NURS 6521 ADVANCED
PHARMACOLOGY COMPREHENSIVE
EXAM QUESTIONS AND VERIFIED
ANSWERS |GRADE A+| JUST RELEASED
1. A patient is prescribed a drug that is known to be a potent CYP3A4 inhibitor. Which of the
following consequences should the nurse practitioner anticipate when this drug is co-
administered with a CYP3A4 substrate?
A. Decreased plasma concentration of the substrate
B. Reduced therapeutic effect of the substrate
C. Increased plasma concentration of the substrate
D. Enhanced excretion of the substrate
Answer: C
Conceptual Explanation: Inhibitors of CYP450 enzymes decrease the metabolism of
substrate drugs, leading to increased plasma concentrations and potential toxicity.
,2. When prescribing an ACE inhibitor to a patient with chronic kidney disease, which
electrolyte imbalance is the most critical to monitor?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypomagnesemia
Answer: A
Conceptual Explanation: ACE inhibitors reduce aldosterone secretion, which can lead to
potassium retention, especially in patients with impaired renal function.
3. A 75-year-old patient has a decreased glomerular filtration rate (GFR). How does this
physiological change affect the pharmacokinetics of renal-excreted drugs?
A. Decreased half-life
B. Increased volume of distribution
C. Enhanced first-pass effect
D. Increased half-life
Answer: D
Conceptual Explanation: Decreased GFR slows the elimination of drugs excreted by the
kidneys, thereby extending the drug’s half-life and increasing the risk of accumulation.
, 4. Which of the following describes the ‘first-pass effect’?
A. The metabolism of an oral drug by the liver before reaching systemic circulation
B. The absorption of a drug through the gastric mucosa
C. The rapid distribution of drugs to the brain
D. The initial binding of a drug to plasma albumin
Answer: A
Conceptual Explanation: The first-pass effect refers to the metabolism of orally
administered drugs in the liver or gut wall before they reach the systemic circulation, often
significantly reducing bioavailability.
5. A patient taking Warfarin (Coumadin) begins a course of Rifampin, a potent CYP450
inducer. What adjustment to the Warfarin dose is likely necessary?
A. Decrease the Warfarin dose
B. Increase the Warfarin dose
C. Discontinue Warfarin immediately
D. No change is necessary
Answer: B
Conceptual Explanation: Rifampin induces CYP450 enzymes, increasing the metabolism
of Warfarin. To maintain a therapeutic INR, the dose of Warfarin must typically be
increased.
PHARMACOLOGY COMPREHENSIVE
EXAM QUESTIONS AND VERIFIED
ANSWERS |GRADE A+| JUST RELEASED
1. A patient is prescribed a drug that is known to be a potent CYP3A4 inhibitor. Which of the
following consequences should the nurse practitioner anticipate when this drug is co-
administered with a CYP3A4 substrate?
A. Decreased plasma concentration of the substrate
B. Reduced therapeutic effect of the substrate
C. Increased plasma concentration of the substrate
D. Enhanced excretion of the substrate
Answer: C
Conceptual Explanation: Inhibitors of CYP450 enzymes decrease the metabolism of
substrate drugs, leading to increased plasma concentrations and potential toxicity.
,2. When prescribing an ACE inhibitor to a patient with chronic kidney disease, which
electrolyte imbalance is the most critical to monitor?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypomagnesemia
Answer: A
Conceptual Explanation: ACE inhibitors reduce aldosterone secretion, which can lead to
potassium retention, especially in patients with impaired renal function.
3. A 75-year-old patient has a decreased glomerular filtration rate (GFR). How does this
physiological change affect the pharmacokinetics of renal-excreted drugs?
A. Decreased half-life
B. Increased volume of distribution
C. Enhanced first-pass effect
D. Increased half-life
Answer: D
Conceptual Explanation: Decreased GFR slows the elimination of drugs excreted by the
kidneys, thereby extending the drug’s half-life and increasing the risk of accumulation.
, 4. Which of the following describes the ‘first-pass effect’?
A. The metabolism of an oral drug by the liver before reaching systemic circulation
B. The absorption of a drug through the gastric mucosa
C. The rapid distribution of drugs to the brain
D. The initial binding of a drug to plasma albumin
Answer: A
Conceptual Explanation: The first-pass effect refers to the metabolism of orally
administered drugs in the liver or gut wall before they reach the systemic circulation, often
significantly reducing bioavailability.
5. A patient taking Warfarin (Coumadin) begins a course of Rifampin, a potent CYP450
inducer. What adjustment to the Warfarin dose is likely necessary?
A. Decrease the Warfarin dose
B. Increase the Warfarin dose
C. Discontinue Warfarin immediately
D. No change is necessary
Answer: B
Conceptual Explanation: Rifampin induces CYP450 enzymes, increasing the metabolism
of Warfarin. To maintain a therapeutic INR, the dose of Warfarin must typically be
increased.
