UT Arlington NURS 5334 Final Exam (pdf) | 2026/2027 | Advanced
Pharmacology for NPs Q&A | Pharmacology
1. Which of the following best defines pharmacokinetics?
A) The impact of drugs on the body
B) The impact of the body on drugs
C) The study of drug receptors
D) The study of drug adverse effects
Correct Answer: The impact of the body on drugs
Rationale: Pharmacokinetics is the study of drug movement throughout the
body, encompassing absorption, distribution, metabolism, and excretion
(ADME). It describes what the body does to the drug, as opposed to
pharmacodynamics, which describes what the drug does to the body.
2. Which pharmacokinetic process is primarily responsible for drug
bioavailability?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Correct Answer: Absorption
Rationale: Bioavailability is the fraction of an administered dose of
unchanged drug that reaches systemic circulation. Absorption is the primary
determinant of bioavailability for non-IV routes.
3. A drug with a high volume of distribution (Vd) is most likely to:
A) Remain mostly in the plasma
B) Require dialysis for overdose removal
C) Accumulate in tissues
D) Have a short half-life
,Correct Answer: Accumulate in tissues
Rationale: High Vd indicates extensive tissue binding and uptake. Drugs with
large Vd (e.g., lipophilic drugs) are widely distributed throughout the body
and dialysis is ineffective for removal.
4. A patient is prescribed a drug that is a weak acid with a pKa of 4.4. In
which part of the gastrointestinal tract will absorption be most rapid?
A) Mouth (pH 7.0)
B) Stomach (pH 1.5)
C) Duodenum (pH 6.0)
D) Colon (pH 7.5)
Correct Answer: Stomach (pH 1.5)
Rationale: Weak acids are non-ionized (lipid-soluble) in acidic environments,
facilitating absorption across cell membranes. The stomach's acidic pH
promotes the non-ionized form of a weak acid, enhancing absorption.
5. A patient with chronic kidney disease (Stage 4) is prescribed a medication
that is primarily renally excreted. Which of the following dose adjustments is
most appropriate?
A) A higher dose to achieve a therapeutic effect
B) A lower dose or longer dosing interval to prevent toxicity
C) The same dose as a patient with normal renal function
D) An increased frequency of administration
Correct Answer: A lower dose or longer dosing interval to prevent toxicity
Rationale: In renal impairment, drug clearance is reduced, leading to drug
accumulation and increased risk of toxicity. Dose reduction or extended
dosing intervals are required to maintain safe therapeutic levels.
6. A drug has a half-life of 24 hours. Approximately how many hours will it
take for the drug to reach steady state?
,A) 24 hours
B) 48 hours
C) 120 hours
D) 240 hours
Correct Answer: 120 hours
Rationale: Steady state is achieved after approximately 4-5 half-lives. With a
half-life of 24 hours, 4-5 half-lives equal 96-120 hours.
7. Grapefruit juice inhibits CYP3A4. What effect would this have on felodipine
(a calcium channel blocker)?
A) Decreased effect
B) Increased toxicity
C) No change
D) Faster elimination
Correct Answer: Increased toxicity
Rationale: Grapefruit juice inhibits CYP3A4 in the intestinal wall and liver,
decreasing the metabolism of drugs like felodipine. This leads to increased
drug levels and potential toxicity.
8. A drug with zero-order kinetics is eliminated at:
A) A constant rate per unit time
B) A constant percentage per unit time
C) An increasing rate over time
D) A decreasing rate over time
Correct Answer: A constant rate per unit time
Rationale: Zero-order kinetics means a constant amount of drug is
eliminated per unit time, regardless of concentration. This is in contrast to
first-order kinetics, where a constant percentage is eliminated.
, 9. A patient with heart failure is prescribed digoxin. Which physiological
change associated with aging would most likely increase the risk of digoxin
toxicity?
A) Increased glomerular filtration rate
B) Decreased lean body mass
C) Increased hepatic blood flow
D) Decreased serum albumin
Correct Answer: Decreased serum albumin
Rationale: Aging is associated with decreased serum albumin. Digoxin is
moderately protein-bound. Lower albumin levels increase the free (active)
fraction of the drug, leading to a greater pharmacological effect and higher
risk of toxicity.
10. Which of the following is a potential adverse effect of long-term NSAID
use?
A) Hypotension
B) Gastrointestinal bleeding
C) Hypokalemia
D) Bronchodilation
Correct Answer: Gastrointestinal bleeding
Rationale: NSAIDs inhibit COX-1, which is protective of the gastric mucosa,
leading to an increased risk of gastrointestinal ulcers and bleeding.
11. A patient with a history of myocardial infarction is prescribed a beta-
blocker. Which of the following is a primary benefit of beta-blocker therapy
post-MI?
