Pharmacology Clear and
Simple A Guide to Drug
Classifications and Dosage
Calculations, 4th Edition
Section 1: History, Basics, and Regulations (Chapters 1–4)
1. Question: What historical event prompted the introduction of the Food, Drug, and
Cosmetic Act of 1938?
Answer & Rationale: The elixir of sulfanilamide tragedy. Diethylene glycol was used
as a solvent, causing widespread poisoning and death, leading to mandatory safety testing
before marketing.
2. Question: Which phase of clinical drug trials involves human subjects testing for
efficacy and safety on a larger scale with the target disease?
Answer & Rationale: Phase II. This phase specifically evaluates the therapeutic
effectiveness of the drug in patients who have the target condition.
3. Question: What schedule contains drugs with no accepted medical use and extreme
potential for abuse?
Answer & Rationale: Schedule I (e.g., heroin, LSD, peyote).
4. Question: Define pharmacodynamics.
Answer & Rationale: The study of what drugs do to the body and how they exert
their cellular and systemic effects.
5. Question: What is an idiosyncratic reaction?
Answer & Rationale: An unexpected, abnormal, or unpredictable individual
response to a medication, often genetically determined.
6. Question: A drug that binds to a receptor and stimulates a cellular response is known as
what?
Answer & Rationale: An agonist.
7. Question: What term describes the time required for the concentration of a drug in the
body to decrease by 50%?
Answer & Rationale: Half-life (t 1/ 2).
8. Question: Which organ system is primarily responsible for the excretion of water-soluble
drug metabolites?
Answer & Rationale: The renal (urinary) system via the kidneys.
9. Question: What is a teratogenic drug effect?
Answer & Rationale: An effect that causes physical birth defects in a developing
fetus when administered during pregnancy.
10. Question: What regulatory agency in the United States is responsible for approving new
prescription and over-the-counter drugs?
Answer & Rationale: The Food and Drug Administration (FDA).
,Section 2: Patient Safety, Prescriptions, and Labels (Chapters 3–5)
11. Question: What are the classic "Rights" of medication administration?
Answer & Rationale: Right patient, right drug, right dose, right time, right route,
right documentation, and right reason.
12. Question: What action should a nurse take immediately if a medication error occurs?
Answer & Rationale: Assess the patient's vital signs and clinical status, notify the
prescribing provider, and complete an incident/variance report.
13. Question: What components must be present on a valid legal prescription?
Answer & Rationale: Patient name, date, drug name, dosage, route, frequency, and
provider signature.
14. Question: What does the abbreviation "PRN" stand for on a prescription?
Answer & Rationale: Pro re nata (as needed).
15. Question: What is a high-alert medication according to safety organizations like ISMP?
Answer & Rationale: Drugs that bear a heightened risk of causing significant
patient harm when used in error (e.g., insulin, heparin, opioids).
16. Question: Why should a nurse never administer a medication from a container with an
illegible or missing label?
Answer & Rationale: It violates safe medication practices and risks severe
administration errors.
17. Question: What does "sublingual" administration mean?
Answer & Rationale: Placing the medication under the tongue to dissolve and absorb
directly into systemic circulation.
18. Question: What type of medication order specifies that a drug is to be given immediately
and only once?
Answer & Rationale: A STAT order.
19. Question: How many patient identifiers must a nurse check prior to administering any
medication?
Answer & Rationale: At least two identifiers (e.g., patient full name and date of birth).
20. Question: What is the purpose of reconciling medications during transitions of care?
Answer & Rationale: To prevent discrepancies, omissions, duplicate therapies, and
dangerous drug interactions.
Section 3: Mathematics and Dosage Calculations (Chapters 6–8)
21. Question: Convert 450 mcgto milligrams.
Answer & Rationale: 0.45 mg (divide by 1,000).
22. Question: Order: Amoxicillin 500 mg PO. Available: 250 mg per capsule. How many
capsules do you administer?
500
Answer & Rationale: 2 capsules( =2).
250
23. Question: Convert 75 kg to pounds (round to the nearest whole number).
Answer & Rationale: 165 lbs (75 ×2.2=165).
24. Question: An IV fluid bag of 500 mLis to infuse over 4 hours. Calculate the pump rate in
mL/hr.
Answer & Rationale: 125 mL/hr (500 ÷ 4 ).
, 25. Question: Order: Heparin 5,000 units subcutaneously. Available: 10,000 units/mL. How
many mL should be injected?
5000
Answer & Rationale: 0.5 mL ( ).
