NUR 210 PHARMACOLOGY
EXAMS 1–4 COMPREHENSIVE REVIEW
Galen College of Nursing | 2026 Actual Exam Format
EXAM 1: FOUNDATIONS OF PHARMACOLOGY
Question 1
A patient is prescribed an oral medication for hypertension, but it is not reducing their
blood pressure. The nurse learns the patient is taking the medication with a large glass
of grapefruit juice. The nurse explains that grapefruit juice inhibits the CY P3A4 enzyme
in the liver. This will result in which of the following?
A) Decreased drug absorption, requiring a higher dose.
B) Increased metabolism of the drug, leading to subtherapeutic levels.
C) Decreased first - pass metabolism, leading to increased dru g levels and potential
toxicity.
D) Increased excretion of the drug in the urine.
Answer: C) Decreased first - pass metabolism, leading to increased drug levels and
potential toxicity.
Rationale: The CYP450 enzyme system in the liver is responsible for metabolizing many
drugs. When a medication is taken orally, it undergoes first - pass metabolism.
Inhibiting this enzyme (e.g., with grapefruit juice) means more of the active drug
survives the liver and enters the systemic circulation, increasing the risk of tox icity.
, Question 2
A nurse is administering medications to an 80 - year - old patient. Which age - related
change in pharmacokinetics should the nurse consider when evaluating the patient's
response to a water - soluble drug?
A) Increased gastric acid production increases drug absorption.
B) Decreased total body water leads to a higher concentration of water - soluble drugs.
C) Increased lean body mass traps lipid - soluble drugs.
D) Decreased renal blood flow has no effect on water - soluble drugs.
Answer: B) Decreased total bo dy water leads to a higher concentration of water -
soluble drugs.
Rationale: As patients age, their percentage of total body water decreases while body
fat increases. Water - soluble drugs (like digoxin or lithium) distribute in a smaller
volume of water, leading to higher peak serum concentrations and an increased risk of
toxicity at normal adult doses.
Question 3
A patient is experiencing a severe anaphylactic reaction to a newly administered
antibiotic. Which of the following medications should the nurse p repare to administer
immediately?
A) Acetaminophen
B) Diphenhydramine and Epinephrine
C) Ibuprofen
D) Ondansetron
Answer: B) Diphenhydramine and Epinephrine
Rationale: Epinephrine is the first - line treatment for anaphylaxis to reverse
bronchoconstriction and vasodilation. Diphenhydramine (an H1 antihistamine) is given
as a secondary agent to block further histamine release.
Question 4
EXAMS 1–4 COMPREHENSIVE REVIEW
Galen College of Nursing | 2026 Actual Exam Format
EXAM 1: FOUNDATIONS OF PHARMACOLOGY
Question 1
A patient is prescribed an oral medication for hypertension, but it is not reducing their
blood pressure. The nurse learns the patient is taking the medication with a large glass
of grapefruit juice. The nurse explains that grapefruit juice inhibits the CY P3A4 enzyme
in the liver. This will result in which of the following?
A) Decreased drug absorption, requiring a higher dose.
B) Increased metabolism of the drug, leading to subtherapeutic levels.
C) Decreased first - pass metabolism, leading to increased dru g levels and potential
toxicity.
D) Increased excretion of the drug in the urine.
Answer: C) Decreased first - pass metabolism, leading to increased drug levels and
potential toxicity.
Rationale: The CYP450 enzyme system in the liver is responsible for metabolizing many
drugs. When a medication is taken orally, it undergoes first - pass metabolism.
Inhibiting this enzyme (e.g., with grapefruit juice) means more of the active drug
survives the liver and enters the systemic circulation, increasing the risk of tox icity.
, Question 2
A nurse is administering medications to an 80 - year - old patient. Which age - related
change in pharmacokinetics should the nurse consider when evaluating the patient's
response to a water - soluble drug?
A) Increased gastric acid production increases drug absorption.
B) Decreased total body water leads to a higher concentration of water - soluble drugs.
C) Increased lean body mass traps lipid - soluble drugs.
D) Decreased renal blood flow has no effect on water - soluble drugs.
Answer: B) Decreased total bo dy water leads to a higher concentration of water -
soluble drugs.
Rationale: As patients age, their percentage of total body water decreases while body
fat increases. Water - soluble drugs (like digoxin or lithium) distribute in a smaller
volume of water, leading to higher peak serum concentrations and an increased risk of
toxicity at normal adult doses.
Question 3
A patient is experiencing a severe anaphylactic reaction to a newly administered
antibiotic. Which of the following medications should the nurse p repare to administer
immediately?
A) Acetaminophen
B) Diphenhydramine and Epinephrine
C) Ibuprofen
D) Ondansetron
Answer: B) Diphenhydramine and Epinephrine
Rationale: Epinephrine is the first - line treatment for anaphylaxis to reverse
bronchoconstriction and vasodilation. Diphenhydramine (an H1 antihistamine) is given
as a secondary agent to block further histamine release.
Question 4
