PHARMACOLOGY &
MEDICATION SAFETY
Original Practice Question Bank
Drug Classes • Safety Principles • Nursing Considerations
Original Self-Study Material with Answers & Rationales
Contents Medication safety & pharmacokinetics • Antibiotics • Cardiovascular • Anticoagulants • Diabetes/endocrine •
Pain/neuro/psych • Respiratory/GI & other high-yield topics
How to use Cover the green answer box, answer each question, then review the rationale. Focus on mechanism, major side
effects, monitoring, and patient teaching.
Disclaimer Original educational material for self-study only. Not a publisher test bank. Not affiliated with Elsevier, Workman,
LaCharity, or any textbook publisher.
Original Nursing Pharmacology Practice Series
,Pharmacology & Medication Safety | Original Practice Bank Self-Study Material
Unit 1: Medication Safety & Pharmacologic Principles
1. The 'five rights' of medication administration traditionally include right patient, right drug, right dose, right route, and right:
A. Documentation
B. Time
C. Physician
D. Pharmacy
Answer: B
Rationale: The classic five rights are patient, drug, dose, route, and time. Documentation is often added as a sixth right.
2. Pharmacokinetics includes which processes?
A. Only drug-receptor binding
B. Absorption, distribution, metabolism, excretion
C. Only therapeutic effects
D. Only adverse effects
Answer: B
Rationale: ADME: absorption, distribution, metabolism, excretion.
3. The first-pass effect refers to:
A. Drug excretion by the kidney
B. Metabolism of an oral drug by the liver before it reaches systemic circulation
C. Injection technique
D. Protein binding only
Answer: B
Rationale: Oral drugs may be extensively metabolized in the liver before systemic availability.
4. A drug's half-life is the time required for:
A. Onset of action
B. Plasma concentration to fall by 50%
C. Peak effect
D. Elimination of all drug
Answer: B
Rationale: Half-life is the time for concentration to decrease by half.
5. Agonists are drugs that:
A. Block receptors
B. Bind receptors and produce a response
C. Have no receptor activity
D. Only cause adverse effects
Answer: B
Rationale: Agonists activate receptors; antagonists block them.
6. Which statement about high-alert medications is correct?
A. They are never used in hospitals
B. Errors with them carry a higher risk of significant patient harm
C. They require no double-check
D. They are only OTC drugs
Answer: B
Rationale: High-alert meds (e.g., insulin, heparin, opioids, chemo) require extra safeguards.
7. The nurse’s priority action before giving any medication is to:
A. Chart that it was given
B. Verify the order and patient identity using two identifiers
C. Ask the family to confirm
D. Skip allergy check if busy
Answer: B
Rationale: Safety starts with order verification and positive patient identification.
Educational Use Only Page 2 Not Affiliated with Any Publisher
,Pharmacology & Medication Safety | Original Practice Bank Self-Study Material
8. Therapeutic index is a measure of:
A. Cost
B. Drug safety margin (ratio of toxic to therapeutic dose)
C. Color of the tablet
D. Route only
Answer: B
Rationale: A narrow therapeutic index means small differences between effective and toxic doses.
9. Which route typically has the fastest onset?
A. Oral
B. Intramuscular
C. Intravenous
D. Transdermal
Answer: C
Rationale: IV administration delivers drug directly into the bloodstream.
10. Protein-bound drug is generally:
A. Immediately active
B. Inactive while bound; only free drug is active
C. Always excreted unchanged
D. Unable to be metabolized ever
Answer: B
Rationale: Only unbound (free) drug can exert pharmacologic effect.
Unit 2: Antibiotics & Anti-Infectives
11. Before starting antibiotics, the nurse should ideally obtain:
A. A meal tray
B. Cultures as ordered
C. Only vital signs
D. Consent for surgery
Answer: B
Rationale: Cultures help identify the organism and guide therapy; obtain before first dose when possible.
12. A common adverse effect of many antibiotics that requires patient teaching is:
A. Improved appetite always
B. Superinfection (e.g., C. difficile, thrush) and GI upset
C. Immediate immunity
D. No need for full course
Answer: B
Rationale: Antibiotics disrupt normal flora; complete the full course as prescribed.
13. Aminoglycosides (e.g., gentamicin) require monitoring for:
A. Only rash
B. Ototoxicity and nephrotoxicity
C. Hyperglycemia only
D. Hypertension only
Answer: B
Rationale: Peak/trough levels and renal/hearing monitoring are important.
14. Vancomycin trough levels are monitored to reduce risk of:
A. Hyperkalemia
B. Nephrotoxicity and ototoxicity
C. Hypoglycemia
D. Bradycardia only
Answer: B
Rationale: Vancomycin can cause renal and hearing toxicity; troughs guide dosing.
