PNM 300 Final Exam Review
Seneca College - Practical Nursing Program
2026 Update
Instructions: Choose the best answer for each question. Questions are designed
to test knowledge of pharmacology principles, drug classifications, safe
administration practices, and professional responsibilities as outlined in the PNM
300 course.
Section 1: Foundational Concepts & Pharmacokinetics (Questions 1-20)
1. A nurse is explaining the term "pharmacokinetics" to a colleague. Which
statement best describes this concept?
a) How a drug exerts its effects on the body at a cellular level.
b) The process of drug movement throughout the body to achieve drug action.
c) The study of the use of drugs to diagnose, prevent, or treat diseases.
d) The genetic factors that influence an individual's response to a drug.
Rationale: Pharmacokinetics is defined as what the body does to a drug,
encompassing absorption, distribution, metabolism, and excretion (ADME).
Option B correctly describes this movement. Option A describes
pharmacodynamics, and option C describes pharmacotherapeutics .
2. A drug given by which of the following routes will be absorbed most rapidly?
a) Intravenous (IV)
b) Intramuscular (IM)
c) Subcutaneous (subcut)
d) Oral (PO)
Rationale: The intravenous route administers the drug directly into the
bloodstream, resulting in 100% bioavailability and the fastest onset of action, as it
bypasses the absorption phase entirely .
3. A patient with liver cirrhosis is prescribed a new medication. The nurse
understands that this patient is at the highest risk for altered which phase of
pharmacokinetics?
,a) Absorption
b) Distribution
c) Metabolism
d) Excretion
Rationale: The liver is the primary site of drug metabolism (biotransformation).
Liver failure, such as from cirrhosis, will impair the liver's ability to metabolize
drugs, leading to drug accumulation and potential toxicity .
4. Which route of administration allows a drug to completely bypass the first-
pass effect?
a) Oral
b) Rectal
c) Sublingual
d) Enteral
Rationale: Drugs absorbed from the GI tract (oral, rectal) travel via the portal vein
to the liver, where they are metabolized (first-pass effect). Sublingual drugs are
absorbed directly into the systemic venous circulation, bypassing the liver and this
effect .
5. The nurse is administering a loading dose of intravenous lidocaine to a
patient. What is the purpose of this initial high dose?
a) To maintain a constant therapeutic level for a prolonged period.
b) To achieve a minimum effective concentration (MEC) rapidly.
c) To test for potential allergic reactions in a controlled manner.
d) To saturate protein-binding sites so the drug can take effect.
Rationale: A loading dose is a larger initial dose designed to quickly raise the
drug's concentration in the plasma to a therapeutic level, ensuring a rapid onset
of action. This is followed by smaller maintenance doses .
6. A patient's medication has a half-life of 24 hours. Approximately how many
days will it take for the drug to reach a steady state?
a) 1-2 days
b) 4-5 days
c) 7-8 days
d) It reaches steady state immediately after the first dose.
,Rationale: Steady state is achieved when the amount of drug administered equals
the amount eliminated, typically after approximately 4-5 half-lives. For a drug
with a 24-hour half-life, this would be 4-5 days.
7. A patient with hypoalbuminemia is at increased risk for drug toxicity because:
a) The drug will be metabolized more slowly by the liver.
b) The drug's absorption from the GI tract will be accelerated.
c) More free, active drug will be available to bind to receptors.
d) The drug will be excreted more slowly by the kidneys.
Rationale: Many drugs bind to plasma proteins like albumin. Only the unbound
(free) drug is pharmacologically active. Low albumin levels (hypoalbuminemia)
mean fewer protein-binding sites, leading to a higher concentration of free drug
and an increased risk of toxicity.
8. A nurse is teaching a patient about a new prescription for an enteric-coated
tablet. Which instruction should the nurse include?
a) Crush the tablet if you have difficulty swallowing it.
b) Take the tablet with an antacid to prevent stomach upset.
c) Swallow the tablet whole without chewing or crushing.
d) Open the capsule and mix the contents with applesauce.
Rationale: Enteric-coated tablets are designed to resist disintegration in the acidic
environment of the stomach and dissolve in the alkaline environment of the small
intestine. Crushing or chewing them destroys this protective coating, leading to
premature drug breakdown, stomach irritation, or altered absorption.
