NURS 5344 Pharmacology Study Guide Bundle | Tests 1–3 | Questions &
Answers | University of Texas Arlington | 2026 Update (A+)
Module 1 review questions:
• What are the BON rules and regulations for prescriptive authority for the advance
practice nurse?
Schedule 1 has no medical indication i.e. Heroin, lsd, marijuana
Schedule 2, hydrocodone, cocaine, methamphetamine, methadone,
Adderall
Prescriptive authority determined by state law. Texas is restrictive.
Supervising physician.
• Describe the pharmacokinetic processes of absorption, distribution, metabolism
and elimination and how differences in these areas affect drug action.
1) Absorption: is the movement from site of administration into the
blood. Affected by surface area, blood flow, lipid solubility, and
PH partitioning.
2) Distribution: drugs carried to body by blood
3) Metabolism: biotransformation occurs in LIVER by pyin450
enzyme
4) Elimination: removal of drugs from body. Via urine, sweat, breast
milk, saliva, exp air. Most drugs excreted by kidney
• Compare and contrast pharmacokinetics and pharmacodynamics of special
populations—pediatrics, older adults and those that are pregnant.
1) Infants and children have organ immaturity, elderly have organ
degeneration
• Analyze a drug interaction to determine an appropriate course of action.
• Identify medications with a narrow therapeutic index requiring drug level
monitoring.
1) Dig, rifampin, theophylline, warfarin, lithium, phenytoin,
aminoglycosides, ciclosporins, carbamazepine, flecainide
• Discuss the effect of ionization and pH on absorption.
1) Like dissolves like. The more lipid soluble a drug is the easier is
crosses the membrane. IONS must become NON-IONIZED to
cross membrane
• Discuss factors affecting drug distribution.
• Discuss barriers affecting drug distribution—such as placental membrane, blood
brain barrier and volume of distribution.
1) Placental membrane movement determined same way as other
membranes (simple diffusion)…opioid dependency, birth defects
2) Blood brain barrier. Capillaries in CNS have tight junctions that
prevent free diffusion. LIPID SOLUBLE
• Discuss the “first-pass effect”—what effect can this have on distribution of a
drug?
1) First pass effect is when the drug gets quickly metabolized by the
liver before it gets passed through the systemic circulation.
RAPID hepatic deactivation.
,• Discuss the significance of the Cytochrome P450 system on metabolism of
drugs.
1) 12 closely related enzyme families metabolize drugs, other 9
families metabolize endogenous compounds
• Discuss the major hepatotoxic drugs and possible effects on drug
metabolism.
• List various routes of drug elimination—review normal renal function including
glomerular filtration, passive tubular reabsorption and active tubular secretion;
describe the implications on drug clearance and how elimination affects prescribing.
• Discuss terms used to describe drug actions-agonist, partial agonist, antagonist.
1) Agonist: mimic
2) Antagonist: block
3) Partial agonist: mimic with intermediate intensity
• Discuss the impact of food on drug absorption, drug metabolism and on drug
toxicity and action—as well as the timing of drug administration.
1) Calcium foods avoid with tetracyclines
2) Grapefruit & cyp3a4 isoenzyme
▪ Slows gi metabolism of many drugs and increases the
amount available for absorption
3) MAO inhibitors & food w/tyramine (aged cheese)- BP can rise to
life threatening levels
Some drugs need to be timed with meals- i.e. taken on an empty
stomach
Module 2 review questions:
1) Why do many medications lack pediatric dosing?
There is a lack of evidence-based literature on safe medications in children
2) Why are neonates at greater risk for toxicity with highly protein bound drugs?
a. Protein binding is decreased in neonates increasing the amount of free drug
available
3) At what age are adult levels of renal function achieved?
a. 12 months or one year
4) what is the most accurate device for measuring a 2.5 ml dose for a child?
a. An oral syringe
5) How do you help prevent medication errors?
a. Write out the term daily
6) Drug sensitivity in the very young results largely from organ immaturity whereas drug
sensitivity in the elderly results from organ degeneration
7) In determining the intensity of response of a drug in a pediatric patient, organ
immaturity puts patient at risk for elevated drug levels and delayed elimination.
8) In pediatric patients, gastric acidity does not reach adult values for 2 years.
9) In the pediatric population, adverse reactions to fluoroquinolones may cause TENDON
RUPTURE
10) Nalidixic acid may cause
, a. Cartilage erosion in children
11) The principles underlying complication to drug therapy in the elderly include:
a. Altered pharmacokinetics, multiple and severe illnesses, multiple drug therapy,
and poor adherence
12) Altered absorption of drugs in the elderly may result in delayed drug response.