10000
26. Question: Calculate the drop rate for 1,000 mLof NS over 10 hours with a drop factor of
20 gtt/mL.
1000× 20
Answer & Rationale: 33 gtt/min ( ).
600
27. Question: Convert 0.05 gramsto milligrams.
Answer & Rationale: 50 mg (0.05 ×1000 ).
28. Question: A child weighs 44 lbs . Convert this weight to kilograms.
Answer & Rationale: 20 kg (44 ÷2.2 ).
29. Question: Order: Morphine 4 mg IV push. Available: 10 mg/mL. How many mL will you
draw up?
4
Answer & Rationale: 0.4 mL( ).
10
30. Question: A patient is ordered a continuous infusion at 40 mL/hrusing tubing with a drop
factor of 60 gtt/mL(microdrip). What is the drip rate?
Answer & Rationale: 40 gtt/min (with microdrip tubing, mL/hr equals gtt/min).
Section 4: Administration Routes (Enteral & Parenteral) (Chapters 9–10)
31. Question: What is the primary advantage of the enteral route of administration?
Answer & Rationale: It is generally safe, convenient, and economical.
32. Question: Can sustained-release tablets be crushed for administration via a gastric
feeding tube?
Answer & Rationale: No. Crushing destroys the extended-release mechanism, leading to
rapid, toxic drug dumping.
33. Question: What is the correct gauge and length needle typically used for a standard adult
intramuscular injection in the deltoid?
Answer & Rationale: 23- to 25-gauge, 1-inch needle.
34. Question: Why is the Z-track technique recommended for intramuscular injections of
irritating medications (like iron dextran)?
Answer & Rationale: To seal the medication deep within the muscle tissue and
prevent staining or irritation of subcutaneous tissues.
35. Question: What angle is appropriate for an intradermal injection (e.g., PPD skin test)?
Answer & Rationale: 5∘to 15∘with the bevel facing upward.
36. Question: What is the maximum volume usually recommended for an IM injection in the
adult deltoid muscle?
Answer & Rationale: 1 mL(maximum 2 mLfor ventrogluteal).
37. Question: When administering eye drops, where should the drop be instilled?
Answer & Rationale: Into the lower conjunctival sac.
38. Question: How should an adult patient's earlobe be pulled when administering ear drops?
Answer & Rationale: Up and back (whereas children under 3 are pulled down and
back).
Simple A Guide to Drug
Classifications and Dosage
Calculations, 4th Edition
Section 1: History, Basics, and Regulations (Chapters 1–4)
1. Question: What historical event prompted the introduction of the Food, Drug, and
Cosmetic Act of 1938?
Answer & Rationale: The elixir of sulfanilamide tragedy. Diethylene glycol was used
as a solvent, causing widespread poisoning and death, leading to mandatory safety testing
before marketing.
2. Question: Which phase of clinical drug trials involves human subjects testing for
efficacy and safety on a larger scale with the target disease?
Answer & Rationale: Phase II. This phase specifically evaluates the therapeutic
effectiveness of the drug in patients who have the target condition.
3. Question: What schedule contains drugs with no accepted medical use and extreme
potential for abuse?
Answer & Rationale: Schedule I (e.g., heroin, LSD, peyote).
4. Question: Define pharmacodynamics.
Answer & Rationale: The study of what drugs do to the body and how they exert
their cellular and systemic effects.
5. Question: What is an idiosyncratic reaction?
Answer & Rationale: An unexpected, abnormal, or unpredictable individual
response to a medication, often genetically determined.
6. Question: A drug that binds to a receptor and stimulates a cellular response is known as
what?
Answer & Rationale: An agonist.
7. Question: What term describes the time required for the concentration of a drug in the
body to decrease by 50%?
Answer & Rationale: Half-life (t 1/ 2).
8. Question: Which organ system is primarily responsible for the excretion of water-soluble
drug metabolites?
Answer & Rationale: The renal (urinary) system via the kidneys.
9. Question: What is a teratogenic drug effect?
Answer & Rationale: An effect that causes physical birth defects in a developing
fetus when administered during pregnancy.
10. Question: What regulatory agency in the United States is responsible for approving new
prescription and over-the-counter drugs?
Answer & Rationale: The Food and Drug Administration (FDA).
,Section 2: Patient Safety, Prescriptions, and Labels (Chapters 3–5)
11. Question: What are the classic "Rights" of medication administration?
Answer & Rationale: Right patient, right drug, right dose, right time, right route,
right documentation, and right reason.
12. Question: What action should a nurse take immediately if a medication error occurs?
Answer & Rationale: Assess the patient's vital signs and clinical status, notify the
prescribing provider, and complete an incident/variance report.
