PHM 2500 Introduction to Pharmacology High
Yield Comprehensive Practice Exam Version 2 with
Rationales and Study Guide for Fall 2026 Nursing
Students Just Released
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
metabolized by the liver. The patient has a history of cirrhosis and elevated
liver enzymes. The nurse anticipates that the medication dosage will need to
be adjusted. Which adjustment is most appropriate
A A lower dose to prevent drug accumulation and toxicity
B A higher dose to achieve therapeutic effect
C No change in the medication dose
D A change to a different route of administration
E More frequent administration of the medication
,
Answer A A lower dose to prevent drug accumulation and toxicity
Rationale Patients with liver disease have reduced hepatic metabolism and
drug clearance. A lower dose is needed to prevent drug accumulation and
toxicity. The nurse should monitor liver function tests and signs of toxicity. A
higher dose would worsen accumulation. Changing the route does not address
the metabolic issue.
Question 2
A nurse is administering a medication that is highly protein-bound. The
patient is also taking another medication that displaces the first medication
from protein binding sites. Which effect should the nurse anticipate
A Increased free drug concentration and increased risk of adverse effects
B Decreased free drug concentration and reduced therapeutic effect
C No change in the medication's effect
D Increased protein binding and reduced free drug
E Decreased absorption of the medication
Answer A Increased free drug concentration and increased risk of adverse
effects
Rationale When a medication is displaced from protein binding sites, the free
unbound concentration increases. The free fraction is pharmacologically
active, so increased free drug concentration leads to enhanced effects and
increased risk of toxicity. The nurse should monitor for signs of toxicity.
Question 3
A nurse is caring for a patient who has been prescribed a medication with a
half-life of 6 hours. The nurse explains that the medication will reach steady
state in approximately how many hours
A 24 to 30 hours
B 12 to 18 hours
C 6 to 12 hours
D 30 to 36 hours
E 36 to 42 hours
Answer A 24 to 30 hours
,
Rationale Steady state is reached after approximately 4 to 5 half-lives. For a
drug with a half-life of 6 hours, steady state will be reached in 24 to 30 hours.
At steady state, the rate of drug administration equals the rate of elimination,
and drug levels remain relatively constant.
Question 4
A nurse is caring for a patient who is receiving a medication that is eliminated
by zero-order kinetics. Which statement accurately describes zero-order
kinetics
A A constant amount of the drug is eliminated per unit time
B A constant fraction of the drug is eliminated per unit time
C The drug is eliminated at a rate proportional to the concentration
D The drug has a non-linear elimination pattern
E The drug is eliminated by first-order kinetics
Answer A A constant amount of the drug is eliminated per unit time
Rationale Zero-order kinetics is characterized by the elimination of a constant
amount of the drug per unit time, regardless of concentration. First-order
kinetics is characterized by elimination of a constant fraction per unit time.
Alcohol and phenytoin at high doses follow zero-order kinetics.
Question 5
A nurse is caring for a patient who has been prescribed a medication that is a
prodrug. The patient asks how the medication works. Which explanation by
the nurse is most accurate
A The medication is inactive and must be converted to an active form in the
body
B The medication is active and does not require conversion
C The medication is excreted unchanged in the urine
D The medication is metabolized in the GI tract
E The medication binds to plasma proteins before becoming active
Answer A The medication is inactive and must be converted to an active form
in the body
Rationale A prodrug is an inactive drug that must be converted to its active
form through metabolic processes in the body, often in the liver. This
,
conversion allows the drug to be targeted to specific tissues or to improve
absorption. After conversion, the active form produces the therapeutic effect.
Question 6
A nurse is caring for a patient who is prescribed a medication that is a
CYP450 enzyme inhibitor. The patient is also taking a medication that is
metabolized by this enzyme. Which effect should the nurse anticipate
A Increased serum concentration of the metabolized medication
B Decreased serum concentration of the metabolized medication
C No change in the serum concentration of the metabolized medication
D Increased elimination of the metabolized medication
E Decreased absorption of the metabolized medication
Answer A Increased serum concentration of the metabolized medication
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.
Question 7
A nurse is caring for a patient who has been prescribed a medication that is a
weak base. The patient's gastrointestinal pH is increased. Which effect will
this have on the absorption of the medication
A Increased absorption because weak bases are better absorbed in alkaline
environments
B Decreased absorption because weak bases require an acidic environment
C No change in absorption because pH does not affect weak bases
D Decreased absorption because the drug will be non-ionized
E Increased absorption because the drug will be protein-bound
Answer A Increased absorption because weak bases are better absorbed in
alkaline environments
Rationale Weak bases are better absorbed in alkaline environments because
they remain non-ionized and lipid-soluble, allowing them to cross cell
membranes easily. In an alkaline environment, a weak base is more non-
ionized and therefore more absorbable. In an acidic environment, weak bases
become ionized and less absorbable.
