NR 566 Advanced Pharmacology Exam
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A 72-year-old patient with chronic kidney disease is prescribed
a medication that is primarily eliminated by the kidneys. Which
pharmacokinetic change is most important for the nurse
practitioner to anticipate?
A. Increased renal clearance
B. Decreased drug absorption
C. Decreased renal clearance
D. Increased hepatic metabolism
Answer: C. Decreased renal clearance
Renal impairment decreases the elimination of medications that
depend substantially on renal excretion. This can increase serum
drug concentrations and prolong the medication's half-life,
raising the risk of adverse effects and toxicity. Dose reduction,
increased dosing intervals, or both may be necessary depending
on the specific medication and degree of renal dysfunction.
,Question 2
A medication has a half-life of approximately 24 hours.
Approximately how long will it take to reach near steady-state
concentrations with repeated dosing?
A. 24 hours
B. 48 hours
C. 4–5 days
D. 10–14 days
Answer: C. 4–5 days
Most drugs reach approximately 94–97% of steady state after
about four to five half-lives. A medication with a 24-hour half-
life therefore generally requires approximately four to five days
to approach steady state. This principle is important when
determining when a drug's maintenance effect can be
appropriately evaluated.
Question 3
Which pharmacodynamic characteristic describes a competitive
antagonist?
A. It permanently activates the receptor
B. It binds reversibly to the same receptor site as an agonist
,C. It increases the maximal efficacy of the agonist
D. It produces the same physiologic response as a full agonist
Answer: B. It binds reversibly to the same receptor site as an
agonist
Competitive antagonists compete with agonists for the same
receptor site. Because the interaction is generally reversible,
increasing the concentration of the agonist can overcome the
antagonistic effect. This differs from noncompetitive or
irreversible antagonism, in which increasing agonist
concentration does not restore the original maximal response.
Question 4
A patient taking an ACE inhibitor develops persistent dry cough.
Which medication class is an appropriate alternative when
continued renin-angiotensin system blockade is indicated?
A. Angiotensin II receptor blocker
B. Thiazide diuretic
C. Loop diuretic
D. Alpha-1 blocker
Answer: A. Angiotensin II receptor blocker
ACE inhibitors increase bradykinin concentrations, which can
contribute to the characteristic persistent dry cough.
Angiotensin II receptor blockers, or ARBs, block the angiotensin
, II receptor without inhibiting bradykinin breakdown and
therefore have a much lower incidence of this cough. ARBs are
not used during pregnancy because of the risk of fetal renal
injury and other serious fetal complications.
Question 5
A patient taking lisinopril develops swelling of the lips and
tongue with difficulty breathing. What is the priority action?
A. Administer the next dose with food
B. Discontinue the medication and provide emergency
treatment
C. Reduce the dose by half
D. Substitute hydrochlorothiazide immediately without further
assessment
Answer: B. Discontinue the medication and provide
emergency treatment
Angioedema involving the tongue, lips, or airway is a potentially
life-threatening adverse effect of ACE inhibitors. The medication
should be discontinued, and the patient requires urgent
evaluation and management of airway compromise.
Rechallenge with an ACE inhibitor should be avoided because
recurrent angioedema may be more severe.
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales 2026 Q&A
Instant Download PDF
Question 1
A 72-year-old patient with chronic kidney disease is prescribed
a medication that is primarily eliminated by the kidneys. Which
pharmacokinetic change is most important for the nurse
practitioner to anticipate?
A. Increased renal clearance
B. Decreased drug absorption
C. Decreased renal clearance
D. Increased hepatic metabolism
Answer: C. Decreased renal clearance
Renal impairment decreases the elimination of medications that
depend substantially on renal excretion. This can increase serum
drug concentrations and prolong the medication's half-life,
raising the risk of adverse effects and toxicity. Dose reduction,
increased dosing intervals, or both may be necessary depending
on the specific medication and degree of renal dysfunction.
,Question 2
A medication has a half-life of approximately 24 hours.
Approximately how long will it take to reach near steady-state
concentrations with repeated dosing?
A. 24 hours
B. 48 hours
C. 4–5 days
D. 10–14 days
Answer: C. 4–5 days
Most drugs reach approximately 94–97% of steady state after
about four to five half-lives. A medication with a 24-hour half-
life therefore generally requires approximately four to five days
to approach steady state. This principle is important when
determining when a drug's maintenance effect can be
appropriately evaluated.
Question 3
Which pharmacodynamic characteristic describes a competitive
antagonist?
A. It permanently activates the receptor
B. It binds reversibly to the same receptor site as an agonist
,C. It increases the maximal efficacy of the agonist
D. It produces the same physiologic response as a full agonist
Answer: B. It binds reversibly to the same receptor site as an
agonist
Competitive antagonists compete with agonists for the same
receptor site. Because the interaction is generally reversible,
increasing the concentration of the agonist can overcome the
antagonistic effect. This differs from noncompetitive or
irreversible antagonism, in which increasing agonist
concentration does not restore the original maximal response.
Question 4
A patient taking an ACE inhibitor develops persistent dry cough.
Which medication class is an appropriate alternative when
continued renin-angiotensin system blockade is indicated?
A. Angiotensin II receptor blocker
B. Thiazide diuretic
C. Loop diuretic
D. Alpha-1 blocker
Answer: A. Angiotensin II receptor blocker
ACE inhibitors increase bradykinin concentrations, which can
contribute to the characteristic persistent dry cough.
Angiotensin II receptor blockers, or ARBs, block the angiotensin
, II receptor without inhibiting bradykinin breakdown and
therefore have a much lower incidence of this cough. ARBs are
not used during pregnancy because of the risk of fetal renal
injury and other serious fetal complications.
Question 5
A patient taking lisinopril develops swelling of the lips and
tongue with difficulty breathing. What is the priority action?
A. Administer the next dose with food
B. Discontinue the medication and provide emergency
treatment
C. Reduce the dose by half
D. Substitute hydrochlorothiazide immediately without further
assessment
Answer: B. Discontinue the medication and provide
emergency treatment
Angioedema involving the tongue, lips, or airway is a potentially
life-threatening adverse effect of ACE inhibitors. The medication
should be discontinued, and the patient requires urgent
evaluation and management of airway compromise.
Rechallenge with an ACE inhibitor should be avoided because
recurrent angioedema may be more severe.
