NU 578 Units 1–5 Exam (2026/2027) (PDF) |
Advanced Nursing | University of South
Alabama
Question 1. The purpose of the NU 578 course is to expand the pharmacological
knowledge of the advanced practice nurse. Which of the following best describes the
primary focus of this course?
A. Surgical techniques and perioperative care management
B. Selection and monitoring of drug therapy for persons throughout the lifespan
C. Diagnostic imaging interpretation and radiological pharmacology
D. Health policy and healthcare administration
Correct Answer: B
Rationale: According to the University of South Alabama course description, NU 578 -
Pharm Adv Practice Nurses focuses on the selection and monitoring of drug therapy for
persons throughout the lifespan. Emphasis is placed on pharmacokinetics and
pharmacotherapeutics of major drug classifications . This distinguishes the course from
surgical, diagnostic, or administrative nursing content.
Question 2. A drug that binds to a receptor and produces a maximum biological
response is known as which of the following?
A. Partial agonist
B. Full agonist
C. Competitive antagonist
D. Inverse agonist
Correct Answer: B
Rationale: A full agonist binds to a receptor and mimics the endogenous ligand to
produce a maximum biological response . A partial agonist (A) produces a submaximal
,response even when all receptors are occupied. A competitive antagonist (C) binds to
the receptor but produces no response while blocking the agonist. An inverse agonist
(D) binds to the same receptor but produces the opposite effect of the agonist.
Question 3. A patient with liver cirrhosis is prescribed a drug with high first-pass
metabolism. What adjustment is most appropriate?
A. Increase the dose due to reduced clearance
B. Decrease the dose due to reduced hepatic metabolism
C. No adjustment is needed
D. Change to a topical formulation
Correct Answer: B
Rationale: In liver cirrhosis, hepatic metabolism is impaired. A drug with high first-pass
metabolism will have increased bioavailability due to reduced hepatic extraction,
requiring a lower dose to avoid toxicity . Increasing the dose (A) would worsen the risk.
While changing to a topical formulation (D) might bypass first-pass metabolism, it is not
the most appropriate first-line adjustment.
Question 4. The cytochrome P450 (CYP450) enzyme system is inhibited by which of the
following substances?
A. St. John's Wort
B. Phenytoin
C. Rifampin
D. Grapefruit juice
Correct Answer: D
Rationale: Grapefruit juice is a well-known inhibitor of the CYP3A4 enzyme, which can
lead to increased serum levels of certain drugs and potential toxicity . St. John's Wort
(A), phenytoin (B), and rifampin (C) are all CYP450 inducers, not inhibitors, meaning they
accelerate drug metabolism and can decrease drug effectiveness.
,Question 5. Which pharmacokinetic process is primarily affected by the first-pass
effect?
A. Excretion
B. Distribution
C. Absorption
D. Metabolism
Correct Answer: D
Rationale: The first-pass effect refers to the rapid hepatic metabolism of a drug
absorbed from the GI tract before it reaches systemic circulation . This is a metabolic
process, as the drug is biotransformed in the liver. Absorption (C) is the movement of
the drug into the bloodstream, distribution (B) is movement from blood to tissues, and
excretion (A) is elimination from the body.
Question 6. According to the Controlled Substances Act, Schedule II drugs have which
of the following characteristics?
A. Have no accepted medical use
B. Require a written prescription and cannot be refilled
C. May be refilled up to 5 times in 6 months
D. Are available over-the-counter in some states
Correct Answer: B
Rationale: Schedule II drugs have a high potential for abuse and require a new written
prescription for every supply; refills are not permitted . Schedule I drugs (A) have no
accepted medical use. Schedule III and IV drugs may have limited refills (C). Over-the-
counter availability (D) applies to non-controlled or Schedule V substances in some
circumstances.
Question 7. Bioavailability is best defined as which of the following?
, A. The total amount of drug excreted in the urine
B. The speed at which a drug reaches the receptor
C. The percentage of administered drug that reaches systemic circulation unchanged
D. The volume of distribution of a drug
Correct Answer: C
Rationale: Bioavailability is the percentage of administered drug that reaches systemic
circulation unchanged. This is a critical pharmacokinetic parameter that determines drug
dosing. Oral drugs have reduced bioavailability due to first-pass metabolism and
incomplete absorption. A drug's speed to the receptor (B) relates to onset of action, not
bioavailability.
Question 8. Which factor most significantly affects drug distribution to the central
nervous system?
A. Gastric pH
B. Plasma albumin levels
C. Blood-brain barrier
D. Renal blood flow
Correct Answer: C
Rationale: The blood-brain barrier consists of tight junctions in brain capillaries that
limit the entry of many drugs into the CNS. Only drugs that are lipid-soluble or have a
transport system can cross the BBB . Gastric pH (A) affects absorption, plasma albumin
(B) affects protein binding and distribution generally, and renal blood flow (D) affects
excretion.
Question 9. What is the term for a drug that requires metabolic conversion to become
pharmacologically active?
