Walden University NURS 6521 Advanced
Pharmacology Final Exam Simulation (2025 Format)
New Latest Version with All Questions, Correct
Answers and Rationale
1. What is the primary site of drug metabolism in the body?
A. Kidneys
B. Liver
C. Lungs
D. Small intestine
Correct Answer: B
Rationale: The liver is the primary site of drug metabolism, mainly via cytochrome P450
enzymes, transforming drugs into excretable forms.
2. A patient is prescribed warfarin. What dietary factor must be monitored?
A. Vitamin C intake
B. Vitamin K intake
C. Sodium intake
D. Protein intake
Correct Answer: B
Rationale: Vitamin K antagonizes warfarin’s inhibition of clotting factors, so consistent intake is
critical to maintain therapeutic INR.
3. What does the term "half-life" refer to in pharmacokinetics?
A. Time to reach peak plasma concentration
B. Time for drug concentration to decrease by 50%
C. Duration of drug action
D. Rate of drug absorption
Correct Answer: B
Rationale: Half-life is the time required for the plasma concentration of a drug to reduce by half,
influencing dosing intervals.
4. A patient on phenytoin develops a rash. What should the nurse do?
A. Continue the drug and monitor
B. Stop the drug and notify the provider
C. Increase the dose
D. Apply topical steroids
Correct Answer: B
Rationale: A rash may indicate a hypersensitivity reaction, such as Stevens-Johnson syndrome,
requiring immediate discontinuation and provider consultation.
5. Which drug class is first-line for managing type 2 diabetes?
A. Sulfonylureas
B. Biguanides
C. Thiazolidinediones
D. DPP-4 inhibitors
Correct Answer: B
,Rationale: Metformin, a biguanide, is the first-line treatment for type 2 diabetes due to its
efficacy and safety profile.
6. True or False: Cytochrome P450 enzyme inducers decrease the metabolism of other drugs.
A. True
B. False
Correct Answer: B
Rationale: Inducers (e.g., rifampin) increase P450 activity, accelerating metabolism and reducing
drug levels.
7. Select all that apply: Which factors influence drug excretion?
A. Renal function
B. Hepatic function
C. Age
D. Body temperature
E. Gender
Correct Answers: A, C, E
Rationale: Renal function, age, and gender affect drug excretion; hepatic function impacts
metabolism, and body temperature has minimal effect.
8. A patient on digoxin has a heart rate of 50 bpm. What should the nurse do?
A. Administer the next dose
B. Hold the dose and notify the provider
C. Increase the dose
D. Monitor for 24 hours
Correct Answer: B
Rationale: Bradycardia may indicate digoxin toxicity, requiring the dose to be held and the
provider notified.
9. What is the mechanism of action of ACE inhibitors?
A. Block angiotensin II receptors
B. Inhibit angiotensin I conversion
C. Reduce sympathetic activity
D. Inhibit sodium reabsorption
Correct Answer: B
Rationale: ACE inhibitors block the conversion of angiotensin I to angiotensin II, reducing
vasoconstriction.
10. A patient is prescribed albuterol for asthma. What is a common side effect?
A. Tremors
B. Sedation
C. Hypotension
D. Weight gain
Correct Answer: A
Rationale: Albuterol, a beta-2 agonist, commonly causes tremors due to stimulation of skeletal
muscle receptors.
11. What is the therapeutic range for INR in a patient on warfarin for atrial fibrillation?
A. 1.0–1.5
B. 2.0–3.0
C. 3.5–4.5
D. 4.0–5.0
, Correct Answer: B
Rationale: An INR of 2.0–3.0 is therapeutic for atrial fibrillation to balance anticoagulation and
bleeding risk.
12. A patient on a statin develops elevated liver enzymes. What should the nurse anticipate?
A. Continue the drug
B. Stop the drug and notify the provider
C. Increase the dose
D. Switch to a diuretic
Correct Answer: B
Rationale: Elevated liver enzymes indicate potential hepatotoxicity, requiring discontinuation
and provider consultation.
13. Which anticoagulant is monitored using PT/INR?
A. Heparin
B. Warfarin
C. Rivaroxaban
D. Enoxaparin
Correct Answer: B
Rationale: Warfarin’s effect on vitamin K-dependent clotting factors is monitored with PT/INR.
14. A patient is prescribed sertraline. What is its drug class?
A. SSRI
B. SNRI
C. MAOI
D. Tricyclic antidepressant
Correct Answer: A
Rationale: Sertraline is a selective serotonin reuptake inhibitor used for depression and anxiety
disorders.
15. What is the primary route of administration for rapid drug absorption?
A. Oral
B. Intravenous
C. Subcutaneous
D. Intramuscular
Correct Answer: B
Rationale: Intravenous administration delivers drugs directly into the bloodstream, bypassing
absorption barriers.
16. True or False: St. John’s Wort can induce cytochrome P450 enzymes.
A. True
B. False
Correct Answer: A
Rationale: St. John’s Wort induces CYP3A4, reducing levels of drugs like oral contraceptives.
