PHM 2500 Introduction to Pharmacology
Comprehensive Practice Exam with
Rationales and Study Guide for Fall 2026
Nursing Students
TABLE OF CONTENTS
Topic Questions
1 Pharmacokinetics and Pharmacodynamics Questions 1 to 20
2 Medication Administration Questions 21 to 35
3 Drug Classifications Questions 36 to 50
4 Antibiotics Questions 51 to 65
5 Antihypertensives Questions 66 to 80
6 Analgesics and NSAIDs Questions 81 to 95
7 Antidiabetic Agents Questions 96 to 110
8 Diuretics Questions 111 to 125
9 Anticoagulants and Antiplatelets Questions 126 to 140
10 Respiratory Medications Questions 141 to 155
11 GI Medications Questions 156 to 170
12 Psychiatric Medications Questions 171 to 185
13 Cardiac Medications Questions 186 to 200
Brief Study Tips by Topic
SECTION 1 PHARMACOKINETICS AND PHARMACODYNAMICS
Questions 1 to 20
Question 1
A nurse is caring for a patient who has been prescribed a medication that is
highly protein-bound. The patient also takes another highly protein-bound
medication. The nurse understands that this combination may result in which
effect
A Increased free drug concentration of both medications due to competition
for binding sites
B Decreased free drug concentration of both medications due to saturation
,
C Increased elimination of both medications from the body
D Decreased therapeutic effect of both medications
E Increased protein binding and reduced drug availability
Answer A Increased free drug concentration of both medications due to
competition for binding sites
Rationale When two highly protein-bound medications are administered
together, they compete for the same protein binding sites. This displacement
increases the free or unbound concentration of both drugs, potentially leading
to increased therapeutic effects and toxicity. The free fraction is
pharmacologically active, so increased free concentration enhances drug
effects. The protein-bound fraction is inactive and acts as a reservoir.
Question 2
A nurse is monitoring a patient who is receiving a drug with a narrow
therapeutic index. Which laboratory value is most important for the nurse to
monitor to prevent toxicity
A Serum drug level
B Serum creatinine level
C Serum albumin level
D Liver function tests
E Complete blood count
Answer A Serum drug level
Rationale For drugs with a narrow therapeutic index, serum drug levels must
be monitored closely because the margin between therapeutic and toxic doses
is small. Drugs such as digoxin, warfarin, lithium, and phenytoin require
therapeutic drug monitoring. Serum creatinine and albumin levels are
important for dosing adjustments but do not directly measure drug
concentration.
Question 3
A patient is receiving a medication that is metabolized by the cytochrome
P450 enzyme system. The patient is also prescribed another medication that is
a CYP450 inhibitor. The nurse anticipates which effect on the first medication
A Increased serum concentration and increased risk of toxicity
B Decreased serum concentration and reduced therapeutic effect
,
C No change in serum concentration
D Increased elimination of the medication
E Decreased absorption of the medication
Answer A Increased serum concentration and increased risk of toxicity
Rationale A CYP450 inhibitor decreases the metabolism of drugs that are
substrates for the enzyme system. When metabolism is inhibited, the serum
concentration of the affected drug increases, leading to enhanced effects and
increased risk of toxicity. The nurse should monitor for signs of toxicity and
adjust the dose as needed.
Question 4
A nurse is educating a patient about a new medication. The patient asks how
the medication will be eliminated from the body. Which organ is primarily
responsible for drug elimination
A Kidneys
B Liver
C Lungs
D Skin
E Gastrointestinal tract
Answer A Kidneys
Rationale The kidneys are the primary organs responsible for drug
elimination through glomerular filtration, tubular secretion, and reabsorption.
The liver metabolizes drugs but does not eliminate them directly. The lungs
eliminate volatile substances. The skin and gastrointestinal tract play minor
roles in elimination.
Question 5
A nurse is caring for a patient with liver disease who is receiving a medication
that is extensively metabolized by the liver. Which adjustment should the
nurse expect for this patient
A A lower dose of the medication
B A higher dose of the medication
C No change in the medication dose
D More frequent administration of the medication
E A change to a different route of administration
,
Answer A A lower dose of the medication
Rationale Patients with liver disease have reduced hepatic metabolism,
leading to drug accumulation and increased risk of toxicity. A lower dose is
typically required to achieve therapeutic effects without toxicity. The nurse
should monitor the patient for signs of drug toxicity and report any concerns.
Question 6
A nurse is administering a medication that is a weak acid. The patient's gastric
pH is decreased. Which effect will this have on the absorption of the
medication
A Increased absorption because weak acids are better absorbed in acidic
environments
B Decreased absorption because weak acids require an alkaline environment
C No change in absorption because pH does not affect weak acids
D Increased absorption because the drug will be ionized and more soluble
E Decreased absorption because the drug will be protein-bound
Answer A Increased absorption because weak acids are better absorbed in
acidic environments
Rationale Weak acids are better absorbed in acidic environments because they
remain non-ionized and lipid-soluble, allowing them to cross cell membranes
easily. In an acidic environment, a weak acid is more non-ionized and
therefore more absorbable. In an alkaline environment, weak acids become
ionized and less absorbable.