A) Increased cardiac output
B) Decreased myocardial oxygen demand
C) Increased heart rate
D) Bronchodilation
Pharmacology for NPs Q&A | Pharmacology
1. Which of the following best defines pharmacokinetics?
A) The impact of drugs on the body
B) The impact of the body on drugs
C) The study of drug receptors
D) The study of drug adverse effects
Correct Answer: The impact of the body on drugs
Rationale: Pharmacokinetics is the study of drug movement throughout the
body, encompassing absorption, distribution, metabolism, and excretion
(ADME). It describes what the body does to the drug, as opposed to
pharmacodynamics, which describes what the drug does to the body.
2. Which pharmacokinetic process is primarily responsible for drug
bioavailability?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Correct Answer: Absorption
Rationale: Bioavailability is the fraction of an administered dose of
unchanged drug that reaches systemic circulation. Absorption is the primary
determinant of bioavailability for non-IV routes.
3. A drug with a high volume of distribution (Vd) is most likely to:
A) Remain mostly in the plasma
B) Require dialysis for overdose removal
C) Accumulate in tissues
D) Have a short half-life
,Correct Answer: Accumulate in tissues
Rationale: High Vd indicates extensive tissue binding and uptake. Drugs with
large Vd (e.g., lipophilic drugs) are widely distributed throughout the body
and dialysis is ineffective for removal.
4. A patient is prescribed a drug that is a weak acid with a pKa of 4.4. In
which part of the gastrointestinal tract will absorption be most rapid?
A) Mouth (pH 7.0)
B) Stomach (pH 1.5)
C) Duodenum (pH 6.0)
D) Colon (pH 7.5)
Correct Answer: Stomach (pH 1.5)
Rationale: Weak acids are non-ionized (lipid-soluble) in acidic environments,
facilitating absorption across cell membranes. The stomach's acidic pH
promotes the non-ionized form of a weak acid, enhancing absorption.
5. A patient with chronic kidney disease (Stage 4) is prescribed a medication
that is primarily renally excreted. Which of the following dose adjustments is
most appropriate?
A) A higher dose to achieve a therapeutic effect
B) A lower dose or longer dosing interval to prevent toxicity
C) The same dose as a patient with normal renal function
D) An increased frequency of administration
Correct Answer: A lower dose or longer dosing interval to prevent toxicity
Rationale: In renal impairment, drug clearance is reduced, leading to drug
accumulation and increased risk of toxicity. Dose reduction or extended
dosing intervals are required to maintain safe therapeutic levels.
6. A drug has a half-life of 24 hours. Approximately how many hours will it
take for the drug to reach steady state?
,A) 24 hours
B) 48 hours
C) 120 hours
D) 240 hours
Correct Answer: 120 hours
Rationale: Steady state is achieved after approximately 4-5 half-lives. With a
half-life of 24 hours, 4-5 half-lives equal 96-120 hours.
7. Grapefruit juice inhibits CYP3A4. What effect would this have on felodipine
(a calcium channel blocker)?
A) Decreased effect
B) Increased toxicity
C) No change
D) Faster elimination
Correct Answer: Increased toxicity
Rationale: Grapefruit juice inhibits CYP3A4 in the intestinal wall and liver,
decreasing the metabolism of drugs like felodipine. This leads to increased
drug levels and potential toxicity.
8. A drug with zero-order kinetics is eliminated at:
A) A constant rate per unit time
B) A constant percentage per unit time
C) An increasing rate over time
D) A decreasing rate over time
Correct Answer: A constant rate per unit time
Rationale: Zero-order kinetics means a constant amount of drug is
eliminated per unit time, regardless of concentration. This is in contrast to
first-order kinetics, where a constant percentage is eliminated.
, 9. A patient with heart failure is prescribed digoxin. Which physiological
change associated with aging would most likely increase the risk of digoxin
toxicity?
A) Increased glomerular filtration rate
B) Decreased lean body mass
C) Increased hepatic blood flow
D) Decreased serum albumin
Correct Answer: Decreased serum albumin
Rationale: Aging is associated with decreased serum albumin. Digoxin is
moderately protein-bound. Lower albumin levels increase the free (active)
fraction of the drug, leading to a greater pharmacological effect and higher
risk of toxicity.
10. Which of the following is a potential adverse effect of long-term NSAID
use?
A) Hypotension
B) Gastrointestinal bleeding
C) Hypokalemia
D) Bronchodilation
Correct Answer: Gastrointestinal bleeding
Rationale: NSAIDs inhibit COX-1, which is protective of the gastric mucosa,
leading to an increased risk of gastrointestinal ulcers and bleeding.
11. A patient with a history of myocardial infarction is prescribed a beta-
blocker. Which of the following is a primary benefit of beta-blocker therapy
post-MI?
A) Increased cardiac output
B) Decreased myocardial oxygen demand
C) Increased heart rate
D) Bronchodilation
