NUR 635 Final Exam Practice Questions
and correct answers Review/ NUR 635
Advanced Pharmacology Final Exam
GCU Latest Practice Questions with
Correct Answers
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS
Question 1: A drug with a high volume of distribution (Vd) is most likely to:
A. Remain primarily in the plasma
B. Distribute extensively into tissues
C. Have a short half-life
D. Be eliminated rapidly by the kidneys
Correct Answer: B. Distribute extensively into tissues
Rationale: High Vd (> total body water) indicates extensive tissue distribution. Drugs like digoxin
and chloroquine have large Vd because they bind to tissues and are not confined to plasma. A
,high Vd also suggests that the drug is not easily removed by dialysis because it is sequestered in
tissues rather than circulating in blood .
Why the others are wrong:
• A: High Vd means the drug leaves the plasma compartment.
• C: Vd and half-life are not directly correlated.
• D: High Vd drugs are not necessarily rapidly eliminated renally.
Question 2: What is the primary site of drug metabolism for most medications?
A. Kidney
B. Liver (Phase I and Phase II reactions)
C. Lungs
D. Intestine
Correct Answer: B. Liver (Phase I and Phase II reactions)
Rationale: The liver is the primary organ for drug biotransformation via cytochrome P450
enzymes (Phase I) and conjugation reactions (Phase II). While the kidneys excrete drugs,
metabolism primarily occurs in the liver .
Why the others are wrong:
• A: The kidney is primarily responsible for drug excretion, not metabolism.
• C: The lungs play a minor role in drug metabolism.
• D: The intestine has some metabolic capacity but is not the primary site.
Question 3: First-pass effect reduces the bioavailability of orally administered drugs because:
A. The drug is excreted unchanged in urine
B. The drug is metabolized in the liver before reaching systemic circulation
C. The drug binds to plasma proteins
D. The drug is absorbed slowly
Correct Answer: B. The drug is metabolized in the liver before reaching systemic circulation
,Rationale: After oral absorption, drugs pass through the portal vein to the liver, where
significant metabolism may occur before reaching systemic circulation. This reduces the amount
of active drug available for therapeutic effect. Drugs like propranolol and lidocaine have high
first-pass metabolism .
Why the others are wrong:
• A: First-pass metabolism is not about renal excretion.
• C: Protein binding occurs after the drug reaches systemic circulation.
• D: Absorption rate is not the primary mechanism of first-pass effect.
Question 4: A patient is receiving a drug that follows zero-order kinetics. This means:
A. A constant fraction of the drug is eliminated per unit time
B. A constant amount of the drug is eliminated per unit time
C. The half-life is constant regardless of dose
D. The drug cannot be measured in plasma
Correct Answer: B. A constant amount of the drug is eliminated per unit time
Rationale: Zero-order kinetics (e.g., phenytoin, ethanol) means the elimination rate is constant,
not proportional to concentration. The half-life increases with dose, and there is a risk of toxicity
when metabolic pathways become saturated. Phenytoin is the classic example of a drug with
zero-order kinetics at therapeutic doses .
Why the others are wrong:
• A: This describes first-order kinetics, where a constant fraction is eliminated.
• C: In zero-order kinetics, half-life increases with dose.
• D: Zero-order drugs can be measured in plasma.
Question 5: The half-life (t½) of a drug is 12 hours. Approximately how long will it take for the
drug to reach steady state?
A. 24 hours
B. 60 hours (5 × half-life)
, C. 12 hours
D. 120 hours
Correct Answer: B. 60 hours (5 × half-life)
Rationale: Steady state is achieved after approximately 4-5 half-lives. For a drug with a 12-hour
half-life: 5 × 12 = 60 hours. At steady state, the rate of drug administration equals the rate of
drug elimination, and plasma concentration remains relatively constant .
Why the others are wrong:
• A: 24 hours would be only 2 half-lives.
• C: One half-life is not sufficient to reach steady state.
• D: 120 hours would be 10 half-lives, which is unnecessary.
Question 6: Grapefruit juice inhibits which cytochrome P450 enzyme, leading to increased drug
levels?
A. CYP2D6
B. CYP3A4
C. CYP1A2
D. CYP2C9
Correct Answer: B. CYP3A4
Rationale: Grapefruit juice inhibits intestinal and hepatic CYP3A4, increasing bioavailability of
drugs like simvastatin, amlodipine, and cyclosporine. Patients should avoid grapefruit juice
when taking medications metabolized by CYP3A4 to prevent toxicity .
Why the others are wrong:
• A: CYP2D6 is inhibited by fluoxetine and quinidine, not grapefruit juice.
• C: CYP1A2 is inhibited by ciprofloxacin, not grapefruit juice.
• D: CYP2C9 is inhibited by amiodarone and fluconazole, not grapefruit juice.
