, NRG 200 Pharmacology for Human Caring
Nursing Final Exam – College of Nursing –
2026/2027 Academic Year – 100 Questions and
Answers Covering Four Core Domains | with
complete solutions.
SECTION 1: PHARMACOKINETICS AND
PHARMACODYNAMICS
1. A nurse is reviewing the concept of pharmacokinetics. Which
statement correctly describes this term?
A) The study of how drugs affect the body at the cellular level
B) The study of the movement of drugs through the body, including
absorption, distribution, metabolism, and excretion
C) The study of drug interactions and adverse effects
D) The study of how drugs bind to receptors to produce a therapeutic effect
Answer: B) The study of the movement of drugs through the body,
including absorption, distribution, metabolism, and excretion
Rationale: Pharmacokinetics refers to the four processes of drug movement
through the body: absorption (into the bloodstream), distribution (to tissues),
metabolism (biotransformation), and excretion (elimination from the body) .
This is distinguished from pharmacodynamics, which is the study of how
drugs affect the body and their mechanism of action at receptor sites .
Understanding pharmacokinetics is essential for determining appropriate
dosing, onset, peak, and duration of drug action, and for making clinical
decisions about medication administration.
2. A medication is prescribed that has a high first-pass effect. The
nurse understands that this means:
,A) The drug is absorbed quickly from the stomach
B) A large portion of the drug is inactivated by the liver before reaching
systemic circulation
C) The drug has a rapid onset of action
D) The drug is excreted unchanged by the kidneys
Answer: B) A large portion of the drug is inactivated by the liver
before reaching systemic circulation
Rationale: The first-pass effect refers to the metabolism of a drug by the
liver before it reaches systemic circulation. Drugs absorbed from the GI tract
are carried via the portal vein to the liver, where a significant portion may be
metabolized to inactive metabolites . This often necessitates higher oral
doses to achieve a therapeutic effect because the drug must survive hepatic
metabolism to reach the systemic circulation. This is why some drugs cannot
be given orally and must be administered via routes that bypass the liver .
3. A patient is prescribed a drug that is a weak acid. In which pH
environment will it be best absorbed orally?
A) Alkaline (small intestine)
B) Acidic (stomach)
C) Neutral (blood)
D) Any pH; absorption is equal
Answer: B) Acidic (stomach)
Rationale: Weak acids are non-ionized and lipid-soluble in acidic
environments such as the stomach, which enhances their absorption across
the gastric mucosa . Weak bases are better absorbed in alkaline
environments like the small intestine. This principle is based on the concept
of ion trapping, where the ionized form of a drug is less lipid-soluble and
therefore less able to cross biological membranes. This is why aspirin (a
weak acid) is well absorbed in the stomach.
4. The nurse administers naloxone to a patient with respiratory
depression. This is an example of:
, A) Agonist action
B) Antagonist action
C) Synergistic effect
D) Tolerance reversal
Answer: B) Antagonist action
Rationale: Naloxone is a pure opioid antagonist that blocks opioid receptors,
reversing the effects of opioids such as respiratory depression and sedation .
An antagonist binds to a receptor but does not activate it, preventing the
endogenous ligand or other agonists from binding. This distinguishes it from
an agonist, which binds and activates the receptor to produce a response.
Naloxone is the standard treatment for opioid overdose and is used
emergently to restore respiratory function.
5. A drug that binds to a receptor and mimics the natural
neurotransmitter, producing a physiologic response, is known as
a(n):
A) Antagonist
B) Agonist
C) Partial agonist
D) Competitive inhibitor
Answer: B) Agonist
Rationale: An agonist is a drug that binds to a receptor and activates it,
producing a physiologic response that mimics the action of the endogenous
ligand . Agonists have affinity for the receptor (they bind) and intrinsic
activity (they produce a response). Full agonists produce the maximal
response, while partial agonists produce a submaximal response. An
antagonist binds to a receptor but does not activate it, instead blocking the
receptor .
6. Which laboratory value indicates impaired renal function that
would require dosage adjustment?
