NRNP 6566 WK1-5 Midterm / Actual Exam Questions
Bank with Definitive Explanations of Answers /
Newest 2025/2026.
Describe cytochrome p450 system - (ANSWER)Cytochrome p450 system is a
series of enzymes used to metabolize medications
Inhibitors - (ANSWER)block metabolic activity from one or more CYP450 enzymes
Inducers - (ANSWER)increase CYP450 enzyme activity by increasing enzyme
synthesis
Describe effect on low and high albumin levels on active drug levels especially for
drugs that are highly protein bound - (ANSWER)Albumin is the plasma protein
with the greatest capacity for binding drugs. Binding plasma proteins affect drug
distribution into tissues, because only drug that is not bound is available to
penetrate tissues, bind to receptors, and exert activity. As free drug leaves the
blood stream, more bound drug is released from binding sites.
Low albumin levels - (ANSWER)malnutrition, chronic illness
Highly protein bound drugs can lead to - (ANSWER)toxicity in patients with low
albumin levels, example malnutrition or chronic illness. This is because there are
fewer than the normal sites for the drug to bind
Describe the ways the hepatic first pass effect- which is metabolism during first
pass through the liver - (ANSWER)Alternative routes include:
, suppository
intravenous
intramuscular
inhalational aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be absorbed directly into
systemic circulation
Be able to calculate creatinine clearance using Cockgraft Gault equation: -
(ANSWER)Male = 140-age times weight in kilograms divided by serum creatinine
times 72.
Women = CRCL (male) times 0.85
Describe what determines the frequency of drug administration - (ANSWER)half
life
plasma concentration
Be familiar with the beers criteria and how to use it - (ANSWER)Potentially
Inappropriate Medication Use in Older Adults
to call attention to medications that are most commonly problematic and thus
should be avoided in older adults
Bank with Definitive Explanations of Answers /
Newest 2025/2026.
Describe cytochrome p450 system - (ANSWER)Cytochrome p450 system is a
series of enzymes used to metabolize medications
Inhibitors - (ANSWER)block metabolic activity from one or more CYP450 enzymes
Inducers - (ANSWER)increase CYP450 enzyme activity by increasing enzyme
synthesis
Describe effect on low and high albumin levels on active drug levels especially for
drugs that are highly protein bound - (ANSWER)Albumin is the plasma protein
with the greatest capacity for binding drugs. Binding plasma proteins affect drug
distribution into tissues, because only drug that is not bound is available to
penetrate tissues, bind to receptors, and exert activity. As free drug leaves the
blood stream, more bound drug is released from binding sites.
Low albumin levels - (ANSWER)malnutrition, chronic illness
Highly protein bound drugs can lead to - (ANSWER)toxicity in patients with low
albumin levels, example malnutrition or chronic illness. This is because there are
fewer than the normal sites for the drug to bind
Describe the ways the hepatic first pass effect- which is metabolism during first
pass through the liver - (ANSWER)Alternative routes include:
, suppository
intravenous
intramuscular
inhalational aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be absorbed directly into
systemic circulation
Be able to calculate creatinine clearance using Cockgraft Gault equation: -
(ANSWER)Male = 140-age times weight in kilograms divided by serum creatinine
times 72.
Women = CRCL (male) times 0.85
Describe what determines the frequency of drug administration - (ANSWER)half
life
plasma concentration
Be familiar with the beers criteria and how to use it - (ANSWER)Potentially
Inappropriate Medication Use in Older Adults
to call attention to medications that are most commonly problematic and thus
should be avoided in older adults
