ANCC AGPCNP COMPREHENSIVE
PRACTICE EXAM 2026 FULL QUESTIONS
AND CORRECT ANSWERS UPDATED
VERSION
⩥ Pharmacokinetics. Answer: the movement of drugs trough the body
(absorption, bioavailability, distribution, metabolism, and excretion)
⩥ Pharmacodynamics. Answer: The study of the physiologic and
biochemical effects of drugs (what a drug does to the body)
⩥ Pharmacogenomics. Answer: the study of how a person's genes affect
response to medications.
⩥ Area under the curve (AUC). Answer: the average amount of a drug in
the blood after a dose is given. It is a measure of the availability
(bioavailability) of a drug after it is administered.
⩥ maximum concentration (Cmax). Answer: The peak serum
concentration of a drug
⩥ Minimum inhibitory concentration (MIC). Answer: the lowest
concentration of an antibiotic that will inhibit the growth of organisms
(after overnight incubation).
,⩥ Trough. Answer: the lowest concentration of a drug after a dose
⩥ First-pass effect. Answer: All oral drugs (except sublingual) must go
through first-pass metabolism before released and used by body.
In the liver the CYP450 system metabolizes the drug and then the active
drug is released to the body to be used.
⩥ What drug cannot be given orally because of extensive first-pass
effect?. Answer: insulin
⩥ Drug Excretion. Answer: Renal filtration accounts for most of drug
excretion. Kidney is the principle organ for drug elimination.
⩥ Age related change to pharmacokinetics. Answer: - Increase in fat-to-
water ratio
- Decrease in albumin and plasma proteins
- Decrease in liver blood flow and size
- Decrease in some CYP450 enzyme pathways (decreased drug
clearance)
- Decrease in glomerular filtration rate (GFR)
⩥ Specific Drugs affected by Kidney Disease. Answer: - NSAIDS
(reduction of renal blood flow will damage kidneys)
, - ACE inhibitors (higher risk of hyperkalemia)
- Warfarin (Higher risk of over coagulation (INR >4). Severe CKD and
ESRD at risk of hemorrhagic complications. Need more frequent
monitoring
- Lithium (increase risk of kidney injury. Monitor renal fxn closely)
- Contrast dye (IV contrast can injure kidneys)
- Potassium sparing diuretics (increased risk of hyperkalemia)
- Oral sodium phosphate (used to cleanse bowel before colonoscopies)
(May cause sudden loss of kidney fxn (AKI) as well as blood mineral
disturbances)
⩥ Potent CYP450 Inhibitors. Answer: - THESE DRUGS SLOW DOWN
CLEARANCE ((increase drug concentration, high risk for drug
overdose or ASEs)) --high likelihood of drug-drug interactions
- Macrolides (erythromycin, clarithromycin, telithromycin)
- Antifungals (ketoconazole, fluconazole, phenytoin)
- Cimetidine (Tagamet)
- Citalopram (Celexa)
- Protease inhibitors (saquinavir, indinavir, nelfinavir)
- Grapefruit Juice (affects CYP450 system)
⩥ What drugs does grapefruit interact with?. Answer: - statins
-erythromycin
-calcium channel blocker ( nifedipine, nisoldipine)
PRACTICE EXAM 2026 FULL QUESTIONS
AND CORRECT ANSWERS UPDATED
VERSION
⩥ Pharmacokinetics. Answer: the movement of drugs trough the body
(absorption, bioavailability, distribution, metabolism, and excretion)
⩥ Pharmacodynamics. Answer: The study of the physiologic and
biochemical effects of drugs (what a drug does to the body)
⩥ Pharmacogenomics. Answer: the study of how a person's genes affect
response to medications.
⩥ Area under the curve (AUC). Answer: the average amount of a drug in
the blood after a dose is given. It is a measure of the availability
(bioavailability) of a drug after it is administered.
⩥ maximum concentration (Cmax). Answer: The peak serum
concentration of a drug
⩥ Minimum inhibitory concentration (MIC). Answer: the lowest
concentration of an antibiotic that will inhibit the growth of organisms
(after overnight incubation).
,⩥ Trough. Answer: the lowest concentration of a drug after a dose
⩥ First-pass effect. Answer: All oral drugs (except sublingual) must go
through first-pass metabolism before released and used by body.
In the liver the CYP450 system metabolizes the drug and then the active
drug is released to the body to be used.
⩥ What drug cannot be given orally because of extensive first-pass
effect?. Answer: insulin
⩥ Drug Excretion. Answer: Renal filtration accounts for most of drug
excretion. Kidney is the principle organ for drug elimination.
⩥ Age related change to pharmacokinetics. Answer: - Increase in fat-to-
water ratio
- Decrease in albumin and plasma proteins
- Decrease in liver blood flow and size
- Decrease in some CYP450 enzyme pathways (decreased drug
clearance)
- Decrease in glomerular filtration rate (GFR)
⩥ Specific Drugs affected by Kidney Disease. Answer: - NSAIDS
(reduction of renal blood flow will damage kidneys)
, - ACE inhibitors (higher risk of hyperkalemia)
- Warfarin (Higher risk of over coagulation (INR >4). Severe CKD and
ESRD at risk of hemorrhagic complications. Need more frequent
monitoring
- Lithium (increase risk of kidney injury. Monitor renal fxn closely)
- Contrast dye (IV contrast can injure kidneys)
- Potassium sparing diuretics (increased risk of hyperkalemia)
- Oral sodium phosphate (used to cleanse bowel before colonoscopies)
(May cause sudden loss of kidney fxn (AKI) as well as blood mineral
disturbances)
⩥ Potent CYP450 Inhibitors. Answer: - THESE DRUGS SLOW DOWN
CLEARANCE ((increase drug concentration, high risk for drug
overdose or ASEs)) --high likelihood of drug-drug interactions
- Macrolides (erythromycin, clarithromycin, telithromycin)
- Antifungals (ketoconazole, fluconazole, phenytoin)
- Cimetidine (Tagamet)
- Citalopram (Celexa)
- Protease inhibitors (saquinavir, indinavir, nelfinavir)
- Grapefruit Juice (affects CYP450 system)
⩥ What drugs does grapefruit interact with?. Answer: - statins
-erythromycin
-calcium channel blocker ( nifedipine, nisoldipine)
