NUR 100 PHARMACOLOGY EXAM 1
FORTIS COLLEGE LATEST 2026/2027
Exam Questions and Correct Answers - Graded A+
75 Questions | 5 Core Sections | Fortis College NUR 100 Curriculum Aligned
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Question Style: 70% Scenario-Based | 30% Direct Recall
Section 1: Foundational Concepts and Pharmacokinetics
Introduction to Pharmacology, Drug Nomenclature, Pharmacokinetics - Absorption, Distribution, Metabolism, Excretion, Half-Life,
and Steady-State
Q1: A nursing student is reviewing medication orders and sees 'acetaminophen' on one order and 'Tylenol' on
another. The student asks the nurse what the difference is. Which response by the nurse is most accurate?
A. 'Tylenol is the generic name and acetaminophen is the trade name.'
B. 'Acetaminophen is the generic name and Tylenol is the brand (trade) name.' [CORRECT]
C. 'Both are brand names manufactured by different companies.'
D. 'Acetaminophen is the chemical name and Tylenol is the generic name.'
Correct Answer: B
Rationale: The generic name (acetaminophen) is the official, nonproprietary name assigned by the United States Adopted
Names (USAN) council and is not owned by any manufacturer. The brand or trade name (Tylenol) is the proprietary name
owned by a specific pharmaceutical company and is typically followed by a trademark symbol. Both names refer to the exact
same drug entity. Option A reverses the relationship, option C incorrectly identifies both as brand names, and option D
confuses the chemical name with the generic name.
Q2: Which of the following best describes a therapeutic drug classification system?
A. A system that classifies drugs by their chemical structure only
B. A system that groups drugs according to their clinical use and effect on the body [CORRECT]
C. A system that organizes drugs by their manufacturer and cost
D. A system that categorizes drugs solely by their route of administration
Correct Answer: B
Rationale: Therapeutic classification groups medications by their clinical use, pharmacological action, and the condition they
are intended to treat (e.g., antihypertensives, antiarrhythmics, antibiotics). This system is the most relevant to nursing practice
because it guides clinical decision-making and helps nurses understand the intended therapeutic effect. Option A describes a
pharmacological or chemical classification, not therapeutic. Option C describes a formulary-based system, and option D
describes an administrative classification, neither of which reflects clinical utility.
Q3: A nurse is preparing a medication derived from a biological source. Which of the following medications is
derived from a plant source?
A. Insulin
B. Morphine [CORRECT]
C. Levothyroxine
D. Prednisone
Page 1
,Correct Answer: B
Rationale: Morphine is an opioid analgesic derived from the opium poppy (Papaver somniferum), making it a plant-derived
drug. Insulin was originally extracted from animal pancreas but is now synthesized recombinantly. Levothyroxine is a synthetic
thyroid hormone. Prednisone is a synthetic corticosteroid. Understanding drug sources is important in pharmacology because
natural sources may exhibit variability in potency, while synthetic drugs offer more consistent dosing and purity.
Q4: A patient takes an oral medication with a meal high in fat content. The nurse explains that this may affect drug
absorption. Which mechanism best describes how a high-fat meal influences the absorption of a highly lipophilic
drug?
A. It decreases gastric emptying, which always reduces drug absorption regardless of drug properties
B. It increases bile secretion, which enhances solubility and absorption of lipophilic drugs [CORRECT]
C. It destroys the active pharmaceutical ingredient in the stomach
D. It has no effect on drug absorption since food only affects the stomach lining
Correct Answer: B
Rationale: A high-fat meal stimulates bile secretion, which emulsifies dietary fats and simultaneously enhances the solubility of
lipophilic (fat-soluble) drugs in the gastrointestinal tract. This increased solubility leads to greater absorption of highly
lipophilic medications. Option A is incorrect because while high-fat meals do slow gastric emptying, the net effect on lipophilic
drugs is typically enhanced, not reduced, absorption. Option C is false because food does not destroy most active
pharmaceutical ingredients, and option D is factually incorrect.
Q5: A patient is prescribed a medication that undergoes extensive first-pass metabolism. The prescriber changes
the route from oral to intravenous (IV). What is the primary pharmacokinetic reason for this route change?
A. IV administration bypasses hepatic metabolism, increasing bioavailability [CORRECT]
B. IV administration speeds up renal excretion of the drug
C. IV administration reduces the drug's protein-binding capacity
D. IV administration decreases the drug's volume of distribution
Correct Answer: A
Rationale: The first-pass effect refers to the presystemic metabolism of a drug by the liver before it reaches systemic
circulation. Drugs taken orally are absorbed from the GI tract into the portal vein, which carries them directly to the liver,
where a significant portion may be metabolized before entering the systemic circulation. IV administration bypasses the GI
tract and the liver's first-pass metabolism entirely, resulting in 100% bioavailability. This is the primary pharmacokinetic
reason for switching from oral to IV for drugs with high first-pass metabolism. Options B, C, and D describe effects related to
excretion, distribution, and protein binding, which are not the primary reason for this route change.
