NURS 5334 -advanced pharmacology-
Final Exam Blueprint EXAM ANSWERS
WITH ACTUAL QUESTIONS 100%
VERIFIED 2026
Final Exam Blueprint – NURS 5334
Topics Covered (approximate % of exam):
1. Pharmacokinetics/Pharmacodynamics – 10%
2. Autonomic Nervous System Drugs – 15%
3. CNS Drugs (antidepressants, antipsychotics, anxiolytics, anticonvulsants) –
15%
4. Cardiovascular Drugs (antihypertensives, antiarrhythmics, anticoagulants) –
20%
5. Antibiotics & Antifungals – 15%
6. Endocrine Drugs (insulin, oral hypoglycemics, thyroid) – 10%
7. Special Populations (pregnancy, pediatrics, geriatrics, renal/hepatic failure) –
10%
8. Adverse Effects, Toxicity, Interactions – 5%
Questions 1–100
,Pharmacokinetics/Pharmacodynamics (1–10)
1. A drug with a high volume of distribution (Vd) is most likely to:
A) Remain mostly in the plasma
B) Require dialysis for overdose removal
C) Accumulate in tissues
D) Have a short half-life
Correct ,,,,answer,,,: C
Rationale: High Vd indicates extensive tissue binding/uptake. Dialysis is ineffective
for such drugs.
2. Which pharmacokinetic process is primarily responsible for drug
bioavailability?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Correct ,,,,answer,,,: A
Rationale: Bioavailability = fraction of unchanged drug reaching systemic circulation
after absorption.
3. A drug with zero-order kinetics:
A) Elimination rate is constant regardless of concentration
B) Half-life remains constant
C) Doubling dose doubles elimination rate
D) Best described by first-order graph
Correct ,,,,answer,,,: A
Rationale: Example: phenytoin, alcohol. Constant amount eliminated per unit time,
not constant fraction.
,4. The half-life (t½) of a drug is 12 hours. How long to reach steady state?
A) 24 hours
B) 36 hours
C) 60 hours
D) 72 hours
Correct ,,,,answer,,,: C (approx. 60 hours – 5 half-lives)
Rationale: Steady state reached in 4–5 half-lives → 12×5=60 hours.
5. Which organ is the primary site of drug metabolism?
A) Kidney
B) Liver
C) Small intestine
D) Lungs
Correct ,,,,answer,,,: B
Rationale: Liver contains CYP450 enzymes; metabolism alters drug
activity/solubility.
6. A weak acid drug (pKa=4.4) is in the stomach (pH=1.4). It will be:
A) Mostly ionized
B) Mostly unionized
C) 50% ionized
D) Trapped in stomach
Correct ,,,,answer,,,: B
Rationale: When pH < pKa for weak acid, drug is unionized → lipid-soluble →
absorbed.
7. First-pass effect reduces bioavailability of drugs given:
A) Intravenously
B) Sublingually
, C) Orally
D) Topically
Correct ,,,,answer,,,: C
Rationale: Oral drugs absorbed from GI tract pass through liver via portal vein before
systemic circulation.
8. Which CYP450 enzyme is most commonly involved in drug interactions?
A) CYP2D6
B) CYP3A4
C) CYP1A2
D) CYP2C9
Correct ,,,,answer,,,: B
Rationale: CYP3A4 metabolizes ~50% of all drugs (statins, CCBs, benzodiazepines,
etc.).
9. Grapefruit juice inhibits CYP3A4. What effect on felodipine (CCB)?
A) Decreased effect
B) Increased toxicity
C) No change
D) Faster elimination
Correct ,,,,answer,,,: B
Rationale: Inhibition → decreased metabolism → increased drug levels → toxicity
(hypotension, bradycardia).
10. Loading dose primarily depends on:
A) Clearance
B) Half-life
C) Volume of distribution
D) Bioavailability
Final Exam Blueprint EXAM ANSWERS
WITH ACTUAL QUESTIONS 100%
VERIFIED 2026
Final Exam Blueprint – NURS 5334
Topics Covered (approximate % of exam):
1. Pharmacokinetics/Pharmacodynamics – 10%
2. Autonomic Nervous System Drugs – 15%
3. CNS Drugs (antidepressants, antipsychotics, anxiolytics, anticonvulsants) –
15%
4. Cardiovascular Drugs (antihypertensives, antiarrhythmics, anticoagulants) –
20%
5. Antibiotics & Antifungals – 15%
6. Endocrine Drugs (insulin, oral hypoglycemics, thyroid) – 10%
7. Special Populations (pregnancy, pediatrics, geriatrics, renal/hepatic failure) –
10%
8. Adverse Effects, Toxicity, Interactions – 5%
Questions 1–100
,Pharmacokinetics/Pharmacodynamics (1–10)
1. A drug with a high volume of distribution (Vd) is most likely to:
A) Remain mostly in the plasma
B) Require dialysis for overdose removal
C) Accumulate in tissues
D) Have a short half-life
Correct ,,,,answer,,,: C
Rationale: High Vd indicates extensive tissue binding/uptake. Dialysis is ineffective
for such drugs.
2. Which pharmacokinetic process is primarily responsible for drug
bioavailability?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Correct ,,,,answer,,,: A
Rationale: Bioavailability = fraction of unchanged drug reaching systemic circulation
after absorption.
3. A drug with zero-order kinetics:
A) Elimination rate is constant regardless of concentration
B) Half-life remains constant
C) Doubling dose doubles elimination rate
D) Best described by first-order graph
Correct ,,,,answer,,,: A
Rationale: Example: phenytoin, alcohol. Constant amount eliminated per unit time,
not constant fraction.
,4. The half-life (t½) of a drug is 12 hours. How long to reach steady state?
A) 24 hours
B) 36 hours
C) 60 hours
D) 72 hours
Correct ,,,,answer,,,: C (approx. 60 hours – 5 half-lives)
Rationale: Steady state reached in 4–5 half-lives → 12×5=60 hours.
5. Which organ is the primary site of drug metabolism?
A) Kidney
B) Liver
C) Small intestine
D) Lungs
Correct ,,,,answer,,,: B
Rationale: Liver contains CYP450 enzymes; metabolism alters drug
activity/solubility.
6. A weak acid drug (pKa=4.4) is in the stomach (pH=1.4). It will be:
A) Mostly ionized
B) Mostly unionized
C) 50% ionized
D) Trapped in stomach
Correct ,,,,answer,,,: B
Rationale: When pH < pKa for weak acid, drug is unionized → lipid-soluble →
absorbed.
7. First-pass effect reduces bioavailability of drugs given:
A) Intravenously
B) Sublingually
, C) Orally
D) Topically
Correct ,,,,answer,,,: C
Rationale: Oral drugs absorbed from GI tract pass through liver via portal vein before
systemic circulation.
8. Which CYP450 enzyme is most commonly involved in drug interactions?
A) CYP2D6
B) CYP3A4
C) CYP1A2
D) CYP2C9
Correct ,,,,answer,,,: B
Rationale: CYP3A4 metabolizes ~50% of all drugs (statins, CCBs, benzodiazepines,
etc.).
9. Grapefruit juice inhibits CYP3A4. What effect on felodipine (CCB)?
A) Decreased effect
B) Increased toxicity
C) No change
D) Faster elimination
Correct ,,,,answer,,,: B
Rationale: Inhibition → decreased metabolism → increased drug levels → toxicity
(hypotension, bradycardia).
10. Loading dose primarily depends on:
A) Clearance
B) Half-life
C) Volume of distribution
D) Bioavailability
