Complete Questions 1-100 Actual Exam
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NR566 Advanced Pharmacology For
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Section 1: Pharmacokinetics & Fundamentals (Qs 1-10)
Q1. Absorption is best defined as the:
A. Process by which the liver breaks down a drug into metabolites
B. Movement of drug from the administration site into the bloodstream
C. Distribution of drug to target tissues throughout the body
D. Elimination of drug through the kidneys
Correct ,,answer,,,,: B
Rationale: Absorption is the movement of a drug from its site of
administration into the systemic circulation. Oral drugs then undergo
first-pass metabolism in the liver, which can significantly reduce
bioavailability .
Q2. Bioavailability is highest with which route of administration?
A. Oral
B. Intramuscular
,C. Subcutaneous
D. Intravenous
Correct ,,answer,,,,: D
Rationale: IV administration provides 100% bioavailability because the
drug enters the systemic circulation directly, bypassing absorption
barriers and the first-pass effect .
Q3. A drug with a large volume of distribution (Vd > 1 L/kg) is most
likely:
A. Highly protein-bound and confined to the vascular space
B. Water-soluble and excreted unchanged in urine
C. Lipid-soluble and distributed into fat, muscle, and organs
D. Subject to extensive first-pass metabolism
Correct ,,answer,,,,: C
Rationale: A large Vd indicates the drug distributes widely into tissues
beyond the vascular space. Lipid-soluble drugs (e.g., diazepam)
penetrate fat, muscle, and organs .
Q4. Which of the following medications requires serum level
monitoring due to a narrow therapeutic index?
A. Metformin
B. Digoxin
C. Lisinopril
D. Amoxicillin
Correct ,,answer,,,,: B
Rationale: Digoxin, lithium, and warfarin have narrow therapeutic
indices — small changes in dose or serum concentration can lead to
subtherapeutic effects or toxicity .
,Q5. Agonists produce:
A. Blockade of receptor activation
B. A maximal response when the receptor is occupied
C. No response regardless of receptor binding
D. A response only when combined with antagonists
Correct ,,answer,,,,: B
Rationale: Agonists bind to receptors and produce a maximal response
when the receptor is occupied. Antagonists block receptor activation;
partial agonists have lower efficacy even at full receptor occupancy .
Q6. First-pass metabolism occurs when a drug is:
A. Administered intravenously
B. Absorbed from the GI tract and metabolized by the liver before
reaching systemic circulation
C. Applied topically to the skin
D. Inhaled directly into the lungs
Correct ,,answer,,,,: B
Rationale: First-pass metabolism refers to the significant metabolism of
an oral drug by the liver before it reaches systemic circulation. This
reduces bioavailability and is why some drugs cannot be given orally .
Q7. A drug with a half-life of 4 hours is administered intravenously.
Approximately how long will it take to reach steady state?
A. 4 hours
B. 8 hours
C. 20 hours
D. 40 hours
Correct ,,answer,,,,: C
Rationale: Steady state is achieved after approximately 4-5 half-lives.
With a 4-hour half-life, steady state is reached in about 16-20 hours .
, Q8. Which of the following factors increases the risk of digoxin
toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct ,,answer,,,,: B
Rationale: Hypokalemia increases the binding of digoxin to the sodium-
potassium ATPase pump, increasing the risk of toxicity and
arrhythmias .
Q9. Which patient population is most vulnerable to drug toxicity
due to immature renal and hepatic function?
A. Older adults over 65
B. Infants (especially neonates)
C. Pregnant women
D. Adolescents
Correct ,,answer,,,,: B
Rationale: Infants, especially neonates, are highly vulnerable to drug
toxicity because their kidneys and livers are immature, leading to slower
drug elimination and higher serum levels for a given dose .
Q10. Which situation represents appropriate prophylactic use of
antibiotics?
A. Treating viral rhinitis in a healthy adult
B. Giving trimethoprim-sulfamethoxazole for recurrent UTIs in a young
woman
C. Prescribing azithromycin for every fever of unknown origin
D. Continuing postoperative antibiotics for 7 days after a clean surgery