NR566 Final Exam Reviewer
Latest Questions and Correct Answers
Academic Cycle
Chamberlain University
Advanced Pharmacology – AGPCNP
100 Questions | A+ Grade
100% Correct Answers
, Table of Contents
Section 1: PK/PD Principles & Geriatric Pharmacology (Q1–Q15)
Section 2: Cardiovascular Pharmacology (Q16–Q35)
Section 3: Endocrine Pharmacology (Q36–Q52)
Section 4: Respiratory Pharmacology (Q53–Q62)
Section 5: Neurological & Psychiatric Pharmacology (Q63–Q80)
Section 6: Infectious Disease Pharmacology (Q81–Q90)
Section 7: Pain & GI/Renal Pharmacology (Q91–Q95)
Section 8: Controlled Substances, Patient Education & Evidence-Based Prescribing (Q96–Q100)
, Section 1: PK/PD Principles & Geriatric Pharmacology (Q1–Q15)
1. A 75-year-old patient takes a highly protein-bound drug. Age-related hypoalbuminemia
increases the risk of which of the following?
A) Decreased volume of distribution
B) Increased free drug concentration and toxicity
C) Reduced hepatic first-pass metabolism
D) Enhanced renal tubular reabsorption
Rationale: Aging is associated with decreased albumin production, which reduces protein-binding
capacity for highly bound drugs (e.g., warfarin, phenytoin). The unbound (free) fraction increases,
raising the risk of drug toxicity even at standard doses (Katzung & Trevor, 2022).
2. Which cytochrome P450 enzyme is responsible for metabolizing the largest proportion
of commonly prescribed medications?
A) CYP2D6
B) CYP2C9
C) CYP3A4
D) CYP1A2
Rationale: CYP3A4 metabolizes approximately 50% of all drugs, including statins, calcium channel
blockers, and many benzodiazepines. It is highly susceptible to drug-drug interactions through
induction (e.g., rifampin) or inhibition (e.g., grapefruit juice, azole antifungals) (Flockhart, 2022).
3. A patient is started on a new medication with a half-life of 12 hours. Approximately how
long will it take to reach steady-state concentration?
A) 12 hours
B) 24 hours
C) 48–60 hours
D) 72–96 hours
Rationale: Steady state is reached after approximately 4–5 half-lives. For a drug with a 12-hour
half-life, steady state occurs in about 48–60 hours (2–2.5 days). This principle guides dose-
adjustment timing and therapeutic drug monitoring (DiPiro et al., 2022).
4. Which medication is identified on the Beers Criteria as potentially inappropriate in
older adults due to an increased risk of falls?
A) Metformin
B) Lisinopril
C) Lorazepam
D) Amlodipine
Rationale: The AGS Beers Criteria recommends avoiding benzodiazepines such as lorazepam in
older adults because they cause sedation, cognitive impairment, and are strongly associated with
falls and hip fractures. Non-pharmacologic approaches or safer alternatives like low-dose
trazodone should be considered (AGS, 2023).
5. A patient with chronic kidney disease has a GFR of 25 mL/min. Which equation is most
appropriate for calculating renal drug dosing?
A) Child-Pugh score
B) Cockcroft-Gault equation
C) MELD score
D) APACHE II score
Rationale: The Cockcroft-Gault equation estimates creatinine clearance using age, weight, and
serum creatinine and remains the most widely used method for renal drug dosing adjustments. It is
preferred by the FDA and most drug manufacturers over eGFR equations for dosing decisions
(KDIGO, 2023).
6. Which of the following describes the first-pass effect?
Latest Questions and Correct Answers
Academic Cycle
Chamberlain University
Advanced Pharmacology – AGPCNP
100 Questions | A+ Grade
100% Correct Answers
, Table of Contents
Section 1: PK/PD Principles & Geriatric Pharmacology (Q1–Q15)
Section 2: Cardiovascular Pharmacology (Q16–Q35)
Section 3: Endocrine Pharmacology (Q36–Q52)
Section 4: Respiratory Pharmacology (Q53–Q62)
Section 5: Neurological & Psychiatric Pharmacology (Q63–Q80)
Section 6: Infectious Disease Pharmacology (Q81–Q90)
Section 7: Pain & GI/Renal Pharmacology (Q91–Q95)
Section 8: Controlled Substances, Patient Education & Evidence-Based Prescribing (Q96–Q100)
, Section 1: PK/PD Principles & Geriatric Pharmacology (Q1–Q15)
1. A 75-year-old patient takes a highly protein-bound drug. Age-related hypoalbuminemia
increases the risk of which of the following?
A) Decreased volume of distribution
B) Increased free drug concentration and toxicity
C) Reduced hepatic first-pass metabolism
D) Enhanced renal tubular reabsorption
Rationale: Aging is associated with decreased albumin production, which reduces protein-binding
capacity for highly bound drugs (e.g., warfarin, phenytoin). The unbound (free) fraction increases,
raising the risk of drug toxicity even at standard doses (Katzung & Trevor, 2022).
2. Which cytochrome P450 enzyme is responsible for metabolizing the largest proportion
of commonly prescribed medications?
A) CYP2D6
B) CYP2C9
C) CYP3A4
D) CYP1A2
Rationale: CYP3A4 metabolizes approximately 50% of all drugs, including statins, calcium channel
blockers, and many benzodiazepines. It is highly susceptible to drug-drug interactions through
induction (e.g., rifampin) or inhibition (e.g., grapefruit juice, azole antifungals) (Flockhart, 2022).
3. A patient is started on a new medication with a half-life of 12 hours. Approximately how
long will it take to reach steady-state concentration?
A) 12 hours
B) 24 hours
C) 48–60 hours
D) 72–96 hours
Rationale: Steady state is reached after approximately 4–5 half-lives. For a drug with a 12-hour
half-life, steady state occurs in about 48–60 hours (2–2.5 days). This principle guides dose-
adjustment timing and therapeutic drug monitoring (DiPiro et al., 2022).
4. Which medication is identified on the Beers Criteria as potentially inappropriate in
older adults due to an increased risk of falls?
A) Metformin
B) Lisinopril
C) Lorazepam
D) Amlodipine
Rationale: The AGS Beers Criteria recommends avoiding benzodiazepines such as lorazepam in
older adults because they cause sedation, cognitive impairment, and are strongly associated with
falls and hip fractures. Non-pharmacologic approaches or safer alternatives like low-dose
trazodone should be considered (AGS, 2023).
5. A patient with chronic kidney disease has a GFR of 25 mL/min. Which equation is most
appropriate for calculating renal drug dosing?
A) Child-Pugh score
B) Cockcroft-Gault equation
C) MELD score
D) APACHE II score
Rationale: The Cockcroft-Gault equation estimates creatinine clearance using age, weight, and
serum creatinine and remains the most widely used method for renal drug dosing adjustments. It is
preferred by the FDA and most drug manufacturers over eGFR equations for dosing decisions
(KDIGO, 2023).
6. Which of the following describes the first-pass effect?
