NRG 200 Pharmacology for Human Caring Nursing – Final Exam
Actual Exam 2026/2027: Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
TABLE OF CONTENTS
Section 1 | Pharmacology Fundamentals & Drug Safety | Q1 – Q10
Section 2 | Anti-Infective & Immunologic Agents | Q11 – Q20
Section 3 | Cardiovascular, Renal & Hematologic Agents | Q21 – Q30
Section 4 | Central Nervous System & Psychopharmacology | Q31 – Q40
Section 5 | Endocrine, GI & Special Populations | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: PHARMACOLOGY FUNDAMENTALS & DRUG SAFETY Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 72-year-old patient with renal impairment is prescribed a medication that is primarily
renally excreted. The nurse notes the patient's creatinine clearance is 28 mL/min. Which
principle should guide the nurse's assessment of drug safety?
A. The drug dose should be reduced or the dosing interval extended to prevent
accumulation and toxicity. ✓ CORRECT
B. The drug should be administered via the intramuscular route to bypass renal
elimination.
C. The nurse should increase the dose to compensate for decreased renal perfusion.
D. The medication should be given with a diuretic to enhance renal clearance.
Correct Answer: A
,Rationale: Renally excreted drugs accumulate in impaired kidney function, so dose
reduction or interval extension is necessary to prevent toxicity. Intramuscular
administration does not bypass renal elimination because the drug still enters systemic
circulation. Nurses should always verify creatinine clearance before administering
renally cleared drugs.
Question 2 of 50
A 45-year-old patient is receiving a new medication that is highly protein-bound. The
nurse notes the patient's albumin level is 2.1 g/dL. Which concern is most valid
regarding drug distribution?
A. The drug will have a decreased volume of distribution and lower tissue levels.
B. More free drug will be available, increasing the risk of pharmacologic effects and
toxicity. ✓ CORRECT
C. The drug will be metabolized more rapidly by the liver due to protein deficiency.
D. Protein-bound drugs are unaffected by low albumin because they bind to globulins
instead.
Correct Answer: B
Rationale: Hypoalbuminemia reduces available protein binding sites, leaving more free
active drug available and increasing the risk of adverse effects and toxicity. Volume of
distribution typically increases rather than decreases with low albumin, and liver
metabolism is not directly accelerated by protein deficiency.
Question 3 of 50
A nurse is preparing to administer digoxin to a 68-year-old patient. Before giving the
dose, the nurse checks the apical pulse and finds it to be 52 beats per minute. Which
action is most appropriate?
A. Administer the dose as ordered because bradycardia is an expected effect of digoxin.
B. Give half the prescribed dose and reassess the pulse in one hour.
, C. Hold the dose and notify the prescriber because a pulse below 60 is a
contraindication. ✓ CORRECT
D. Administer the dose with atropine to prevent further slowing of the heart rate.
Correct Answer: C
Rationale: Digoxin can cause bradycardia and heart block, and a pulse below 60 is a
standard parameter for holding the dose and contacting the prescriber. Administering
the dose could worsen bradycardia or precipitate complete heart block. Nurses should
always assess apical pulse before giving cardiac glycosides.
Question 4 of 50
A 38-year-old patient asks why the nurse is checking their identification band before
administering a medication. Which response best reflects the Joint Commission's
National Patient Safety Goals?
A. The identification band confirms the patient's insurance coverage for the medication.
B. Checking the band is required only for high-alert medications like insulin and heparin.
C. The band verifies the patient's room assignment to prevent medication errors.
D. Two patient identifiers are used to ensure the right patient receives the right
medication. ✓ CORRECT
Correct Answer: D
Rationale: The Joint Commission requires two patient identifiers, typically name and
birth date or medical record number, to prevent wrong-patient medication errors.
Insurance verification and room assignment are not the purposes of patient
identification checks, and this applies to all medications rather than only high-alert
drugs.
Question 5 of 50
A 55-year-old patient is prescribed a medication with a narrow therapeutic index. The
nurse knows that which nursing action is most critical for this type of drug?