Q6: A pharmaceutical manufacturer reports that a new drug has a bioavailability of 40% when administered
orally. The nurse understands that this means:
A. 40% of the administered dose reaches the site of action
B. 40% of the administered dose reaches systemic circulation unchanged [CORRECT]
C. 60% of the drug is excreted unchanged by the kidneys
D. The drug is 40% bound to plasma proteins
Correct Answer: B
Rationale: Bioavailability (F) is defined as the fraction or percentage of an administered dose of unchanged drug that reaches
the systemic circulation. A bioavailability of 40% means that only 40% of the oral dose survives first-pass metabolism,
absorption barriers, and other presystemic elimination processes to enter the bloodstream. Option A is incorrect because
bioavailability refers to reaching systemic circulation, not necessarily the specific site of action (which depends on
distribution). Option C confuses bioavailability with renal excretion, and option D confuses bioavailability with protein
binding.
Q7: A patient is taking two highly protein-bound drugs: Drug A (98% bound) and Drug B (96% bound). The
nurse anticipates which potential pharmacokinetic interaction?
Page 2
, A. Both drugs will be freely available in their active, unbound form
B. Drug B may displace Drug A from plasma proteins, increasing free (active) Drug A levels [CORRECT]
C. The combination will increase total protein synthesis in the liver
D. Protein binding will prevent both drugs from reaching any target tissue
Correct Answer: B
Rationale: When two highly protein-bound drugs are administered concurrently, competitive displacement can occur. Drug B
may displace Drug A from plasma protein binding sites, transiently increasing the free (pharmacologically active)
concentration of Drug A in the bloodstream. This can lead to toxicity if the free concentration rises significantly. Option A is
incorrect because highly protein-bound drugs have very little free drug available. Option C is not a pharmacokinetic
interaction caused by co-administration. Option D is incorrect because only the bound fraction is restricted; the free fraction is
still able to reach target tissues.
Q8: A patient with a CNS infection is prescribed an antibiotic. The nurse understands that which characteristic is
most important for the drug to effectively treat this infection?
A. High molecular weight and high degree of ionization
B. High lipid solubility and low molecular weight [CORRECT]
C. Being highly protein-bound to albumin
D. Being water-soluble with a large polar surface area
Correct Answer: B
Rationale: The blood-brain barrier (BBB) is a highly selective semipermeable barrier that restricts the passage of many
substances from the bloodstream into the CNS. Drugs that are highly lipid-soluble and have low molecular weight can more
easily cross the BBB by passive diffusion through the endothelial cell membranes. Highly ionized, water-soluble, or
large-molecule drugs have difficulty penetrating the BBB. Option A describes properties that would impede BBB penetration.
Option C would reduce the free drug available to cross. Option D describes properties that also limit BBB penetration.
Q9: Which of the following cytochrome P450 enzymes is responsible for metabolizing the largest number of
commonly prescribed drugs?
A. CYP1A2
B. CYP2C9
C. CYP2D6
D. CYP3A4 [CORRECT]
Correct Answer: D
Rationale: CYP3A4 is the most abundant cytochrome P450 enzyme in the liver and is responsible for metabolizing
approximately 50% of all clinically used drugs. It plays a major role in the metabolism of many drug classes including
benzodiazepines, calcium channel blockers, macrolide antibiotics, and many others. Understanding CYP3A4 is critical for
predicting drug-drug interactions because many inhibitors (e.g., ketoconazole, grapefruit juice) and inducers (e.g., rifampin,
St. John's wort) affect this enzyme. While CYP2D6, CYP2C9, and CYP1A2 are also clinically important, they metabolize fewer
drugs than CYP3A4.
Q10: A nurse is reviewing a patient's medication profile and notes that the patient takes a CYP3A4 inhibitor.
Which effect should the nurse anticipate for drugs metabolized by CYP3A4?
A. Increased metabolism leading to decreased drug effect
B. Decreased metabolism leading to increased drug levels and potential toxicity [CORRECT]
C. No effect because CYP3A4 only metabolizes endogenous substances
D. Enhanced renal excretion of the CYP3A4-metabolized drugs
Correct Answer: B
Rationale: A CYP3A4 inhibitor reduces the metabolic activity of the CYP3A4 enzyme, thereby decreasing the metabolism of
drugs that are CYP3A4 substrates. This results in increased plasma levels of those drugs, which can lead to enhanced
pharmacological effects and potential toxicity. Common CYP3A4 inhibitors include ketoconazole, erythromycin, and
grapefruit juice. Option A describes the effect of a CYP inducer, not an inhibitor. Option C is incorrect because CYP3A4
Page 3
FORTIS COLLEGE LATEST 2026/2027
Exam Questions and Correct Answers - Graded A+
75 Questions | 5 Core Sections | Fortis College NUR 100 Curriculum Aligned
Cognitive Levels: 30% Recall | 50% Application | 20% Analysis
Question Style: 70% Scenario-Based | 30% Direct Recall
Section 1: Foundational Concepts and Pharmacokinetics
Introduction to Pharmacology, Drug Nomenclature, Pharmacokinetics - Absorption, Distribution, Metabolism, Excretion, Half-Life,
and Steady-State
Q1: A nursing student is reviewing medication orders and sees 'acetaminophen' on one order and 'Tylenol' on
another. The student asks the nurse what the difference is. Which response by the nurse is most accurate?