13) If an elderly patient is on two protein binding drugs you will decrease the dose of
warfarin.
14) Because of reduced albumin levels, protein binding drugs decrease, causing the level of
free drug to rise.
15) The most important cause of adverse drug reactions in the elderly is drug accumulation
secondary to reduced renal excretion.
16) In the elderly, the proper index of renal function is creatinine clearance or GFR
17) Name factors underlying the increase in adverse reactions in the geriatric population:
• Polypharmacy
• Severe illness, multiple pathologies, greater use of drugs that have a low therapeutic index
• Inadequate supervision
• Poor patient adherence
18) The list that identifies drugs with a high likelihood of causing adverse effects in the
elderly..Beers list
19) The primary mechanism of antibacterial action of the penicillin’s involves inhibition of:
a. Cell wall synthesis by binding and inactivating penicillin binding proteins (PBPs)
20) Which statements about vancomycin are accurate?
a. Causes red man syndrome, active against methicillin resistant staphylococci,
inhibits cell wall synthesis
21) The mechanism of action of the tetracyclines involves:
a. Bacteriostatic, protein synthesis inhibitors
22) Regarding the mechanism of action of aminoglycosides:
a. The drugs cause misreading of the code on the mRNA template to inhibit protein
synthesis, cause ototoxicity and nephrotoxicity
23) Bacterial action of gentamicin: Gentamicin continues to exert antibacterial effects even
after plasma levels decrease below detectable levels
24) Stop STATIN while taking erythromycin (macrolide, inhibit protein synthesis, good for
pen allergy)
25) 24 yo female with travelers’ diarrhea: gram negative, give Cipro, first line quinolones
a. amoxicillin will work for gram +
b. isoniazid for tuberculosis
c. trimethoprim rarely given alone
26) Fluoroquinolones have different therapeutic applications depending on the generation.
a. 1st generation: ciprofloxacin- gram – , polynephritis, uti and intractable diarrhea
b. 2nd generation: Levofloxacin- skin infections and UTI
c. 3rd generation- moxifloxacin- resp infections
d. 4th generation- Delafloxacin- skin and skin structures
Nalidixic acid- synthetic quinolone- could cause cartilage erosion.
27) MOST likely SULFONAMIDE adverse reaction:
, a. Skin reactions
28) Ciprofloxacin- during treatment, tendonitis and even tendon rupture may occur.
29) The primary reason for the use of drug combinations in the treatment of TB is to delay
or prevent the emergence of resistance
30) Fluconazole primary route of elimination is RENAL
31) 55-year-old man who has been on anticoagulant treatment for many years is diagnosed
with TB. Which of the following antimycobacterial agents would most likely induce
cytochrome P450 enzymes in the patient’s liver thereby modify the effects of his
anticoagulant treatment?
a. RIFAMPIN
32) Which drug is an antiviral that can be used to treat herpes simplex virus?
a. Acyclovir (valacyclovir & famciclovir)
33) Which of the following describes the mechanism of action of oseltamivir (Tamiflu)?
a. Selectively inhibits neuramidase
34) First gen cephalosporins are best against which of the following organisms?
a. Gram POSITIVE cocci
35) Isoniazid can cause serious adverse effects including: hepatitis, periph neuropathy,
seizures
36) Cefepime is eliminated via TUBULAR secretion and or glomerular filtration.
37) Which of the following is a common adverse effect of trimethoprim/sulfamethoxazole
(Bactrim)?
a. Skin reaction, Steven Johnson syndrome
38) Which cephalosporins cause bleeding tendencies: cefotetan and ceftriaxone
39) Which cephalosporins induce alcohol intolerance?
a. Cefotetan and cefazolin
40) Which macrolide is least likely to cause QT prolongation?
a. Azithromycin
41) Which of the following cephalosporins has activity against gram neg anaerobic
pathogens such as Bacteroides fragilis?
a. Cefoxitin (Mefoxin) (2nd generation)
42) 20-year-old comes to office with UTI. Gram positive. Enterococcus. Oral treatment
option: Amoxicillin
43) The first line aBx for a pt with comorbidities who has pneumonia would be
LEVOFLOXACIN
44) 4-Week-old infant with Chlamydial pneumonia…treat with ERYTHROMYCIN
45) which of the following is the primary method of B lactam resistance with Strep
pneumoniae?
a. Modification of target size
46) An 80-year-old patient will begin taking cefdinir (Omnicef). Before initiating therapy, the
nurse practitioner should order Creatinine Clearance.
