NURS 676 ADVANCED PHARMACOLOGY
MIDTERM CERTIFICATION EVALUATION TESTS
2026 COMPLETE QUESTIONS AND ANSWERS
100 PERCENT CORRECT
◉ If you have a patient experiencing a pharmacokinetic drug
interaction, consider...... Answer: CYP450.
◉ · Some drugs or exogenous substances can induce CYP isozymes
(less effect). Example.... Answer: St. John's wort (CYP3A4) and
hormonal birth control
◉ CYP450-related drug interactions can make predicting blood
plasma levels/steady state levels difficult.
Example.... Answer: If a drug inhibits enzymatic activity, a substrate
drug for that enzyme system will have a greater concentration in the
blood.
◉ If a drug inhibits CYP isozymes, what is the effect of the substrate
drug Answer: The substrate drug will have greater effect
◉ Phase 2 Metabolism Answer: · Polar group is conjugated to the
drug
,· Results in increased polarity of the drug
◉ Types of phase 2 metabolism reactions Answer: - Glycine
conjugation
-Glucuronide conjugation
-Sulfate conjugation
◉ What is competitive antagonism? Answer: where one drug
displaces another on cell receptors.
◉ How is metabolism effected by different ethnic groups? Answer:
Different ethnic groups may have different hepatic metabolism rates
◉ Routes of elimination Answer: 1. Pulmonary = expired in the air
(volatile substances)
2. Bile = excreted in feces
3. Renal
-glomerular filtration
- tubular reabsorption
- tubular secretion
◉ Glomerular filtration rate (GFR) (Normal) Answer: 90-125L/min
,◉ Most elimination involves..... Answer: renal function. (Renal blood
flow, creatinine clearance (CrCl) )
◉ Linear drug elimination Answer: Rate of elimination is
proportional to amount of drug present
◉ volatile drugs are excreted by the.... Answer: lungs
◉ Bioavailability Answer: A measure of the extent of drug
absorption for a given drug and route (from 0% to 100%).
◉ Which route of administration has the greatest bioavailability
Answer: intravenous, putting entire dose into a patients vein and
bypassing absorption.
◉ Which route of administration bypasses first-pass metabolism in
the liver Answer: intravenous
◉ Which method of administration has variable and erratic
absorption Answer: rectal
◉ What is a half-life? Answer: the time required for serum plasma
concentrations to decrease by one-half, 50%
, ◉ When is a steady state reached? Answer: after 4-5 half lives
◉ What is zero-order (nonlinear) pharmacokinetics Answer: a drug
is metabolized at a constant rate per unit time
◉ Why is help life important Answer: -determines how frequently a
drug must be administered.
-predicts how long toxic effects can last (when the drug is over the
minimum toxic level)
◉ what is Michaelis-menten pharmacokinetics Answer: the rate of
drug elimination is directly proportional to the concentration of free
drug
◉ Why is peak and trough measured Answer: to see if a drug is
within its therapeutic range
◉ What is narrow therapeutic index Answer: when the difference
between effective dose and a toxic blood level is small
◉ what is a wide therapeutic index? Answer: Greater distance
between effective dose and toxic dose, requires less intense
monitoring
MIDTERM CERTIFICATION EVALUATION TESTS
2026 COMPLETE QUESTIONS AND ANSWERS
100 PERCENT CORRECT
◉ If you have a patient experiencing a pharmacokinetic drug
interaction, consider...... Answer: CYP450.
◉ · Some drugs or exogenous substances can induce CYP isozymes
(less effect). Example.... Answer: St. John's wort (CYP3A4) and
hormonal birth control
◉ CYP450-related drug interactions can make predicting blood
plasma levels/steady state levels difficult.
Example.... Answer: If a drug inhibits enzymatic activity, a substrate
drug for that enzyme system will have a greater concentration in the
blood.
◉ If a drug inhibits CYP isozymes, what is the effect of the substrate
drug Answer: The substrate drug will have greater effect
◉ Phase 2 Metabolism Answer: · Polar group is conjugated to the
drug
,· Results in increased polarity of the drug
◉ Types of phase 2 metabolism reactions Answer: - Glycine
conjugation
-Glucuronide conjugation
-Sulfate conjugation
◉ What is competitive antagonism? Answer: where one drug
displaces another on cell receptors.
◉ How is metabolism effected by different ethnic groups? Answer:
Different ethnic groups may have different hepatic metabolism rates
◉ Routes of elimination Answer: 1. Pulmonary = expired in the air
(volatile substances)
2. Bile = excreted in feces
3. Renal
-glomerular filtration
- tubular reabsorption
- tubular secretion
◉ Glomerular filtration rate (GFR) (Normal) Answer: 90-125L/min
,◉ Most elimination involves..... Answer: renal function. (Renal blood
flow, creatinine clearance (CrCl) )
◉ Linear drug elimination Answer: Rate of elimination is
proportional to amount of drug present
◉ volatile drugs are excreted by the.... Answer: lungs
◉ Bioavailability Answer: A measure of the extent of drug
absorption for a given drug and route (from 0% to 100%).
◉ Which route of administration has the greatest bioavailability
Answer: intravenous, putting entire dose into a patients vein and
bypassing absorption.
◉ Which route of administration bypasses first-pass metabolism in
the liver Answer: intravenous
◉ Which method of administration has variable and erratic
absorption Answer: rectal
◉ What is a half-life? Answer: the time required for serum plasma
concentrations to decrease by one-half, 50%
, ◉ When is a steady state reached? Answer: after 4-5 half lives
◉ What is zero-order (nonlinear) pharmacokinetics Answer: a drug
is metabolized at a constant rate per unit time
◉ Why is help life important Answer: -determines how frequently a
drug must be administered.
-predicts how long toxic effects can last (when the drug is over the
minimum toxic level)
◉ what is Michaelis-menten pharmacokinetics Answer: the rate of
drug elimination is directly proportional to the concentration of free
drug
◉ Why is peak and trough measured Answer: to see if a drug is
within its therapeutic range
◉ What is narrow therapeutic index Answer: when the difference
between effective dose and a toxic blood level is small
◉ what is a wide therapeutic index? Answer: Greater distance
between effective dose and toxic dose, requires less intense
monitoring
