NURS 5220 ADVANCED
PHARMACOLOGY PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS
WITH EXPLANATIONS JUST RELEASED
1. A patient with a creatinine clearance of 30 mL/min is prescribed a drug primarily excreted
by the kidneys. Which pharmacokinetic adjustment is most appropriate?
A. Increase the loading dose to reach steady state faster.
B. Decrease the maintenance dose or lengthen the dosing interval.
C. Decrease the dosing interval to maintain therapeutic levels.
D. Change the route of administration to bypass renal filtration.
Answer: B
Conceptual Explanation: In patients with renal impairment, the clearance of drugs
eliminated by the kidneys is reduced, leading to potential toxicity. Adjustments involve
decreasing the maintenance dose or increasing the time between doses to prevent
accumulation.
2. Which of the following describes the ‘First-Pass Effect’ in pharmacology?
A. The rapid distribution of a drug to the heart and brain.
B. The excretion of a drug through the biliary system into the feces.
,C. Metabolism of a drug in the liver before it reaches systemic circulation.
D. The binding of a drug to plasma proteins during its first circuit.
Answer: C
Conceptual Explanation: The first-pass effect refers to the metabolism of an orally
administered drug in the liver or gut wall before it reaches the systemic circulation, often
significantly reducing bioavailability.
3. A drug has a half-life of 6 hours. How long will it take for approximately 94% of the drug to
be eliminated from the body?
A. 12 hours
B. 24 hours
C. 18 hours
D. 30 hours
Answer: B
Conceptual Explanation: It takes approximately 4 half-lives to reach 93.75% (roughly
94%) elimination. 6 hours x 4 = 24 hours.
4. A patient is taking Phenobarbital, a known hepatic enzyme inducer. If the patient is also
taking Warfarin, what effect should the clinician anticipate?
A. Increased Warfarin levels and increased risk of bleeding.
B. Decreased Warfarin levels and increased risk of clotting.
, C. No change in Warfarin metabolism.
D. Decreased Phenobarbital levels due to competition.
Answer: B
Conceptual Explanation: Enzyme inducers like Phenobarbital increase the metabolism of
substrate drugs like Warfarin, leading to lower plasma concentrations and reduced
therapeutic effect (clotting risk).
5. What is the primary mechanism of action of ACE inhibitors in treating hypertension?
A. Antagonizing the AT1 receptors directly.
B. Blocking the conversion of Angiotensin I to Angiotensin II.
C. Inhibiting the release of Renin from the juxtaglomerular cells.
D. Promoting the excretion of potassium in the distal tubule.
Answer: B
Conceptual Explanation: ACE inhibitors block the Angiotensin-Converting Enzyme,
preventing the formation of Angiotensin II, a potent vasoconstrictor.
6. A patient develops a dry, non-productive cough while taking Lisinopril. This is most likely
due to the accumulation of which substance?
A. Bradykinin
B. Aldosterone
C. Angiotensin I
PHARMACOLOGY PRACTICE EXAM
QUESTIONS AND CORRECT ANSWERS
WITH EXPLANATIONS JUST RELEASED
1. A patient with a creatinine clearance of 30 mL/min is prescribed a drug primarily excreted
by the kidneys. Which pharmacokinetic adjustment is most appropriate?
A. Increase the loading dose to reach steady state faster.
B. Decrease the maintenance dose or lengthen the dosing interval.
C. Decrease the dosing interval to maintain therapeutic levels.
D. Change the route of administration to bypass renal filtration.
Answer: B
Conceptual Explanation: In patients with renal impairment, the clearance of drugs
eliminated by the kidneys is reduced, leading to potential toxicity. Adjustments involve
decreasing the maintenance dose or increasing the time between doses to prevent
accumulation.
2. Which of the following describes the ‘First-Pass Effect’ in pharmacology?
A. The rapid distribution of a drug to the heart and brain.
B. The excretion of a drug through the biliary system into the feces.
,C. Metabolism of a drug in the liver before it reaches systemic circulation.
D. The binding of a drug to plasma proteins during its first circuit.
Answer: C
Conceptual Explanation: The first-pass effect refers to the metabolism of an orally
administered drug in the liver or gut wall before it reaches the systemic circulation, often
significantly reducing bioavailability.
3. A drug has a half-life of 6 hours. How long will it take for approximately 94% of the drug to
be eliminated from the body?
A. 12 hours
B. 24 hours
C. 18 hours
D. 30 hours
Answer: B
Conceptual Explanation: It takes approximately 4 half-lives to reach 93.75% (roughly
94%) elimination. 6 hours x 4 = 24 hours.
4. A patient is taking Phenobarbital, a known hepatic enzyme inducer. If the patient is also
taking Warfarin, what effect should the clinician anticipate?
A. Increased Warfarin levels and increased risk of bleeding.
B. Decreased Warfarin levels and increased risk of clotting.
, C. No change in Warfarin metabolism.
D. Decreased Phenobarbital levels due to competition.
Answer: B
Conceptual Explanation: Enzyme inducers like Phenobarbital increase the metabolism of
substrate drugs like Warfarin, leading to lower plasma concentrations and reduced
therapeutic effect (clotting risk).
5. What is the primary mechanism of action of ACE inhibitors in treating hypertension?
A. Antagonizing the AT1 receptors directly.
B. Blocking the conversion of Angiotensin I to Angiotensin II.
C. Inhibiting the release of Renin from the juxtaglomerular cells.
D. Promoting the excretion of potassium in the distal tubule.
Answer: B
Conceptual Explanation: ACE inhibitors block the Angiotensin-Converting Enzyme,
preventing the formation of Angiotensin II, a potent vasoconstrictor.
6. A patient develops a dry, non-productive cough while taking Lisinopril. This is most likely
due to the accumulation of which substance?
A. Bradykinin
B. Aldosterone
C. Angiotensin I
