NU 150 / NUR 150
Pharmacology
Galen College of Nursing
NU 150 / NUR 150 Exam 4
Questions & Answers Plus
Detailed Rationales
Latest 2026 | PDF
THIS EXAM CONTAINS:
✓100% Pass
✓Multiple Choice ( A-D)
✓Detailed Rationales For Each Question
✓Correct Answers For Each Question
✓250 Qs & Answers
,SECTION 1: PHARMACOKINETICS AND
PHARMACODYNAMICS (Questions 1-30)
1. The nurse is administering a drug that is highly protein-bound. A patient
with hypoalbuminemia will most likely experience which effect?
A. Decreased drug effect due to increased metabolism
B. Increased free drug levels and risk of toxicity
C. Decreased absorption due to low protein
D. No change in drug levels
*Rationale: Hypoalbuminemia reduces the number of protein-binding sites
available for drug binding, leading to an increase in the unbound (free) fraction
of the drug. Only unbound drug is pharmacologically active and can exert
therapeutic or toxic effects. With fewer protein-binding sites, more free drug is
available, increasing the risk of toxicity. The nurse should monitor the patient
closely for signs of toxicity and may need to adjust the dose. This is particularly
important for drugs with a narrow therapeutic index.
2. A drug has a half-life of 6 hours. How many hours will it take to reach steady
state?
A. 12 hours
B. 24 hours
C. 30 hours
D. 48 hours
*Rationale: Steady state is reached after approximately 4 to 5 half-lives of drug
administration. With a half-life of 6 hours, steady state is achieved in 4 to 5
half-lives, which equals 24 to 30 hours. The most accurate answer is 30 hours (5
half-lives × 6 hours). At steady state, the rate of drug administration equals the
rate of drug elimination, and the plasma concentration remains relatively
constant. The nurse should understand that it takes about 5 half-lives to reach
steady state when starting a new medication.
3. Which factors affect drug absorption? (Select all that apply)
,A. Gastric pH
B. Presence of food
C. Blood flow to the site of administration
D. Drug solubility
E. Patient's age
*Rationale: All of the listed factors affect drug absorption. Gastric pH affects the
ionization and solubility of drugs. The presence of food can delay or enhance
absorption depending on the drug. Blood flow to the absorption site affects the
rate at which the drug is carried away. Drug solubility (lipid solubility) affects
how easily the drug crosses cell membranes. Patient's age affects gastric
emptying, intestinal motility, and blood flow, all of which influence absorption.
The nurse should consider these factors when administering medications and
educating patients.
4. The nurse is caring for a patient receiving a drug with a narrow therapeutic
index. The nurse should pay particular attention to which parameter?
A. The drug's half-life
B. The drug's peak and trough levels
C. The drug's route of administration
D. The drug's cost
*Rationale: Drugs with a narrow therapeutic index have a small margin
between therapeutic and toxic doses. Monitoring peak and trough levels is
essential to ensure the drug remains within the therapeutic range and to avoid
toxicity. Peak levels indicate the highest concentration, while trough levels
indicate the lowest concentration before the next dose. The nurse should draw
trough levels just before the next dose and peak levels at a specified time after
administration. Examples of narrow therapeutic index drugs include digoxin,
warfarin, phenytoin, and aminoglycosides.
5. What does the term "first-pass effect" refer to?
A. Metabolism of a drug by the liver before it reaches systemic circulation
B. Metabolism of a drug by the liver before it reaches systemic circulation
C. The rapid absorption of a drug after oral administration
D. The first step in drug excretion by the kidneys
, *Rationale: The first-pass effect refers to the metabolism of an orally
administered drug by the liver before it reaches systemic circulation. This
reduces the bioavailability of the drug, meaning a higher oral dose is often
needed to achieve the same effect as an IV dose. Drugs with extensive first-pass
metabolism include propranolol, nitroglycerin, and morphine. The nurse should
be aware that alternative routes (sublingual, IV, transdermal) may be used to
bypass the first-pass effect when necessary.
6. Rank the following routes of administration from fastest onset to slowest
onset: IV push, Oral, IM injection, Sublingual, Subcutaneous
A. Oral, Sublingual, IM, Subcutaneous, IV
B. IV, Sublingual, IM, Subcutaneous, Oral
C. Sublingual, IV, IM, Subcutaneous, Oral
D. IV, IM, Subcutaneous, Sublingual, Oral
*Rationale: The correct order from fastest to slowest onset is: IV push
(immediate), Sublingual (rapid absorption through mucosa), IM injection
(absorption through muscle tissue), Subcutaneous (absorption through
subcutaneous tissue), and Oral (slowest due to digestion and first-pass effect).
The nurse should select the route of administration based on the urgency of the
clinical situation, the drug's properties, and the patient's condition.
7. Which of the following is an example of a CYP450 inducer?
A. Clarithromycin
B. Ketoconazole
C. Rifampin
D. Cimetidine
*Rationale: Rifampin is a potent CYP450 inducer, meaning it increases the
metabolism of other drugs, potentially reducing their effectiveness.
Clarithromycin, ketoconazole, and cimetidine are CYP450 inhibitors, meaning
they decrease the metabolism of other drugs, potentially increasing their levels
and risk of toxicity. The nurse should monitor for drug interactions when
rifampin is prescribed and may need to adjust doses of other medications.
Common drugs affected by CYP450 inducers include warfarin, oral
contraceptives, and anticonvulsants.