47) Long term use of Clindamycin therapy should be warned of:
a. C.Diff diarrhea
Answers | University of Texas Arlington | 2026 Update (A+)
Module 1 review questions:
• What are the BON rules and regulations for prescriptive authority for the advance
practice nurse?
Schedule 1 has no medical indication i.e. Heroin, lsd, marijuana
Schedule 2, hydrocodone, cocaine, methamphetamine, methadone,
Adderall
Prescriptive authority determined by state law. Texas is restrictive.
Supervising physician.
• Describe the pharmacokinetic processes of absorption, distribution, metabolism
and elimination and how differences in these areas affect drug action.
1) Absorption: is the movement from site of administration into the
blood. Affected by surface area, blood flow, lipid solubility, and
PH partitioning.
2) Distribution: drugs carried to body by blood
3) Metabolism: biotransformation occurs in LIVER by pyin450
enzyme
4) Elimination: removal of drugs from body. Via urine, sweat, breast
milk, saliva, exp air. Most drugs excreted by kidney
• Compare and contrast pharmacokinetics and pharmacodynamics of special
populations—pediatrics, older adults and those that are pregnant.
1) Infants and children have organ immaturity, elderly have organ
degeneration
• Analyze a drug interaction to determine an appropriate course of action.
• Identify medications with a narrow therapeutic index requiring drug level
monitoring.
1) Dig, rifampin, theophylline, warfarin, lithium, phenytoin,
aminoglycosides, ciclosporins, carbamazepine, flecainide
• Discuss the effect of ionization and pH on absorption.
1) Like dissolves like. The more lipid soluble a drug is the easier is
crosses the membrane. IONS must become NON-IONIZED to
cross membrane
• Discuss factors affecting drug distribution.
• Discuss barriers affecting drug distribution—such as placental membrane, blood
brain barrier and volume of distribution.
1) Placental membrane movement determined same way as other
membranes (simple diffusion)…opioid dependency, birth defects
2) Blood brain barrier. Capillaries in CNS have tight junctions that
prevent free diffusion. LIPID SOLUBLE
• Discuss the “first-pass effect”—what effect can this have on distribution of a
drug?
1) First pass effect is when the drug gets quickly metabolized by the
liver before it gets passed through the systemic circulation.
RAPID hepatic deactivation.
,• Discuss the significance of the Cytochrome P450 system on metabolism of
drugs.
1) 12 closely related enzyme families metabolize drugs, other 9
families metabolize endogenous compounds
• Discuss the major hepatotoxic drugs and possible effects on drug
metabolism.
• List various routes of drug elimination—review normal renal function including
glomerular filtration, passive tubular reabsorption and active tubular secretion;
describe the implications on drug clearance and how elimination affects prescribing.
• Discuss terms used to describe drug actions-agonist, partial agonist, antagonist.
1) Agonist: mimic
2) Antagonist: block
3) Partial agonist: mimic with intermediate intensity
• Discuss the impact of food on drug absorption, drug metabolism and on drug
toxicity and action—as well as the timing of drug administration.
1) Calcium foods avoid with tetracyclines
2) Grapefruit & cyp3a4 isoenzyme
▪ Slows gi metabolism of many drugs and increases the
amount available for absorption
3) MAO inhibitors & food w/tyramine (aged cheese)- BP can rise to
life threatening levels
Some drugs need to be timed with meals- i.e. taken on an empty
stomach
Module 2 review questions:
1) Why do many medications lack pediatric dosing?
There is a lack of evidence-based literature on safe medications in children
2) Why are neonates at greater risk for toxicity with highly protein bound drugs?
a. Protein binding is decreased in neonates increasing the amount of free drug
available
3) At what age are adult levels of renal function achieved?
a. 12 months or one year
4) what is the most accurate device for measuring a 2.5 ml dose for a child?
a. An oral syringe
5) How do you help prevent medication errors?
a. Write out the term daily
6) Drug sensitivity in the very young results largely from organ immaturity whereas drug
sensitivity in the elderly results from organ degeneration
7) In determining the intensity of response of a drug in a pediatric patient, organ
immaturity puts patient at risk for elevated drug levels and delayed elimination.
8) In pediatric patients, gastric acidity does not reach adult values for 2 years.
9) In the pediatric population, adverse reactions to fluoroquinolones may cause TENDON
RUPTURE
10) Nalidixic acid may cause
, a. Cartilage erosion in children
11) The principles underlying complication to drug therapy in the elderly include:
a. Altered pharmacokinetics, multiple and severe illnesses, multiple drug therapy,
and poor adherence
12) Altered absorption of drugs in the elderly may result in delayed drug response.
