Applied Pharmacology
Final Exam Review
(Questions & Solutions)
2025
1
,Multiple Choice Questions (MCQs)
A 65-year-old patient with chronic kidney disease is prescribed digoxin
for heart failure. Which pharmacokinetic change should the nurse most
closely monitor?
A) Increased hepatic metabolism
B) Decreased renal clearance
C) Accelerated intestinal absorption
D) Increased plasma protein binding
ANS: B) Decreased renal clearance
Rationale: Digoxin is primarily cleared by the kidneys; renal impairment
decreases clearance, increasing toxicity risk.
A patient receiving phenytoin for seizure control develops gum
hypertrophy. What is the primary mechanism behind this adverse effect?
A) Direct toxic effect on gingival fibroblasts
B) Hypersensitivity reaction
C) Altered calcium metabolism
D) Excessive immunosuppression
ANS: A) Direct toxic effect on gingival fibroblasts
Rationale: Phenytoin stimulates gingival fibroblast proliferation causing
hyperplasia.
Which neurotransmitter system is primarily targeted by selective
serotonin reuptake inhibitors (SSRIs)?
A) Dopaminergic
B) GABAergic
C) Serotonergic
D) Adrenergic
ANS: C) Serotonergic
Rationale: SSRIs increase serotonin levels by blocking its reuptake in the
CNS.
2
, Which phase of the cell cycle is specifically targeted by antimetabolite
anticancer drugs such as methotrexate?
A) G0 phase
B) S phase
C) M phase
D) G2 phase
ANS: B) S phase
Rationale: Antimetabolites interfere with DNA synthesis during the S
phase.
A patient administered with statins is advised to avoid grapefruit juice.
What is the reason for this interaction?
A) It increases gastric pH affecting drug absorption
B) It induces hepatic CYP3A4 enzymes
C) It inhibits CYP3A4 enzymes leading to increased statin plasma levels
D) It binds directly to statins reducing efficacy
ANS: C) It inhibits CYP3A4 enzymes leading to increased statin plasma
levels
Rationale: Grapefruit juice inhibits CYP3A4, decreasing metabolism and
increasing statin toxicity risk.
Fill-in-the-Blank Questions
The enzyme predominantly responsible for the bioactivation of prodrugs
in the liver is ______________.
ANS: cytochrome P450 (CYP450)
Rationale: CYP450 enzymes metabolize many prodrugs into active
pharmacologic agents.
The pharmacological term for the dose causing 50% of the maximal effect
is ______________.
ANS: ED50 (Effective Dose 50)
Rationale: ED50 represents the dose at which 50% of the maximal effect
is achieved.
3
Final Exam Review
(Questions & Solutions)
2025
1
,Multiple Choice Questions (MCQs)
A 65-year-old patient with chronic kidney disease is prescribed digoxin
for heart failure. Which pharmacokinetic change should the nurse most
closely monitor?
A) Increased hepatic metabolism
B) Decreased renal clearance
C) Accelerated intestinal absorption
D) Increased plasma protein binding
ANS: B) Decreased renal clearance
Rationale: Digoxin is primarily cleared by the kidneys; renal impairment
decreases clearance, increasing toxicity risk.
A patient receiving phenytoin for seizure control develops gum
hypertrophy. What is the primary mechanism behind this adverse effect?
A) Direct toxic effect on gingival fibroblasts
B) Hypersensitivity reaction
C) Altered calcium metabolism
D) Excessive immunosuppression
ANS: A) Direct toxic effect on gingival fibroblasts
Rationale: Phenytoin stimulates gingival fibroblast proliferation causing
hyperplasia.
Which neurotransmitter system is primarily targeted by selective
serotonin reuptake inhibitors (SSRIs)?
A) Dopaminergic
B) GABAergic
C) Serotonergic
D) Adrenergic
ANS: C) Serotonergic
Rationale: SSRIs increase serotonin levels by blocking its reuptake in the
CNS.
2
, Which phase of the cell cycle is specifically targeted by antimetabolite
anticancer drugs such as methotrexate?
A) G0 phase
B) S phase
C) M phase
D) G2 phase
ANS: B) S phase
Rationale: Antimetabolites interfere with DNA synthesis during the S
phase.
A patient administered with statins is advised to avoid grapefruit juice.
What is the reason for this interaction?
A) It increases gastric pH affecting drug absorption
B) It induces hepatic CYP3A4 enzymes
C) It inhibits CYP3A4 enzymes leading to increased statin plasma levels
D) It binds directly to statins reducing efficacy
ANS: C) It inhibits CYP3A4 enzymes leading to increased statin plasma
levels
Rationale: Grapefruit juice inhibits CYP3A4, decreasing metabolism and
increasing statin toxicity risk.
Fill-in-the-Blank Questions
The enzyme predominantly responsible for the bioactivation of prodrugs
in the liver is ______________.
ANS: cytochrome P450 (CYP450)
Rationale: CYP450 enzymes metabolize many prodrugs into active
pharmacologic agents.
The pharmacological term for the dose causing 50% of the maximal effect
is ______________.
ANS: ED50 (Effective Dose 50)
Rationale: ED50 represents the dose at which 50% of the maximal effect
is achieved.
3
