Clayton’s Basic Pharmacology for Nurses,
20th Edition
Comprehensive Original Practice Examination
Authors of source textbook: Michelle J. Willihnganz, MS, RN, CNE; Samuel L. Gurevitz,
PharmD, CGP
Important: This is an original practice examination designed around the pharmacology concepts
and chapter structure of the 20th edition. It is not an official Elsevier test bank and does not
reproduce publisher questions.
PART I — BASIC PHARMACOLOGY AND
MEDICATION SAFETY
Question 1
A nurse is explaining pharmacokinetics to a nursing student. Which process describes the
movement of a medication from the gastrointestinal tract into the bloodstream?
A. Distribution
B. Absorption
C. Metabolism
D. Excretion
Answer: B. Absorption
Rationale: Absorption is the movement of a drug from its site of administration into systemic
circulation.
,Question 2
A medication has a high first-pass effect. Which route would generally avoid significant hepatic
first-pass metabolism?
A. Oral
B. Enteral feeding tube
C. Sublingual
D. Gastric
Answer: C. Sublingual
Rationale: Sublingual medications enter systemic circulation through the oral mucosa and
largely bypass initial hepatic metabolism.
Question 3
The nurse administers a medication that binds to receptors and produces a physiologic response.
The medication is acting as a:
A. Antagonist
B. Agonist
C. Inhibitor
D. Catalyst
Answer: B. Agonist
Rationale: An agonist binds to a receptor and activates it to produce a response. An antagonist
blocks or interferes with receptor activation.
Question 4
Which patient is at greatest risk for altered medication pharmacokinetics?
A. Healthy young adult
B. Older adult with impaired renal function
C. Healthy adolescent
D. Adult with normal liver and kidney function
Answer: B. Older adult with impaired renal function
,Rationale: Reduced renal function can decrease drug elimination and increase drug
accumulation and toxicity.
Question 5
A nurse is reviewing medication orders before administration. Which action best demonstrates
safe medication practice?
A. Administering a medication based on memory
B. Comparing the medication with the prescription and patient identification information
C. Asking another patient to confirm the medication
D. Administering the medication before checking allergies
Answer: B. Comparing the medication with the prescription and patient identification
information
Rationale: Medication safety requires systematic verification of the medication order, patient
identity, dose, route, timing, allergies, and other relevant parameters.
Question 6 — SATA
Which findings should the nurse assess before administering a newly prescribed medication?
Select all that apply.
A. Medication allergies
B. Relevant laboratory results
C. Current medication list
D. Relevant vital signs
E. Patient's favorite food
Answers: A, B, C, D
Rationale: Allergies, laboratory values, medication history, and appropriate physiologic
measurements can affect medication safety.
Question 7
A patient says, “I don't understand why I need to tell you about the herbal products I take.” What
is the nurse's best response?
, A. “Herbal products cannot interact with prescription medications.”
B. “Only prescription medications need to be reported.”
C. “Some herbal products can alter medication effects or increase adverse effects.”
D. “Herbal products are always safer than prescription medications.”
Answer: C.
Rationale: Complementary and herbal products may interact with medications and should be
included in medication reconciliation.
Question 8
Which finding should cause the nurse to question an opioid prescription most urgently?
A. Respiratory rate of 8/min
B. Heart rate of 82/min
C. Blood pressure of 128/76 mm Hg
D. Temperature of 37°C
Answer: A. Respiratory rate of 8/min
Rationale: Significant respiratory depression is a potentially life-threatening opioid adverse
effect.
PART II — MEDICATION ADMINISTRATION
Question 9
The nurse prepares an intramuscular injection. Which factor most directly influences the
selection of an injection site?
A. Patient's favorite sleeping position
B. Medication volume and tissue characteristics
C. Patient's educational level
D. Time of day
Answer: B.
Rationale: Medication volume, viscosity, patient age, muscle mass, and tissue condition
influence safe IM-site selection.
