitors are contraindicated during pregnancy because they can cause fetal
injury.
10. Which medication class lowers blood pressure by blocking angiotensin II
receptors?
A. Angiotensin receptor blockers (ARBs)
B. Beta blockers
C. Calcium channel blockers
D. Loop diuretics
, Correct Answer: A
Rationale: ARBs inhibit the effects of angiotensin II by blocking its receptors.
11. Which beta blocker is cardioselective?
A. Metoprolol
B. Propranolol
C. Carvedilol
D. Labetalol
Correct Answer: A
Rationale: Metoprolol primarily blocks beta-1 receptors at usual therapeutic doses.
12. Which adverse effect is commonly associated with beta blockers?
A. Bradycardia
B. Hyperglycemia
C. Tachycardia
D. Insomnia in every patient
Correct Answer: A
Rationale: Beta blockers reduce heart rate and may cause symptomatic bradycardia.
13. Which laboratory value should be monitored closely in a patient taking
furosemide?
A. Potassium
B. Calcium only
C. Bilirubin only
D. Platelet count only
Correct Answer: A
Rationale: Loop diuretics increase urinary potassium loss, increasing the risk of hypokalemia.
correct answers and rationales
1. Which phase of pharmacokinetics describes the movement of a drug from the
site of administration into the bloodstream?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: A
Rationale: Absorption is the process by which a drug enters the systemic circulation after
administration.
2. Which organ is primarily responsible for drug metabolism?
A. Liver
B. Kidney
C. Lung
D. Pancreas
Correct Answer: A
Rationale: The liver is the principal site of drug metabolism through Phase I and Phase II
enzymatic reactions.
3. Which organ is primarily responsible for eliminating most medications from
the body?
A. Kidney
B. Heart
C. Stomach
D. Spleen
Correct Answer: A
Rationale: Most drugs and their metabolites are eliminated by the kidneys through filtration,
secretion, and reabsorption.
,4. A medication with a narrow therapeutic index requires:
A. Careful monitoring to avoid toxicity or subtherapeutic effects
B. Less frequent monitoring
C. Larger doses to improve effectiveness
D. No laboratory monitoring
Correct Answer: A
Rationale: Drugs with a narrow therapeutic index have a small margin between effective and
toxic doses.
5. Which factor most commonly affects drug metabolism in older adults?
A. Reduced hepatic blood flow and liver function
B. Increased liver size
C. Faster gastrointestinal motility
D. Increased muscle mass
Correct Answer: A
Rationale: Aging commonly decreases hepatic blood flow and metabolic capacity, increasing the
risk of adverse drug effects.
6. Which medication class is considered first-line therapy for uncomplicated
hypertension in many adults?
A. Thiazide diuretics
B. Opioids
C. Antihistamines
D. Antacids
Correct Answer: A
Rationale: Thiazide diuretics are among the recommended first-line antihypertensive agents
depending on patient characteristics.
7. Which adverse effect is commonly associated with ACE inhibitors?
,A. Persistent dry cough
B. Bradycardia
C. Hyperthyroidism
D. Constipation
Correct Answer: A
Rationale: ACE inhibitors may increase bradykinin levels, leading to a persistent dry cough.
8. Which electrolyte abnormality may occur with ACE inhibitor therapy?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Correct Answer: A
Rationale: ACE inhibitors reduce aldosterone secretion, which may increase serum potassium.
9. Which antihypertensive medication class should generally be avoided during
pregnancy?
A. ACE inhibitors
B. Calcium channel blockers
C. Methyldopa
D. Labetalol
Correct Answer: A
Rationale: ACE inhibitors are contraindicated during pregnancy because they can cause fetal
injury.
10. Which medication class lowers blood pressure by blocking angiotensin II
receptors?
A. Angiotensin receptor blockers (ARBs)
B. Beta blockers
C. Calcium channel blockers
D. Loop diuretics
, Correct Answer: A
Rationale: ARBs inhibit the effects of angiotensin II by blocking its receptors.
11. Which beta blocker is cardioselective?
A. Metoprolol
B. Propranolol
C. Carvedilol
D. Labetalol
Correct Answer: A
Rationale: Metoprolol primarily blocks beta-1 receptors at usual therapeutic doses.
12. Which adverse effect is commonly associated with beta blockers?
A. Bradycardia
B. Hyperglycemia
C. Tachycardia
D. Insomnia in every patient
Correct Answer: A
Rationale: Beta blockers reduce heart rate and may cause symptomatic bradycardia.
13. Which laboratory value should be monitored closely in a patient taking
furosemide?
A. Potassium
B. Calcium only
C. Bilirubin only
D. Platelet count only
Correct Answer: A
Rationale: Loop diuretics increase urinary potassium loss, increasing the risk of hypokalemia.
