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NURS 676 Advanced
Pharmacology Actual 2025
Midterm Exam (WCU)
Questions and Answers
Summer Semester
Question 1
A nurse practitioner is prescribing a medication that undergoes extensive first-pass metabolism.
Which route of administration should be avoided to maximize bioavailability?
A. Intravenous
B. Oral
C. Intramuscular
D. Subcutaneous
Correct Answer: B. Oral
Rationale: Oral medications undergo first-pass metabolism in the liver, reducing bioavailability.
Intravenous administration bypasses the liver, maximizing bioavailability, while intramuscular
and subcutaneous routes have less first-pass effect compared to oral.
Question 2
Which pharmacokinetic parameter describes the time it takes for a drug’s plasma concentration
to decrease by half?
A. Volume of distribution
B. Clearance
C. Half-life
D. Bioavailability
Correct Answer: C. Half-life
Rationale: Half-life is the time required for a drug’s plasma concentration to reduce by 50%,
, 2
influencing dosing intervals and steady-state achievement. Other parameters describe different
aspects of drug disposition.
Question 3
A client is prescribed warfarin. Which pharmacodynamic interaction is most concerning when
co-administered with ibuprofen?
A. Increased risk of bleeding
B. Decreased anticoagulant effect
C. Increased risk of hepatotoxicity
D. Decreased renal clearance
Correct Answer: A. Increased risk of bleeding
Rationale: Both warfarin (anticoagulant) and ibuprofen (NSAID) inhibit platelet function and
increase bleeding risk, a significant pharmacodynamic interaction requiring careful monitoring.
Question 4
A nurse is educating a client on metformin. Which mechanism of action should the nurse
explain?
A. Increases insulin secretion
B. Decreases hepatic glucose production
C. Blocks sodium channels
D. Inhibits ACE enzyme
Correct Answer: B. Decreases hepatic glucose production
Rationale: Metformin, a biguanide, primarily reduces hepatic gluconeogenesis, lowering blood
glucose in type 2 diabetes. It does not affect insulin secretion, sodium channels, or ACE activity.
Question 5
A client with renal impairment is prescribed a medication with high renal clearance. What
adjustment is most likely needed?
A. Increase the dose
B. Decrease the dose
C. Shorten the dosing interval
D. Administer with food
NURS 676 Advanced
Pharmacology Actual 2025
Midterm Exam (WCU)
Questions and Answers
Summer Semester
Question 1
A nurse practitioner is prescribing a medication that undergoes extensive first-pass metabolism.
Which route of administration should be avoided to maximize bioavailability?
A. Intravenous
B. Oral
C. Intramuscular
D. Subcutaneous
Correct Answer: B. Oral
Rationale: Oral medications undergo first-pass metabolism in the liver, reducing bioavailability.
Intravenous administration bypasses the liver, maximizing bioavailability, while intramuscular
and subcutaneous routes have less first-pass effect compared to oral.
Question 2
Which pharmacokinetic parameter describes the time it takes for a drug’s plasma concentration
to decrease by half?
A. Volume of distribution
B. Clearance
C. Half-life
D. Bioavailability
Correct Answer: C. Half-life
Rationale: Half-life is the time required for a drug’s plasma concentration to reduce by 50%,
, 2
influencing dosing intervals and steady-state achievement. Other parameters describe different
aspects of drug disposition.
Question 3
A client is prescribed warfarin. Which pharmacodynamic interaction is most concerning when
co-administered with ibuprofen?
A. Increased risk of bleeding
B. Decreased anticoagulant effect
C. Increased risk of hepatotoxicity
D. Decreased renal clearance
Correct Answer: A. Increased risk of bleeding
Rationale: Both warfarin (anticoagulant) and ibuprofen (NSAID) inhibit platelet function and
increase bleeding risk, a significant pharmacodynamic interaction requiring careful monitoring.
Question 4
A nurse is educating a client on metformin. Which mechanism of action should the nurse
explain?
A. Increases insulin secretion
B. Decreases hepatic glucose production
C. Blocks sodium channels
D. Inhibits ACE enzyme
Correct Answer: B. Decreases hepatic glucose production
Rationale: Metformin, a biguanide, primarily reduces hepatic gluconeogenesis, lowering blood
glucose in type 2 diabetes. It does not affect insulin secretion, sodium channels, or ACE activity.
Question 5
A client with renal impairment is prescribed a medication with high renal clearance. What
adjustment is most likely needed?
A. Increase the dose
B. Decrease the dose
C. Shorten the dosing interval
D. Administer with food