Yield Comprehensive Practice Exam Version 2 with
Rationales and Study Guide for Fall 2026 Nursing
Students Just Released
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
metabolized by the liver. The patient has a history of cirrhosis and elevated
liver enzymes. The nurse anticipates that the medication dosage will need to
be adjusted. Which adjustment is most appropriate
A A lower dose to prevent drug accumulation and toxicity
B A higher dose to achieve therapeutic effect
C No change in the medication dose
D A change to a different route of administration
E More frequent administration of the medication
,
Answer A A lower dose to prevent drug accumulation and toxicity
Rationale Patients with liver disease have reduced hepatic metabolism and
drug clearance. A lower dose is needed to prevent drug accumulation and
toxicity. The nurse should monitor liver function tests and signs of toxicity. A
higher dose would worsen accumulation. Changing the route does not address
the metabolic issue.
Question 2
A nurse is administering a medication that is highly protein-bound. The
patient is also taking another medication that displaces the first medication
from protein binding sites. Which effect should the nurse anticipate
A Increased free drug concentration and increased risk of adverse effects
B Decreased free drug concentration and reduced therapeutic effect
C No change in the medication's effect
D Increased protein binding and reduced free drug
E Decreased absorption of the medication
Answer A Increased free drug concentration and increased risk of adverse
effects
Rationale When a medication is displaced from protein binding sites, the free
unbound concentration increases. The free fraction is pharmacologically
active, so increased free drug concentration leads to enhanced effects and
increased risk of toxicity. The nurse should monitor for signs of toxicity.
Question 3
A nurse is caring for a patient who has been prescribed a medication with a
half-life of 6 hours. The nurse explains that the medication will reach steady
state in approximately how many hours
A 24 to 30 hours
B 12 to 18 hours
C 6 to 12 hours
D 30 to 36 hours
E 36 to 42 hours
Answer A 24 to 30 hours
,
Rationale Steady state is reached after approximately 4 to 5 half-lives. For a
drug with a half-life of 6 hours, steady state will be reached in 24 to 30 hours.
At steady state, the rate of drug administration equals the rate of elimination,
and drug levels remain relatively constant.
Question 4
A nurse is caring for a patient who is receiving a medication that is eliminated
by zero-order kinetics. Which statement accurately describes zero-order
kinetics
A A constant amount of the drug is eliminated per unit time
B A constant fraction of the drug is eliminated per unit time
C The drug is eliminated at a rate proportional to the concentration
D The drug has a non-linear elimination pattern
E The drug is eliminated by first-order kinetics
Answer A A constant amount of the drug is eliminated per unit time
Rationale Zero-order kinetics is characterized by the elimination of a constant
amount of the drug per unit time, regardless of concentration. First-order
kinetics is characterized by elimination of a constant fraction per unit time.
Alcohol and phenytoin at high doses follow zero-order kinetics.
Question 5
A nurse is caring for a patient who has been prescribed a medication that is a
prodrug. The patient asks how the medication works. Which explanation by
the nurse is most accurate
A The medication is inactive and must be converted to an active form in the
body
B The medication is active and does not require conversion
C The medication is excreted unchanged in the urine
D The medication is metabolized in the GI tract
E The medication binds to plasma proteins before becoming active
Answer A The medication is inactive and must be converted to an active form
in the body
Rationale A prodrug is an inactive drug that must be converted to its active
form through metabolic processes in the body, often in the liver. This
,
conversion allows the drug to be targeted to specific tissues or to improve
absorption. After conversion, the active form produces the therapeutic effect.
Question 6
A nurse is caring for a patient who is prescribed a medication that is a
CYP450 enzyme inhibitor. The patient is also taking a medication that is
metabolized by this enzyme. Which effect should the nurse anticipate
A Increased serum concentration of the metabolized medication
B Decreased serum concentration of the metabolized medication
C No change in the serum concentration of the metabolized medication
D Increased elimination of the metabolized medication
E Decreased absorption of the metabolized medication
Answer A Increased serum concentration of the metabolized medication
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.
Question 7
A nurse is caring for a patient who has been prescribed a medication that is a
weak base. The patient's gastrointestinal pH is increased. Which effect will
this have on the absorption of the medication
A Increased absorption because weak bases are better absorbed in alkaline
environments
B Decreased absorption because weak bases require an acidic environment
C No change in absorption because pH does not affect weak bases
D Decreased absorption because the drug will be non-ionized
E Increased absorption because the drug will be protein-bound
Answer A Increased absorption because weak bases are better absorbed in
alkaline environments
Rationale Weak bases are better absorbed in alkaline environments because
they remain non-ionized and lipid-soluble, allowing them to cross cell
membranes easily. In an alkaline environment, a weak base is more non-
ionized and therefore more absorbable. In an acidic environment, weak bases
become ionized and less absorbable.
