NURS5334 Advanced Pharmacology Final Exam | 2025/2026 Q&A Guide | Verified Questions and Correct Answers

NURS5334 Advanced Pharm Final –
2025/2026 Q&A Guide
Section 1: Introduction
This document includes a verified set of final exam questions and answers for NURS5334
Advanced Pharmacology, tailored for 2025/2026. Covers advanced pharmacokinetics,
prescribing guidelines, drug interactions, and safe administration.

Section 2: Exam Questions and Answers
Advanced Pharmacokinetics (15 Questions)

Question 1: What determines an anesthetic’s ability to penetrate the axon membrane?
A) Water solubility, protein binding, pH
B) Molecular size, lipid solubility, ionization at tissue pH
C) Blood flow, polarity, enzyme activity
D) Half-life, volume of distribution, clearance
Correct Answer: B) Molecular size, lipid solubility, ionization at tissue pH
Rationale: These properties govern the anesthetic’s ability to cross lipid-rich axonal
membranes, affecting onset and potency.

Question 2: A drug has a high hepatic extraction ratio. What does this imply?
A) Minimal first-pass metabolism
B) Extensive liver metabolism
C) Rapid renal clearance
D) High bioavailability
Correct Answer: B) Extensive liver metabolism
Rationale: High hepatic extraction means the liver metabolizes a significant portion of the
drug before systemic circulation, reducing bioavailability.

Question 3 (NGN SATA): Which factors influence a drug’s volume of distribution? Select
all that apply:
A) Tissue binding
B) Plasma protein binding
C) Lipid solubility
D) Renal clearance
Correct Answer: A) Tissue binding, B) Plasma protein binding, C) Lipid solubility
Rationale: Volume of distribution is affected by binding to tissues or plasma proteins and the
drug’s ability to dissolve in lipids, not renal clearance.

Question 4: A drug’s half-life is 8 hours. How long until 87.5% of the drug is eliminated?
A) 16 hours
B) 24 hours
C) 32 hours
D) 40 hours

, Correct Answer: B) 24 hours
Rationale: 87.5% elimination occurs after 3 half-lives (50% at 8 hours, 75% at 16 hours,
87.5% at 24 hours).

Question 5 (NGN Case Study): A client receives a drug with zero-order kinetics. What is
expected?
Case: Client is prescribed phenytoin for seizures.
A) Constant rate of elimination regardless of concentration
B) Elimination proportional to drug concentration
C) Increased clearance with higher doses
D) No metabolism by the liver
Correct Answer: A) Constant rate of elimination regardless of concentration
Rationale: Zero-order kinetics (e.g., phenytoin) means elimination occurs at a fixed rate,
risking toxicity at high doses.

Question 6: Which factor most affects a drug’s bioavailability?
A) Route of administration
B) Plasma protein binding
C) Renal excretion rate
D) Drug half-life
Correct Answer: A) Route of administration
Rationale: Oral drugs undergo first-pass metabolism, reducing bioavailability compared to
IV administration.

Question 7: A drug is highly ionized at physiological pH. What is the impact on absorption?
A) Enhanced absorption in the stomach
B) Reduced absorption in the intestines
C) Increased renal clearance
D) No effect on absorption
Correct Answer: B) Reduced absorption in the intestines
Rationale: Ionized drugs are less lipid-soluble, impairing absorption across intestinal
membranes.

Question 8: What is the primary route of elimination for most drugs?
A) Biliary excretion
B) Renal excretion
C) Pulmonary exhalation
D) Sweat secretion
Correct Answer: B) Renal excretion
Rationale: The kidneys excrete most drugs or their metabolites, either via filtration or tubular
secretion.

Question 9: A client has reduced CYP450 enzyme activity. What is the expected effect?
A) Decreased drug metabolism
B) Increased drug clearance
C) Reduced drug half-life
D) Enhanced bioavailability
Correct Answer: A) Decreased drug metabolism
Rationale: CYP450 enzymes metabolize drugs; reduced activity prolongs drug action and
increases risk of toxicity.