9. A patient asks why their prescription medication costs less than the brand-
name version. The nurse explains that the less expensive medication is a generic
drug. For a generic drug to be approved, it must be:
a) Bioequivalent to the brand-name drug.
b) Cheaper to manufacture than the brand-name drug.
c) Identical in inactive ingredients to the brand-name drug.
d) More potent than the brand-name drug to achieve the same effect.
Rationale: Generic drugs must demonstrate bioequivalence, meaning they have
the same rate and extent of absorption as the brand-name (innovator) drug,
delivering the same amount of active ingredient to the site of action .
, 10. Which statement about adverse drug reactions is accurate?
a) All adverse effects are also allergic reactions.
b) Adverse effects are always predictable and dose-dependent.
c) An idiosyncratic reaction is an unexpected effect based on an individual's
genetic makeup.
d) Side effects are the same as toxic effects, just less severe.
Rationale: An idiosyncratic reaction is an abnormal, unexpected response to a
drug that is peculiar to an individual, often due to genetic differences in drug
metabolism . Side effects are predictable, unintended effects, while toxic effects
are the result of overdose or drug accumulation.
11. The study of what the drug does to the body, including its mechanism of
action, is known as:
a) Pharmacokinetics
b) Pharmacodynamics
c) Pharmacotherapeutics
d) Toxicology
Rationale: Pharmacodynamics is the study of the biochemical and physiological
effects of drugs on the body and their mechanisms of action .
12. A drug that acts as an agonist will produce which effect?
a) It binds to a receptor and prevents it from being activated.
b) It binds to a receptor and activates it, producing a response.
c) It alters the rate of drug metabolism in the liver.
d) It increases the excretion of another drug through the kidneys.
Rationale: An agonist binds to a receptor and mimics the body's natural chemical
messengers, activating the receptor to produce a therapeutic response. An
antagonist, in contrast, blocks the receptor.
13. The nurse knows that a drug's therapeutic index (TI) provides information
about the drug's:
a) Margin of safety.
b) Peak concentration level.
c) Duration of action.
d) Affinity for protein binding.
Seneca College - Practical Nursing Program
2026 Update
Instructions: Choose the best answer for each question. Questions are designed
to test knowledge of pharmacology principles, drug classifications, safe
administration practices, and professional responsibilities as outlined in the PNM
300 course.
Section 1: Foundational Concepts & Pharmacokinetics (Questions 1-20)
1. A nurse is explaining the term "pharmacokinetics" to a colleague. Which
statement best describes this concept?
a) How a drug exerts its effects on the body at a cellular level.
b) The process of drug movement throughout the body to achieve drug action.
c) The study of the use of drugs to diagnose, prevent, or treat diseases.
d) The genetic factors that influence an individual's response to a drug.
Rationale: Pharmacokinetics is defined as what the body does to a drug,
encompassing absorption, distribution, metabolism, and excretion (ADME).
Option B correctly describes this movement. Option A describes
pharmacodynamics, and option C describes pharmacotherapeutics .
2. A drug given by which of the following routes will be absorbed most rapidly?
a) Intravenous (IV)
b) Intramuscular (IM)
c) Subcutaneous (subcut)
d) Oral (PO)
Rationale: The intravenous route administers the drug directly into the
bloodstream, resulting in 100% bioavailability and the fastest onset of action, as it
bypasses the absorption phase entirely .
3. A patient with liver cirrhosis is prescribed a new medication. The nurse
understands that this patient is at the highest risk for altered which phase of
pharmacokinetics?
,a) Absorption
b) Distribution
c) Metabolism
d) Excretion
Rationale: The liver is the primary site of drug metabolism (biotransformation).
Liver failure, such as from cirrhosis, will impair the liver's ability to metabolize
drugs, leading to drug accumulation and potential toxicity .
4. Which route of administration allows a drug to completely bypass the first-
pass effect?
a) Oral
b) Rectal
c) Sublingual
d) Enteral
Rationale: Drugs absorbed from the GI tract (oral, rectal) travel via the portal vein
to the liver, where they are metabolized (first-pass effect). Sublingual drugs are
absorbed directly into the systemic venous circulation, bypassing the liver and this
effect .
