NURS 5338 FINAL EXAM | QUESTIONS AND
ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS - UTA.
SECTION A: PHARMACOKINETICS AND PHARMACODYNAMICS
Question 1
An APRN is prescribing a medication that is a weak acid with a pKa of 4.5. In which
body compartment will this drug primarily be absorbed?
A) Stomach (pH 1.5-2.0)
B) Small intestine (pH 6.0-7.5)
C) Blood (pH 7.35-7.45)
D) Urine (pH 5.0-8.0)
Correct Answer: A
Rationale: Weak acids are non-ionized (lipid-soluble) and well absorbed in acidic
environments like the stomach. The rule: ionized = trapped; non-ionized =
absorbed. When pH is below the pKa, the acidic drug is predominantly non-
ionized, favoring absorption. Weak bases are better absorbed in the intestine .
Question 2
A patient is taking two highly protein-bound drugs (98% each). Which
pharmacokinetic phenomenon is most likely to occur?
A) Decreased drug half-life
B) Drug displacement and increased free drug concentration
C) Increased renal excretion
D) Decreased volume of distribution
, Correct Answer: B
Rationale: When two highly protein-bound drugs are co-administered, they
compete for binding sites on plasma proteins. Displacement of one drug increases
its free (unbound) concentration, potentially leading to toxicity. The free fraction is
pharmacologically active .
Question 3
Drug X has a half-life of 4 hours. Approximately how long will it take for the drug
to reach steady state?
A) 8 hours
B) 12 hours
C) 20 hours
D) 40 hours
Correct Answer: C
Rationale: Steady state is reached after approximately 4-5 half-lives. For a drug
with a 4-hour half-life: 4 half-lives = 4 × 4 = 16 hours; 5 half-lives = 5 × 4 = 20
hours. Therefore, steady state occurs in about 20 hours regardless of dosing
interval .
Question 4
A medication with a narrow therapeutic index (NTI) means:
A) The drug has a wide margin of safety
B) Small changes in dose can lead to toxicity or inefficacy
C) The drug is only available intravenously
D) The drug has no side effects
Correct Answer: B
Rationale: Narrow therapeutic index drugs have a small window between the
minimum effective concentration (MEC) and the minimum toxic concentration
ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS - UTA.
SECTION A: PHARMACOKINETICS AND PHARMACODYNAMICS
Question 1
An APRN is prescribing a medication that is a weak acid with a pKa of 4.5. In which
body compartment will this drug primarily be absorbed?
A) Stomach (pH 1.5-2.0)
B) Small intestine (pH 6.0-7.5)
C) Blood (pH 7.35-7.45)
D) Urine (pH 5.0-8.0)
Correct Answer: A
Rationale: Weak acids are non-ionized (lipid-soluble) and well absorbed in acidic
environments like the stomach. The rule: ionized = trapped; non-ionized =
absorbed. When pH is below the pKa, the acidic drug is predominantly non-
ionized, favoring absorption. Weak bases are better absorbed in the intestine .
Question 2
A patient is taking two highly protein-bound drugs (98% each). Which
pharmacokinetic phenomenon is most likely to occur?
A) Decreased drug half-life
B) Drug displacement and increased free drug concentration
C) Increased renal excretion
D) Decreased volume of distribution
, Correct Answer: B
Rationale: When two highly protein-bound drugs are co-administered, they
compete for binding sites on plasma proteins. Displacement of one drug increases
its free (unbound) concentration, potentially leading to toxicity. The free fraction is
pharmacologically active .
Question 3
Drug X has a half-life of 4 hours. Approximately how long will it take for the drug
to reach steady state?
A) 8 hours
B) 12 hours
C) 20 hours
D) 40 hours
Correct Answer: C
Rationale: Steady state is reached after approximately 4-5 half-lives. For a drug
with a 4-hour half-life: 4 half-lives = 4 × 4 = 16 hours; 5 half-lives = 5 × 4 = 20
hours. Therefore, steady state occurs in about 20 hours regardless of dosing
interval .
Question 4
A medication with a narrow therapeutic index (NTI) means:
A) The drug has a wide margin of safety
B) Small changes in dose can lead to toxicity or inefficacy
C) The drug is only available intravenously
D) The drug has no side effects
Correct Answer: B
Rationale: Narrow therapeutic index drugs have a small window between the
minimum effective concentration (MEC) and the minimum toxic concentration