1|Page
LEHNE’S PHARMACOTHERAPEUTICS EXAM Q&A 2026 | 160
VERIFIED QUESTIONS WITH ANSWERS & RATIONALES,100%
CORRECT ALREADY GRADED A+
1 — Topic: Pharmacokinetics
An advanced practice nurse explains to a patient that the liver plays an
important role in drug metabolism. Which statement best describes this
process?
A. The liver eliminates drugs through urine
B. The liver converts drugs into more water-soluble forms
C. The liver enhances drug absorption in the intestines
D. The liver prevents drugs from entering systemic circulation
Correct Answer: B
Rationale: The liver uses enzymatic processes (primarily the CYP450
system) to convert drugs into more water-soluble metabolites for easier
elimination. This biotransformation prevents accumulation and toxicity.
2 — Topic: Pharmacodynamics
A nurse practitioner explains that drug receptors are important
because:
A. They act as binding sites determining drug effects
B. They accelerate drug absorption in the stomach
C. They ensure drugs are eliminated from the body
D. They prevent drug interactions
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Correct Answer: A
Rationale: Drug receptors are proteins that interact with drugs to
produce effects. The magnitude of response depends on drug affinity
and intrinsic activity.
3 — Topic: Prescriptive authority
An advanced practice nurse prescribes medication for the first time.
Which principle of safe prescribing is most critical?
A. Always prescribe the newest drug available
B. Base prescriptions on clinical guidelines and patient needs
C. Use samples before prescribing generic equivalents
D. Prescribe drugs without considering contraindications
Correct Answer: B
Rationale: Safe prescribing requires evidence-based practice, clinical
guidelines, and individualizing therapy to avoid adverse events and
improve outcomes.
4 — Topic: Drug metabolism
A patient with advanced liver disease is prescribed a hepatically
metabolized drug. What adjustment is most appropriate?
A. Increase the drug dose
B. Administer the drug more frequently
C. Reduce the drug dose or extend dosing interval
D. Stop drug administration completely
Correct Answer: C
Rationale: Impaired liver function reduces metabolism, leading to drug
accumulation and toxicity. Dose adjustment or extended intervals are
necessary.
5 — Topic: Adverse effects
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A client develops a cough while taking an ACE inhibitor. Which
alternative class is most appropriate?
A. Beta blockers
B. Angiotensin receptor blockers (ARBs)
C. Calcium channel blockers
D. Thiazide diuretics
Correct Answer: B
Rationale: ARBs provide similar therapeutic benefits as ACE inhibitors
without the bradykinin-mediated cough, making them preferred in
intolerant patients.
6 — Topic: Pharmacogenomics
An African American client is prescribed an antihypertensive. Which
drug class is often more effective in this population?
A. Beta blockers
B. ACE inhibitors
C. Calcium channel blockers
D. Alpha-2 agonists
Correct Answer: C
Rationale: Calcium channel blockers and thiazide diuretics are more
effective in African American populations due to lower renin activity
compared with ACE inhibitors and beta blockers.
7 — Topic: Antibiotics
Which antibiotic is contraindicated in children under 8 due to
permanent tooth discoloration?
A. Penicillin
B. Tetracycline
C. Cephalosporin
D. Macrolide
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Correct Answer: B
Rationale: Tetracyclines bind to calcium in developing teeth, causing
discoloration and enamel hypoplasia, making them inappropriate in
children and pregnant women.
8 — Topic: Pregnancy safety
Which antihypertensive drug is considered safe in pregnancy?
A. Lisinopril
B. Losartan
C. Methyldopa
D. Spironolactone
Correct Answer: C
Rationale: Methyldopa and labetalol are preferred for managing
hypertension in pregnancy. ACE inhibitors and ARBs are
contraindicated due to fetal toxicity.
9 — Topic: Drug interactions
A patient taking warfarin is prescribed trimethoprim-sulfamethoxazole.
What is the nurse practitioner’s best action?
A. Increase warfarin dose
B. Discontinue warfarin immediately
C. Monitor INR closely and adjust dose as needed
D. Reassure the client no action is necessary
Correct Answer: C
Rationale: TMP-SMX increases warfarin’s anticoagulant effect by
inhibiting metabolism, raising bleeding risk. INR must be monitored and
dose adjusted.