5. The nurse is administering a loading dose of intravenous lidocaine to a
patient. What is the purpose of this initial high dose?
a) To maintain a constant therapeutic level for a prolonged period.
b) To achieve a minimum effective concentration (MEC) rapidly.
c) To test for potential allergic reactions in a controlled manner.
d) To saturate protein-binding sites so the drug can take effect.
Rationale: A loading dose is a larger initial dose designed to quickly raise the
drug's concentration in the plasma to a therapeutic level, ensuring a rapid onset
of action. This is followed by smaller maintenance doses .
6. A patient's medication has a half-life of 24 hours. Approximately how many
days will it take for the drug to reach a steady state?
a) 1-2 days
b) 4-5 days
c) 7-8 days
d) It reaches steady state immediately after the first dose.
,Rationale: Steady state is achieved when the amount of drug administered equals
the amount eliminated, typically after approximately 4-5 half-lives. For a drug
with a 24-hour half-life, this would be 4-5 days.
7. A patient with hypoalbuminemia is at increased risk for drug toxicity because:
a) The drug will be metabolized more slowly by the liver.
b) The drug's absorption from the GI tract will be accelerated.
c) More free, active drug will be available to bind to receptors.
d) The drug will be excreted more slowly by the kidneys.
Rationale: Many drugs bind to plasma proteins like albumin. Only the unbound
(free) drug is pharmacologically active. Low albumin levels (hypoalbuminemia)
mean fewer protein-binding sites, leading to a higher concentration of free drug
and an increased risk of toxicity.
8. A nurse is teaching a patient about a new prescription for an enteric-coated
tablet. Which instruction should the nurse include?
a) Crush the tablet if you have difficulty swallowing it.
b) Take the tablet with an antacid to prevent stomach upset.
c) Swallow the tablet whole without chewing or crushing.
d) Open the capsule and mix the contents with applesauce.
Rationale: Enteric-coated tablets are designed to resist disintegration in the acidic
environment of the stomach and dissolve in the alkaline environment of the small
intestine. Crushing or chewing them destroys this protective coating, leading to
premature drug breakdown, stomach irritation, or altered absorption.
9. A patient asks why their prescription medication costs less than the brand-
name version. The nurse explains that the less expensive medication is a generic
drug. For a generic drug to be approved, it must be:
a) Bioequivalent to the brand-name drug.
b) Cheaper to manufacture than the brand-name drug.
c) Identical in inactive ingredients to the brand-name drug.
d) More potent than the brand-name drug to achieve the same effect.
Rationale: Generic drugs must demonstrate bioequivalence, meaning they have
the same rate and extent of absorption as the brand-name (innovator) drug,
delivering the same amount of active ingredient to the site of action .
, 10. Which statement about adverse drug reactions is accurate?
a) All adverse effects are also allergic reactions.
b) Adverse effects are always predictable and dose-dependent.
c) An idiosyncratic reaction is an unexpected effect based on an individual's
genetic makeup.
d) Side effects are the same as toxic effects, just less severe.
Rationale: An idiosyncratic reaction is an abnormal, unexpected response to a
drug that is peculiar to an individual, often due to genetic differences in drug
metabolism . Side effects are predictable, unintended effects, while toxic effects
are the result of overdose or drug accumulation.
11. The study of what the drug does to the body, including its mechanism of
action, is known as:
a) Pharmacokinetics
b) Pharmacodynamics
c) Pharmacotherapeutics
d) Toxicology
Rationale: Pharmacodynamics is the study of the biochemical and physiological
effects of drugs on the body and their mechanisms of action .
12. A drug that acts as an agonist will produce which effect?
a) It binds to a receptor and prevents it from being activated.
b) It binds to a receptor and activates it, producing a response.
c) It alters the rate of drug metabolism in the liver.
d) It increases the excretion of another drug through the kidneys.
Rationale: An agonist binds to a receptor and mimics the body's natural chemical
messengers, activating the receptor to produce a therapeutic response. An
antagonist, in contrast, blocks the receptor.
13. The nurse knows that a drug's therapeutic index (TI) provides information
about the drug's:
a) Margin of safety.
b) Peak concentration level.
c) Duration of action.
d) Affinity for protein binding.
