, NURS 5334 FINAL EXAM
Advanced Pharmacology
University of Texas at Arlington (UTA)
100-Question Comprehensive Practice Examination
2026/2027 Edition
1. A patient has severe hypoalbuminemia while taking a highly protein-bound medication. Which change
is most likely initially?
A) Lower receptor affinity
B) Faster renal filtration of bound drug
C) Higher free-drug concentration
D) Complete loss of first-pass metabolism
Correct Answer: Higher free-drug concentration
Rationale: Only unbound drug is available to cross membranes and interact with receptors. Low albumin can therefore
increase the active free fraction of highly protein-bound drugs and raise toxicity risk even when the total measured
concentration appears unchanged.
2. What best defines a pharmacologic antagonist?
A) A drug that binds and fully activates a receptor
B) A drug that increases synthesis of an endogenous ligand
C) A drug with receptor affinity but no intrinsic activity
D) A drug that irreversibly destroys every receptor
Correct Answer: A drug with receptor affinity but no intrinsic activity
Rationale: An antagonist occupies a receptor without activating it, thereby reducing or blocking agonist effects. Affinity
refers to binding, while intrinsic activity describes the ability to produce a response after binding.
3. A partial agonist is administered in the presence of a full agonist at the same receptor. What can occur?
A) The partial agonist can reduce the maximal effect produced by the full agonist
B) The partial agonist always produces a larger effect than the full agonist
C) The receptor becomes permanently inactive
D) Drug clearance immediately stops
Correct Answer: The partial agonist can reduce the maximal effect produced by the full agonist
Rationale: Partial agonists have affinity but lower intrinsic activity than full agonists. By competing for receptors, they
can functionally reduce the overall response produced by a full agonist.
4. Which pharmacokinetic process is most directly described by the term bioavailability?
A) The amount of drug bound to tissue receptors
NURS 5334 Final Exam | Practice Examination | 2026/2027 Edition | Page 1
, B) The rate of renal tubular secretion only
C) The fraction of an administered dose reaching systemic circulation unchanged
D) The intensity of the drug's therapeutic effect
Correct Answer: The fraction of an administered dose reaching systemic circulation unchanged
Rationale: Bioavailability describes how much of a dose reaches systemic circulation in active form. Oral drugs may
have reduced bioavailability because of incomplete absorption and first-pass metabolism.
5. A drug is a strong CYP450 inhibitor. What effect is expected on a substrate primarily metabolized by
that enzyme?
A) The substrate concentration must fall
B) The substrate concentration may rise
C) The substrate becomes pharmacologically inactive before absorption
D) The substrate is excreted faster through the lungs
Correct Answer: The substrate concentration may rise
Rationale: Enzyme inhibition slows metabolism of susceptible substrates, often increasing circulating drug
concentrations and toxicity risk. The magnitude depends on the substrate, inhibitor strength, and therapeutic index.
6. A strong CYP450 inducer is started in a patient taking a susceptible substrate. Which outcome is most
likely?
A) Reduced substrate concentration and reduced effect
B) Immediate receptor blockade
C) Loss of renal perfusion in all patients
D) Increased protein binding only
Correct Answer: Reduced substrate concentration and reduced effect
Rationale: Induction increases enzyme activity over time, accelerating metabolism of susceptible substrates. This can
lower drug concentrations and reduce therapeutic response.
7. Which prescribing principle best reduces preventable medication errors?
A) Use nonstandard abbreviations to save time
B) Write complete, unambiguous directions including dose, route, frequency, and indication when appropriate
C) Omit patient identifiers if the pharmacy knows the patient
D) Rely on verbal instructions instead of documentation
Correct Answer: Write complete, unambiguous directions including dose, route, frequency, and indication
when appropriate
Rationale: Clear and complete prescriptions reduce ambiguity and dispensing errors. Standardized terminology, patient
identifiers, and complete directions improve safety and communication.
