NSG 3250 COMPREHENSIVE EXAM 1 -
ADVANCED PHARMACOLOGY |
QUESTIONS AND ANSWERS |2026/2027
UPDATE | JUST RELEASED - GALEN
COLLEGE OF NURSING.
1. Which pharmacokinetic process is primarily affected in a patient with severe liver cirrhosis?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: D
Conceptual Explanation: Metabolism occurs primarily in the liver via the cytochrome
P450 system; liver cirrhosis impairs the enzymatic breakdown of drugs.
2. A patient is prescribed a drug with a high first-pass effect. Which route of administration
would result in the lowest bioavailability?
A. Intravenous
,B. Sublingual
C. Oral
D. Transdermal
Answer: C
Conceptual Explanation: Oral drugs are absorbed from the GI tract and pass through the
liver via the portal vein before reaching systemic circulation, significantly reducing their
concentration.
3. When assessing for drug toxicity, the nurse understands that a drug with a narrow
therapeutic index:
A. Is very safe to administer without monitoring
B. Has a large margin between effective and lethal doses
C. Requires close monitoring of serum drug levels
D. Is metabolized very slowly by the kidneys
Answer: C
Conceptual Explanation: A narrow therapeutic index means the ratio between the
therapeutic dose and the toxic dose is small, requiring monitoring to prevent toxicity.
4. Which statement best describes the concept of drug ‘half-life’?
A. The time required for the amount of drug in the body to decrease by 50%
B. The duration of time the drug remains at a therapeutic level
, C. The time it takes for the drug to reach its peak effect
D. The interval between the administration of the first and second dose
Answer: A
Conceptual Explanation: Half-life is the time required for the plasma concentration of a
drug to reduce to half its original value.
5. An elderly patient has low serum albumin levels. How does this impact the distribution of
highly protein-bound drugs?
A. It decreases the concentration of free, active drug
B. It has no effect on drug distribution
C. It increases the risk of drug toxicity due to more free drug
D. It results in rapid excretion of the drug
Answer: C
Conceptual Explanation: Fewer albumin binding sites mean more drug remains ‘free’ or
unbound, which is the active form that can lead to toxicity.
6. A patient is taking a drug that inhibits the Cytochrome P450 (CYP450) enzyme system.
What is the likely result if they take another drug metabolized by that same system?
A. The second drug will be excreted faster
B. The levels of the second drug will increase, potentially causing toxicity
C. The second drug will have a decreased effect
ADVANCED PHARMACOLOGY |
QUESTIONS AND ANSWERS |2026/2027
UPDATE | JUST RELEASED - GALEN
COLLEGE OF NURSING.
1. Which pharmacokinetic process is primarily affected in a patient with severe liver cirrhosis?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: D
Conceptual Explanation: Metabolism occurs primarily in the liver via the cytochrome
P450 system; liver cirrhosis impairs the enzymatic breakdown of drugs.
2. A patient is prescribed a drug with a high first-pass effect. Which route of administration
would result in the lowest bioavailability?
A. Intravenous
,B. Sublingual
C. Oral
D. Transdermal
Answer: C
Conceptual Explanation: Oral drugs are absorbed from the GI tract and pass through the
liver via the portal vein before reaching systemic circulation, significantly reducing their
concentration.
3. When assessing for drug toxicity, the nurse understands that a drug with a narrow
therapeutic index:
A. Is very safe to administer without monitoring
B. Has a large margin between effective and lethal doses
C. Requires close monitoring of serum drug levels
D. Is metabolized very slowly by the kidneys
Answer: C
Conceptual Explanation: A narrow therapeutic index means the ratio between the
therapeutic dose and the toxic dose is small, requiring monitoring to prevent toxicity.
4. Which statement best describes the concept of drug ‘half-life’?
A. The time required for the amount of drug in the body to decrease by 50%
B. The duration of time the drug remains at a therapeutic level
, C. The time it takes for the drug to reach its peak effect
D. The interval between the administration of the first and second dose
Answer: A
Conceptual Explanation: Half-life is the time required for the plasma concentration of a
drug to reduce to half its original value.
5. An elderly patient has low serum albumin levels. How does this impact the distribution of
highly protein-bound drugs?
A. It decreases the concentration of free, active drug
B. It has no effect on drug distribution
C. It increases the risk of drug toxicity due to more free drug
D. It results in rapid excretion of the drug
Answer: C
Conceptual Explanation: Fewer albumin binding sites mean more drug remains ‘free’ or
unbound, which is the active form that can lead to toxicity.
6. A patient is taking a drug that inhibits the Cytochrome P450 (CYP450) enzyme system.
What is the likely result if they take another drug metabolized by that same system?
A. The second drug will be excreted faster
B. The levels of the second drug will increase, potentially causing toxicity
C. The second drug will have a decreased effect