A. 'Tylenol is the generic name and acetaminophen is the trade name.'
B. 'Acetaminophen is the generic name and Tylenol is the brand (trade) name.' [CORRECT]
C. 'Both are brand names manufactured by different companies.'
D. 'Acetaminophen is the chemical name and Tylenol is the generic name.'
Correct Answer: B
Rationale: The generic name (acetaminophen) is the official, nonproprietary name assigned by the United States Adopted
Names (USAN) council and is not owned by any manufacturer. The brand or trade name (Tylenol) is the proprietary name
owned by a specific pharmaceutical company and is typically followed by a trademark symbol. Both names refer to the exact
same drug entity. Option A reverses the relationship, option C incorrectly identifies both as brand names, and option D
confuses the chemical name with the generic name.
Q2: Which of the following best describes a therapeutic drug classification system?
A. A system that classifies drugs by their chemical structure only
B. A system that groups drugs according to their clinical use and effect on the body [CORRECT]
C. A system that organizes drugs by their manufacturer and cost
D. A system that categorizes drugs solely by their route of administration
Correct Answer: B
Rationale: Therapeutic classification groups medications by their clinical use, pharmacological action, and the condition they
are intended to treat (e.g., antihypertensives, antiarrhythmics, antibiotics). This system is the most relevant to nursing practice
because it guides clinical decision-making and helps nurses understand the intended therapeutic effect. Option A describes a
pharmacological or chemical classification, not therapeutic. Option C describes a formulary-based system, and option D
describes an administrative classification, neither of which reflects clinical utility.
Q3: A nurse is preparing a medication derived from a biological source. Which of the following medications is
derived from a plant source?
A. Insulin
B. Morphine [CORRECT]
C. Levothyroxine
D. Prednisone
Page 1
,Correct Answer: B
Rationale: Morphine is an opioid analgesic derived from the opium poppy (Papaver somniferum), making it a plant-derived
drug. Insulin was originally extracted from animal pancreas but is now synthesized recombinantly. Levothyroxine is a synthetic
thyroid hormone. Prednisone is a synthetic corticosteroid. Understanding drug sources is important in pharmacology because
natural sources may exhibit variability in potency, while synthetic drugs offer more consistent dosing and purity.
Q4: A patient takes an oral medication with a meal high in fat content. The nurse explains that this may affect drug
absorption. Which mechanism best describes how a high-fat meal influences the absorption of a highly lipophilic
drug?
A. It decreases gastric emptying, which always reduces drug absorption regardless of drug properties
B. It increases bile secretion, which enhances solubility and absorption of lipophilic drugs [CORRECT]
C. It destroys the active pharmaceutical ingredient in the stomach
D. It has no effect on drug absorption since food only affects the stomach lining
Correct Answer: B
Rationale: A high-fat meal stimulates bile secretion, which emulsifies dietary fats and simultaneously enhances the solubility of
lipophilic (fat-soluble) drugs in the gastrointestinal tract. This increased solubility leads to greater absorption of highly
lipophilic medications. Option A is incorrect because while high-fat meals do slow gastric emptying, the net effect on lipophilic
drugs is typically enhanced, not reduced, absorption. Option C is false because food does not destroy most active
pharmaceutical ingredients, and option D is factually incorrect.
Q5: A patient is prescribed a medication that undergoes extensive first-pass metabolism. The prescriber changes
the route from oral to intravenous (IV). What is the primary pharmacokinetic reason for this route change?
A. IV administration bypasses hepatic metabolism, increasing bioavailability [CORRECT]
B. IV administration speeds up renal excretion of the drug
C. IV administration reduces the drug's protein-binding capacity
D. IV administration decreases the drug's volume of distribution
Correct Answer: A
Rationale: The first-pass effect refers to the presystemic metabolism of a drug by the liver before it reaches systemic
circulation. Drugs taken orally are absorbed from the GI tract into the portal vein, which carries them directly to the liver,
where a significant portion may be metabolized before entering the systemic circulation. IV administration bypasses the GI
tract and the liver's first-pass metabolism entirely, resulting in 100% bioavailability. This is the primary pharmacokinetic
reason for switching from oral to IV for drugs with high first-pass metabolism. Options B, C, and D describe effects related to
excretion, distribution, and protein binding, which are not the primary reason for this route change.