Actual Exam 2026/2027: Complete Exam-Style Questions with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
TABLE OF CONTENTS
Section 1 | Pharmacology Fundamentals & Drug Safety | Q1 – Q10
Section 2 | Anti-Infective & Immunologic Agents | Q11 – Q20
Section 3 | Cardiovascular, Renal & Hematologic Agents | Q21 – Q30
Section 4 | Central Nervous System & Psychopharmacology | Q31 – Q40
Section 5 | Endocrine, GI & Special Populations | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: PHARMACOLOGY FUNDAMENTALS & DRUG SAFETY Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 72-year-old patient with renal impairment is prescribed a medication that is primarily
renally excreted. The nurse notes the patient's creatinine clearance is 28 mL/min. Which
principle should guide the nurse's assessment of drug safety?
A. The drug dose should be reduced or the dosing interval extended to prevent
accumulation and toxicity. ✓ CORRECT
B. The drug should be administered via the intramuscular route to bypass renal
elimination.
C. The nurse should increase the dose to compensate for decreased renal perfusion.
D. The medication should be given with a diuretic to enhance renal clearance.
Correct Answer: A
,Rationale: Renally excreted drugs accumulate in impaired kidney function, so dose
reduction or interval extension is necessary to prevent toxicity. Intramuscular
administration does not bypass renal elimination because the drug still enters systemic
circulation. Nurses should always verify creatinine clearance before administering
renally cleared drugs.
Question 2 of 50
A 45-year-old patient is receiving a new medication that is highly protein-bound. The
nurse notes the patient's albumin level is 2.1 g/dL. Which concern is most valid
regarding drug distribution?
A. The drug will have a decreased volume of distribution and lower tissue levels.
B. More free drug will be available, increasing the risk of pharmacologic effects and
toxicity. ✓ CORRECT
C. The drug will be metabolized more rapidly by the liver due to protein deficiency.
D. Protein-bound drugs are unaffected by low albumin because they bind to globulins
instead.
Correct Answer: B
Rationale: Hypoalbuminemia reduces available protein binding sites, leaving more free
active drug available and increasing the risk of adverse effects and toxicity. Volume of
distribution typically increases rather than decreases with low albumin, and liver
metabolism is not directly accelerated by protein deficiency.
Question 3 of 50
A nurse is preparing to administer digoxin to a 68-year-old patient. Before giving the
dose, the nurse checks the apical pulse and finds it to be 52 beats per minute. Which
action is most appropriate?
A. Administer the dose as ordered because bradycardia is an expected effect of digoxin.
B. Give half the prescribed dose and reassess the pulse in one hour.
, C. Hold the dose and notify the prescriber because a pulse below 60 is a
contraindication. ✓ CORRECT
D. Administer the dose with atropine to prevent further slowing of the heart rate.
Correct Answer: C
Rationale: Digoxin can cause bradycardia and heart block, and a pulse below 60 is a
standard parameter for holding the dose and contacting the prescriber. Administering
the dose could worsen bradycardia or precipitate complete heart block. Nurses should
always assess apical pulse before giving cardiac glycosides.
Question 4 of 50
A 38-year-old patient asks why the nurse is checking their identification band before
administering a medication. Which response best reflects the Joint Commission's
National Patient Safety Goals?
A. The identification band confirms the patient's insurance coverage for the medication.
B. Checking the band is required only for high-alert medications like insulin and heparin.
C. The band verifies the patient's room assignment to prevent medication errors.
D. Two patient identifiers are used to ensure the right patient receives the right
medication. ✓ CORRECT
Correct Answer: D
Rationale: The Joint Commission requires two patient identifiers, typically name and
birth date or medical record number, to prevent wrong-patient medication errors.
Insurance verification and room assignment are not the purposes of patient
identification checks, and this applies to all medications rather than only high-alert
drugs.
Question 5 of 50
A 55-year-old patient is prescribed a medication with a narrow therapeutic index. The
nurse knows that which nursing action is most critical for this type of drug?
