WGU D027 Advanced Pathopharmacological Foundations –
FULL EXAM Comprehensive -Question Practice Exam –
2025 Edition
Q1. A patient is prescribed a drug with a narrow therapeutic index. Which action is most
important?
A) Administer the drug with meals
B) Monitor vital signs only
C) Monitor serum drug levels regularly
D) Increase the dose if symptoms persist
Explanation: Narrow therapeutic index drugs (e.g., digoxin, lithium) require monitoring
to prevent toxicity.
Q2. Which process describes the movement of a drug from the bloodstream into tissues?
A) Metabolism
B) Excretion
C) Distribution
D) Absorption
Explanation: Distribution is the process by which drugs reach target tissues after
entering circulation.
Q3. A patient has liver disease. How does this most likely affect drug metabolism?
A) Decreased metabolism leading to prolonged drug effect
B) Increased drug clearance
C) No effect on pharmacokinetics
D) Accelerated drug absorption
Explanation: Hepatic impairment reduces metabolism, increasing risk of accumulation
and toxicity.
Q4. A first-pass effect is most relevant for which route of administration?
A) Intravenous
B) Oral
C) Subcutaneous
D) Inhalation
Explanation: Oral drugs pass through the liver before systemic circulation, reducing
bioavailability.
Q5. Which factor primarily affects a drug’s half-life?
, A) Rate of metabolism and excretion
B) Route of administration
C) Protein binding only
D) Therapeutic index
Explanation: Half-life depends on how quickly the body metabolizes and eliminates the
drug.
Cardiovascular Pharmacology
Q6. Which class of drugs is first-line for heart failure with reduced ejection fraction?
A) ACE inhibitors
B) Beta-agonists
C) Loop diuretics alone
D) Calcium channel blockers
Explanation: ACE inhibitors reduce afterload and improve survival in HFrEF.
Q7. A patient develops a persistent dry cough on an ACE inhibitor. What is the best next step?
A) Continue the ACE inhibitor
B) Switch to an ARB
C) Start a beta-blocker instead
D) Increase ACE dose
Explanation: ARBs provide similar benefits without causing cough.
Q8. Which medication is contraindicated in severe bradycardia?
A) ACE inhibitor
B) Beta-blocker
C) Loop diuretic
D) ARB
Explanation: Beta-blockers reduce heart rate; dangerous if bradycardia is present.
Q9. Digoxin toxicity is most likely in a patient with:
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypertension
Explanation: Low potassium enhances digoxin binding to myocardial cells, increasing
toxicity risk.
Q10. Which drug class reduces both preload and afterload in heart failure?
FULL EXAM Comprehensive -Question Practice Exam –
2025 Edition
Q1. A patient is prescribed a drug with a narrow therapeutic index. Which action is most
important?
A) Administer the drug with meals
B) Monitor vital signs only
C) Monitor serum drug levels regularly
D) Increase the dose if symptoms persist
Explanation: Narrow therapeutic index drugs (e.g., digoxin, lithium) require monitoring
to prevent toxicity.
Q2. Which process describes the movement of a drug from the bloodstream into tissues?
A) Metabolism
B) Excretion
C) Distribution
D) Absorption
Explanation: Distribution is the process by which drugs reach target tissues after
entering circulation.
Q3. A patient has liver disease. How does this most likely affect drug metabolism?
A) Decreased metabolism leading to prolonged drug effect
B) Increased drug clearance
C) No effect on pharmacokinetics
D) Accelerated drug absorption
Explanation: Hepatic impairment reduces metabolism, increasing risk of accumulation
and toxicity.
Q4. A first-pass effect is most relevant for which route of administration?
A) Intravenous
B) Oral
C) Subcutaneous
D) Inhalation
Explanation: Oral drugs pass through the liver before systemic circulation, reducing
bioavailability.
Q5. Which factor primarily affects a drug’s half-life?
, A) Rate of metabolism and excretion
B) Route of administration
C) Protein binding only
D) Therapeutic index
Explanation: Half-life depends on how quickly the body metabolizes and eliminates the
drug.
Cardiovascular Pharmacology
Q6. Which class of drugs is first-line for heart failure with reduced ejection fraction?
A) ACE inhibitors
B) Beta-agonists
C) Loop diuretics alone
D) Calcium channel blockers
Explanation: ACE inhibitors reduce afterload and improve survival in HFrEF.
Q7. A patient develops a persistent dry cough on an ACE inhibitor. What is the best next step?
A) Continue the ACE inhibitor
B) Switch to an ARB
C) Start a beta-blocker instead
D) Increase ACE dose
Explanation: ARBs provide similar benefits without causing cough.
Q8. Which medication is contraindicated in severe bradycardia?
A) ACE inhibitor
B) Beta-blocker
C) Loop diuretic
D) ARB
Explanation: Beta-blockers reduce heart rate; dangerous if bradycardia is present.
Q9. Digoxin toxicity is most likely in a patient with:
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypertension
Explanation: Low potassium enhances digoxin binding to myocardial cells, increasing
toxicity risk.
Q10. Which drug class reduces both preload and afterload in heart failure?
