1
PHARMACOLOGY NURS 251 FINAL EXAM 2026/2027 |
Portage Learning / ABCNursing / Geneva College | Verified
Answers | Complete Q&A | 100% Pass Guarantee - A+ Graded
Section 1: Pharmacokinetics & Pharmacodynamics (Q1-15)
Q1. A nurse is reviewing pharmacokinetics. Which process describes the
movement of a drug from the site of administration into the bloodstream?
A. Distribution B. Metabolism C. Absorption [CORRECT] D. Excretion
Rationale: Absorption is the process by which a drug moves from its site of
administration into the bloodstream; distribution refers to movement throughout
body tissues, metabolism to chemical transformation, and excretion to elimination.
Correct Answer: C
Q2. A patient with severe liver cirrhosis is prescribed a medication that
undergoes extensive first-pass metabolism. What is the nurse's primary concern?
A. The drug will be excreted too rapidly B. The drug's bioavailability will be increased,
risking toxicity [CORRECT] C. The drug will have no therapeutic effect D. The patient
will develop an allergic reaction
Rationale: First-pass metabolism occurs in the liver; in severe cirrhosis, reduced
hepatic metabolism increases bioavailability, potentially causing drug toxicity.
Correct Answer: B
Q3. [Portage Learning Virtual Patient] A 68-year-old virtual patient with alcoholic
liver disease is prescribed diazepam. The nurse recognizes that the drug's half-
life will be significantly prolonged due to decreased:
,2
A. Renal excretion B. Hepatic metabolism [CORRECT] C. GI absorption D. Plasma
protein binding
Rationale: Diazepam undergoes extensive hepatic metabolism; liver disease impairs
this process, prolonging half-life and increasing sedation risk.
Correct Answer: B
Q4. The therapeutic index of a drug is calculated as:
A. ED50 divided by LD50 B. LD50 divided by ED50 [CORRECT] C. ED50 plus LD50 D.
LD50 minus ED50
Rationale: Therapeutic index = LD50/ED50; a higher index indicates a wider margin of
safety between the effective dose and lethal dose.
Correct Answer: B
Q5. A drug that binds to a receptor and produces a maximal response is best
described as a:
A. Antagonist B. Partial agonist C. Full agonist [CORRECT] D. Inverse agonist
Rationale: A full agonist has both high affinity for the receptor and high intrinsic
activity, producing a maximal biologic response.
Correct Answer: C
Q6. A patient taking propranolol experiences reduced heart rate and blood
pressure. Propranolol is best classified as a:
A. Agonist B. Antagonist [CORRECT] C. Partial agonist D. Physiologic antagonist
Rationale: Propranolol is a non-selective beta-adrenergic antagonist (beta-blocker)
that blocks receptor sites without activating them, preventing catecholamine action.
,3
Correct Answer: B
Q7. Which factor would most likely increase the absorption of an orally
administered drug?
A. Increased GI motility B. Administration with food that binds the drug C. Presence
of an acidic environment for an acidic drug [CORRECT] D. Concurrent administration
of activated charcoal
Rationale: Acidic drugs are more lipid-soluble in acidic environments (ionization
principle), enhancing absorption; basic drugs absorb better in alkaline environments.
Correct Answer: C
Q8. A drug with a half-life of 6 hours is administered repeatedly. Approximately
how long will it take to reach steady-state concentration?
A. 6 hours B. 12 hours C. 24 hours D. 30 hours [CORRECT]
Rationale: Steady state is typically reached after 4-5 half-lives; 5 × 6 hours = 30
hours.
Correct Answer: D
Q9. The nurse understands that a drug highly bound to plasma proteins
(albumin):
A. Is more readily filtered by the kidneys B. Has increased free drug available if
another highly protein-bound drug is added [CORRECT] C. Is less likely to cause
drug interactions D. Is rapidly metabolized by the liver
Rationale: Highly protein-bound drugs compete for binding sites; adding another
protein-bound drug displaces the first, increasing free (active) drug concentration
and risk of toxicity.
, 4
Correct Answer: B
Q10. [Food-Drug Interaction] A patient taking atorvastatin asks if they can drink
grapefruit juice daily. The nurse's best response is:
A. Grapefruit juice increases the metabolism of statins B. Grapefruit juice inhibits
CYP3A4, increasing statin levels and risk of rhabdomyolysis [CORRECT] C. Grapefruit
juice has no effect on statin metabolism D. Grapefruit juice decreases statin
absorption
Rationale: Grapefruit juice inhibits intestinal CYP3A4, increasing statin bioavailability
and the risk of adverse effects including myopathy and rhabdomyolysis.
Correct Answer: B
Q11. A patient with renal failure is prescribed a drug primarily excreted
unchanged by the kidneys. The nurse should anticipate:
A. A decreased loading dose B. A decreased maintenance dose [CORRECT] C. An
increased maintenance dose D. No change in dosing
Rationale: Renal impairment reduces drug elimination, causing accumulation; the
maintenance dose should be reduced to prevent toxicity while the loading dose may
remain unchanged.
