NUR 600 Advanced Clinical Pharmacology, Core Pharmacological Principles Exam with Questions and Answers

It covers key domains which include; Pharmacokinetics, Pharmacodynamics and Pharmacogenomics. A patient with hepatic cirrhosis is prescribed a drug with a high first-pass metabolism. Which pharmacokinetic change is most likely to occur? a. Decreased oral bioavailability b. Increased oral bioavailability c. Decreased volume of distribution d. Increased renal clearance Correct Answer b. Increased oral bioavailability Rationale In hepatic cirrhosis, liver function is impaired, reducing first-pass metabolism. Drugs that normally undergo extensive hepatic metabolism will have less degradation during their first pass through the liver, resulting in increased systemic availability when taken orally. A drug that is highly protein-bound is administered to a patient with severe hypoalbuminemia. What is the most likely pharmacokinetic consequence? a. Decreased free drug concentration b. Increased free drug concentration c. Decreased elimination half-life d. Reduced drug efficacy Correct Answer b. Increased free drug concentration Rationale Low albumin levels reduce available binding sites for drugs. This increases the fraction of unbound (active) drug in plasma, which can enhance pharmacologic effects and increase risk of toxicity. A medication follows zero-order kinetics. Which statement best describes its elimination? a. A constant percentage of the drug is eliminated per unit time b. Elimination depends on renal perfusion c. A constant amount of the drug is eliminated per unit time d. Elimination rate decreases as concentration increases Correct Answer c. A constant amount of the drug is eliminated per unit time Rationale Zero-order kinetics occurs when elimination pathways are saturated. As a result, a fixed amount of drug is metabolized per unit time regardless of plasma concentration, increasing risk of accumulation.