PHARMACOLOGY WEEK (NURS 180)
2026 QUESTIONS AND ANSWERS
1. Which phase of pharmacokinetics is most significantly impacted by the first-pass effect
when a drug is administered orally?
A. Distribution
B. Excretion
C. Absorption
D. Metabolism
Answer: D
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug after oral administration before it reaches the systemic circulation.
2. A patient is prescribed a drug with a narrow therapeutic index. What is the nurse’s primary
responsibility?
A. Instruct the patient to double the dose if a dose is missed
B. Increase the dose if no effect is seen
C. Administer the drug only on an empty stomach
D. Monitor serum drug levels closely
,Answer: D
Conceptual Explanation: Drugs with a narrow therapeutic index have a small margin
between effective and toxic doses, requiring serum level monitoring.
3. Which mechanism describes a ‘competitive antagonist’?
A. It binds to the receptor and activates it partially.
B. It binds to the same site as the agonist but does not activate it.
C. It permanently binds to the receptor site via covalent bonds.
D. It binds to an allosteric site to change the receptor shape.
Answer: B
Conceptual Explanation: Competitive antagonists compete for the same receptor site as
the agonist but do not initiate a biological response.
4. A patient exhibits wheezing and hypotension after an IV dose of Penicillin. What is the
priority nursing action?
A. Discontinue the infusion immediately
B. Slow the infusion rate
C. Document the reaction in the chart
D. Administer an oral antihistamine
Answer: A
, Conceptual Explanation: These are signs of anaphylaxis; the immediate priority is to stop
the causative agent to prevent further exposure.
5. Which pharmacokinetic process is primarily affected by a patient’s serum albumin levels?
A. Elimination
B. Metabolism
C. Distribution
D. Absorption
Answer: C
Conceptual Explanation: Distribution is affected by protein binding; many drugs bind to
albumin. Low albumin leads to higher levels of free, active drug.
6. Which enzyme system in the liver is responsible for the metabolism of the majority of
medications?
A. Acetylcholinesterase
B. Creatine Kinase
C. Cytochrome P450
D. Monoamine Oxidase
Answer: C
Conceptual Explanation: The CYP450 system is the primary enzyme family involved in
drug metabolism in the liver.
2026 QUESTIONS AND ANSWERS
1. Which phase of pharmacokinetics is most significantly impacted by the first-pass effect
when a drug is administered orally?
A. Distribution
B. Excretion
C. Absorption
D. Metabolism
Answer: D
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug after oral administration before it reaches the systemic circulation.
2. A patient is prescribed a drug with a narrow therapeutic index. What is the nurse’s primary
responsibility?
A. Instruct the patient to double the dose if a dose is missed
B. Increase the dose if no effect is seen
C. Administer the drug only on an empty stomach
D. Monitor serum drug levels closely
,Answer: D
Conceptual Explanation: Drugs with a narrow therapeutic index have a small margin
between effective and toxic doses, requiring serum level monitoring.
3. Which mechanism describes a ‘competitive antagonist’?
A. It binds to the receptor and activates it partially.
B. It binds to the same site as the agonist but does not activate it.
C. It permanently binds to the receptor site via covalent bonds.
D. It binds to an allosteric site to change the receptor shape.
Answer: B
Conceptual Explanation: Competitive antagonists compete for the same receptor site as
the agonist but do not initiate a biological response.
4. A patient exhibits wheezing and hypotension after an IV dose of Penicillin. What is the
priority nursing action?
A. Discontinue the infusion immediately
B. Slow the infusion rate
C. Document the reaction in the chart
D. Administer an oral antihistamine
Answer: A
, Conceptual Explanation: These are signs of anaphylaxis; the immediate priority is to stop
the causative agent to prevent further exposure.
5. Which pharmacokinetic process is primarily affected by a patient’s serum albumin levels?
A. Elimination
B. Metabolism
C. Distribution
D. Absorption
Answer: C
Conceptual Explanation: Distribution is affected by protein binding; many drugs bind to
albumin. Low albumin leads to higher levels of free, active drug.
6. Which enzyme system in the liver is responsible for the metabolism of the majority of
medications?
A. Acetylcholinesterase
B. Creatine Kinase
C. Cytochrome P450
D. Monoamine Oxidase
Answer: C
Conceptual Explanation: The CYP450 system is the primary enzyme family involved in
drug metabolism in the liver.
