NUR 631 ADVANCED PHARMACOLOGY
FINAL EXAM QUESTIONS AND
ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. A patient with a history of heart failure and chronic kidney disease is started on an ACE
inhibitor. Which physiological mechanism explains the potential for acute kidney injury in this
patient?
A. Dilation of the afferent arteriole decreasing glomerular pressure
B. Constriction of the efferent arteriole increasing glomerular filtration
C. Dilation of the efferent arteriole leading to a drop in intraglomerular pressure
D. Inhibition of the sodium-potassium-chloride symporter in the Loop of Henle
Answer: C
Conceptual Explanation: ACE inhibitors block the production of Angiotensin II, which
normally constricts the efferent arteriole. Dilation of this arteriole reduces the filtration
pressure, which can lead to a drop in GFR in patients dependent on that pressure.
2. Which of the following describes ‘zero-order kinetics’ as it applies to Phenytoin?
A. The rate of elimination is proportional to the plasma concentration
B. The half-life remains constant as the dose increases
,C. A constant amount of drug is eliminated per unit of time regardless of concentration
D. The drug follows a linear relationship between dose and serum levels
Answer: C
Conceptual Explanation: Zero-order kinetics means the metabolic pathways are
saturated, so a constant amount (not fraction) of drug is cleared, making small dose
increases lead to toxic levels.
3. When prescribing Amiodarone, the nurse practitioner must monitor which of the following
due to its unique chemical structure?
A. Serum calcium levels due to parathyroid suppression
B. Thyroid function tests due to high iodine content
C. Urinary protein due to nephrotic syndrome risk
D. Blood glucose due to insulin resistance
Answer: B
Conceptual Explanation: Amiodarone contains iodine and can cause both hypothyroidism
and hyperthyroidism (Wolff-Chaikoff effect or Jod-Basedow phenomenon).
4. A patient on Warfarin requires therapy with a potent CYP3A4 inhibitor. What is the
expected effect on the International Normalized Ratio (INR)?
A. The INR will increase, increasing the risk of bleeding
B. The INR will decrease, increasing the risk of clots
, C. The INR will remain stable as Warfarin is not metabolized by CYP3A4
D. The INR will fluctuate unpredictably due to protein binding displacement
Answer: A
Conceptual Explanation: Warfarin (specifically the R-isomer) is metabolized by CYP3A4.
Inhibiting this enzyme slows metabolism, increasing drug levels and the INR.
5. What is the primary mechanism of action of GLP-1 receptor agonists in the management of
Type 2 Diabetes?
A. Inhibition of the SGLT2 transporter in the proximal tubule
B. Antagonism of the glucagon receptor in the liver
C. Direct stimulation of the PPAR-gamma receptor in adipose tissue
D. Potentiation of glucose-dependent insulin secretion and slowing of gastric emptying
Answer: D
Conceptual Explanation: GLP-1 agonists mimic incretins, which enhance insulin release
only when glucose is present, suppress glucagon, and slow gastric emptying.
6. Which antibiotic is associated with a high risk of Clostridioides difficile infection due to its
broad disruption of anaerobic gut flora?
A. Doxycycline
B. Linezolid
C. Nitrofurantoin
FINAL EXAM QUESTIONS AND
ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. A patient with a history of heart failure and chronic kidney disease is started on an ACE
inhibitor. Which physiological mechanism explains the potential for acute kidney injury in this
patient?
A. Dilation of the afferent arteriole decreasing glomerular pressure
B. Constriction of the efferent arteriole increasing glomerular filtration
C. Dilation of the efferent arteriole leading to a drop in intraglomerular pressure
D. Inhibition of the sodium-potassium-chloride symporter in the Loop of Henle
Answer: C
Conceptual Explanation: ACE inhibitors block the production of Angiotensin II, which
normally constricts the efferent arteriole. Dilation of this arteriole reduces the filtration
pressure, which can lead to a drop in GFR in patients dependent on that pressure.
2. Which of the following describes ‘zero-order kinetics’ as it applies to Phenytoin?
A. The rate of elimination is proportional to the plasma concentration
B. The half-life remains constant as the dose increases
,C. A constant amount of drug is eliminated per unit of time regardless of concentration
D. The drug follows a linear relationship between dose and serum levels
Answer: C
Conceptual Explanation: Zero-order kinetics means the metabolic pathways are
saturated, so a constant amount (not fraction) of drug is cleared, making small dose
increases lead to toxic levels.
3. When prescribing Amiodarone, the nurse practitioner must monitor which of the following
due to its unique chemical structure?
A. Serum calcium levels due to parathyroid suppression
B. Thyroid function tests due to high iodine content
C. Urinary protein due to nephrotic syndrome risk
D. Blood glucose due to insulin resistance
Answer: B
Conceptual Explanation: Amiodarone contains iodine and can cause both hypothyroidism
and hyperthyroidism (Wolff-Chaikoff effect or Jod-Basedow phenomenon).
4. A patient on Warfarin requires therapy with a potent CYP3A4 inhibitor. What is the
expected effect on the International Normalized Ratio (INR)?
A. The INR will increase, increasing the risk of bleeding
B. The INR will decrease, increasing the risk of clots
, C. The INR will remain stable as Warfarin is not metabolized by CYP3A4
D. The INR will fluctuate unpredictably due to protein binding displacement
Answer: A
Conceptual Explanation: Warfarin (specifically the R-isomer) is metabolized by CYP3A4.
Inhibiting this enzyme slows metabolism, increasing drug levels and the INR.
5. What is the primary mechanism of action of GLP-1 receptor agonists in the management of
Type 2 Diabetes?
A. Inhibition of the SGLT2 transporter in the proximal tubule
B. Antagonism of the glucagon receptor in the liver
C. Direct stimulation of the PPAR-gamma receptor in adipose tissue
D. Potentiation of glucose-dependent insulin secretion and slowing of gastric emptying
Answer: D
Conceptual Explanation: GLP-1 agonists mimic incretins, which enhance insulin release
only when glucose is present, suppress glucagon, and slow gastric emptying.
6. Which antibiotic is associated with a high risk of Clostridioides difficile infection due to its
broad disruption of anaerobic gut flora?
A. Doxycycline
B. Linezolid
C. Nitrofurantoin