17. Select all that apply: Which are adverse effects of loop diuretics?
A. Hypokalemia
B. Hyponatremia
C. Hyperglycemia
D. Dehydration
E. Bradycardia
Correct Answers: A, B, D
Pharmacology Final Exam Simulation (2025 Format)
New Latest Version with All Questions, Correct
Answers and Rationale
1. What is the primary site of drug metabolism in the body?
A. Kidneys
B. Liver
C. Lungs
D. Small intestine
Correct Answer: B
Rationale: The liver is the primary site of drug metabolism, mainly via cytochrome P450
enzymes, transforming drugs into excretable forms.
2. A patient is prescribed warfarin. What dietary factor must be monitored?
A. Vitamin C intake
B. Vitamin K intake
C. Sodium intake
D. Protein intake
Correct Answer: B
Rationale: Vitamin K antagonizes warfarin’s inhibition of clotting factors, so consistent intake is
critical to maintain therapeutic INR.
3. What does the term "half-life" refer to in pharmacokinetics?
A. Time to reach peak plasma concentration
B. Time for drug concentration to decrease by 50%
C. Duration of drug action
D. Rate of drug absorption
Correct Answer: B
Rationale: Half-life is the time required for the plasma concentration of a drug to reduce by half,
influencing dosing intervals.
4. A patient on phenytoin develops a rash. What should the nurse do?
A. Continue the drug and monitor
B. Stop the drug and notify the provider
C. Increase the dose
D. Apply topical steroids
Correct Answer: B
Rationale: A rash may indicate a hypersensitivity reaction, such as Stevens-Johnson syndrome,
requiring immediate discontinuation and provider consultation.
5. Which drug class is first-line for managing type 2 diabetes?
A. Sulfonylureas
B. Biguanides
C. Thiazolidinediones
D. DPP-4 inhibitors
Correct Answer: B
,Rationale: Metformin, a biguanide, is the first-line treatment for type 2 diabetes due to its
efficacy and safety profile.
6. True or False: Cytochrome P450 enzyme inducers decrease the metabolism of other drugs.
A. True
B. False
Correct Answer: B
Rationale: Inducers (e.g., rifampin) increase P450 activity, accelerating metabolism and reducing
drug levels.
7. Select all that apply: Which factors influence drug excretion?
A. Renal function
B. Hepatic function
C. Age
D. Body temperature
E. Gender
Correct Answers: A, C, E
Rationale: Renal function, age, and gender affect drug excretion; hepatic function impacts
metabolism, and body temperature has minimal effect.
8. A patient on digoxin has a heart rate of 50 bpm. What should the nurse do?
A. Administer the next dose
B. Hold the dose and notify the provider
C. Increase the dose
D. Monitor for 24 hours
Correct Answer: B
Rationale: Bradycardia may indicate digoxin toxicity, requiring the dose to be held and the
provider notified.
9. What is the mechanism of action of ACE inhibitors?
A. Block angiotensin II receptors
B. Inhibit angiotensin I conversion
C. Reduce sympathetic activity
D. Inhibit sodium reabsorption
Correct Answer: B
Rationale: ACE inhibitors block the conversion of angiotensin I to angiotensin II, reducing
vasoconstriction.
10. A patient is prescribed albuterol for asthma. What is a common side effect?
A. Tremors
B. Sedation
C. Hypotension
D. Weight gain
Correct Answer: A
Rationale: Albuterol, a beta-2 agonist, commonly causes tremors due to stimulation of skeletal
muscle receptors.
11. What is the therapeutic range for INR in a patient on warfarin for atrial fibrillation?
A. 1.0–1.5
B. 2.0–3.0
C. 3.5–4.5
D. 4.0–5.0
, Correct Answer: B
Rationale: An INR of 2.0–3.0 is therapeutic for atrial fibrillation to balance anticoagulation and
bleeding risk.
12. A patient on a statin develops elevated liver enzymes. What should the nurse anticipate?
A. Continue the drug
B. Stop the drug and notify the provider
C. Increase the dose
D. Switch to a diuretic
Correct Answer: B
Rationale: Elevated liver enzymes indicate potential hepatotoxicity, requiring discontinuation
and provider consultation.
13. Which anticoagulant is monitored using PT/INR?
A. Heparin
B. Warfarin
C. Rivaroxaban
D. Enoxaparin
Correct Answer: B
Rationale: Warfarin’s effect on vitamin K-dependent clotting factors is monitored with PT/INR.
14. A patient is prescribed sertraline. What is its drug class?
A. SSRI
B. SNRI
C. MAOI
D. Tricyclic antidepressant
Correct Answer: A
Rationale: Sertraline is a selective serotonin reuptake inhibitor used for depression and anxiety
disorders.
15. What is the primary route of administration for rapid drug absorption?
A. Oral
B. Intravenous
C. Subcutaneous
D. Intramuscular
Correct Answer: B
Rationale: Intravenous administration delivers drugs directly into the bloodstream, bypassing
absorption barriers.
16. True or False: St. John’s Wort can induce cytochrome P450 enzymes.
A. True
B. False
Correct Answer: A
Rationale: St. John’s Wort induces CYP3A4, reducing levels of drugs like oral contraceptives.
17. Select all that apply: Which are adverse effects of loop diuretics?
A. Hypokalemia
B. Hyponatremia
C. Hyperglycemia
D. Dehydration
E. Bradycardia
Correct Answers: A, B, D