A. Metabolite
B. Prodrug
C. Inert substance
D. Antagonist
Advanced Nursing | University of South
Alabama
Question 1. The purpose of the NU 578 course is to expand the pharmacological
knowledge of the advanced practice nurse. Which of the following best describes the
primary focus of this course?
A. Surgical techniques and perioperative care management
B. Selection and monitoring of drug therapy for persons throughout the lifespan
C. Diagnostic imaging interpretation and radiological pharmacology
D. Health policy and healthcare administration
Correct Answer: B
Rationale: According to the University of South Alabama course description, NU 578 -
Pharm Adv Practice Nurses focuses on the selection and monitoring of drug therapy for
persons throughout the lifespan. Emphasis is placed on pharmacokinetics and
pharmacotherapeutics of major drug classifications . This distinguishes the course from
surgical, diagnostic, or administrative nursing content.
Question 2. A drug that binds to a receptor and produces a maximum biological
response is known as which of the following?
A. Partial agonist
B. Full agonist
C. Competitive antagonist
D. Inverse agonist
Correct Answer: B
Rationale: A full agonist binds to a receptor and mimics the endogenous ligand to
produce a maximum biological response . A partial agonist (A) produces a submaximal
,response even when all receptors are occupied. A competitive antagonist (C) binds to
the receptor but produces no response while blocking the agonist. An inverse agonist
(D) binds to the same receptor but produces the opposite effect of the agonist.
Question 3. A patient with liver cirrhosis is prescribed a drug with high first-pass
metabolism. What adjustment is most appropriate?
A. Increase the dose due to reduced clearance
B. Decrease the dose due to reduced hepatic metabolism
C. No adjustment is needed
D. Change to a topical formulation
Correct Answer: B
Rationale: In liver cirrhosis, hepatic metabolism is impaired. A drug with high first-pass
metabolism will have increased bioavailability due to reduced hepatic extraction,
requiring a lower dose to avoid toxicity . Increasing the dose (A) would worsen the risk.
While changing to a topical formulation (D) might bypass first-pass metabolism, it is not
the most appropriate first-line adjustment.
Question 4. The cytochrome P450 (CYP450) enzyme system is inhibited by which of the
following substances?
A. St. John's Wort
B. Phenytoin
C. Rifampin
D. Grapefruit juice
Correct Answer: D
Rationale: Grapefruit juice is a well-known inhibitor of the CYP3A4 enzyme, which can
lead to increased serum levels of certain drugs and potential toxicity . St. John's Wort
(A), phenytoin (B), and rifampin (C) are all CYP450 inducers, not inhibitors, meaning they
accelerate drug metabolism and can decrease drug effectiveness.
,Question 5. Which pharmacokinetic process is primarily affected by the first-pass
effect?
A. Excretion
B. Distribution
C. Absorption
D. Metabolism
Correct Answer: D
Rationale: The first-pass effect refers to the rapid hepatic metabolism of a drug
absorbed from the GI tract before it reaches systemic circulation . This is a metabolic
process, as the drug is biotransformed in the liver. Absorption (C) is the movement of
the drug into the bloodstream, distribution (B) is movement from blood to tissues, and
excretion (A) is elimination from the body.
Question 6. According to the Controlled Substances Act, Schedule II drugs have which
of the following characteristics?
A. Have no accepted medical use
B. Require a written prescription and cannot be refilled
C. May be refilled up to 5 times in 6 months
D. Are available over-the-counter in some states
Correct Answer: B
Rationale: Schedule II drugs have a high potential for abuse and require a new written
prescription for every supply; refills are not permitted . Schedule I drugs (A) have no
accepted medical use. Schedule III and IV drugs may have limited refills (C). Over-the-
counter availability (D) applies to non-controlled or Schedule V substances in some
circumstances.
Question 7. Bioavailability is best defined as which of the following?
, A. The total amount of drug excreted in the urine
B. The speed at which a drug reaches the receptor
C. The percentage of administered drug that reaches systemic circulation unchanged
D. The volume of distribution of a drug
Correct Answer: C
Rationale: Bioavailability is the percentage of administered drug that reaches systemic
circulation unchanged. This is a critical pharmacokinetic parameter that determines drug
dosing. Oral drugs have reduced bioavailability due to first-pass metabolism and
incomplete absorption. A drug's speed to the receptor (B) relates to onset of action, not
bioavailability.
Question 8. Which factor most significantly affects drug distribution to the central
nervous system?
A. Gastric pH
B. Plasma albumin levels
C. Blood-brain barrier
D. Renal blood flow
Correct Answer: C
Rationale: The blood-brain barrier consists of tight junctions in brain capillaries that
limit the entry of many drugs into the CNS. Only drugs that are lipid-soluble or have a
transport system can cross the BBB . Gastric pH (A) affects absorption, plasma albumin
(B) affects protein binding and distribution generally, and renal blood flow (D) affects
excretion.
Question 9. What is the term for a drug that requires metabolic conversion to become
pharmacologically active?
A. Metabolite
B. Prodrug
C. Inert substance
D. Antagonist
