D441 Pharmacology Final Exam Practice 2026 |WGU
1. Which pharmacokinetic process involves the chemical alteration of a drug by
enzyme systems?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: D
Rationale: Metabolism, primarily occurring in the liver, is the biochemical alteration of a
drug into an inactive metabolite, a more soluble compound, or a more potent metabolite.
2. A patient is prescribed a drug with a high ‘first-pass effect.’ How should this
drug primarily be administered to achieve therapeutic levels?
A. Orally
B. Sublingually
C. Parenterally
D. Rectally
Answer: C
Rationale: The first-pass effect is the metabolism of a drug by the liver before it reaches
systemic circulation. Parenteral routes (IV, IM) bypass the liver initially, ensuring higher
bioavailability.
,3. What is the term for a drug that binds to a receptor and prevents a biological
response?
A. Agonist
B. Synergist
C. Antagonist
D. Potentiator
Answer: C
Rationale: An antagonist binds to a receptor but does not activate it; instead, it blocks
agonists from binding, preventing a response.
4. A drug has a half-life of 4 hours. If 100mg is administered, how much drug
remains in the body after 12 hours?
A. 50mg
B. 25mg
C. 6.25mg
D. 12.5mg
Answer: D
Rationale: After 4 hours (1 half-life), 50mg remains. After 8 hours (2 half-lives), 25mg
remains. After 12 hours (3 half-lives), 12.5mg remains.
5. A patient taking Lisinopril for hypertension develops a dry, persistent cough.
What is the most likely cause?
A. Heart failure worsening
B. Viral upper respiratory infection
C. Allergic reaction to the filler
D. Accumulation of bradykinin
Answer: D
Rationale: ACE inhibitors prevent the breakdown of bradykinin in the lungs, which can
lead to a dry, non-productive cough in some patients.
, 6. Before administering Digoxin, the nurse must assess which vital sign for a full
minute?
A. Blood pressure
B. Respiratory rate
C. Temperature
D. Apical pulse
Answer: D
Rationale: Digoxin is a positive inotrope and negative chronotrope. It slows the heart rate;
the apical pulse must be at least 60 bpm in adults to safely administer.
7. Which laboratory value is used to monitor the therapeutic effect of Warfarin
(Coumadin)?
A. PTT
B. Hemoglobin
C. Platelet count
D. PT/INR
Answer: D
Rationale: PT (Prothrombin Time) and INR (International Normalized Ratio) are standard
tests used to monitor the effectiveness of Warfarin therapy.
8. What is the antidote for Heparin toxicity?
A. Protamine Sulfate
B. Glucagon
C. Vitamin K
D. Acetylcysteine
Answer: A
Rationale: Protamine Sulfate is the specific antagonist used to reverse the anticoagulant
effects of Heparin.
1. Which pharmacokinetic process involves the chemical alteration of a drug by
enzyme systems?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: D
Rationale: Metabolism, primarily occurring in the liver, is the biochemical alteration of a
drug into an inactive metabolite, a more soluble compound, or a more potent metabolite.
2. A patient is prescribed a drug with a high ‘first-pass effect.’ How should this
drug primarily be administered to achieve therapeutic levels?
A. Orally
B. Sublingually
C. Parenterally
D. Rectally
Answer: C
Rationale: The first-pass effect is the metabolism of a drug by the liver before it reaches
systemic circulation. Parenteral routes (IV, IM) bypass the liver initially, ensuring higher
bioavailability.
,3. What is the term for a drug that binds to a receptor and prevents a biological
response?
A. Agonist
B. Synergist
C. Antagonist
D. Potentiator
Answer: C
Rationale: An antagonist binds to a receptor but does not activate it; instead, it blocks
agonists from binding, preventing a response.
4. A drug has a half-life of 4 hours. If 100mg is administered, how much drug
remains in the body after 12 hours?
A. 50mg
B. 25mg
C. 6.25mg
D. 12.5mg
Answer: D
Rationale: After 4 hours (1 half-life), 50mg remains. After 8 hours (2 half-lives), 25mg
remains. After 12 hours (3 half-lives), 12.5mg remains.
5. A patient taking Lisinopril for hypertension develops a dry, persistent cough.
What is the most likely cause?
A. Heart failure worsening
B. Viral upper respiratory infection
C. Allergic reaction to the filler
D. Accumulation of bradykinin
Answer: D
Rationale: ACE inhibitors prevent the breakdown of bradykinin in the lungs, which can
lead to a dry, non-productive cough in some patients.
, 6. Before administering Digoxin, the nurse must assess which vital sign for a full
minute?
A. Blood pressure
B. Respiratory rate
C. Temperature
D. Apical pulse
Answer: D
Rationale: Digoxin is a positive inotrope and negative chronotrope. It slows the heart rate;
the apical pulse must be at least 60 bpm in adults to safely administer.
7. Which laboratory value is used to monitor the therapeutic effect of Warfarin
(Coumadin)?
A. PTT
B. Hemoglobin
C. Platelet count
D. PT/INR
Answer: D
Rationale: PT (Prothrombin Time) and INR (International Normalized Ratio) are standard
tests used to monitor the effectiveness of Warfarin therapy.
8. What is the antidote for Heparin toxicity?
A. Protamine Sulfate
B. Glucagon
C. Vitamin K
D. Acetylcysteine
Answer: A
Rationale: Protamine Sulfate is the specific antagonist used to reverse the anticoagulant
effects of Heparin.
