NURS 6521 ADVANCED
PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. Which pharmacokinetic process is most significantly affected by the first-pass effect when
a drug is administered orally?
A. Distribution
B. Absorption
C. Excretion
D. Metabolism
Answer: D
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of an
orally administered drug before it reaches the systemic circulation.
2. When prescribing an ACE inhibitor such as Lisinopril, which electrolyte imbalance must the
nurse practitioner monitor for?
A. Hypocalcemia
,B. Hypokalemia
C. Hypernatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors block aldosterone secretion, which can lead to
potassium retention and hyperkalemia.
3. A patient with a history of heart failure is prescribed Digoxin. What is the primary
mechanism of action of this medication?
A. Negative inotrope and positive chronotrope
B. Positive inotrope and negative chronotrope
C. Positive inotrope and positive chronotrope
D. Negative inotrope and negative chronotrope
Answer: B
Conceptual Explanation: Digoxin increases the force of myocardial contraction (positive
inotrope) and slows the heart rate (negative chronotrope).
4. Which antibiotic class is most frequently associated with the risk of tendon rupture,
particularly in older adults?
A. Penicillins
B. Macrolides
, C. Fluoroquinolones
D. Tetracyclines
Answer: C
Conceptual Explanation: Fluoroquinolones like Ciprofloxacin carry a boxed warning for
tendonitis and tendon rupture.
5. A patient is being treated for a systemic fungal infection with Amphotericin B. Which organ
system is at the highest risk for toxicity?
A. Kidneys
B. Pancreas
C. Liver
D. Heart
Answer: A
Conceptual Explanation: Nephrotoxicity is a major dose-limiting adverse effect of
Amphotericin B.
6. What is the mechanism of action of Warfarin in preventing blood clots?
A. Directly inhibits Factor Xa
B. Inhibits Vitamin K epoxide reductase
C. Directly inhibits Thrombin
PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. Which pharmacokinetic process is most significantly affected by the first-pass effect when
a drug is administered orally?
A. Distribution
B. Absorption
C. Excretion
D. Metabolism
Answer: D
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of an
orally administered drug before it reaches the systemic circulation.
2. When prescribing an ACE inhibitor such as Lisinopril, which electrolyte imbalance must the
nurse practitioner monitor for?
A. Hypocalcemia
,B. Hypokalemia
C. Hypernatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors block aldosterone secretion, which can lead to
potassium retention and hyperkalemia.
3. A patient with a history of heart failure is prescribed Digoxin. What is the primary
mechanism of action of this medication?
A. Negative inotrope and positive chronotrope
B. Positive inotrope and negative chronotrope
C. Positive inotrope and positive chronotrope
D. Negative inotrope and negative chronotrope
Answer: B
Conceptual Explanation: Digoxin increases the force of myocardial contraction (positive
inotrope) and slows the heart rate (negative chronotrope).
4. Which antibiotic class is most frequently associated with the risk of tendon rupture,
particularly in older adults?
A. Penicillins
B. Macrolides
, C. Fluoroquinolones
D. Tetracyclines
Answer: C
Conceptual Explanation: Fluoroquinolones like Ciprofloxacin carry a boxed warning for
tendonitis and tendon rupture.
5. A patient is being treated for a systemic fungal infection with Amphotericin B. Which organ
system is at the highest risk for toxicity?
A. Kidneys
B. Pancreas
C. Liver
D. Heart
Answer: A
Conceptual Explanation: Nephrotoxicity is a major dose-limiting adverse effect of
Amphotericin B.
6. What is the mechanism of action of Warfarin in preventing blood clots?
A. Directly inhibits Factor Xa
B. Inhibits Vitamin K epoxide reductase
C. Directly inhibits Thrombin
