NUR 210 PRINCIPLES OF
PHARMACOLOGY - FINAL EXAM
QUESTIONS AND ANSWERS 2026/2027
1. A patient is administered a drug that is known to be a prodrug. Which statement best
describes the pharmacokinetics of this medication?
A. The drug is active upon administration and becomes inactive after liver metabolism.
B. The drug bypasses the first-pass effect and is excreted unchanged by the kidneys.
C. The drug requires metabolic conversion, usually by the liver, to become
pharmacologically active.
D. The drug is highly protein-bound and requires displacement to become active.
Answer: C
Conceptual Explanation: A prodrug is an inactive compound that must be metabolized
(often by cytochrome P450 enzymes in the liver) into its active form to exert a therapeutic
effect.
2. If a drug has a half-life of 6 hours, what percentage of the drug will remain in the body 24
hours after a single intravenous bolus dose?
A. 25%
B. 6.25%
,C. 12.5%
D. 3.125%
Answer: B
Conceptual Explanation: After 24 hours (four half-lives), the remaining amount is
calculated as 100% -> 50% -> 25% -> 12.5% -> 6.25%.
3. A patient is taking Phenobarbital, a known hepatic enzyme inducer, along with Warfarin.
What is the most likely clinical outcome?
A. Decreased therapeutic effect of Warfarin, requiring a dose increase.
B. Increased risk of bleeding due to elevated Warfarin levels.
C. Acute renal failure due to competitive inhibition at the nephron.
D. Increased toxicity of Phenobarbital due to Warfarin competition.
Answer: A
Conceptual Explanation: Enzyme inducers increase the metabolism of other drugs (like
Warfarin), leading to lower serum levels and reduced therapeutic efficacy.
4. Which of the following describes a drug with a low Therapeutic Index (TI)?
A. The drug is safe to administer without monitoring blood levels.
B. The drug is easily excreted and does not accumulate in tissues.
C. The drug has a long half-life and requires once-daily dosing.
, D. The margin between the effective dose and the toxic dose is narrow.
Answer: D
Conceptual Explanation: A low therapeutic index indicates that the lethal or toxic dose is
very close to the effective dose, requiring close monitoring (e.g., Digoxin, Lithium).
5. In pharmacodynamics, how is an ‘Inverse Agonist’ distinguished from a ‘Competitive
Antagonist’?
A. Inverse agonists bind to a different site than the endogenous ligand.
B. Competitive antagonists increase the baseline activity of the receptor.
C. Inverse agonists reduce the constitutive activity of a receptor below its basal level.
D. There is no difference; both terms are used interchangeably.
Answer: C
Conceptual Explanation: While antagonists block the action of agonists, inverse agonists
actually reduce the spontaneous (constitutive) activity of the receptor system.
6. A patient presents with Pinpoint pupils, respiratory depression, and bradycardia. The nurse
suspects opioid overdose. Which medication is the priority intervention?
A. Flumazenil
B. Acetylcysteine
C. Physostigmine
D. Naloxone
PHARMACOLOGY - FINAL EXAM
QUESTIONS AND ANSWERS 2026/2027
1. A patient is administered a drug that is known to be a prodrug. Which statement best
describes the pharmacokinetics of this medication?
A. The drug is active upon administration and becomes inactive after liver metabolism.
B. The drug bypasses the first-pass effect and is excreted unchanged by the kidneys.
C. The drug requires metabolic conversion, usually by the liver, to become
pharmacologically active.
D. The drug is highly protein-bound and requires displacement to become active.
Answer: C
Conceptual Explanation: A prodrug is an inactive compound that must be metabolized
(often by cytochrome P450 enzymes in the liver) into its active form to exert a therapeutic
effect.
2. If a drug has a half-life of 6 hours, what percentage of the drug will remain in the body 24
hours after a single intravenous bolus dose?
A. 25%
B. 6.25%
,C. 12.5%
D. 3.125%
Answer: B
Conceptual Explanation: After 24 hours (four half-lives), the remaining amount is
calculated as 100% -> 50% -> 25% -> 12.5% -> 6.25%.
3. A patient is taking Phenobarbital, a known hepatic enzyme inducer, along with Warfarin.
What is the most likely clinical outcome?
A. Decreased therapeutic effect of Warfarin, requiring a dose increase.
B. Increased risk of bleeding due to elevated Warfarin levels.
C. Acute renal failure due to competitive inhibition at the nephron.
D. Increased toxicity of Phenobarbital due to Warfarin competition.
Answer: A
Conceptual Explanation: Enzyme inducers increase the metabolism of other drugs (like
Warfarin), leading to lower serum levels and reduced therapeutic efficacy.
4. Which of the following describes a drug with a low Therapeutic Index (TI)?
A. The drug is safe to administer without monitoring blood levels.
B. The drug is easily excreted and does not accumulate in tissues.
C. The drug has a long half-life and requires once-daily dosing.
, D. The margin between the effective dose and the toxic dose is narrow.
Answer: D
Conceptual Explanation: A low therapeutic index indicates that the lethal or toxic dose is
very close to the effective dose, requiring close monitoring (e.g., Digoxin, Lithium).
5. In pharmacodynamics, how is an ‘Inverse Agonist’ distinguished from a ‘Competitive
Antagonist’?
A. Inverse agonists bind to a different site than the endogenous ligand.
B. Competitive antagonists increase the baseline activity of the receptor.
C. Inverse agonists reduce the constitutive activity of a receptor below its basal level.
D. There is no difference; both terms are used interchangeably.
Answer: C
Conceptual Explanation: While antagonists block the action of agonists, inverse agonists
actually reduce the spontaneous (constitutive) activity of the receptor system.
6. A patient presents with Pinpoint pupils, respiratory depression, and bradycardia. The nurse
suspects opioid overdose. Which medication is the priority intervention?
A. Flumazenil
B. Acetylcysteine
C. Physostigmine
D. Naloxone