Question 7: Bioavailability refers to:
and correct answers Review/ NUR 635
Advanced Pharmacology Final Exam
GCU Latest Practice Questions with
Correct Answers
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS
Question 1: A drug with a high volume of distribution (Vd) is most likely to:
A. Remain primarily in the plasma
B. Distribute extensively into tissues
C. Have a short half-life
D. Be eliminated rapidly by the kidneys
Correct Answer: B. Distribute extensively into tissues
Rationale: High Vd (> total body water) indicates extensive tissue distribution. Drugs like digoxin
and chloroquine have large Vd because they bind to tissues and are not confined to plasma. A
,high Vd also suggests that the drug is not easily removed by dialysis because it is sequestered in
tissues rather than circulating in blood .
Why the others are wrong:
• A: High Vd means the drug leaves the plasma compartment.
• C: Vd and half-life are not directly correlated.
• D: High Vd drugs are not necessarily rapidly eliminated renally.
Question 2: What is the primary site of drug metabolism for most medications?
A. Kidney
B. Liver (Phase I and Phase II reactions)
C. Lungs
D. Intestine
Correct Answer: B. Liver (Phase I and Phase II reactions)
Rationale: The liver is the primary organ for drug biotransformation via cytochrome P450
enzymes (Phase I) and conjugation reactions (Phase II). While the kidneys excrete drugs,
metabolism primarily occurs in the liver .
Why the others are wrong:
• A: The kidney is primarily responsible for drug excretion, not metabolism.
• C: The lungs play a minor role in drug metabolism.
• D: The intestine has some metabolic capacity but is not the primary site.
Question 3: First-pass effect reduces the bioavailability of orally administered drugs because:
A. The drug is excreted unchanged in urine
B. The drug is metabolized in the liver before reaching systemic circulation
C. The drug binds to plasma proteins
D. The drug is absorbed slowly
Correct Answer: B. The drug is metabolized in the liver before reaching systemic circulation
,Rationale: After oral absorption, drugs pass through the portal vein to the liver, where
significant metabolism may occur before reaching systemic circulation. This reduces the amount
of active drug available for therapeutic effect. Drugs like propranolol and lidocaine have high
first-pass metabolism .
Why the others are wrong:
• A: First-pass metabolism is not about renal excretion.
• C: Protein binding occurs after the drug reaches systemic circulation.
• D: Absorption rate is not the primary mechanism of first-pass effect.
Question 4: A patient is receiving a drug that follows zero-order kinetics. This means:
A. A constant fraction of the drug is eliminated per unit time
B. A constant amount of the drug is eliminated per unit time
C. The half-life is constant regardless of dose
D. The drug cannot be measured in plasma
Correct Answer: B. A constant amount of the drug is eliminated per unit time
Rationale: Zero-order kinetics (e.g., phenytoin, ethanol) means the elimination rate is constant,
not proportional to concentration. The half-life increases with dose, and there is a risk of toxicity
when metabolic pathways become saturated. Phenytoin is the classic example of a drug with
zero-order kinetics at therapeutic doses .
Why the others are wrong:
• A: This describes first-order kinetics, where a constant fraction is eliminated.
• C: In zero-order kinetics, half-life increases with dose.
• D: Zero-order drugs can be measured in plasma.
Question 5: The half-life (t½) of a drug is 12 hours. Approximately how long will it take for the
drug to reach steady state?
A. 24 hours
B. 60 hours (5 × half-life)
, C. 12 hours
D. 120 hours
Correct Answer: B. 60 hours (5 × half-life)
Rationale: Steady state is achieved after approximately 4-5 half-lives. For a drug with a 12-hour
half-life: 5 × 12 = 60 hours. At steady state, the rate of drug administration equals the rate of
drug elimination, and plasma concentration remains relatively constant .
Why the others are wrong:
• A: 24 hours would be only 2 half-lives.
• C: One half-life is not sufficient to reach steady state.
• D: 120 hours would be 10 half-lives, which is unnecessary.
Question 6: Grapefruit juice inhibits which cytochrome P450 enzyme, leading to increased drug
levels?
A. CYP2D6
B. CYP3A4
C. CYP1A2
D. CYP2C9
Correct Answer: B. CYP3A4
Rationale: Grapefruit juice inhibits intestinal and hepatic CYP3A4, increasing bioavailability of
drugs like simvastatin, amlodipine, and cyclosporine. Patients should avoid grapefruit juice
when taking medications metabolized by CYP3A4 to prevent toxicity .
Why the others are wrong:
• A: CYP2D6 is inhibited by fluoxetine and quinidine, not grapefruit juice.
• C: CYP1A2 is inhibited by ciprofloxacin, not grapefruit juice.
• D: CYP2C9 is inhibited by amiodarone and fluconazole, not grapefruit juice.
Question 7: Bioavailability refers to:
