NURS 8024 Advanced Pharmacology
– Comprehensive Exam with 100
questions updated 2026 new!!
Questions 1–25 (Foundations, PK/PD, ANS)
Which pharmacokinetic process is most affected by first-pass metabolism?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
A drug with a high extraction ratio is most sensitive to changes in:
A. Plasma protein binding
B. Hepatic blood flow
C. Renal clearance
D. Volume of distribution
The primary site of action for most beta-lactam antibiotics is:
A. Bacterial ribosome
B. Bacterial cell wall synthesis
C. Bacterial DNA gyrase
D. Bacterial folic acid pathway
Which receptor subtype mediates the majority of cardiac effects of norepinephrine?
A. α1
B. α2
C. β1
D. β2
,A patient on a narrow-therapeutic-index drug develops toxicity after starting a strong CYP3A4
inhibitor. This is an example of a:
A. Pharmacodynamic interaction
B. Pharmacokinetic interaction
C. Pharmaceutical incompatibility
D. Idiosyncratic reaction
Zero-order elimination kinetics means:
A. A constant fraction of drug is eliminated per unit time
B. A constant amount of drug is eliminated per unit time
C. Elimination rate increases with concentration
D. Half-life is independent of dose
Which autonomic drug is a selective α1-antagonist commonly used for BPH?
A. Propranolol
B. Prazosin
C. Atenolol
D. Clonidine
Bethanechol is contraindicated in:
A. Postoperative urinary retention
B. Mechanical GI obstruction
C. Neurogenic bladder
D. Xerostomia
The antidote for organophosphate (AChE inhibitor) poisoning is:
A. Atropine + pralidoxime
B. Physostigmine alone
C. Naloxone
D. Flumazenil
,Which parameter best predicts the time to steady state?
A. Clearance
B. Volume of distribution
C. Half-life
D. Bioavailability
A drug that is a pure antagonist at μ-opioid receptors is:
A. Morphine
B. Buprenorphine
C. Naloxone
D. Fentanyl
Intrinsic activity refers to:
A. Affinity for the receptor
B. Ability of the drug-receptor complex to produce a response
C. Rate of absorption
D. Plasma protein binding
Which beta-blocker is non-selective and also blocks α1 receptors?
A. Metoprolol
B. Atenolol
C. Carvedilol
D. Bisoprolol
Competitive antagonists:
A. Decrease Emax
B. Shift the dose-response curve to the right without changing Emax
C. Irreversibly bind the receptor
D. Have intrinsic activity
The volume of distribution (Vd) is low when a drug:
, A. Extensively binds to tissues
B. Remains largely in plasma
C. Is highly lipid-soluble
D. Undergoes extensive first-pass
Which enzyme system is most commonly involved in Phase I drug metabolism?
A. UGTs
B. CYPs
C. SULTs
D. GSTs
A partial agonist:
A. Can never produce a full response even at full receptor occupancy
B. Always acts as an antagonist
C. Has zero affinity
D. Increases Emax of a full agonist
Epinephrine is preferred over norepinephrine in anaphylaxis primarily because of its:
A. Pure α1 activity
B. β2-mediated bronchodilation
C. Longer half-life
D. Oral bioavailability
Which statement about prodrugs is correct?
A. They are active as administered
B. They require metabolic conversion to the active moiety
C. They always have higher bioavailability
D. They bypass first-pass metabolism
Tachyphylaxis is:
A. Immediate hypersensitivity
– Comprehensive Exam with 100
questions updated 2026 new!!
Questions 1–25 (Foundations, PK/PD, ANS)
Which pharmacokinetic process is most affected by first-pass metabolism?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
A drug with a high extraction ratio is most sensitive to changes in:
A. Plasma protein binding
B. Hepatic blood flow
C. Renal clearance
D. Volume of distribution
The primary site of action for most beta-lactam antibiotics is:
A. Bacterial ribosome
B. Bacterial cell wall synthesis
C. Bacterial DNA gyrase
D. Bacterial folic acid pathway
Which receptor subtype mediates the majority of cardiac effects of norepinephrine?
A. α1
B. α2
C. β1
D. β2
,A patient on a narrow-therapeutic-index drug develops toxicity after starting a strong CYP3A4
inhibitor. This is an example of a:
A. Pharmacodynamic interaction
B. Pharmacokinetic interaction
C. Pharmaceutical incompatibility
D. Idiosyncratic reaction
Zero-order elimination kinetics means:
A. A constant fraction of drug is eliminated per unit time
B. A constant amount of drug is eliminated per unit time
C. Elimination rate increases with concentration
D. Half-life is independent of dose
Which autonomic drug is a selective α1-antagonist commonly used for BPH?
A. Propranolol
B. Prazosin
C. Atenolol
D. Clonidine
Bethanechol is contraindicated in:
A. Postoperative urinary retention
B. Mechanical GI obstruction
C. Neurogenic bladder
D. Xerostomia
The antidote for organophosphate (AChE inhibitor) poisoning is:
A. Atropine + pralidoxime
B. Physostigmine alone
C. Naloxone
D. Flumazenil
,Which parameter best predicts the time to steady state?
A. Clearance
B. Volume of distribution
C. Half-life
D. Bioavailability
A drug that is a pure antagonist at μ-opioid receptors is:
A. Morphine
B. Buprenorphine
C. Naloxone
D. Fentanyl
Intrinsic activity refers to:
A. Affinity for the receptor
B. Ability of the drug-receptor complex to produce a response
C. Rate of absorption
D. Plasma protein binding
Which beta-blocker is non-selective and also blocks α1 receptors?
A. Metoprolol
B. Atenolol
C. Carvedilol
D. Bisoprolol
Competitive antagonists:
A. Decrease Emax
B. Shift the dose-response curve to the right without changing Emax
C. Irreversibly bind the receptor
D. Have intrinsic activity
The volume of distribution (Vd) is low when a drug:
, A. Extensively binds to tissues
B. Remains largely in plasma
C. Is highly lipid-soluble
D. Undergoes extensive first-pass
Which enzyme system is most commonly involved in Phase I drug metabolism?
A. UGTs
B. CYPs
C. SULTs
D. GSTs
A partial agonist:
A. Can never produce a full response even at full receptor occupancy
B. Always acts as an antagonist
C. Has zero affinity
D. Increases Emax of a full agonist
Epinephrine is preferred over norepinephrine in anaphylaxis primarily because of its:
A. Pure α1 activity
B. β2-mediated bronchodilation
C. Longer half-life
D. Oral bioavailability
Which statement about prodrugs is correct?
A. They are active as administered
B. They require metabolic conversion to the active moiety
C. They always have higher bioavailability
D. They bypass first-pass metabolism
Tachyphylaxis is:
A. Immediate hypersensitivity
