NUR 635 Final Exam – GCU — Master Review &
Preparation Guide 2025/2026 <Latest Version>
Module 1: Foundational Principles & Prescriptive Authority
1. What is the primary goal of the Prescription Drug Monitoring Program (PDMP)?
A. To regulate the cost of prescription medications.
B. To track the prescribing and dispensing of controlled substances. ✓
C. To ensure patients take their medications as directed.
D. To provide drug information to pharmacists.
2. The "Half-Life" of a drug is best defined as:
A. The time it takes for a drug to be completely eliminated from the body.
B. The time it takes for the drug to reach its peak concentration.
C. The time it takes for the plasma concentration of a drug to be reduced by 50%. ✓
D. The time it takes for a drug to begin exerting its therapeutic effect.
3. A drug with a high first-pass effect:
A. Is best administered via a transdermal patch.
B. Is extensively metabolized by the liver before reaching systemic circulation. ✓
C. Has a very long half-life.
D. Is not affected by liver disease.
4. Pharmacodynamics refers to:
A. What the body does to the drug (absorption, distribution, metabolism, excretion).
B. What the drug does to the body, including its mechanism of action. ✓
C. The study of genetic variations in drug response.
D. The process of drug development.
5. When prescribing a Schedule II controlled substance, which action is generally prohibited?
A. Writing the prescription.
B. Providing refills on the same prescription. ✓
C. Requiring a patient follow-up.
D. Faxing the prescription to the pharmacy in certain circumstances.
6. The "Therapeutic Index" (TI) is a measure of a drug's safety. A drug with a narrow TI:
A. Requires less monitoring.
B. Has a wide margin of safety.
C. Requires careful dosing and close monitoring because the difference between a therapeutic
,and toxic dose is small. ✓
D. Is always a controlled substance.
7. Which organ is primarily responsible for the excretion of most drugs?
A. Liver
B. Lungs
C. Kidneys ✓
D. Skin
8. A prodrug is:
A. An inactive drug that requires metabolism to become active. ✓
B. A drug that is only used in pediatric populations.
C. A drug that is always administered intravenously.
D. A drug that has multiple mechanisms of action.
Module 2: Cardiovascular & Renal Pharmacology
9. Which class of antihypertensive drugs is often considered first-line therapy, especially in
African American patients?
A. ACE Inhibitors
B. Thiazide Diuretics ✓
C. Beta-Blockers
D. Calcium Channel Blockers (Non-Dihydropyridine)
10. A patient prescribed an ACE Inhibitor (e.g., Lisinopril) should be monitored for:
A. Hypokalemia
B. Peripheral Edema
C. A persistent dry cough ✓
D. Tachycardia
11. Which laboratory value is most critical to monitor before and during statin (HMG-CoA
reductase inhibitor) therapy?