Nursing Final Exam – College of Nursing –
2026/2027 Academic Year – 100 Questions and
Answers Covering Four Core Domains | with
complete solutions.
SECTION 1: PHARMACOKINETICS AND
PHARMACODYNAMICS
1. A nurse is reviewing the concept of pharmacokinetics. Which
statement correctly describes this term?
A) The study of how drugs affect the body at the cellular level
B) The study of the movement of drugs through the body, including
absorption, distribution, metabolism, and excretion
C) The study of drug interactions and adverse effects
D) The study of how drugs bind to receptors to produce a therapeutic effect
Answer: B) The study of the movement of drugs through the body,
including absorption, distribution, metabolism, and excretion
Rationale: Pharmacokinetics refers to the four processes of drug movement
through the body: absorption (into the bloodstream), distribution (to tissues),
metabolism (biotransformation), and excretion (elimination from the body) .
This is distinguished from pharmacodynamics, which is the study of how
drugs affect the body and their mechanism of action at receptor sites .
Understanding pharmacokinetics is essential for determining appropriate
dosing, onset, peak, and duration of drug action, and for making clinical
decisions about medication administration.
2. A medication is prescribed that has a high first-pass effect. The
nurse understands that this means:
,A) The drug is absorbed quickly from the stomach
B) A large portion of the drug is inactivated by the liver before reaching
systemic circulation
C) The drug has a rapid onset of action
D) The drug is excreted unchanged by the kidneys
Answer: B) A large portion of the drug is inactivated by the liver
before reaching systemic circulation
Rationale: The first-pass effect refers to the metabolism of a drug by the
liver before it reaches systemic circulation. Drugs absorbed from the GI tract
are carried via the portal vein to the liver, where a significant portion may be
metabolized to inactive metabolites . This often necessitates higher oral
doses to achieve a therapeutic effect because the drug must survive hepatic
metabolism to reach the systemic circulation. This is why some drugs cannot
be given orally and must be administered via routes that bypass the liver .
3. A patient is prescribed a drug that is a weak acid. In which pH
environment will it be best absorbed orally?
A) Alkaline (small intestine)
B) Acidic (stomach)
C) Neutral (blood)
D) Any pH; absorption is equal
Answer: B) Acidic (stomach)
Rationale: Weak acids are non-ionized and lipid-soluble in acidic
environments such as the stomach, which enhances their absorption across
the gastric mucosa . Weak bases are better absorbed in alkaline
environments like the small intestine. This principle is based on the concept
of ion trapping, where the ionized form of a drug is less lipid-soluble and
therefore less able to cross biological membranes. This is why aspirin (a
weak acid) is well absorbed in the stomach.
4. The nurse administers naloxone to a patient with respiratory
depression. This is an example of:
, A) Agonist action
B) Antagonist action
C) Synergistic effect
D) Tolerance reversal
Answer: B) Antagonist action
Rationale: Naloxone is a pure opioid antagonist that blocks opioid receptors,
reversing the effects of opioids such as respiratory depression and sedation .
An antagonist binds to a receptor but does not activate it, preventing the
endogenous ligand or other agonists from binding. This distinguishes it from
an agonist, which binds and activates the receptor to produce a response.
Naloxone is the standard treatment for opioid overdose and is used
emergently to restore respiratory function.
5. A drug that binds to a receptor and mimics the natural
neurotransmitter, producing a physiologic response, is known as
a(n):
A) Antagonist
B) Agonist
C) Partial agonist
D) Competitive inhibitor
Answer: B) Agonist
Rationale: An agonist is a drug that binds to a receptor and activates it,
producing a physiologic response that mimics the action of the endogenous
ligand . Agonists have affinity for the receptor (they bind) and intrinsic
activity (they produce a response). Full agonists produce the maximal
response, while partial agonists produce a submaximal response. An
antagonist binds to a receptor but does not activate it, instead blocking the
receptor .
6. Which laboratory value indicates impaired renal function that
would require dosage adjustment?