8. A medication has a narrow therapeutic index. What does that imply?
NURS 5334 Final Exam | Practice Examination | 2026/2027 Edition | Page 2
Advanced Pharmacology
University of Texas at Arlington (UTA)
100-Question Comprehensive Practice Examination
2026/2027 Edition
1. A patient has severe hypoalbuminemia while taking a highly protein-bound medication. Which change
is most likely initially?
A) Lower receptor affinity
B) Faster renal filtration of bound drug
C) Higher free-drug concentration
D) Complete loss of first-pass metabolism
Correct Answer: Higher free-drug concentration
Rationale: Only unbound drug is available to cross membranes and interact with receptors. Low albumin can therefore
increase the active free fraction of highly protein-bound drugs and raise toxicity risk even when the total measured
concentration appears unchanged.
2. What best defines a pharmacologic antagonist?
A) A drug that binds and fully activates a receptor
B) A drug that increases synthesis of an endogenous ligand
C) A drug with receptor affinity but no intrinsic activity
D) A drug that irreversibly destroys every receptor
Correct Answer: A drug with receptor affinity but no intrinsic activity
Rationale: An antagonist occupies a receptor without activating it, thereby reducing or blocking agonist effects. Affinity
refers to binding, while intrinsic activity describes the ability to produce a response after binding.
3. A partial agonist is administered in the presence of a full agonist at the same receptor. What can occur?
A) The partial agonist can reduce the maximal effect produced by the full agonist
B) The partial agonist always produces a larger effect than the full agonist
C) The receptor becomes permanently inactive
D) Drug clearance immediately stops
Correct Answer: The partial agonist can reduce the maximal effect produced by the full agonist
Rationale: Partial agonists have affinity but lower intrinsic activity than full agonists. By competing for receptors, they
can functionally reduce the overall response produced by a full agonist.
4. Which pharmacokinetic process is most directly described by the term bioavailability?
A) The amount of drug bound to tissue receptors
NURS 5334 Final Exam | Practice Examination | 2026/2027 Edition | Page 1
, B) The rate of renal tubular secretion only
C) The fraction of an administered dose reaching systemic circulation unchanged
D) The intensity of the drug's therapeutic effect
Correct Answer: The fraction of an administered dose reaching systemic circulation unchanged
Rationale: Bioavailability describes how much of a dose reaches systemic circulation in active form. Oral drugs may
have reduced bioavailability because of incomplete absorption and first-pass metabolism.
5. A drug is a strong CYP450 inhibitor. What effect is expected on a substrate primarily metabolized by
that enzyme?
A) The substrate concentration must fall
B) The substrate concentration may rise
C) The substrate becomes pharmacologically inactive before absorption
D) The substrate is excreted faster through the lungs
Correct Answer: The substrate concentration may rise
Rationale: Enzyme inhibition slows metabolism of susceptible substrates, often increasing circulating drug
concentrations and toxicity risk. The magnitude depends on the substrate, inhibitor strength, and therapeutic index.
6. A strong CYP450 inducer is started in a patient taking a susceptible substrate. Which outcome is most
likely?
A) Reduced substrate concentration and reduced effect
B) Immediate receptor blockade
C) Loss of renal perfusion in all patients
D) Increased protein binding only
Correct Answer: Reduced substrate concentration and reduced effect
Rationale: Induction increases enzyme activity over time, accelerating metabolism of susceptible substrates. This can
lower drug concentrations and reduce therapeutic response.
7. Which prescribing principle best reduces preventable medication errors?
A) Use nonstandard abbreviations to save time
B) Write complete, unambiguous directions including dose, route, frequency, and indication when appropriate
C) Omit patient identifiers if the pharmacy knows the patient
D) Rely on verbal instructions instead of documentation
Correct Answer: Write complete, unambiguous directions including dose, route, frequency, and indication
when appropriate
Rationale: Clear and complete prescriptions reduce ambiguity and dispensing errors. Standardized terminology, patient
identifiers, and complete directions improve safety and communication.
8. A medication has a narrow therapeutic index. What does that imply?
NURS 5334 Final Exam | Practice Examination | 2026/2027 Edition | Page 2
