NURS 5663 Advanced Pharmacology Practice Quizzes Original
Practice Questions | Weeks 1–6
Week 1: Pharmacokinetics, Pharmacodynamics, Drug
Interactions, Pharmacogenomics
1. A patient is started on a drug with a narrow therapeutic
index. The nurse practitioner understands that this drug
requires:
A. Less frequent monitoring of serum drug levels
B. Careful dose titration and monitoring for toxicity
C. A higher initial loading dose to ensure efficacy
D. Avoidance of all other medications
Answer: B
Rationale: Narrow therapeutic index drugs have a small range
between effective and toxic doses. They require careful dose
titration and monitoring of serum drug levels to avoid toxicity or
therapeutic failure.
2. Which cytochrome P450 enzyme is responsible for
metabolizing the largest percentage of clinically used drugs?
A. CYP2D6
B. CYP3A4
C. CYP1A2
D. CYP2C9
,Answer: B
Rationale: CYP3A4 is the most abundant CYP enzyme and
metabolizes approximately 50% of all drugs. Inhibitors and
inducers of this enzyme cause many clinically significant drug
interactions.
3. A patient has a genetic polymorphism that results in
decreased activity of CYP2D6. The patient is prescribed
codeine for pain. What effect is expected?
A. Increased conversion of codeine to morphine, leading to
toxicity
B. Decreased conversion of codeine to morphine, leading to
reduced analgesic effect
C. No change in codeine metabolism
D. Rapid development of tolerance to codeine
Answer: B
Rationale: Codeine is a prodrug that requires CYP2D6 for
conversion to its active metabolite, morphine. Poor
metabolizers have reduced conversion and thus decreased
analgesic effect.
4. Which term describes the process by which a drug enters
the systemic circulation from its site of administration?
A. Distribution
B. Absorption
, C. Metabolism
D. Excretion
Answer: B
Rationale: Absorption is the movement of a drug from its site of
administration into the bloodstream. Distribution is movement
to tissues, metabolism is biotransformation, and excretion is
elimination.
5. A drug that binds to a receptor and produces a maximal
response is called a:
A. Partial agonist
B. Antagonist
C. Full agonist
D. Inverse agonist
Answer: C
Rationale: A full agonist binds to a receptor and produces a
maximal biological response. A partial agonist produces less
than maximal response. An antagonist blocks the receptor. An
inverse agonist produces the opposite effect of the agonist.
6. A patient is taking a drug that is a substrate for P-
glycoprotein (P-gp). The patient is started on a P-gp inhibitor.
What is the expected effect on the first drug?
A. Decreased absorption and decreased plasma concentration
B. Increased absorption and increased plasma concentration
Practice Questions | Weeks 1–6
Week 1: Pharmacokinetics, Pharmacodynamics, Drug
Interactions, Pharmacogenomics
1. A patient is started on a drug with a narrow therapeutic
index. The nurse practitioner understands that this drug
requires:
A. Less frequent monitoring of serum drug levels
B. Careful dose titration and monitoring for toxicity
C. A higher initial loading dose to ensure efficacy
D. Avoidance of all other medications
Answer: B
Rationale: Narrow therapeutic index drugs have a small range
between effective and toxic doses. They require careful dose
titration and monitoring of serum drug levels to avoid toxicity or
therapeutic failure.
2. Which cytochrome P450 enzyme is responsible for
metabolizing the largest percentage of clinically used drugs?
A. CYP2D6
B. CYP3A4
C. CYP1A2
D. CYP2C9
,Answer: B
Rationale: CYP3A4 is the most abundant CYP enzyme and
metabolizes approximately 50% of all drugs. Inhibitors and
inducers of this enzyme cause many clinically significant drug
interactions.
3. A patient has a genetic polymorphism that results in
decreased activity of CYP2D6. The patient is prescribed
codeine for pain. What effect is expected?
A. Increased conversion of codeine to morphine, leading to
toxicity
B. Decreased conversion of codeine to morphine, leading to
reduced analgesic effect
C. No change in codeine metabolism
D. Rapid development of tolerance to codeine
Answer: B
Rationale: Codeine is a prodrug that requires CYP2D6 for
conversion to its active metabolite, morphine. Poor
metabolizers have reduced conversion and thus decreased
analgesic effect.
4. Which term describes the process by which a drug enters
the systemic circulation from its site of administration?
A. Distribution
B. Absorption
, C. Metabolism
D. Excretion
Answer: B
Rationale: Absorption is the movement of a drug from its site of
administration into the bloodstream. Distribution is movement
to tissues, metabolism is biotransformation, and excretion is
elimination.
5. A drug that binds to a receptor and produces a maximal
response is called a:
A. Partial agonist
B. Antagonist
C. Full agonist
D. Inverse agonist
Answer: C
Rationale: A full agonist binds to a receptor and produces a
maximal biological response. A partial agonist produces less
than maximal response. An antagonist blocks the receptor. An
inverse agonist produces the opposite effect of the agonist.
6. A patient is taking a drug that is a substrate for P-
glycoprotein (P-gp). The patient is started on a P-gp inhibitor.
What is the expected effect on the first drug?
A. Decreased absorption and decreased plasma concentration
B. Increased absorption and increased plasma concentration