Pharmacology
Galen College of Nursing
NU 150 / NUR 150 Exam 4
Questions & Answers Plus
Detailed Rationales
Latest 2026 | PDF
THIS EXAM CONTAINS:
✓100% Pass
✓Multiple Choice ( A-D)
✓Detailed Rationales For Each Question
✓Correct Answers For Each Question
✓250 Qs & Answers
,SECTION 1: PHARMACOKINETICS AND
PHARMACODYNAMICS (Questions 1-30)
1. The nurse is administering a drug that is highly protein-bound. A patient
with hypoalbuminemia will most likely experience which effect?
A. Decreased drug effect due to increased metabolism
B. Increased free drug levels and risk of toxicity
C. Decreased absorption due to low protein
D. No change in drug levels
*Rationale: Hypoalbuminemia reduces the number of protein-binding sites
available for drug binding, leading to an increase in the unbound (free) fraction
of the drug. Only unbound drug is pharmacologically active and can exert
therapeutic or toxic effects. With fewer protein-binding sites, more free drug is
available, increasing the risk of toxicity. The nurse should monitor the patient
closely for signs of toxicity and may need to adjust the dose. This is particularly
important for drugs with a narrow therapeutic index.
2. A drug has a half-life of 6 hours. How many hours will it take to reach steady
state?
A. 12 hours
B. 24 hours
C. 30 hours
D. 48 hours
*Rationale: Steady state is reached after approximately 4 to 5 half-lives of drug
administration. With a half-life of 6 hours, steady state is achieved in 4 to 5
half-lives, which equals 24 to 30 hours. The most accurate answer is 30 hours (5
half-lives × 6 hours). At steady state, the rate of drug administration equals the
rate of drug elimination, and the plasma concentration remains relatively
constant. The nurse should understand that it takes about 5 half-lives to reach
steady state when starting a new medication.
3. Which factors affect drug absorption? (Select all that apply)
,A. Gastric pH
B. Presence of food
C. Blood flow to the site of administration
D. Drug solubility
E. Patient's age
*Rationale: All of the listed factors affect drug absorption. Gastric pH affects the
ionization and solubility of drugs. The presence of food can delay or enhance
absorption depending on the drug. Blood flow to the absorption site affects the
rate at which the drug is carried away. Drug solubility (lipid solubility) affects
how easily the drug crosses cell membranes. Patient's age affects gastric
emptying, intestinal motility, and blood flow, all of which influence absorption.
The nurse should consider these factors when administering medications and
educating patients.
4. The nurse is caring for a patient receiving a drug with a narrow therapeutic
index. The nurse should pay particular attention to which parameter?
A. The drug's half-life
B. The drug's peak and trough levels
C. The drug's route of administration
D. The drug's cost
*Rationale: Drugs with a narrow therapeutic index have a small margin
between therapeutic and toxic doses. Monitoring peak and trough levels is
essential to ensure the drug remains within the therapeutic range and to avoid
toxicity. Peak levels indicate the highest concentration, while trough levels
indicate the lowest concentration before the next dose. The nurse should draw
trough levels just before the next dose and peak levels at a specified time after
administration. Examples of narrow therapeutic index drugs include digoxin,
warfarin, phenytoin, and aminoglycosides.
5. What does the term "first-pass effect" refer to?
A. Metabolism of a drug by the liver before it reaches systemic circulation
B. Metabolism of a drug by the liver before it reaches systemic circulation
C. The rapid absorption of a drug after oral administration
D. The first step in drug excretion by the kidneys
, *Rationale: The first-pass effect refers to the metabolism of an orally
administered drug by the liver before it reaches systemic circulation. This
reduces the bioavailability of the drug, meaning a higher oral dose is often
needed to achieve the same effect as an IV dose. Drugs with extensive first-pass
metabolism include propranolol, nitroglycerin, and morphine. The nurse should
be aware that alternative routes (sublingual, IV, transdermal) may be used to
bypass the first-pass effect when necessary.
6. Rank the following routes of administration from fastest onset to slowest
onset: IV push, Oral, IM injection, Sublingual, Subcutaneous
A. Oral, Sublingual, IM, Subcutaneous, IV
B. IV, Sublingual, IM, Subcutaneous, Oral
C. Sublingual, IV, IM, Subcutaneous, Oral
D. IV, IM, Subcutaneous, Sublingual, Oral
*Rationale: The correct order from fastest to slowest onset is: IV push
(immediate), Sublingual (rapid absorption through mucosa), IM injection
(absorption through muscle tissue), Subcutaneous (absorption through
subcutaneous tissue), and Oral (slowest due to digestion and first-pass effect).
The nurse should select the route of administration based on the urgency of the
clinical situation, the drug's properties, and the patient's condition.
7. Which of the following is an example of a CYP450 inducer?
A. Clarithromycin
B. Ketoconazole
C. Rifampin
D. Cimetidine
*Rationale: Rifampin is a potent CYP450 inducer, meaning it increases the
metabolism of other drugs, potentially reducing their effectiveness.
Clarithromycin, ketoconazole, and cimetidine are CYP450 inhibitors, meaning
they decrease the metabolism of other drugs, potentially increasing their levels
and risk of toxicity. The nurse should monitor for drug interactions when
rifampin is prescribed and may need to adjust doses of other medications.
Common drugs affected by CYP450 inducers include warfarin, oral
contraceptives, and anticonvulsants.