13) If an elderly patient is on two protein binding drugs you will decrease the dose of
warfarin.
14) Because of reduced albumin levels, protein binding drugs decrease, causing the level of
free drug to rise.
15) The most important cause of adverse drug reactions in the elderly is drug accumulation
secondary to reduced renal excretion.
16) In the elderly, the proper index of renal function is creatinine clearance or GFR
17) Name factors underlying the increase in adverse reactions in the geriatric population:
• Polypharmacy
• Severe illness, multiple pathologies, greater use of drugs that have a low therapeutic index
• Inadequate supervision
• Poor patient adherence
18) The list that identifies drugs with a high likelihood of causing adverse effects in the
elderly..Beers list
19) The primary mechanism of antibacterial action of the penicillin’s involves inhibition of:
a. Cell wall synthesis by binding and inactivating penicillin binding proteins (PBPs)
20) Which statements about vancomycin are accurate?
a. Causes red man syndrome, active against methicillin resistant staphylococci,
inhibits cell wall synthesis
21) The mechanism of action of the tetracyclines involves:
a. Bacteriostatic, protein synthesis inhibitors
22) Regarding the mechanism of action of aminoglycosides:
a. The drugs cause misreading of the code on the mRNA template to inhibit protein
synthesis, cause ototoxicity and nephrotoxicity
23) Bacterial action of gentamicin: Gentamicin continues to exert antibacterial effects even
after plasma levels decrease below detectable levels
24) Stop STATIN while taking erythromycin (macrolide, inhibit protein synthesis, good for
pen allergy)
25) 24 yo female with travelers’ diarrhea: gram negative, give Cipro, first line quinolones
a. amoxicillin will work for gram +
b. isoniazid for tuberculosis
c. trimethoprim rarely given alone
26) Fluoroquinolones have different therapeutic applications depending on the generation.
a. 1st generation: ciprofloxacin- gram – , polynephritis, uti and intractable diarrhea
b. 2nd generation: Levofloxacin- skin infections and UTI
c. 3rd generation- moxifloxacin- resp infections
d. 4th generation- Delafloxacin- skin and skin structures
Nalidixic acid- synthetic quinolone- could cause cartilage erosion.
27) MOST likely SULFONAMIDE adverse reaction:
, a. Skin reactions
28) Ciprofloxacin- during treatment, tendonitis and even tendon rupture may occur.
29) The primary reason for the use of drug combinations in the treatment of TB is to delay
or prevent the emergence of resistance
30) Fluconazole primary route of elimination is RENAL
31) 55-year-old man who has been on anticoagulant treatment for many years is diagnosed
with TB. Which of the following antimycobacterial agents would most likely induce
cytochrome P450 enzymes in the patient’s liver thereby modify the effects of his
anticoagulant treatment?
a. RIFAMPIN
32) Which drug is an antiviral that can be used to treat herpes simplex virus?
a. Acyclovir (valacyclovir & famciclovir)
33) Which of the following describes the mechanism of action of oseltamivir (Tamiflu)?
a. Selectively inhibits neuramidase
34) First gen cephalosporins are best against which of the following organisms?
a. Gram POSITIVE cocci
35) Isoniazid can cause serious adverse effects including: hepatitis, periph neuropathy,
seizures
36) Cefepime is eliminated via TUBULAR secretion and or glomerular filtration.
37) Which of the following is a common adverse effect of trimethoprim/sulfamethoxazole
(Bactrim)?
a. Skin reaction, Steven Johnson syndrome
38) Which cephalosporins cause bleeding tendencies: cefotetan and ceftriaxone
39) Which cephalosporins induce alcohol intolerance?
a. Cefotetan and cefazolin
40) Which macrolide is least likely to cause QT prolongation?
a. Azithromycin
41) Which of the following cephalosporins has activity against gram neg anaerobic
pathogens such as Bacteroides fragilis?
a. Cefoxitin (Mefoxin) (2nd generation)
42) 20-year-old comes to office with UTI. Gram positive. Enterococcus. Oral treatment
option: Amoxicillin
43) The first line aBx for a pt with comorbidities who has pneumonia would be
LEVOFLOXACIN
44) 4-Week-old infant with Chlamydial pneumonia…treat with ERYTHROMYCIN
45) which of the following is the primary method of B lactam resistance with Strep
pneumoniae?
a. Modification of target size
46) An 80-year-old patient will begin taking cefdinir (Omnicef). Before initiating therapy, the
nurse practitioner should order Creatinine Clearance.
47) Long term use of Clindamycin therapy should be warned of:
a. C.Diff diarrhea
