NURS 5334/ NURS5334 Exam 2 – Advanced
Pharmacology Review Actual Exam 2026/2027 |
Complete Exam-Style Questions with Detailed Rationales
| Pass Guaranteed – A+ Graded
Q1: Which pharmacokinetic phase involves the movement of a drug from its site of
administration into the bloodstream?
A. Distribution
B. Absorption [CORRECT]
C. Metabolism
D. Excretion
Correct Answer: B
Rationale: Correct because absorption is the process by which a drug enters systemic
circulation from its administration site, influenced by route, blood flow, and drug properties.
---
Q2: Which factor most significantly affects drug distribution in the body?
A. Protein binding [CORRECT]
B. Renal function
C. Hepatic function
D. Route of administration
Correct Answer: A
Rationale: Correct because drugs bound to plasma proteins (especially albumin) are
pharmacologically inactive and cannot cross membranes, limiting distribution to target tissues.
---
Q3: A patient with hepatic cirrhosis requires dose adjustment of a hepatically metabolized drug.
Which pharmacokinetic parameter is most affected?
A. Absorption
B. Distribution
C. First-pass metabolism [CORRECT]
D. Renal excretion
Correct Answer: C
Rationale: Correct because cirrhosis impairs hepatic enzyme activity and portal blood flow,
reducing first-pass metabolism and increasing drug bioavailability.
,---
Q4: Which cytochrome P450 enzyme is responsible for metabolizing the majority of clinically
used drugs?
A. CYP2D6
B. CYP3A4 [CORRECT]
C. CYP2C9
D. CYP1A2
Correct Answer: B
Rationale: Correct because CYP3A4 metabolizes approximately 50% of all prescription
medications and is the most abundant hepatic and intestinal CYP enzyme.
---
Q5: A patient taking warfarin is prescribed fluconazole. Which interaction is expected?
A. Decreased warfarin effect
B. Increased INR and bleeding risk [CORRECT]
C. No significant interaction
D. Reduced fluconazole efficacy
Correct Answer: B
Rationale: Correct because fluconazole inhibits CYP2C9, which metabolizes warfarin, leading to
increased warfarin levels, elevated INR, and bleeding risk.
---
Q6: Which mechanism of action describes ACE inhibitors?
A. Block angiotensin II receptors
B. Inhibit conversion of angiotensin I to angiotensin II [CORRECT]
C. Directly dilate arterioles
D. Reduce heart rate
Correct Answer: B
Rationale: Correct because ACE inhibitors prevent the conversion of angiotensin I to
angiotensin II, reducing vasoconstriction and aldosterone secretion.
---
Q7: A patient on lisinopril develops a persistent dry cough. Which mechanism explains this side
effect?
A. Accumulation of bradykinin [CORRECT]
B. Direct irritation of the airway
C. Histamine release
, D. Beta-2 receptor blockade
Correct Answer: A
Rationale: Correct because ACE inhibition prevents bradykinin degradation, causing bradykinin
accumulation that irritates the airways and produces a dry cough.
---
Q8: Which adverse effect is most concerning in a patient taking spironolactone?
A. Hypokalemia
B. Hyperkalemia [CORRECT]
C. Hyponatremia
D. Hypocalcemia
Correct Answer: B
Rationale: Correct because spironolactone is a potassium-sparing diuretic that retains
potassium, increasing the risk of hyperkalemia, especially with ACE inhibitors or ARBs.
---
Q9: A patient with heart failure is prescribed carvedilol. Which receptor activity does this
medication have?
A. Beta-1 selective blockade
B. Alpha-1 and beta blockade [CORRECT]
C. Beta-2 agonist
D. Alpha-1 selective blockade
Correct Answer: B
Rationale: Correct because carvedilol is a nonselective beta-blocker with alpha-1 blocking
activity, providing additional vasodilation beneficial in heart failure.
---
Q10: Which laboratory value requires monitoring in a patient taking atorvastatin?
A. Serum potassium
B. Liver function tests [CORRECT]
C. Serum sodium
D. Thyroid function
Correct Answer: B
Rationale: Correct because statins can cause hepatotoxicity; baseline and periodic LFTs are
required to detect elevated transaminases.
