BSN3A Pharmacology – Exam Practice Questions & Verified Answers with
Rationales (2026 Latest Update) – Comprehensive 250-Question Practice
Exam
Questions 1–250
1. A patient is prescribed a medication that undergoes extensive first-pass
metabolism. Which route of administration would the nurse expect to have
the highest bioavailability?
A) Oral
B) Sublingual
C) Intravenous
D) Rectal
Answer C: Intravenous
Rationale: IV administration bypasses first-pass metabolism entirely,
delivering 100% bioavailability.
,2. A patient asks the nurse why the oral dose of a drug is higher than the IV
dose. The nurse explains this is due to:
A) Faster absorption orally
B) First-pass effect in the liver
C) Decreased protein binding
D) Increased renal excretion
Answer B: First-pass effect in the liver
Rationale: Oral drugs are metabolized in the liver before reaching systemic
circulation, reducing bioavailability.
3. Which route of administration has the fastest onset of action?
A) Oral
B) Subcutaneous
C) Intravenous
D) Transdermal
Answer C: Intravenous
Rationale: IV administration delivers the drug directly into the bloodstream
for immediate effect.
,4. A patient has a serum drug half-life of 4 hours. After 16 hours, what
percentage of the drug remains in the body?
A) 25%
B) 6.25%
C) 12.5%
D) 50%
Answer B: 6.25%
Rationale: After 4 half-lives (16 hours), drug concentration is 6.25% of original
(50%→25%→12.5%→6.25%).
5. Which factor increases the risk of drug toxicity in older adults?
A) Increased hepatic blood flow
B) Increased renal clearance
C) Decreased renal function and decreased hepatic metabolism
D) Increased gastric emptying
Answer C: Decreased renal function and decreased hepatic metabolism
Rationale: Age-related decline in renal and hepatic function reduces drug
clearance, increasing toxicity risk.
6. A patient with liver disease is prescribed a medication metabolized by the
liver. The nurse anticipates:
, A) Decreased drug effect
B) Increased drug effect and risk of toxicity
C) No change in drug effect
D) Faster drug excretion
Answer B: Increased drug effect and risk of toxicity
Rationale: Impaired hepatic metabolism leads to drug accumulation,
increasing therapeutic and adverse effects.
7. A patient with renal impairment is prescribed a medication excreted by
the kidneys. The nurse should monitor for:
A) Decreased drug effect
B) Increased drug levels and toxicity
C) No change in drug levels
D) Faster drug excretion
Answer B: Increased drug levels and toxicity
Rationale: Renal impairment reduces drug excretion, leading to accumulation
and toxicity.
8. The term "bioavailability" refers to:
A) The speed of drug absorption
B) The fraction of an administered dose that reaches systemic circulation
Rationales (2026 Latest Update) – Comprehensive 250-Question Practice
Exam
Questions 1–250
1. A patient is prescribed a medication that undergoes extensive first-pass
metabolism. Which route of administration would the nurse expect to have
the highest bioavailability?
A) Oral
B) Sublingual
C) Intravenous
D) Rectal
Answer C: Intravenous
Rationale: IV administration bypasses first-pass metabolism entirely,
delivering 100% bioavailability.
,2. A patient asks the nurse why the oral dose of a drug is higher than the IV
dose. The nurse explains this is due to:
A) Faster absorption orally
B) First-pass effect in the liver
C) Decreased protein binding
D) Increased renal excretion
Answer B: First-pass effect in the liver
Rationale: Oral drugs are metabolized in the liver before reaching systemic
circulation, reducing bioavailability.
3. Which route of administration has the fastest onset of action?
A) Oral
B) Subcutaneous
C) Intravenous
D) Transdermal
Answer C: Intravenous
Rationale: IV administration delivers the drug directly into the bloodstream
for immediate effect.
,4. A patient has a serum drug half-life of 4 hours. After 16 hours, what
percentage of the drug remains in the body?
A) 25%
B) 6.25%
C) 12.5%
D) 50%
Answer B: 6.25%
Rationale: After 4 half-lives (16 hours), drug concentration is 6.25% of original
(50%→25%→12.5%→6.25%).
5. Which factor increases the risk of drug toxicity in older adults?
A) Increased hepatic blood flow
B) Increased renal clearance
C) Decreased renal function and decreased hepatic metabolism
D) Increased gastric emptying
Answer C: Decreased renal function and decreased hepatic metabolism
Rationale: Age-related decline in renal and hepatic function reduces drug
clearance, increasing toxicity risk.
6. A patient with liver disease is prescribed a medication metabolized by the
liver. The nurse anticipates:
, A) Decreased drug effect
B) Increased drug effect and risk of toxicity
C) No change in drug effect
D) Faster drug excretion
Answer B: Increased drug effect and risk of toxicity
Rationale: Impaired hepatic metabolism leads to drug accumulation,
increasing therapeutic and adverse effects.
7. A patient with renal impairment is prescribed a medication excreted by
the kidneys. The nurse should monitor for:
A) Decreased drug effect
B) Increased drug levels and toxicity
C) No change in drug levels
D) Faster drug excretion
Answer B: Increased drug levels and toxicity
Rationale: Renal impairment reduces drug excretion, leading to accumulation
and toxicity.
8. The term "bioavailability" refers to:
A) The speed of drug absorption
B) The fraction of an administered dose that reaches systemic circulation
