CEA NR568 / NR 568 Advanced
Pharmacology CEA Exam Prep Test Bank
150 Practice Questions with Verified
Answers & Detailed Rationales
Chamberlain University | 2026/2027
Update | A+ Graded
SECTION 1: GENERAL PHARMACOLOGY &
PHARMACOKINETICS (Questions 1-10)
1. Approximately how many days are required to achieve steady-state warfarin
levels?
• A) 1 to 2 days
• B) 7 to 9 days
• C) 24 hours
• D) 30 days
Rationale: Steady state is reached after 4 to 5 half-lives. With a warfarin half-life of
about 36 to 42 hours, 5 half-lives equals 180 to 210 hours, or approximately 7.5 to 8
days. This is why warfarin requires bridging with heparin for acute thromboembolism .
2. A patient with renal impairment (CrCl 25 mL/min) requires a drug that is 90%
renally excreted. The recommended dosing adjustment is to:
• A) Reduce the dose or prolong the dosing interval proportionally to CrCl
• B) Increase the dose to achieve therapeutic levels
, • C) No adjustment needed
• D) Double the loading dose
Rationale: For drugs that are highly renally excreted, the dose should be reduced or the
dosing interval prolonged proportionally to creatinine clearance to prevent
accumulation and toxicity .
3. The bioavailability of propranolol is only about 25% despite nearly complete
gastrointestinal absorption. This is best explained by:
• A) First-pass metabolism in the liver
• B) Plasma protein binding
• C) Poor GI absorption
• D) Renal clearance
Rationale: Propranolol undergoes extensive first-pass metabolism in the liver,
significantly reducing its bioavailability despite near-complete GI absorption .
4. Which of the following is a key monitoring parameter for vancomycin therapy?
• A) Peak and trough levels
• B) Liver function tests
• C) Blood glucose
• D) Serum sodium
Rationale: Vancomycin requires monitoring of peak and trough levels to ensure
therapeutic efficacy and prevent nephrotoxicity and ototoxicity. BMP and CBC should
also be monitored .
5. Furosemide is a loop diuretic that blocks the Na-K-2Cl transporter in the
ascending loop of Henle. Which electrolyte disturbance is most concerning?
• A) Hyperkalemia
• B) Hypokalemia
, • C) Hypercalcemia
• D) Hypermagnesemia
Rationale: Furosemide causes hypokalemia, hyponatremia, hypomagnesemia, and
hypocalcemia. Monitoring electrolytes, especially potassium, is essential to prevent
cardiac arrhythmias .
6. Patients who overdose on amitriptyline (a TCA) should be treated with which
agent?
• A) Glucagon IV
• B) Sodium bicarbonate IV
• C) Calcium chloride IV
• D) Phenylephrine PO
Rationale: Sodium bicarbonate is the treatment of choice for TCA toxicity to counteract
cardiotoxicity and prevent arrhythmias .
7. Signs of extrapyramidal effects include all of the following EXCEPT:
• A) Acute dystonia
• B) Parkinsonism
• C) Akathisia
• D) Agranulocytosis
Rationale: Extrapyramidal symptoms include acute dystonia, parkinsonism, and
akathisia. Agranulocytosis is a serious adverse effect associated with second-generation
antipsychotics like clozapine, not an EPS symptom .
8. Which of the following is a MAOI?
• A) Bupropion
• B) Phenelzine (Nardil)
• C) Fluoxetine
, • D) Mirtazapine
Rationale: Phenelzine (Nardil), isocarboxazid (Marplan), tranylcypromine (Parnate), and
selegiline (Emsam)-transdermal are examples of MAOIs. Bupropion and mirtazapine are
atypical antidepressants, and fluoxetine is an SSRI .
9. MAOIs carry a black box warning for which adverse effect?
• A) Seizures
• B) Hypertensive crisis
• C) Agranulocytosis
• D) QT prolongation
Rationale: MAOIs can cause hypertensive crisis when combined with
sympathomimetics, TCAs, SSRIs, or foods high in tyramine .
10. Clozapine carries a black box warning for:
• A) Agranulocytosis
• B) Seizures
• C) QT prolongation
• D) Weight gain
Rationale: Clozapine has a black box warning for agranulocytosis, requiring monitoring
of WBC and neutrophils prior to starting and throughout treatment .