---
Pharmacology Review Actual Exam 2026/2027 |
Complete Exam-Style Questions with Detailed Rationales
| Pass Guaranteed – A+ Graded
Q1: Which pharmacokinetic phase involves the movement of a drug from its site of
administration into the bloodstream?
A. Distribution
B. Absorption [CORRECT]
C. Metabolism
D. Excretion
Correct Answer: B
Rationale: Correct because absorption is the process by which a drug enters systemic
circulation from its administration site, influenced by route, blood flow, and drug properties.
---
Q2: Which factor most significantly affects drug distribution in the body?
A. Protein binding [CORRECT]
B. Renal function
C. Hepatic function
D. Route of administration
Correct Answer: A
Rationale: Correct because drugs bound to plasma proteins (especially albumin) are
pharmacologically inactive and cannot cross membranes, limiting distribution to target tissues.
---
Q3: A patient with hepatic cirrhosis requires dose adjustment of a hepatically metabolized drug.
Which pharmacokinetic parameter is most affected?
A. Absorption
B. Distribution
C. First-pass metabolism [CORRECT]
D. Renal excretion
Correct Answer: C
Rationale: Correct because cirrhosis impairs hepatic enzyme activity and portal blood flow,
reducing first-pass metabolism and increasing drug bioavailability.
,---
Q4: Which cytochrome P450 enzyme is responsible for metabolizing the majority of clinically
used drugs?
A. CYP2D6
B. CYP3A4 [CORRECT]
C. CYP2C9
D. CYP1A2
Correct Answer: B
Rationale: Correct because CYP3A4 metabolizes approximately 50% of all prescription
medications and is the most abundant hepatic and intestinal CYP enzyme.
---
Q5: A patient taking warfarin is prescribed fluconazole. Which interaction is expected?
A. Decreased warfarin effect
B. Increased INR and bleeding risk [CORRECT]
C. No significant interaction
D. Reduced fluconazole efficacy
Correct Answer: B
Rationale: Correct because fluconazole inhibits CYP2C9, which metabolizes warfarin, leading to
increased warfarin levels, elevated INR, and bleeding risk.
---
Q6: Which mechanism of action describes ACE inhibitors?
A. Block angiotensin II receptors
B. Inhibit conversion of angiotensin I to angiotensin II [CORRECT]
C. Directly dilate arterioles
D. Reduce heart rate
Correct Answer: B
Rationale: Correct because ACE inhibitors prevent the conversion of angiotensin I to
angiotensin II, reducing vasoconstriction and aldosterone secretion.
---
Q7: A patient on lisinopril develops a persistent dry cough. Which mechanism explains this side
effect?
A. Accumulation of bradykinin [CORRECT]
B. Direct irritation of the airway
C. Histamine release
, D. Beta-2 receptor blockade
Correct Answer: A
Rationale: Correct because ACE inhibition prevents bradykinin degradation, causing bradykinin
accumulation that irritates the airways and produces a dry cough.
---
Q8: Which adverse effect is most concerning in a patient taking spironolactone?
A. Hypokalemia
B. Hyperkalemia [CORRECT]
C. Hyponatremia
D. Hypocalcemia
Correct Answer: B
Rationale: Correct because spironolactone is a potassium-sparing diuretic that retains
potassium, increasing the risk of hyperkalemia, especially with ACE inhibitors or ARBs.
---
Q9: A patient with heart failure is prescribed carvedilol. Which receptor activity does this
medication have?
A. Beta-1 selective blockade
B. Alpha-1 and beta blockade [CORRECT]
C. Beta-2 agonist
D. Alpha-1 selective blockade
Correct Answer: B
Rationale: Correct because carvedilol is a nonselective beta-blocker with alpha-1 blocking
activity, providing additional vasodilation beneficial in heart failure.
---
Q10: Which laboratory value requires monitoring in a patient taking atorvastatin?
A. Serum potassium
B. Liver function tests [CORRECT]
C. Serum sodium
D. Thyroid function
Correct Answer: B
Rationale: Correct because statins can cause hepatotoxicity; baseline and periodic LFTs are
required to detect elevated transaminases.
---
