BSN 215 Pharmalacogy I
Complete Final Exam (Qns & Ans)
2025
Question 1:
A 65‑year‑old patient with chronic kidney disease is prescribed
Drug X, which in healthy individuals has a half‑life of 4 hours.
Due to his reduced renal clearance (approximately 50% lower
than normal), what would be the anticipated new half‑life of Drug
X in this patient?
A. 4 hours
B. 6 hours
C. 8 hours
D. 12 hours
Correct ANS: C. 8 hours
©2025
, Rationale: The half‑life of a drug is inversely proportional to its
clearance. With a 50% reduction in clearance, the drug’s half‑life
is expected to double from 4 to 8 hours.
---
Question 2:
A nurse is administering a drug that is a known substrate of the
cytochrome P450 3A4 enzyme. Which concurrent medication is
most likely to increase the plasma concentration of this drug?
A. Rifampin
B. St. John’s Wort
C. Ketoconazole
D. Carbamazepine
Correct ANS: C. Ketoconazole
Rationale: Ketoconazole is a potent inhibitor of CYP3A4 and
will decrease the metabolism of the substrate, leading to increased
plasma levels and potential toxicity.
---
©2025
, Question 3:
A drug acting as a full agonist at the beta-adrenergic receptor is
administered to a patient. Which of the following best describes
the effect of this medication at the receptor level?
A. It binds to the receptor and blocks the effect of endogenous
catecholamines.
B. It binds to the receptor and produces a maximal physiological
response.
C. It binds to the receptor and partially activates it regardless of
dose.
D. It binds to an allosteric site, modulating but not initiating
receptor activity.
Correct ANS: B. It binds to the receptor and produces a
maximal physiological response.
Rationale: A full agonist binds to a receptor and triggers the
maximum possible response compared to the endogenous ligand,
fully activating the receptor.
---
Question 4:
For a medication with a narrow therapeutic index, which aspect is
most critical for nursing care to avoid adverse effects?
©2025
, A. Patient’s preference for the route of administration
B. Precise dosing and vigilant monitoring of serum drug levels
C. Ensuring the medication is provided in colorful packaging for
patient reassurance
D. Emphasizing cost‐effectiveness of the therapy
Correct ANS: B. Precise dosing and vigilant monitoring of
serum drug levels
Rationale: Drugs with a narrow therapeutic index have a small
margin between therapeutic and toxic concentrations, requiring
meticulous dosing and close monitoring to ensure patient safety.
---
Question 5:
A patient is prescribed an antihypertensive that is predominantly
metabolized by the liver via Phase I reactions. Which factor can
significantly alter the drug’s clearance in this patient?
A. Renal function
B. Co-administration of liver enzyme inducers
C. Variations in gastrointestinal motility
D. The pH of the drug solution
©2025
Complete Final Exam (Qns & Ans)
2025
Question 1:
A 65‑year‑old patient with chronic kidney disease is prescribed
Drug X, which in healthy individuals has a half‑life of 4 hours.
Due to his reduced renal clearance (approximately 50% lower
than normal), what would be the anticipated new half‑life of Drug
X in this patient?
A. 4 hours
B. 6 hours
C. 8 hours
D. 12 hours
Correct ANS: C. 8 hours
©2025
, Rationale: The half‑life of a drug is inversely proportional to its
clearance. With a 50% reduction in clearance, the drug’s half‑life
is expected to double from 4 to 8 hours.
---
Question 2:
A nurse is administering a drug that is a known substrate of the
cytochrome P450 3A4 enzyme. Which concurrent medication is
most likely to increase the plasma concentration of this drug?
A. Rifampin
B. St. John’s Wort
C. Ketoconazole
D. Carbamazepine
Correct ANS: C. Ketoconazole
Rationale: Ketoconazole is a potent inhibitor of CYP3A4 and
will decrease the metabolism of the substrate, leading to increased
plasma levels and potential toxicity.
---
©2025
, Question 3:
A drug acting as a full agonist at the beta-adrenergic receptor is
administered to a patient. Which of the following best describes
the effect of this medication at the receptor level?
A. It binds to the receptor and blocks the effect of endogenous
catecholamines.
B. It binds to the receptor and produces a maximal physiological
response.
C. It binds to the receptor and partially activates it regardless of
dose.
D. It binds to an allosteric site, modulating but not initiating
receptor activity.
Correct ANS: B. It binds to the receptor and produces a
maximal physiological response.
Rationale: A full agonist binds to a receptor and triggers the
maximum possible response compared to the endogenous ligand,
fully activating the receptor.
---
Question 4:
For a medication with a narrow therapeutic index, which aspect is
most critical for nursing care to avoid adverse effects?
©2025
, A. Patient’s preference for the route of administration
B. Precise dosing and vigilant monitoring of serum drug levels
C. Ensuring the medication is provided in colorful packaging for
patient reassurance
D. Emphasizing cost‐effectiveness of the therapy
Correct ANS: B. Precise dosing and vigilant monitoring of
serum drug levels
Rationale: Drugs with a narrow therapeutic index have a small
margin between therapeutic and toxic concentrations, requiring
meticulous dosing and close monitoring to ensure patient safety.
---
Question 5:
A patient is prescribed an antihypertensive that is predominantly
metabolized by the liver via Phase I reactions. Which factor can
significantly alter the drug’s clearance in this patient?
A. Renal function
B. Co-administration of liver enzyme inducers
C. Variations in gastrointestinal motility
D. The pH of the drug solution
©2025