A. Serum Creatinine
B. Liver Function Tests (LFTs) ✓
C. Hemoglobin A1c
D. Thyroid Stimulating Hormone (TSH)
12. The primary mechanism of action of Metoprolol (a beta-blocker) is:
A. Vasodilation
,B. Blocking angiotensin II receptors
C. Competitive blockade of beta-1 adrenergic receptors in the heart. ✓
D. Inhibition of calcium influx into vascular smooth muscle.
13. Which diuretic is most associated with causing hyperkalemia?
A. Furosemide (Loop Diuretic)
B. Hydrochlorothiazide (Thiazide Diuretic)
C. Spironolactone (Potassium-Sparing Diuretic) ✓
D. Bumetanide (Loop Diuretic)
14. The antidote for a heparin overdose is:
A. Vitamin K
B. Protamine Sulfate ✓
C. Naloxone
D. Flumazenil
15. What is the mechanism of action of Clopidogrel (Plavix)?
A. Inhibition of Vitamin K epoxide reductase.
B. Inhibition of the P2Y12 component of ADP receptors on platelets, preventing activation. ✓
C. Direct inhibition of thrombin.
D. Blockade of glycoprotein IIb/IIIa receptors.
16. Which statement is TRUE regarding Warfarin (Coumadin)?
A. It has a rapid onset of action (within hours).
B. Its anticoagulant effect is reversed with Vitamin K. ✓
C. It requires no routine monitoring (INR).
D. It works by directly inhibiting thrombin.
Module 3: Endocrine & Metabolic Pharmacology
17. First-line pharmacologic therapy for Type 2 Diabetes is typically:
A. Insulin
B. SGLT2 Inhibitors
C. Metformin ✓
D. Sulfonylureas
18. A major side effect of SGLT2 inhibitors (e.g., Canagliflozin) is an increased risk for:
A. Hypoglycemia
B. Genitourinary fungal infections ✓
, C. Lactic Acidosis
D. Heart Failure
19. Which insulin has the most rapid onset and shortest duration of action?
A. Insulin Glargine (Lantus)
B. Insulin Detemir (Levemir)
C. NPH Insulin
D. Insulin Lispro (Humalog) ✓
20. Levothyroxine (Synthroid) is a synthetic form of:
A. T3 (Triiodothyronine)
B. T4 (Thyroxine) ✓
C. TSH (Thyroid Stimulating Hormone)
D. Calcitonin
21. A common, non-serious side effect of Metformin that can be mitigated by taking with food
is:
A. Lactic Acidosis
B. Gastrointestinal distress (diarrhea, nausea) ✓
C. Hypoglycemia
D. Metallic Taste
22. Which drug class for osteoporosis works by inhibiting bone resorption?
A. Anabolic agents (e.g., Teriparatide)
B. Bisphosphonates (e.g., Alendronate) ✓
C. Calcium Supplements
D. Vitamin D
23. The "Sick Day Rules" for a patient on Metformin instruct them to:
A. Double their dose when they are ill.
B. Temporarily hold the medication during acute illness that could lead to dehydration or renal
impairment. ✓
C. Always take it, regardless of oral intake.
D. Switch to insulin during any illness.
Module 4: Psychopharmacology
24. The therapeutic effect of SSRIs (e.g., Sertraline) is primarily due to:
A. Blocking dopamine receptors.
Preparation Guide 2025/2026 <Latest Version>
Module 1: Foundational Principles & Prescriptive Authority
1. What is the primary goal of the Prescription Drug Monitoring Program (PDMP)?
A. To regulate the cost of prescription medications.
B. To track the prescribing and dispensing of controlled substances. ✓
C. To ensure patients take their medications as directed.
D. To provide drug information to pharmacists.
2. The "Half-Life" of a drug is best defined as:
A. The time it takes for a drug to be completely eliminated from the body.
B. The time it takes for the drug to reach its peak concentration.
C. The time it takes for the plasma concentration of a drug to be reduced by 50%. ✓
D. The time it takes for a drug to begin exerting its therapeutic effect.
3. A drug with a high first-pass effect:
A. Is best administered via a transdermal patch.
B. Is extensively metabolized by the liver before reaching systemic circulation. ✓
C. Has a very long half-life.
D. Is not affected by liver disease.
4. Pharmacodynamics refers to:
A. What the body does to the drug (absorption, distribution, metabolism, excretion).
B. What the drug does to the body, including its mechanism of action. ✓
C. The study of genetic variations in drug response.
D. The process of drug development.
5. When prescribing a Schedule II controlled substance, which action is generally prohibited?
A. Writing the prescription.
B. Providing refills on the same prescription. ✓
C. Requiring a patient follow-up.
D. Faxing the prescription to the pharmacy in certain circumstances.
6. The "Therapeutic Index" (TI) is a measure of a drug's safety. A drug with a narrow TI:
A. Requires less monitoring.
B. Has a wide margin of safety.
C. Requires careful dosing and close monitoring because the difference between a therapeutic
,and toxic dose is small. ✓
D. Is always a controlled substance.
7. Which organ is primarily responsible for the excretion of most drugs?
A. Liver
B. Lungs
C. Kidneys ✓
D. Skin
8. A prodrug is:
A. An inactive drug that requires metabolism to become active. ✓
B. A drug that is only used in pediatric populations.
C. A drug that is always administered intravenously.
D. A drug that has multiple mechanisms of action.
Module 2: Cardiovascular & Renal Pharmacology
9. Which class of antihypertensive drugs is often considered first-line therapy, especially in
African American patients?