20th Edition
Comprehensive Original Practice Examination
Authors of source textbook: Michelle J. Willihnganz, MS, RN, CNE; Samuel L. Gurevitz,
PharmD, CGP
Important: This is an original practice examination designed around the pharmacology concepts
and chapter structure of the 20th edition. It is not an official Elsevier test bank and does not
reproduce publisher questions.
PART I — BASIC PHARMACOLOGY AND
MEDICATION SAFETY
Question 1
A nurse is explaining pharmacokinetics to a nursing student. Which process describes the
movement of a medication from the gastrointestinal tract into the bloodstream?
A. Distribution
B. Absorption
C. Metabolism
D. Excretion
Answer: B. Absorption
Rationale: Absorption is the movement of a drug from its site of administration into systemic
circulation.
,Question 2
A medication has a high first-pass effect. Which route would generally avoid significant hepatic
first-pass metabolism?
A. Oral
B. Enteral feeding tube
C. Sublingual
D. Gastric
Answer: C. Sublingual
Rationale: Sublingual medications enter systemic circulation through the oral mucosa and
largely bypass initial hepatic metabolism.
Question 3
The nurse administers a medication that binds to receptors and produces a physiologic response.
The medication is acting as a:
A. Antagonist
B. Agonist
C. Inhibitor
D. Catalyst
Answer: B. Agonist
Rationale: An agonist binds to a receptor and activates it to produce a response. An antagonist
blocks or interferes with receptor activation.
Question 4
Which patient is at greatest risk for altered medication pharmacokinetics?
A. Healthy young adult
B. Older adult with impaired renal function
C. Healthy adolescent
D. Adult with normal liver and kidney function
Answer: B. Older adult with impaired renal function
,Rationale: Reduced renal function can decrease drug elimination and increase drug
accumulation and toxicity.
Question 5
A nurse is reviewing medication orders before administration. Which action best demonstrates
safe medication practice?
A. Administering a medication based on memory
B. Comparing the medication with the prescription and patient identification information
C. Asking another patient to confirm the medication
D. Administering the medication before checking allergies
Answer: B. Comparing the medication with the prescription and patient identification
information
Rationale: Medication safety requires systematic verification of the medication order, patient
identity, dose, route, timing, allergies, and other relevant parameters.
Question 6 — SATA
Which findings should the nurse assess before administering a newly prescribed medication?
Select all that apply.
A. Medication allergies
B. Relevant laboratory results
C. Current medication list
D. Relevant vital signs
E. Patient's favorite food
Answers: A, B, C, D
Rationale: Allergies, laboratory values, medication history, and appropriate physiologic
measurements can affect medication safety.
Question 7
A patient says, “I don't understand why I need to tell you about the herbal products I take.” What
is the nurse's best response?
, A. “Herbal products cannot interact with prescription medications.”
B. “Only prescription medications need to be reported.”
C. “Some herbal products can alter medication effects or increase adverse effects.”
D. “Herbal products are always safer than prescription medications.”
Answer: C.
Rationale: Complementary and herbal products may interact with medications and should be
included in medication reconciliation.
Question 8
Which finding should cause the nurse to question an opioid prescription most urgently?
A. Respiratory rate of 8/min
B. Heart rate of 82/min
C. Blood pressure of 128/76 mm Hg
D. Temperature of 37°C
Answer: A. Respiratory rate of 8/min
Rationale: Significant respiratory depression is a potentially life-threatening opioid adverse
effect.
PART II — MEDICATION ADMINISTRATION
Question 9
The nurse prepares an intramuscular injection. Which factor most directly influences the
selection of an injection site?
A. Patient's favorite sleeping position
B. Medication volume and tissue characteristics
C. Patient's educational level
D. Time of day
Answer: B.
Rationale: Medication volume, viscosity, patient age, muscle mass, and tissue condition
influence safe IM-site selection.
