Page 1 of 126
2026/27 NURS 676, ADVANCED
PHARMACOLOGY FINAL EXAM (SPRING
QTR) WITH 100% CORRECT ANSWERS WITH
RATIONALE AND GRADED A+ (SUCCESS
GUARANTEED):WEST COAST UNIVERSITY
1. A patient with liver cirrhosis is prescribed a drug with
high first-pass metabolism. What change is most
appropriate?
A. Increase the dose
B. Decrease the dose
,Page 2 of 126
C. Administer intravenously
D. No change needed
Correct Answer: B – Liver disease reduces first-pass
metabolism, leading to higher bioavailability; dose reduction
prevents toxicity.
2. Which statement best describes the blood-brain barrier
(BBB) effect on drug distribution?
A. Lipophilic drugs cross easily
B. Hydrophilic drugs cross easily
C. All drugs cross freely
D. Only ionized drugs cross
Correct Answer: A – The BBB is lipid-based; lipophilic drugs
passively diffuse through.
3. A patient takes a drug with a half-life of 12 hours. How
long to reach steady state?
A. 24 hours
B. 48 hours
,Page 3 of 126
C. 60 hours
D. 72 hours
Correct Answer: C – Steady state = 4–5 half-lives → 48–60
hours; closest is 60 hours.
4. Which cytochrome P450 enzyme is most commonly
involved in drug-drug interactions?
A. CYP1A2
B. CYP2D6
C. CYP3A4
D. CYP2E1
Correct Answer: C – CYP3A4 metabolizes >50% of all drugs.
5. A drug with zero-order kinetics:
A. Eliminates constant amount per time
B. Eliminates constant fraction per time
C. Has a constant half-life
D. Is always renally cleared
, Page 4 of 126
Correct Answer: A – Example: phenytoin; saturation of
metabolic pathways.
6. Which factor increases volume of distribution (Vd)?
A. High protein binding
B. Low lipophilicity
C. High tissue binding
D. Large molecular weight
Correct Answer: C – High tissue binding pulls drug out of
plasma.
7. A patient has a glomerular filtration rate (GFR) of 25
mL/min. Which antibiotic requires no dose adjustment?
A. Gentamicin
B. Amoxicillin
C. Ceftriaxone
D. Vancomycin
Correct Answer: C – Ceftriaxone is hepatically excreted.
2026/27 NURS 676, ADVANCED
PHARMACOLOGY FINAL EXAM (SPRING
QTR) WITH 100% CORRECT ANSWERS WITH
RATIONALE AND GRADED A+ (SUCCESS
GUARANTEED):WEST COAST UNIVERSITY
1. A patient with liver cirrhosis is prescribed a drug with
high first-pass metabolism. What change is most
appropriate?
A. Increase the dose
B. Decrease the dose
,Page 2 of 126
C. Administer intravenously
D. No change needed
Correct Answer: B – Liver disease reduces first-pass
metabolism, leading to higher bioavailability; dose reduction
prevents toxicity.
2. Which statement best describes the blood-brain barrier
(BBB) effect on drug distribution?
A. Lipophilic drugs cross easily
B. Hydrophilic drugs cross easily
C. All drugs cross freely
D. Only ionized drugs cross
Correct Answer: A – The BBB is lipid-based; lipophilic drugs
passively diffuse through.
3. A patient takes a drug with a half-life of 12 hours. How
long to reach steady state?
A. 24 hours
B. 48 hours
,Page 3 of 126
C. 60 hours
D. 72 hours
Correct Answer: C – Steady state = 4–5 half-lives → 48–60
hours; closest is 60 hours.
4. Which cytochrome P450 enzyme is most commonly
involved in drug-drug interactions?
A. CYP1A2
B. CYP2D6
C. CYP3A4
D. CYP2E1
Correct Answer: C – CYP3A4 metabolizes >50% of all drugs.
5. A drug with zero-order kinetics:
A. Eliminates constant amount per time
B. Eliminates constant fraction per time
C. Has a constant half-life
D. Is always renally cleared
, Page 4 of 126
Correct Answer: A – Example: phenytoin; saturation of
metabolic pathways.
6. Which factor increases volume of distribution (Vd)?
A. High protein binding
B. Low lipophilicity
C. High tissue binding
D. Large molecular weight
Correct Answer: C – High tissue binding pulls drug out of
plasma.
7. A patient has a glomerular filtration rate (GFR) of 25
mL/min. Which antibiotic requires no dose adjustment?
A. Gentamicin
B. Amoxicillin
C. Ceftriaxone
D. Vancomycin
Correct Answer: C – Ceftriaxone is hepatically excreted.