A. ACE Inhibitors
B. Thiazide Diuretics ✓
C. Beta-Blockers
D. Calcium Channel Blockers (Non-Dihydropyridine)
10. A patient prescribed an ACE Inhibitor (e.g., Lisinopril) should be monitored for:
A. Hypokalemia
B. Peripheral Edema
C. A persistent dry cough ✓
D. Tachycardia
11. Which laboratory value is most critical to monitor before and during statin (HMG-CoA
reductase inhibitor) therapy?
A. Serum Creatinine
B. Liver Function Tests (LFTs) ✓
C. Hemoglobin A1c
D. Thyroid Stimulating Hormone (TSH)
12. The primary mechanism of action of Metoprolol (a beta-blocker) is:
A. Vasodilation
,B. Blocking angiotensin II receptors
C. Competitive blockade of beta-1 adrenergic receptors in the heart. ✓
D. Inhibition of calcium influx into vascular smooth muscle.
13. Which diuretic is most associated with causing hyperkalemia?
A. Furosemide (Loop Diuretic)
B. Hydrochlorothiazide (Thiazide Diuretic)
C. Spironolactone (Potassium-Sparing Diuretic) ✓
D. Bumetanide (Loop Diuretic)
14. The antidote for a heparin overdose is:
A. Vitamin K
B. Protamine Sulfate ✓
C. Naloxone
D. Flumazenil
15. What is the mechanism of action of Clopidogrel (Plavix)?
A. Inhibition of Vitamin K epoxide reductase.
B. Inhibition of the P2Y12 component of ADP receptors on platelets, preventing activation. ✓
C. Direct inhibition of thrombin.
D. Blockade of glycoprotein IIb/IIIa receptors.
16. Which statement is TRUE regarding Warfarin (Coumadin)?
A. It has a rapid onset of action (within hours).
B. Its anticoagulant effect is reversed with Vitamin K. ✓
C. It requires no routine monitoring (INR).
D. It works by directly inhibiting thrombin.
Module 3: Endocrine & Metabolic Pharmacology
17. First-line pharmacologic therapy for Type 2 Diabetes is typically:
A. Insulin
B. SGLT2 Inhibitors
C. Metformin ✓
D. Sulfonylureas
18. A major side effect of SGLT2 inhibitors (e.g., Canagliflozin) is an increased risk for:
A. Hypoglycemia
B. Genitourinary fungal infections ✓
, C. Lactic Acidosis
D. Heart Failure
19. Which insulin has the most rapid onset and shortest duration of action?
A. Insulin Glargine (Lantus)
B. Insulin Detemir (Levemir)
C. NPH Insulin
D. Insulin Lispro (Humalog) ✓
20. Levothyroxine (Synthroid) is a synthetic form of:
A. T3 (Triiodothyronine)
B. T4 (Thyroxine) ✓
C. TSH (Thyroid Stimulating Hormone)
D. Calcitonin
21. A common, non-serious side effect of Metformin that can be mitigated by taking with food
is:
A. Lactic Acidosis
B. Gastrointestinal distress (diarrhea, nausea) ✓
C. Hypoglycemia
D. Metallic Taste
22. Which drug class for osteoporosis works by inhibiting bone resorption?
A. Anabolic agents (e.g., Teriparatide)
B. Bisphosphonates (e.g., Alendronate) ✓
C. Calcium Supplements
D. Vitamin D
23. The "Sick Day Rules" for a patient on Metformin instruct them to:
A. Double their dose when they are ill.
B. Temporarily hold the medication during acute illness that could lead to dehydration or renal
impairment. ✓
C. Always take it, regardless of oral intake.
D. Switch to insulin during any illness.
Module 4: Psychopharmacology
24. The therapeutic effect of SSRIs (e.g., Sertraline) is primarily due to:
A. Blocking dopamine receptors.