13. Question: What components must be present on a valid legal prescription?
Answer & Rationale: Patient name, date, drug name, dosage, route, frequency, and
provider signature.
14. Question: What does the abbreviation "PRN" stand for on a prescription?
Answer & Rationale: Pro re nata (as needed).
15. Question: What is a high-alert medication according to safety organizations like ISMP?
Answer & Rationale: Drugs that bear a heightened risk of causing significant
patient harm when used in error (e.g., insulin, heparin, opioids).
16. Question: Why should a nurse never administer a medication from a container with an
illegible or missing label?
Answer & Rationale: It violates safe medication practices and risks severe
administration errors.
17. Question: What does "sublingual" administration mean?
Answer & Rationale: Placing the medication under the tongue to dissolve and absorb
directly into systemic circulation.
18. Question: What type of medication order specifies that a drug is to be given immediately
and only once?
Answer & Rationale: A STAT order.
19. Question: How many patient identifiers must a nurse check prior to administering any
medication?
Answer & Rationale: At least two identifiers (e.g., patient full name and date of birth).
20. Question: What is the purpose of reconciling medications during transitions of care?
Answer & Rationale: To prevent discrepancies, omissions, duplicate therapies, and
dangerous drug interactions.
Section 3: Mathematics and Dosage Calculations (Chapters 6–8)
21. Question: Convert 450 mcgto milligrams.
Answer & Rationale: 0.45 mg (divide by 1,000).
22. Question: Order: Amoxicillin 500 mg PO. Available: 250 mg per capsule. How many
capsules do you administer?
500
Answer & Rationale: 2 capsules( =2).
250
23. Question: Convert 75 kg to pounds (round to the nearest whole number).
Answer & Rationale: 165 lbs (75 ×2.2=165).
24. Question: An IV fluid bag of 500 mLis to infuse over 4 hours. Calculate the pump rate in
mL/hr.
Answer & Rationale: 125 mL/hr (500 ÷ 4 ).
, 25. Question: Order: Heparin 5,000 units subcutaneously. Available: 10,000 units/mL. How
many mL should be injected?
5000
Answer & Rationale: 0.5 mL ( ).
10000
26. Question: Calculate the drop rate for 1,000 mLof NS over 10 hours with a drop factor of
20 gtt/mL.
1000× 20
Answer & Rationale: 33 gtt/min ( ).
600
27. Question: Convert 0.05 gramsto milligrams.
Answer & Rationale: 50 mg (0.05 ×1000 ).
28. Question: A child weighs 44 lbs . Convert this weight to kilograms.
Answer & Rationale: 20 kg (44 ÷2.2 ).
29. Question: Order: Morphine 4 mg IV push. Available: 10 mg/mL. How many mL will you
draw up?
4
Answer & Rationale: 0.4 mL( ).
10
30. Question: A patient is ordered a continuous infusion at 40 mL/hrusing tubing with a drop
factor of 60 gtt/mL(microdrip). What is the drip rate?
Answer & Rationale: 40 gtt/min (with microdrip tubing, mL/hr equals gtt/min).
Section 4: Administration Routes (Enteral & Parenteral) (Chapters 9–10)
31. Question: What is the primary advantage of the enteral route of administration?
Answer & Rationale: It is generally safe, convenient, and economical.
32. Question: Can sustained-release tablets be crushed for administration via a gastric
feeding tube?
Answer & Rationale: No. Crushing destroys the extended-release mechanism, leading to
rapid, toxic drug dumping.
33. Question: What is the correct gauge and length needle typically used for a standard adult
intramuscular injection in the deltoid?
Answer & Rationale: 23- to 25-gauge, 1-inch needle.
34. Question: Why is the Z-track technique recommended for intramuscular injections of
irritating medications (like iron dextran)?
Answer & Rationale: To seal the medication deep within the muscle tissue and
prevent staining or irritation of subcutaneous tissues.
35. Question: What angle is appropriate for an intradermal injection (e.g., PPD skin test)?
Answer & Rationale: 5∘to 15∘with the bevel facing upward.
36. Question: What is the maximum volume usually recommended for an IM injection in the
adult deltoid muscle?
Answer & Rationale: 1 mL(maximum 2 mLfor ventrogluteal).
37. Question: When administering eye drops, where should the drop be instilled?
Answer & Rationale: Into the lower conjunctival sac.
38. Question: How should an adult patient's earlobe be pulled when administering ear drops?
Answer & Rationale: Up and back (whereas children under 3 are pulled down and
back).