Question 7
A nurse is caring for a patient who has been prescribed a medication that has
a half-life of 24 hours. The nurse explains that the medication will reach
steady state in approximately how many days
A 5 days
B 3 days
C 2 days
D 7 days
E 10 days
Answer A 5 days
Comprehensive Practice Exam with
Rationales and Study Guide for Fall 2026
Nursing Students
TABLE OF CONTENTS
Topic Questions
1 Pharmacokinetics and Pharmacodynamics Questions 1 to 20
2 Medication Administration Questions 21 to 35
3 Drug Classifications Questions 36 to 50
4 Antibiotics Questions 51 to 65
5 Antihypertensives Questions 66 to 80
6 Analgesics and NSAIDs Questions 81 to 95
7 Antidiabetic Agents Questions 96 to 110
8 Diuretics Questions 111 to 125
9 Anticoagulants and Antiplatelets Questions 126 to 140
10 Respiratory Medications Questions 141 to 155
11 GI Medications Questions 156 to 170
12 Psychiatric Medications Questions 171 to 185
13 Cardiac Medications Questions 186 to 200
Brief Study Tips by Topic
SECTION 1 PHARMACOKINETICS AND PHARMACODYNAMICS
Questions 1 to 20
Question 1
A nurse is caring for a patient who has been prescribed a medication that is
highly protein-bound. The patient also takes another highly protein-bound
medication. The nurse understands that this combination may result in which
effect
A Increased free drug concentration of both medications due to competition
for binding sites
B Decreased free drug concentration of both medications due to saturation
,
C Increased elimination of both medications from the body
D Decreased therapeutic effect of both medications
E Increased protein binding and reduced drug availability
Answer A Increased free drug concentration of both medications due to
competition for binding sites
Rationale When two highly protein-bound medications are administered
together, they compete for the same protein binding sites. This displacement
increases the free or unbound concentration of both drugs, potentially leading
to increased therapeutic effects and toxicity. The free fraction is
pharmacologically active, so increased free concentration enhances drug
effects. The protein-bound fraction is inactive and acts as a reservoir.
Question 2
A nurse is monitoring a patient who is receiving a drug with a narrow
therapeutic index. Which laboratory value is most important for the nurse to
monitor to prevent toxicity
A Serum drug level
B Serum creatinine level
C Serum albumin level
D Liver function tests
E Complete blood count
Answer A Serum drug level
Rationale For drugs with a narrow therapeutic index, serum drug levels must
be monitored closely because the margin between therapeutic and toxic doses
is small. Drugs such as digoxin, warfarin, lithium, and phenytoin require
therapeutic drug monitoring. Serum creatinine and albumin levels are
important for dosing adjustments but do not directly measure drug
concentration.
Question 3
A patient is receiving a medication that is metabolized by the cytochrome
P450 enzyme system. The patient is also prescribed another medication that is
a CYP450 inhibitor. The nurse anticipates which effect on the first medication
A Increased serum concentration and increased risk of toxicity
B Decreased serum concentration and reduced therapeutic effect
,
C No change in serum concentration
D Increased elimination of the medication
E Decreased absorption of the medication
Answer A Increased serum concentration and increased risk of toxicity
Rationale A CYP450 inhibitor decreases the metabolism of drugs that are
substrates for the enzyme system. When metabolism is inhibited, the serum
concentration of the affected drug increases, leading to enhanced effects and
increased risk of toxicity. The nurse should monitor for signs of toxicity and
adjust the dose as needed.
Question 4
A nurse is educating a patient about a new medication. The patient asks how
the medication will be eliminated from the body. Which organ is primarily
responsible for drug elimination
A Kidneys
B Liver
C Lungs
D Skin
E Gastrointestinal tract
Answer A Kidneys
Rationale The kidneys are the primary organs responsible for drug
elimination through glomerular filtration, tubular secretion, and reabsorption.
The liver metabolizes drugs but does not eliminate them directly. The lungs
eliminate volatile substances. The skin and gastrointestinal tract play minor
roles in elimination.
Question 5
A nurse is caring for a patient with liver disease who is receiving a medication
that is extensively metabolized by the liver. Which adjustment should the
nurse expect for this patient
A A lower dose of the medication
B A higher dose of the medication
C No change in the medication dose
D More frequent administration of the medication
E A change to a different route of administration
,
Answer A A lower dose of the medication
Rationale Patients with liver disease have reduced hepatic metabolism,
leading to drug accumulation and increased risk of toxicity. A lower dose is
typically required to achieve therapeutic effects without toxicity. The nurse
should monitor the patient for signs of drug toxicity and report any concerns.
Question 6
A nurse is administering a medication that is a weak acid. The patient's gastric
pH is decreased. Which effect will this have on the absorption of the
medication
A Increased absorption because weak acids are better absorbed in acidic
environments
B Decreased absorption because weak acids require an alkaline environment
C No change in absorption because pH does not affect weak acids
D Increased absorption because the drug will be ionized and more soluble
E Decreased absorption because the drug will be protein-bound
Answer A Increased absorption because weak acids are better absorbed in
acidic environments
Rationale Weak acids are better absorbed in acidic environments because they
remain non-ionized and lipid-soluble, allowing them to cross cell membranes
easily. In an acidic environment, a weak acid is more non-ionized and
therefore more absorbable. In an alkaline environment, weak acids become
ionized and less absorbable.
Question 7
A nurse is caring for a patient who has been prescribed a medication that has
a half-life of 24 hours. The nurse explains that the medication will reach
steady state in approximately how many days
A 5 days
B 3 days
C 2 days
D 7 days
E 10 days
Answer A 5 days
