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Wilkes NSG 533 Final Exam: Comprehensive
Advanced Pharmacology Practice Test 200
Questions & Answers Explanation
1. Which factor increases the volume of distribution (Vd) of a
drug?
a) High plasma protein binding
b) High lipophilicity
c) Low tissue binding
d) Large molecular weight
Answer: b) High lipophilicity (promotes tissue distribution)
2. A patient with heart failure has reduced hepatic blood flow.
This will most significantly affect clearance of which drug?
a) Gentamicin
b) Lidocaine
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c) Lithium
d) Digoxin
Answer: b) Lidocaine (high extraction ratio drug; clearance
depends on liver blood flow)
3. Scenario: A 70 kg patient receives 350 mg IV bolus. Plasma
concentration is 5 mg/L. What is Vd?
a) 7 L
b) 35 L
c) 70 L
d) 350 L
Answer: c) 70 L (350 mg ÷ 5 mg/L)
4. A drug follows zero-order kinetics. Which statement is
correct?
a) Half-life is constant
b) Doubling dose doubles time to eliminate
c) Elimination rate is proportional to concentration
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d) Most drugs follow zero-order kinetics
Answer: b) Doubling dose doubles time to eliminate
5. Which organ is the primary site of Phase II metabolism?
a) Kidney
b) Liver
c) Intestine
d) Lung
Answer: b) Liver (glucuronidation, sulfation, etc.)
6. A drug with extensive first-pass metabolism is given orally
versus IV. Oral bioavailability will be:
a) Higher
b) Lower
c) Equal
d) Unchanged
Answer: b) Lower
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7. Scenario: A patient on warfarin (highly protein-bound) is
given sulfamethoxazole. What happens?
a) Reduced warfarin effect
b) Increased INR and bleeding risk
c) No change
d) Increased warfarin metabolism
Answer: b) Increased INR and bleeding risk (displacement
increases free warfarin)
8. Which CYP450 enzyme is most commonly involved in drug
interactions?
a) CYP1A2
b) CYP2D6
c) CYP3A4
d) CYP2C9
Answer: c) CYP3A4
Wilkes NSG 533 Final Exam: Comprehensive
Advanced Pharmacology Practice Test 200
Questions & Answers Explanation
1. Which factor increases the volume of distribution (Vd) of a
drug?
a) High plasma protein binding
b) High lipophilicity
c) Low tissue binding
d) Large molecular weight
Answer: b) High lipophilicity (promotes tissue distribution)
2. A patient with heart failure has reduced hepatic blood flow.
This will most significantly affect clearance of which drug?
a) Gentamicin
b) Lidocaine
,Page 2 of 80
c) Lithium
d) Digoxin
Answer: b) Lidocaine (high extraction ratio drug; clearance
depends on liver blood flow)
3. Scenario: A 70 kg patient receives 350 mg IV bolus. Plasma
concentration is 5 mg/L. What is Vd?
a) 7 L
b) 35 L
c) 70 L
d) 350 L
Answer: c) 70 L (350 mg ÷ 5 mg/L)
4. A drug follows zero-order kinetics. Which statement is
correct?
a) Half-life is constant
b) Doubling dose doubles time to eliminate
c) Elimination rate is proportional to concentration
,Page 3 of 80
d) Most drugs follow zero-order kinetics
Answer: b) Doubling dose doubles time to eliminate
5. Which organ is the primary site of Phase II metabolism?
a) Kidney
b) Liver
c) Intestine
d) Lung
Answer: b) Liver (glucuronidation, sulfation, etc.)
6. A drug with extensive first-pass metabolism is given orally
versus IV. Oral bioavailability will be:
a) Higher
b) Lower
c) Equal
d) Unchanged
Answer: b) Lower
, Page 4 of 80
7. Scenario: A patient on warfarin (highly protein-bound) is
given sulfamethoxazole. What happens?
a) Reduced warfarin effect
b) Increased INR and bleeding risk
c) No change
d) Increased warfarin metabolism
Answer: b) Increased INR and bleeding risk (displacement
increases free warfarin)
8. Which CYP450 enzyme is most commonly involved in drug
interactions?
a) CYP1A2
b) CYP2D6
c) CYP3A4
d) CYP2C9
Answer: c) CYP3A4