SECTION 2: CARDIOVASCULAR PHARMACOLOGY
(Questions 11-25)
11. A 39-year-old African-American male is 25 pounds overweight and has been
diagnosed with hypertension. The most likely initial drug therapy is:
Pharmacology CEA Exam Prep Test Bank
150 Practice Questions with Verified
Answers & Detailed Rationales
Chamberlain University | 2026/2027
Update | A+ Graded
SECTION 1: GENERAL PHARMACOLOGY &
PHARMACOKINETICS (Questions 1-10)
1. Approximately how many days are required to achieve steady-state warfarin
levels?
• A) 1 to 2 days
• B) 7 to 9 days
• C) 24 hours
• D) 30 days
Rationale: Steady state is reached after 4 to 5 half-lives. With a warfarin half-life of
about 36 to 42 hours, 5 half-lives equals 180 to 210 hours, or approximately 7.5 to 8
days. This is why warfarin requires bridging with heparin for acute thromboembolism .
2. A patient with renal impairment (CrCl 25 mL/min) requires a drug that is 90%
renally excreted. The recommended dosing adjustment is to:
• A) Reduce the dose or prolong the dosing interval proportionally to CrCl
• B) Increase the dose to achieve therapeutic levels
, • C) No adjustment needed
• D) Double the loading dose
Rationale: For drugs that are highly renally excreted, the dose should be reduced or the
dosing interval prolonged proportionally to creatinine clearance to prevent
accumulation and toxicity .
3. The bioavailability of propranolol is only about 25% despite nearly complete
gastrointestinal absorption. This is best explained by:
• A) First-pass metabolism in the liver
• B) Plasma protein binding
• C) Poor GI absorption
• D) Renal clearance
Rationale: Propranolol undergoes extensive first-pass metabolism in the liver,
significantly reducing its bioavailability despite near-complete GI absorption .
4. Which of the following is a key monitoring parameter for vancomycin therapy?
• A) Peak and trough levels
• B) Liver function tests
• C) Blood glucose
• D) Serum sodium
Rationale: Vancomycin requires monitoring of peak and trough levels to ensure
therapeutic efficacy and prevent nephrotoxicity and ototoxicity. BMP and CBC should
also be monitored .
5. Furosemide is a loop diuretic that blocks the Na-K-2Cl transporter in the
ascending loop of Henle. Which electrolyte disturbance is most concerning?
• A) Hyperkalemia
• B) Hypokalemia
, • C) Hypercalcemia
• D) Hypermagnesemia
Rationale: Furosemide causes hypokalemia, hyponatremia, hypomagnesemia, and
hypocalcemia. Monitoring electrolytes, especially potassium, is essential to prevent
cardiac arrhythmias .
6. Patients who overdose on amitriptyline (a TCA) should be treated with which
agent?
• A) Glucagon IV
• B) Sodium bicarbonate IV
• C) Calcium chloride IV
• D) Phenylephrine PO
Rationale: Sodium bicarbonate is the treatment of choice for TCA toxicity to counteract
cardiotoxicity and prevent arrhythmias .
7. Signs of extrapyramidal effects include all of the following EXCEPT:
• A) Acute dystonia
• B) Parkinsonism
• C) Akathisia
• D) Agranulocytosis
Rationale: Extrapyramidal symptoms include acute dystonia, parkinsonism, and
akathisia. Agranulocytosis is a serious adverse effect associated with second-generation
antipsychotics like clozapine, not an EPS symptom .
8. Which of the following is a MAOI?
• A) Bupropion
• B) Phenelzine (Nardil)
• C) Fluoxetine
, • D) Mirtazapine
Rationale: Phenelzine (Nardil), isocarboxazid (Marplan), tranylcypromine (Parnate), and
selegiline (Emsam)-transdermal are examples of MAOIs. Bupropion and mirtazapine are
atypical antidepressants, and fluoxetine is an SSRI .
9. MAOIs carry a black box warning for which adverse effect?
• A) Seizures
• B) Hypertensive crisis
• C) Agranulocytosis
• D) QT prolongation
Rationale: MAOIs can cause hypertensive crisis when combined with
sympathomimetics, TCAs, SSRIs, or foods high in tyramine .
10. Clozapine carries a black box warning for:
• A) Agranulocytosis
• B) Seizures
• C) QT prolongation
• D) Weight gain
Rationale: Clozapine has a black box warning for agranulocytosis, requiring monitoring
of WBC and neutrophils prior to starting and throughout treatment .
SECTION 2: CARDIOVASCULAR PHARMACOLOGY
(Questions 11-25)
11. A 39-year-old African-American male is 25 pounds overweight and has been
diagnosed with hypertension. The most likely initial drug therapy is:
