NR-604 Advanced Pharmacology Practice Exam | 120
Questions with Answers and Rationales
Foundations of pharmacology
1. What does oral bioavailability describe?
A. The fraction of a dose reaching systemic circulation unchanged
B. The maximal receptor response
C. The fraction bound to receptors
D. The time required for renal elimination
2. A drug follows first-order elimination. What remains after four half-lives with no
additional doses?
A. 6.25%
B. 25%
C. 50%
D. 0%
3. Which variable most directly determines a loading dose for a target plasma
concentration?
A. Elimination rate alone
B. Renal clearance alone
C. Dosing interval alone
D. Volume of distribution
4.Which variable most directly determines the maintenance dose rate at a
target steady-state concentration?
A. Clearance
B. Volume of distribution alone
C. Receptor affinity alone
D. Tablet color
5. With linear kinetics, approximately when is steady state approached during repeated
dosing?
1
, A. Only after drug discontinuation
B. After four to five half-lives
C. After exactly 24 hours for every drug
D. After one dose for every drug
6.A strong CYP inhibitor is added to an active drug primarily metabolized by that
enzyme. What is the likely result?
A. Reduced absorption in every case
B. Increased drug exposure
C. Increased clearance
D. Guaranteed loss of efficacy
2
,7. What can a strong enzyme inducer do to an active substrate drug?
A. Prevent renal excretion
B. Increase receptor affinity
C. Immediately eliminate all adverse effects
D. Lower its plasma concentration
8. A reversible competitive antagonist typically causes which concentration-response
change?
A. Irreversible receptor destruction
B. A permanently increased maximal response
C. A rightward shift with preserved maximal response if enough agonist is given
D. A leftward shift with increased potency
9. An older adult has reduced renal function. Which prescribing principle is most
appropriate?
A. Assess drug-specific renal dosing and monitor response
B. Use age alone to double the dose
C. Assume normal clearance if creatinine appears normal
D. Avoid every medication
Cardiovascular pharmacology
10. A patient taking lisinopril develops tongue swelling and difficulty breathing. What
is the priority?
A. Give the next dose with food
B. Add potassium supplementation
C. Stop lisinopril and obtain emergency airway assessment
D. Wait until the next routine visit
11. Which laboratory tests are especially important after starting an ACE inhibitor?
A. Vitamin B12 only
B. Amylase and lipase only
C. Serum potassium and renal function
3
, D. Hemoglobin A1c only
12. A persistent dry cough develops with an ACE inhibitor. What commonly explains
it?
A. Histamine receptor blockade
B. Direct bacterial infection
C. Excess thyroid hormone
D. Accumulation of bradykinin
4
Questions with Answers and Rationales
Foundations of pharmacology
1. What does oral bioavailability describe?
A. The fraction of a dose reaching systemic circulation unchanged
B. The maximal receptor response
C. The fraction bound to receptors
D. The time required for renal elimination
2. A drug follows first-order elimination. What remains after four half-lives with no
additional doses?
A. 6.25%
B. 25%
C. 50%
D. 0%
3. Which variable most directly determines a loading dose for a target plasma
concentration?
A. Elimination rate alone
B. Renal clearance alone
C. Dosing interval alone
D. Volume of distribution
4.Which variable most directly determines the maintenance dose rate at a
target steady-state concentration?
A. Clearance
B. Volume of distribution alone
C. Receptor affinity alone
D. Tablet color
5. With linear kinetics, approximately when is steady state approached during repeated
dosing?
1
, A. Only after drug discontinuation
B. After four to five half-lives
C. After exactly 24 hours for every drug
D. After one dose for every drug
6.A strong CYP inhibitor is added to an active drug primarily metabolized by that
enzyme. What is the likely result?
A. Reduced absorption in every case
B. Increased drug exposure
C. Increased clearance
D. Guaranteed loss of efficacy
2
,7. What can a strong enzyme inducer do to an active substrate drug?
A. Prevent renal excretion
B. Increase receptor affinity
C. Immediately eliminate all adverse effects
D. Lower its plasma concentration
8. A reversible competitive antagonist typically causes which concentration-response
change?
A. Irreversible receptor destruction
B. A permanently increased maximal response
C. A rightward shift with preserved maximal response if enough agonist is given
D. A leftward shift with increased potency
9. An older adult has reduced renal function. Which prescribing principle is most
appropriate?
A. Assess drug-specific renal dosing and monitor response
B. Use age alone to double the dose
C. Assume normal clearance if creatinine appears normal
D. Avoid every medication
Cardiovascular pharmacology
10. A patient taking lisinopril develops tongue swelling and difficulty breathing. What
is the priority?
A. Give the next dose with food
B. Add potassium supplementation
C. Stop lisinopril and obtain emergency airway assessment
D. Wait until the next routine visit
11. Which laboratory tests are especially important after starting an ACE inhibitor?
A. Vitamin B12 only
B. Amylase and lipase only
C. Serum potassium and renal function
3
, D. Hemoglobin A1c only
12. A persistent dry cough develops with an ACE inhibitor. What commonly explains
it?
A. Histamine receptor blockade
B. Direct bacterial infection
C. Excess thyroid hormone
D. Accumulation of bradykinin
4