Correct Answer: B
Q12. The cytochrome P450 enzyme system is primarily responsible for:
A. Drug absorption in the stomach B. Phase I metabolic reactions (oxidation,
reduction, hydrolysis) [CORRECT] C. Drug excretion via bile D. Drug distribution
across the blood-brain barrier
PHARMACOLOGY NURS 251 FINAL EXAM 2026/2027 |
Portage Learning / ABCNursing / Geneva College | Verified
Answers | Complete Q&A | 100% Pass Guarantee - A+ Graded
Section 1: Pharmacokinetics & Pharmacodynamics (Q1-15)
Q1. A nurse is reviewing pharmacokinetics. Which process describes the
movement of a drug from the site of administration into the bloodstream?
A. Distribution B. Metabolism C. Absorption [CORRECT] D. Excretion
Rationale: Absorption is the process by which a drug moves from its site of
administration into the bloodstream; distribution refers to movement throughout
body tissues, metabolism to chemical transformation, and excretion to elimination.
Correct Answer: C
Q2. A patient with severe liver cirrhosis is prescribed a medication that
undergoes extensive first-pass metabolism. What is the nurse's primary concern?
A. The drug will be excreted too rapidly B. The drug's bioavailability will be increased,
risking toxicity [CORRECT] C. The drug will have no therapeutic effect D. The patient
will develop an allergic reaction
Rationale: First-pass metabolism occurs in the liver; in severe cirrhosis, reduced
hepatic metabolism increases bioavailability, potentially causing drug toxicity.
Correct Answer: B
Q3. [Portage Learning Virtual Patient] A 68-year-old virtual patient with alcoholic
liver disease is prescribed diazepam. The nurse recognizes that the drug's half-
life will be significantly prolonged due to decreased:
,2
A. Renal excretion B. Hepatic metabolism [CORRECT] C. GI absorption D. Plasma
protein binding
Rationale: Diazepam undergoes extensive hepatic metabolism; liver disease impairs
this process, prolonging half-life and increasing sedation risk.
Correct Answer: B
Q4. The therapeutic index of a drug is calculated as:
A. ED50 divided by LD50 B. LD50 divided by ED50 [CORRECT] C. ED50 plus LD50 D.
LD50 minus ED50
Rationale: Therapeutic index = LD50/ED50; a higher index indicates a wider margin of
safety between the effective dose and lethal dose.
Correct Answer: B
Q5. A drug that binds to a receptor and produces a maximal response is best
described as a:
A. Antagonist B. Partial agonist C. Full agonist [CORRECT] D. Inverse agonist
Rationale: A full agonist has both high affinity for the receptor and high intrinsic
activity, producing a maximal biologic response.
Correct Answer: C
Q6. A patient taking propranolol experiences reduced heart rate and blood
pressure. Propranolol is best classified as a:
A. Agonist B. Antagonist [CORRECT] C. Partial agonist D. Physiologic antagonist
Rationale: Propranolol is a non-selective beta-adrenergic antagonist (beta-blocker)
that blocks receptor sites without activating them, preventing catecholamine action.
,3
Correct Answer: B
Q7. Which factor would most likely increase the absorption of an orally
administered drug?
A. Increased GI motility B. Administration with food that binds the drug C. Presence
of an acidic environment for an acidic drug [CORRECT] D. Concurrent administration
of activated charcoal
Rationale: Acidic drugs are more lipid-soluble in acidic environments (ionization
principle), enhancing absorption; basic drugs absorb better in alkaline environments.
Correct Answer: C
Q8. A drug with a half-life of 6 hours is administered repeatedly. Approximately
how long will it take to reach steady-state concentration?
A. 6 hours B. 12 hours C. 24 hours D. 30 hours [CORRECT]
Rationale: Steady state is typically reached after 4-5 half-lives; 5 × 6 hours = 30
hours.
Correct Answer: D
Q9. The nurse understands that a drug highly bound to plasma proteins
(albumin):
A. Is more readily filtered by the kidneys B. Has increased free drug available if
another highly protein-bound drug is added [CORRECT] C. Is less likely to cause
drug interactions D. Is rapidly metabolized by the liver
Rationale: Highly protein-bound drugs compete for binding sites; adding another
protein-bound drug displaces the first, increasing free (active) drug concentration
and risk of toxicity.
, 4
Correct Answer: B
Q10. [Food-Drug Interaction] A patient taking atorvastatin asks if they can drink
grapefruit juice daily. The nurse's best response is:
A. Grapefruit juice increases the metabolism of statins B. Grapefruit juice inhibits
CYP3A4, increasing statin levels and risk of rhabdomyolysis [CORRECT] C. Grapefruit
juice has no effect on statin metabolism D. Grapefruit juice decreases statin
absorption
Rationale: Grapefruit juice inhibits intestinal CYP3A4, increasing statin bioavailability
and the risk of adverse effects including myopathy and rhabdomyolysis.
Correct Answer: B
Q11. A patient with renal failure is prescribed a drug primarily excreted
unchanged by the kidneys. The nurse should anticipate:
A. A decreased loading dose B. A decreased maintenance dose [CORRECT] C. An
increased maintenance dose D. No change in dosing
Rationale: Renal impairment reduces drug elimination, causing accumulation; the
maintenance dose should be reduced to prevent toxicity while the loading dose may
remain unchanged.
Correct Answer: B
Q12. The cytochrome P450 enzyme system is primarily responsible for:
A. Drug absorption in the stomach B. Phase I metabolic reactions (oxidation,
reduction, hydrolysis) [CORRECT] C. Drug excretion via bile D. Drug distribution
across the blood-brain barrier
