NURS 6521 ADVANCED
PHARMACOLOGY MIDTERM EXAM
STUDY GUIDE QUESTIONS AND
VERIFIED ANSWERS |GRADE A+| JUST
RELEASED
1. A drug has a half-life of 6 hours. If a patient takes a single dose of 400 mg, how much of the
drug will remain in the system after 24 hours?
A. 100 mg
B. 25 mg
C. 50 mg
D. 12.5 mg
Answer: B
Conceptual Explanation: After 24 hours, four half-lives have passed (24/6 = 4). The
amount remaining is calculated as: 400mg / 2 = 200mg (1st), / 2 = 100mg (2nd), / 2 =
50mg (3rd), / 2 = 25mg (4th).
,2. Which process of pharmacokinetics is most significantly affected by the ‘first-pass effect’
during oral administration?
A. Distribution
B. Excretion
C. Metabolism
D. Absorption
Answer: C
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug absorbed from the gastrointestinal tract before it reaches the systemic circulation.
3. An advanced practice nurse is prescribing a drug that is highly protein-bound. If the patient
has severe hypoalbuminemia, what is the most likely pharmacological outcome?
A. The therapeutic effect will decrease.
B. The drug’s half-life will be significantly lengthened.
C. The drug will be excreted more slowly by the kidneys.
D. The free fraction of the drug will increase, potentially leading to toxicity.
Answer: D
Conceptual Explanation: Albumin is the primary protein for drug binding.
Hypoalbuminemia results in fewer binding sites, increasing the concentration of free
(active) drug, which can lead to toxicity.
, 4. A patient is taking a drug that is a potent inducer of the Cytochrome P450 (CYP) enzyme
system. How will this affect a second drug metabolized by the same system?
A. It will increase the serum levels of the second drug.
B. It will decrease the serum levels of the second drug.
C. It will decrease the rate of metabolism of the second drug.
D. It will have no effect on the second drug.
Answer: B
Conceptual Explanation: Enzyme inducers increase the metabolic activity of the CYP
system, leading to faster breakdown of substrate drugs and lower plasma concentrations.
5. Which characteristic of a drug indicates that it has a narrow therapeutic index?
A. The drug requires once-daily dosing.
B. The drug is metabolized by multiple enzyme pathways.
C. The drug is highly effective at low concentrations.
D. There is a small margin between the effective dose and the toxic dose.
Answer: D
Conceptual Explanation: A narrow therapeutic index means that the difference between
the dose required for efficacy and the dose that causes toxicity is small, requiring close
monitoring.
PHARMACOLOGY MIDTERM EXAM
STUDY GUIDE QUESTIONS AND
VERIFIED ANSWERS |GRADE A+| JUST
RELEASED
1. A drug has a half-life of 6 hours. If a patient takes a single dose of 400 mg, how much of the
drug will remain in the system after 24 hours?
A. 100 mg
B. 25 mg
C. 50 mg
D. 12.5 mg
Answer: B
Conceptual Explanation: After 24 hours, four half-lives have passed (24/6 = 4). The
amount remaining is calculated as: 400mg / 2 = 200mg (1st), / 2 = 100mg (2nd), / 2 =
50mg (3rd), / 2 = 25mg (4th).
,2. Which process of pharmacokinetics is most significantly affected by the ‘first-pass effect’
during oral administration?
A. Distribution
B. Excretion
C. Metabolism
D. Absorption
Answer: C
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug absorbed from the gastrointestinal tract before it reaches the systemic circulation.
3. An advanced practice nurse is prescribing a drug that is highly protein-bound. If the patient
has severe hypoalbuminemia, what is the most likely pharmacological outcome?
A. The therapeutic effect will decrease.
B. The drug’s half-life will be significantly lengthened.
C. The drug will be excreted more slowly by the kidneys.
D. The free fraction of the drug will increase, potentially leading to toxicity.
Answer: D
Conceptual Explanation: Albumin is the primary protein for drug binding.
Hypoalbuminemia results in fewer binding sites, increasing the concentration of free
(active) drug, which can lead to toxicity.
, 4. A patient is taking a drug that is a potent inducer of the Cytochrome P450 (CYP) enzyme
system. How will this affect a second drug metabolized by the same system?
A. It will increase the serum levels of the second drug.
B. It will decrease the serum levels of the second drug.
C. It will decrease the rate of metabolism of the second drug.
D. It will have no effect on the second drug.
Answer: B
Conceptual Explanation: Enzyme inducers increase the metabolic activity of the CYP
system, leading to faster breakdown of substrate drugs and lower plasma concentrations.
5. Which characteristic of a drug indicates that it has a narrow therapeutic index?
A. The drug requires once-daily dosing.
B. The drug is metabolized by multiple enzyme pathways.
C. The drug is highly effective at low concentrations.
D. There is a small margin between the effective dose and the toxic dose.
Answer: D
Conceptual Explanation: A narrow therapeutic index means that the difference between
the dose required for efficacy and the dose that causes toxicity is small, requiring close
monitoring.
