NURS 6521 ADVANCED
PHARMACOLOGY EXAM REVIEW
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A patient with chronic kidney disease (CKD) is prescribed a drug that is primarily excreted
via the kidneys. If the drug’s half-life is 12 hours in a healthy individual, what should the
practitioner expect in this patient?
A. The half-life will decrease, requiring more frequent dosing.
B. The drug’s bioavailability will increase due to decreased metabolism.
C. The volume of distribution will decrease significantly.
D. The half-life will increase, requiring a reduction in dose or frequency.
Answer: D
Conceptual Explanation: In patients with renal impairment, the clearance of drugs
excreted by the kidneys is reduced, leading to a prolonged half-life and potential
accumulation. Dosage adjustments are necessary to prevent toxicity.
2. A 65-year-old patient taking Warfarin for atrial fibrillation is prescribed Amiodarone. What
interaction should the nurse practitioner anticipate?
A. Increased INR levels and risk of bleeding due to CYP2C9 inhibition.
,B. Increased risk of thrombosis due to Warfarin antagonism.
C. Decreased INR levels due to induction of CYP450.
D. No significant interaction as they work on different pathways.
Answer: A
Conceptual Explanation: Amiodarone is a potent inhibitor of CYP2C9, the enzyme
responsible for metabolizing the S-isomer of Warfarin. This leads to increased Warfarin
levels and a higher INR.
3. Which of the following is a critical laboratory parameter to monitor in a patient starting
Clozapine for treatment-resistant schizophrenia?
A. Serum Potassium
B. Thyroid Stimulating Hormone (TSH)
C. Absolute Neutrophil Count (ANC)
D. Serum Creatinine
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. Strict
monitoring of the ANC is required to mitigate the risk of severe life-threatening infections.
4. When prescribing an ACE inhibitor to a patient with diabetes and hypertension, which
physiological effect is most beneficial for renal protection?
A. Vasodilation of the efferent arteriole.
, B. Vasoconstriction of the afferent arteriole.
C. Increased secretion of aldosterone.
D. Increased glomerular filtration pressure.
Answer: A
Conceptual Explanation: ACE inhibitors cause vasodilation of the efferent arteriole, which
decreases intraglomerular pressure, thereby slowing the progression of diabetic
nephropathy.
5. A patient taking Digoxin presents with nausea, blurred vision, and a heart rate of 48 bpm.
Which electrolyte abnormality increases the risk of this toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hyponatremia
Answer: B
Conceptual Explanation: Hypokalemia increases Digoxin binding to the Na+/K+ ATPase
pump, significantly increasing the risk of Digoxin toxicity even if serum Digoxin levels are
within the therapeutic range.
PHARMACOLOGY EXAM REVIEW
QUESTIONS AND ANSWERS 100%
VERIFIED BY EXPERTS. 2026/2027
1. A patient with chronic kidney disease (CKD) is prescribed a drug that is primarily excreted
via the kidneys. If the drug’s half-life is 12 hours in a healthy individual, what should the
practitioner expect in this patient?
A. The half-life will decrease, requiring more frequent dosing.
B. The drug’s bioavailability will increase due to decreased metabolism.
C. The volume of distribution will decrease significantly.
D. The half-life will increase, requiring a reduction in dose or frequency.
Answer: D
Conceptual Explanation: In patients with renal impairment, the clearance of drugs
excreted by the kidneys is reduced, leading to a prolonged half-life and potential
accumulation. Dosage adjustments are necessary to prevent toxicity.
2. A 65-year-old patient taking Warfarin for atrial fibrillation is prescribed Amiodarone. What
interaction should the nurse practitioner anticipate?
A. Increased INR levels and risk of bleeding due to CYP2C9 inhibition.
,B. Increased risk of thrombosis due to Warfarin antagonism.
C. Decreased INR levels due to induction of CYP450.
D. No significant interaction as they work on different pathways.
Answer: A
Conceptual Explanation: Amiodarone is a potent inhibitor of CYP2C9, the enzyme
responsible for metabolizing the S-isomer of Warfarin. This leads to increased Warfarin
levels and a higher INR.
3. Which of the following is a critical laboratory parameter to monitor in a patient starting
Clozapine for treatment-resistant schizophrenia?
A. Serum Potassium
B. Thyroid Stimulating Hormone (TSH)
C. Absolute Neutrophil Count (ANC)
D. Serum Creatinine
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. Strict
monitoring of the ANC is required to mitigate the risk of severe life-threatening infections.
4. When prescribing an ACE inhibitor to a patient with diabetes and hypertension, which
physiological effect is most beneficial for renal protection?
A. Vasodilation of the efferent arteriole.
, B. Vasoconstriction of the afferent arteriole.
C. Increased secretion of aldosterone.
D. Increased glomerular filtration pressure.
Answer: A
Conceptual Explanation: ACE inhibitors cause vasodilation of the efferent arteriole, which
decreases intraglomerular pressure, thereby slowing the progression of diabetic
nephropathy.
5. A patient taking Digoxin presents with nausea, blurred vision, and a heart rate of 48 bpm.
Which electrolyte abnormality increases the risk of this toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hyponatremia
Answer: B
Conceptual Explanation: Hypokalemia increases Digoxin binding to the Na+/K+ ATPase
pump, significantly increasing the risk of Digoxin toxicity even if serum Digoxin levels are
within the therapeutic range.
