NURS 251 Pharmacology (Modules 1-10) Exam Portage
Learning / Geneva College (2026/2027) 100% Verified
Questions & Answers Guide
MODULE 1: Introduction to Pharmacology & Pharmacokinetics
1. A patient receives a medication intravenously (IV). Which route of
administration bypasses the "first-pass" effect?
A. Oral (PO)
B. Sublingual
C. Intravenous (IV)
D. Intramuscular (IM)
Answer: C
Rationale: The first-pass effect occurs when a drug is absorbed from the GI tract
and goes directly to the liver via the portal vein, where it is partially metabolized
before reaching systemic circulation. IV, IM, and sublingual routes bypass the GI
tract and liver initially, but IV is the absolute bypass as it enters directly into the
bloodstream.
2. A drug has a half-life of 8 hours. If a 400 mg dose is administered, how much of
the drug will remain in the body after 24 hours (assuming no further doses are
given)?
A. 50 mg
B. 100 mg
C. 200 mg
D. 25 mg
Answer: A
,Rationale: The half-life is the time it takes for half of the drug to be eliminated.
At 8 hours (1 half-life): 200 mg remains.
At 16 hours (2 half-lives): 100 mg remains.
At 24 hours (3 half-lives): 50 mg remains.
3. Which term describes the process by which a medication is altered by the body,
usually in the liver, into a more water-soluble form for excretion?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: C
Rationale: Metabolism (biotransformation) is the process of chemically altering
the drug, primarily in the liver, to make it easier to excrete via the kidneys.
4. A patient taking a medication that is highly protein-bound requires a dosage
adjustment if they have which condition?
A. Hypertension
B. Hypoalbuminemia (low serum albumin)
C. Hyperkalemia
D. Hyponatremia
Answer: B
Rationale: Highly protein-bound drugs attach to plasma proteins (mostly albumin).
If albumin levels are low, there are fewer binding sites, leading to higher levels of
free (active) drug in the blood, increasing the risk of toxicity.
, 5. A nurse is preparing to administer a medication that is a known teratogen.
What is the primary action the nurse must take before administration?
A. Administer an antiemetic first.
B. Ensure the patient is not pregnant.
C. Mix the medication with food.
D. Monitor the patient's blood pressure closely.
Answer: B
Rationale: Teratogens are drugs that can cause birth defects in a fetus. Ensuring
the patient is not pregnant (or verifying a negative pregnancy test) is a critical
safety priority before administration.
MODULE 2: Drugs Affecting the Central Nervous System (CNS)
6. A patient receiving an opioid analgesic develops a respiratory rate of 8
breaths/min. Which medication should the nurse anticipate administering as an
antidote?
A. Flumazenil
B. Naloxone
C. Naloxone
D. Acetylcysteine
Answer: B (Note: Option C is a duplicate in some test banks to trick students;
Naloxone is the opioid antagonist).
Rationale: Naloxone (Narcan) is the specific opioid antagonist used to reverse
opioid-induced respiratory depression.
Learning / Geneva College (2026/2027) 100% Verified
Questions & Answers Guide
MODULE 1: Introduction to Pharmacology & Pharmacokinetics
1. A patient receives a medication intravenously (IV). Which route of
administration bypasses the "first-pass" effect?
A. Oral (PO)
B. Sublingual
C. Intravenous (IV)
D. Intramuscular (IM)
Answer: C
Rationale: The first-pass effect occurs when a drug is absorbed from the GI tract
and goes directly to the liver via the portal vein, where it is partially metabolized
before reaching systemic circulation. IV, IM, and sublingual routes bypass the GI
tract and liver initially, but IV is the absolute bypass as it enters directly into the
bloodstream.
2. A drug has a half-life of 8 hours. If a 400 mg dose is administered, how much of
the drug will remain in the body after 24 hours (assuming no further doses are
given)?
A. 50 mg
B. 100 mg
C. 200 mg
D. 25 mg
Answer: A
,Rationale: The half-life is the time it takes for half of the drug to be eliminated.
At 8 hours (1 half-life): 200 mg remains.
At 16 hours (2 half-lives): 100 mg remains.
At 24 hours (3 half-lives): 50 mg remains.
3. Which term describes the process by which a medication is altered by the body,
usually in the liver, into a more water-soluble form for excretion?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: C
Rationale: Metabolism (biotransformation) is the process of chemically altering
the drug, primarily in the liver, to make it easier to excrete via the kidneys.
4. A patient taking a medication that is highly protein-bound requires a dosage
adjustment if they have which condition?
A. Hypertension
B. Hypoalbuminemia (low serum albumin)
C. Hyperkalemia
D. Hyponatremia
Answer: B
Rationale: Highly protein-bound drugs attach to plasma proteins (mostly albumin).
If albumin levels are low, there are fewer binding sites, leading to higher levels of
free (active) drug in the blood, increasing the risk of toxicity.
, 5. A nurse is preparing to administer a medication that is a known teratogen.
What is the primary action the nurse must take before administration?
A. Administer an antiemetic first.
B. Ensure the patient is not pregnant.
C. Mix the medication with food.
D. Monitor the patient's blood pressure closely.
Answer: B
Rationale: Teratogens are drugs that can cause birth defects in a fetus. Ensuring
the patient is not pregnant (or verifying a negative pregnancy test) is a critical
safety priority before administration.
MODULE 2: Drugs Affecting the Central Nervous System (CNS)
6. A patient receiving an opioid analgesic develops a respiratory rate of 8
breaths/min. Which medication should the nurse anticipate administering as an
antidote?
A. Flumazenil
B. Naloxone
C. Naloxone
D. Acetylcysteine
Answer: B (Note: Option C is a duplicate in some test banks to trick students;
Naloxone is the opioid antagonist).
Rationale: Naloxone (Narcan) is the specific opioid antagonist used to reverse
opioid-induced respiratory depression.