Q6: A pharmaceutical manufacturer reports that a new drug has a bioavailability of 40% when administered
orally. The nurse understands that this means:
A. 40% of the administered dose reaches the site of action
B. 40% of the administered dose reaches systemic circulation unchanged [CORRECT]
C. 60% of the drug is excreted unchanged by the kidneys
D. The drug is 40% bound to plasma proteins
Correct Answer: B
Rationale: Bioavailability (F) is defined as the fraction or percentage of an administered dose of unchanged drug that reaches
the systemic circulation. A bioavailability of 40% means that only 40% of the oral dose survives first-pass metabolism,
absorption barriers, and other presystemic elimination processes to enter the bloodstream. Option A is incorrect because
bioavailability refers to reaching systemic circulation, not necessarily the specific site of action (which depends on
distribution). Option C confuses bioavailability with renal excretion, and option D confuses bioavailability with protein
binding.
Q7: A patient is taking two highly protein-bound drugs: Drug A (98% bound) and Drug B (96% bound). The
nurse anticipates which potential pharmacokinetic interaction?
Page 2
, A. Both drugs will be freely available in their active, unbound form
B. Drug B may displace Drug A from plasma proteins, increasing free (active) Drug A levels [CORRECT]
C. The combination will increase total protein synthesis in the liver
D. Protein binding will prevent both drugs from reaching any target tissue
Correct Answer: B
Rationale: When two highly protein-bound drugs are administered concurrently, competitive displacement can occur. Drug B
may displace Drug A from plasma protein binding sites, transiently increasing the free (pharmacologically active)
concentration of Drug A in the bloodstream. This can lead to toxicity if the free concentration rises significantly. Option A is
incorrect because highly protein-bound drugs have very little free drug available. Option C is not a pharmacokinetic
interaction caused by co-administration. Option D is incorrect because only the bound fraction is restricted; the free fraction is
still able to reach target tissues.
Q8: A patient with a CNS infection is prescribed an antibiotic. The nurse understands that which characteristic is
most important for the drug to effectively treat this infection?
A. High molecular weight and high degree of ionization
B. High lipid solubility and low molecular weight [CORRECT]
C. Being highly protein-bound to albumin
D. Being water-soluble with a large polar surface area
Correct Answer: B
Rationale: The blood-brain barrier (BBB) is a highly selective semipermeable barrier that restricts the passage of many
substances from the bloodstream into the CNS. Drugs that are highly lipid-soluble and have low molecular weight can more
easily cross the BBB by passive diffusion through the endothelial cell membranes. Highly ionized, water-soluble, or
large-molecule drugs have difficulty penetrating the BBB. Option A describes properties that would impede BBB penetration.
Option C would reduce the free drug available to cross. Option D describes properties that also limit BBB penetration.
Q9: Which of the following cytochrome P450 enzymes is responsible for metabolizing the largest number of
commonly prescribed drugs?
A. CYP1A2
B. CYP2C9
C. CYP2D6
D. CYP3A4 [CORRECT]
Correct Answer: D
Rationale: CYP3A4 is the most abundant cytochrome P450 enzyme in the liver and is responsible for metabolizing
approximately 50% of all clinically used drugs. It plays a major role in the metabolism of many drug classes including
benzodiazepines, calcium channel blockers, macrolide antibiotics, and many others. Understanding CYP3A4 is critical for
predicting drug-drug interactions because many inhibitors (e.g., ketoconazole, grapefruit juice) and inducers (e.g., rifampin,
St. John's wort) affect this enzyme. While CYP2D6, CYP2C9, and CYP1A2 are also clinically important, they metabolize fewer
drugs than CYP3A4.
Q10: A nurse is reviewing a patient's medication profile and notes that the patient takes a CYP3A4 inhibitor.
Which effect should the nurse anticipate for drugs metabolized by CYP3A4?
A. Increased metabolism leading to decreased drug effect
B. Decreased metabolism leading to increased drug levels and potential toxicity [CORRECT]
C. No effect because CYP3A4 only metabolizes endogenous substances
D. Enhanced renal excretion of the CYP3A4-metabolized drugs
Correct Answer: B
Rationale: A CYP3A4 inhibitor reduces the metabolic activity of the CYP3A4 enzyme, thereby decreasing the metabolism of
drugs that are CYP3A4 substrates. This results in increased plasma levels of those drugs, which can lead to enhanced
pharmacological effects and potential toxicity. Common CYP3A4 inhibitors include ketoconazole, erythromycin, and
grapefruit juice. Option A describes the effect of a CYP inducer, not an inhibitor. Option C is incorrect because CYP3A4
Page 3
