NURS 6521 ADVANCED PHARMACOLOGY FINAL
EXAM 300 MULTIPLE-CHOICE QUESTIONS WITH
ANSWERS AND RATIONALES
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS (Questions 1-40)
Question 1
A patient asks why a higher dose of a medication is needed orally compared to IV.
What is the nurse's best response?
A. "Oral medications are absorbed faster, so they are broken down quicker."
B. "The liver metabolizes a portion of the oral drug before it reaches the
bloodstream."
C. "Oral medications bind to protein in the stomach, making them inactive."
D. "The kidneys filter out oral medications more efficiently than IV medications."
Correct Answer: B
Rationale: This describes the first-pass effect. Orally administered drugs are
absorbed from the GI tract and carried via the hepatic portal system to the liver,
,where significant metabolism may occur before reaching systemic circulation.
This reduces bioavailability and requires higher oral doses compared to IV
administration .
---
Question 2
A drug has a half-life of 12 hours. How long will it take to reach steady state?
A. 12 hours
B. 24 hours
C. 60 hours
D. 72 hours
Correct Answer: C
Rationale: Steady state is typically achieved after approximately 4-5 half-lives.
Therefore, 12 hours × 5 = 60 hours. At this point, drug accumulation and
elimination reach equilibrium .
---
Question 3
,A nurse is reviewing lab results and notes a drug has a narrow therapeutic index
(NTI). What is the primary implication of this characteristic?
A. The drug has a wide margin of safety.
B. The drug requires routine monitoring of serum levels.
C. The drug does not require dosage adjustments.
D. The drug is safe for over-the-counter use.
Correct Answer: B
Rationale: A narrow therapeutic index means the difference between the
minimum effective concentration and the toxic concentration is small. Small
changes in dose or metabolism can lead to toxicity, necessitating close monitoring
(e.g., Warfarin, Digoxin, Phenytoin) .
---
Question 4
A patient is taking Drug A and a newly prescribed Drug B. The nurse notes that
Drug B displaces Drug A from plasma albumin. What is the expected result?
A. Decreased effect of Drug A
B. Increased free fraction of Drug A
, C. Increased excretion of Drug A
D. Decreased absorption of Drug B
Correct Answer: B
Rationale: Displacement from protein binding sites increases the amount of free
(unbound) drug in circulation. Only free drug is pharmacologically active,
potentially increasing the effect and risk of toxicity of Drug A .
---
Question 5
A patient with hepatic cirrhosis is prescribed a drug metabolized by the liver.
What adjustment is needed?
A. Increase the dose
B. Decrease the dose
C. No change needed
D. Change to IV route
Correct Answer: B
EXAM 300 MULTIPLE-CHOICE QUESTIONS WITH
ANSWERS AND RATIONALES
SECTION 1: PHARMACOKINETICS & PHARMACODYNAMICS (Questions 1-40)
Question 1
A patient asks why a higher dose of a medication is needed orally compared to IV.
What is the nurse's best response?
A. "Oral medications are absorbed faster, so they are broken down quicker."
B. "The liver metabolizes a portion of the oral drug before it reaches the
bloodstream."
C. "Oral medications bind to protein in the stomach, making them inactive."
D. "The kidneys filter out oral medications more efficiently than IV medications."
Correct Answer: B
Rationale: This describes the first-pass effect. Orally administered drugs are
absorbed from the GI tract and carried via the hepatic portal system to the liver,
,where significant metabolism may occur before reaching systemic circulation.
This reduces bioavailability and requires higher oral doses compared to IV
administration .
---
Question 2
A drug has a half-life of 12 hours. How long will it take to reach steady state?
A. 12 hours
B. 24 hours
C. 60 hours
D. 72 hours
Correct Answer: C
Rationale: Steady state is typically achieved after approximately 4-5 half-lives.
Therefore, 12 hours × 5 = 60 hours. At this point, drug accumulation and
elimination reach equilibrium .
---
Question 3
,A nurse is reviewing lab results and notes a drug has a narrow therapeutic index
(NTI). What is the primary implication of this characteristic?
A. The drug has a wide margin of safety.
B. The drug requires routine monitoring of serum levels.
C. The drug does not require dosage adjustments.
D. The drug is safe for over-the-counter use.
Correct Answer: B
Rationale: A narrow therapeutic index means the difference between the
minimum effective concentration and the toxic concentration is small. Small
changes in dose or metabolism can lead to toxicity, necessitating close monitoring
(e.g., Warfarin, Digoxin, Phenytoin) .
---
Question 4
A patient is taking Drug A and a newly prescribed Drug B. The nurse notes that
Drug B displaces Drug A from plasma albumin. What is the expected result?
A. Decreased effect of Drug A
B. Increased free fraction of Drug A
, C. Increased excretion of Drug A
D. Decreased absorption of Drug B
Correct Answer: B
Rationale: Displacement from protein binding sites increases the amount of free
(unbound) drug in circulation. Only free drug is pharmacologically active,
potentially increasing the effect and risk of toxicity of Drug A .
---
Question 5
A patient with hepatic cirrhosis is prescribed a drug metabolized by the liver.
What adjustment is needed?
A. Increase the dose
B. Decrease the dose
C. No change needed
D. Change to IV route
Correct Answer: B