10 — Topic: Antibiotic stewardship
LEHNE’S PHARMACOTHERAPEUTICS EXAM Q&A 2026 | 160
VERIFIED QUESTIONS WITH ANSWERS & RATIONALES,100%
CORRECT ALREADY GRADED A+
1 — Topic: Pharmacokinetics
An advanced practice nurse explains to a patient that the liver plays an
important role in drug metabolism. Which statement best describes this
process?
A. The liver eliminates drugs through urine
B. The liver converts drugs into more water-soluble forms
C. The liver enhances drug absorption in the intestines
D. The liver prevents drugs from entering systemic circulation
Correct Answer: B
Rationale: The liver uses enzymatic processes (primarily the CYP450
system) to convert drugs into more water-soluble metabolites for easier
elimination. This biotransformation prevents accumulation and toxicity.
2 — Topic: Pharmacodynamics
A nurse practitioner explains that drug receptors are important
because:
A. They act as binding sites determining drug effects
B. They accelerate drug absorption in the stomach
C. They ensure drugs are eliminated from the body
D. They prevent drug interactions
,2|Page
Correct Answer: A
Rationale: Drug receptors are proteins that interact with drugs to
produce effects. The magnitude of response depends on drug affinity
and intrinsic activity.
3 — Topic: Prescriptive authority
An advanced practice nurse prescribes medication for the first time.
Which principle of safe prescribing is most critical?
A. Always prescribe the newest drug available
B. Base prescriptions on clinical guidelines and patient needs
C. Use samples before prescribing generic equivalents
D. Prescribe drugs without considering contraindications
Correct Answer: B
Rationale: Safe prescribing requires evidence-based practice, clinical
guidelines, and individualizing therapy to avoid adverse events and
improve outcomes.
4 — Topic: Drug metabolism
A patient with advanced liver disease is prescribed a hepatically
metabolized drug. What adjustment is most appropriate?
A. Increase the drug dose
B. Administer the drug more frequently
C. Reduce the drug dose or extend dosing interval
D. Stop drug administration completely
Correct Answer: C
Rationale: Impaired liver function reduces metabolism, leading to drug
accumulation and toxicity. Dose adjustment or extended intervals are
necessary.
5 — Topic: Adverse effects
,3|Page
A client develops a cough while taking an ACE inhibitor. Which
alternative class is most appropriate?
A. Beta blockers
B. Angiotensin receptor blockers (ARBs)
C. Calcium channel blockers
D. Thiazide diuretics
Correct Answer: B
Rationale: ARBs provide similar therapeutic benefits as ACE inhibitors
without the bradykinin-mediated cough, making them preferred in
intolerant patients.
6 — Topic: Pharmacogenomics
An African American client is prescribed an antihypertensive. Which
drug class is often more effective in this population?
A. Beta blockers
B. ACE inhibitors
C. Calcium channel blockers
D. Alpha-2 agonists
Correct Answer: C
Rationale: Calcium channel blockers and thiazide diuretics are more
effective in African American populations due to lower renin activity
compared with ACE inhibitors and beta blockers.
7 — Topic: Antibiotics
Which antibiotic is contraindicated in children under 8 due to
permanent tooth discoloration?
A. Penicillin
B. Tetracycline
C. Cephalosporin
D. Macrolide
, 4|Page
Correct Answer: B
Rationale: Tetracyclines bind to calcium in developing teeth, causing
discoloration and enamel hypoplasia, making them inappropriate in
children and pregnant women.
8 — Topic: Pregnancy safety
Which antihypertensive drug is considered safe in pregnancy?
A. Lisinopril
B. Losartan
C. Methyldopa
D. Spironolactone
Correct Answer: C
Rationale: Methyldopa and labetalol are preferred for managing
hypertension in pregnancy. ACE inhibitors and ARBs are
contraindicated due to fetal toxicity.
9 — Topic: Drug interactions
A patient taking warfarin is prescribed trimethoprim-sulfamethoxazole.
What is the nurse practitioner’s best action?
A. Increase warfarin dose
B. Discontinue warfarin immediately
C. Monitor INR closely and adjust dose as needed
D. Reassure the client no action is necessary
Correct Answer: C
Rationale: TMP-SMX increases warfarin’s anticoagulant effect by
inhibiting metabolism, raising bleeding risk. INR must be monitored and
dose adjusted.
10 — Topic: Antibiotic stewardship
