NURS 6521 ADVANCED
PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A patient with chronic kidney disease is prescribed a drug that is primarily excreted via the
kidneys. How should the provider adjust the dosage to prevent toxicity?
A. Decrease the dose or increase the dosing interval.
B. Increase the dose to ensure therapeutic levels are reached.
C. Maintain the standard dose but monitor liver enzymes.
D. Administer the drug with a high-protein meal.
Answer: A
Conceptual Explanation: Renal impairment reduces the clearance of drugs, leading to
accumulation. Adjustments involve lowering the dose or spacing out administrations.
2. Which process of pharmacokinetics is most significantly affected by the ‘first-pass effect’
after oral administration?
A. Excretion
B. Metabolism
C. Distribution
,D. Absorption
Answer: B
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug absorbed from the GI tract before it reaches systemic circulation.
3. A patient is taking a drug that is a known CYP450 inducer. What effect will this have on a
co-administered ‘prodrug’ that requires activation by the same enzyme?
A. The therapeutic effect of the prodrug will decrease.
B. The prodrug will remain in its inactive state longer.
C. The therapeutic effect of the prodrug will increase, potentially leading to toxicity.
D. There will be no change in the prodrug’s activity.
Answer: C
Conceptual Explanation: Inducers increase enzyme activity. For a prodrug, faster
metabolism means faster conversion to its active form, increasing levels.
4. Which of the following is a primary characteristic of a drug with a narrow therapeutic
index?
A. It has a high safety margin and does not require monitoring.
B. The lethal dose is significantly higher than the effective dose.
C. It is absorbed rapidly across the blood-brain barrier.
D. There is a small difference between the effective dose and the toxic dose.
, Answer: D
Conceptual Explanation: A narrow therapeutic index indicates that small changes in
dosage or blood levels can lead to either subtherapeutic effects or toxicity.
5. When prescribing an ACE inhibitor to a patient with heart failure, which electrolyte
abnormality is the provider most concerned about?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors reduce aldosterone secretion, which can lead to
potassium retention and hyperkalemia.
6. A patient taking Digoxin for atrial fibrillation reports seeing yellow-green halos around
lights. What is the priority nursing action?
A. Assess for signs of digoxin toxicity and check serum levels.
B. Document the finding as a common side effect.
C. Instruct the patient to increase potassium intake.
D. Administer the next scheduled dose immediately.
Answer: A
PHARMACOLOGY FINAL EXAM
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A patient with chronic kidney disease is prescribed a drug that is primarily excreted via the
kidneys. How should the provider adjust the dosage to prevent toxicity?
A. Decrease the dose or increase the dosing interval.
B. Increase the dose to ensure therapeutic levels are reached.
C. Maintain the standard dose but monitor liver enzymes.
D. Administer the drug with a high-protein meal.
Answer: A
Conceptual Explanation: Renal impairment reduces the clearance of drugs, leading to
accumulation. Adjustments involve lowering the dose or spacing out administrations.
2. Which process of pharmacokinetics is most significantly affected by the ‘first-pass effect’
after oral administration?
A. Excretion
B. Metabolism
C. Distribution
,D. Absorption
Answer: B
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug absorbed from the GI tract before it reaches systemic circulation.
3. A patient is taking a drug that is a known CYP450 inducer. What effect will this have on a
co-administered ‘prodrug’ that requires activation by the same enzyme?
A. The therapeutic effect of the prodrug will decrease.
B. The prodrug will remain in its inactive state longer.
C. The therapeutic effect of the prodrug will increase, potentially leading to toxicity.
D. There will be no change in the prodrug’s activity.
Answer: C
Conceptual Explanation: Inducers increase enzyme activity. For a prodrug, faster
metabolism means faster conversion to its active form, increasing levels.
4. Which of the following is a primary characteristic of a drug with a narrow therapeutic
index?
A. It has a high safety margin and does not require monitoring.
B. The lethal dose is significantly higher than the effective dose.
C. It is absorbed rapidly across the blood-brain barrier.
D. There is a small difference between the effective dose and the toxic dose.
, Answer: D
Conceptual Explanation: A narrow therapeutic index indicates that small changes in
dosage or blood levels can lead to either subtherapeutic effects or toxicity.
5. When prescribing an ACE inhibitor to a patient with heart failure, which electrolyte
abnormality is the provider most concerned about?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hyperkalemia
Answer: D
Conceptual Explanation: ACE inhibitors reduce aldosterone secretion, which can lead to
potassium retention and hyperkalemia.
6. A patient taking Digoxin for atrial fibrillation reports seeing yellow-green halos around
lights. What is the priority nursing action?
A. Assess for signs of digoxin toxicity and check serum levels.
B. Document the finding as a common side effect.
C. Instruct the patient to increase potassium intake.
D. Administer the next scheduled dose immediately.
Answer: A