Educational Use Only Page 3 Not Affiliated with Any Publisher
, Pharmacology & Medication Safety | Original Practice Bank Self-Study Material
15. Metronidazole teaching includes avoiding:
A. Water
B. Alcohol (disulfiram-like reaction)
C. All foods
D. Exercise
Answer: B
Rationale: Alcohol with metronidazole can cause severe nausea/vomiting and other reactions.
16. Tetracyclines are generally avoided in children and pregnancy because of risk to:
A. Liver only
B. Teeth and bone development
C. Hair growth
D. Vision only
Answer: B
Rationale: Tetracyclines can discolor developing teeth and affect bone.
17. A patient on sulfonamides should be taught to:
A. Avoid fluids
B. Increase fluid intake to reduce crystalluria risk
C. Stop if urine is yellow
D. Take with only dairy
Answer: B
Rationale: Adequate hydration helps prevent crystalluria.
18. Red man syndrome is associated with rapid infusion of:
A. Penicillin
B. Vancomycin
C. Ciprofloxacin
D. Metronidazole
Answer: B
Rationale: Rapid vancomycin infusion can cause histamine release (red man syndrome).
19. Fluoroquinolones carry a risk of:
A. Only mild headache
B. Tendonitis/tendon rupture and CNS effects
C. Hyperglycemia exclusively
D. No black-box warnings
Answer: B
Rationale: BBW includes tendinopathy and other serious risks.
20. Penicillin allergy cross-sensitivity is most concerning with which class?
A. Macrolides
B. Cephalosporins (especially earlier generations)
C. Aminoglycosides
D. Tetracyclines
Answer: B
Rationale: Cross-reactivity exists between penicillins and cephalosporins; assess allergy history carefully.
Unit 3: Cardiovascular Medications
21. ACE inhibitors commonly end in:
A. -olol
B. -pril
C. -sartan
D. -dipine
Answer: B
Rationale: ACE inhibitors: -pril (lisinopril, enalapril, etc.).
Educational Use Only Page 4 Not Affiliated with Any Publisher
MEDICATION SAFETY
Original Practice Question Bank
Drug Classes • Safety Principles • Nursing Considerations
Original Self-Study Material with Answers & Rationales
Contents Medication safety & pharmacokinetics • Antibiotics • Cardiovascular • Anticoagulants • Diabetes/endocrine •
Pain/neuro/psych • Respiratory/GI & other high-yield topics
How to use Cover the green answer box, answer each question, then review the rationale. Focus on mechanism, major side
effects, monitoring, and patient teaching.
Disclaimer Original educational material for self-study only. Not a publisher test bank. Not affiliated with Elsevier, Workman,
LaCharity, or any textbook publisher.
Original Nursing Pharmacology Practice Series
,Pharmacology & Medication Safety | Original Practice Bank Self-Study Material
Unit 1: Medication Safety & Pharmacologic Principles
1. The 'five rights' of medication administration traditionally include right patient, right drug, right dose, right route, and right:
A. Documentation
B. Time
C. Physician
D. Pharmacy
Answer: B
Rationale: The classic five rights are patient, drug, dose, route, and time. Documentation is often added as a sixth right.
2. Pharmacokinetics includes which processes?
A. Only drug-receptor binding
B. Absorption, distribution, metabolism, excretion
C. Only therapeutic effects
D. Only adverse effects
Answer: B
Rationale: ADME: absorption, distribution, metabolism, excretion.
3. The first-pass effect refers to:
A. Drug excretion by the kidney
B. Metabolism of an oral drug by the liver before it reaches systemic circulation
C. Injection technique
D. Protein binding only
Answer: B
Rationale: Oral drugs may be extensively metabolized in the liver before systemic availability.
4. A drug's half-life is the time required for:
A. Onset of action
B. Plasma concentration to fall by 50%
C. Peak effect
D. Elimination of all drug
Answer: B
Rationale: Half-life is the time for concentration to decrease by half.
5. Agonists are drugs that:
A. Block receptors
B. Bind receptors and produce a response
C. Have no receptor activity
D. Only cause adverse effects
Answer: B
Rationale: Agonists activate receptors; antagonists block them.
6. Which statement about high-alert medications is correct?
A. They are never used in hospitals
B. Errors with them carry a higher risk of significant patient harm
C. They require no double-check
D. They are only OTC drugs
Answer: B
Rationale: High-alert meds (e.g., insulin, heparin, opioids, chemo) require extra safeguards.
7. The nurse’s priority action before giving any medication is to:
A. Chart that it was given
B. Verify the order and patient identity using two identifiers
C. Ask the family to confirm
D. Skip allergy check if busy
Answer: B
Rationale: Safety starts with order verification and positive patient identification.
Educational Use Only Page 2 Not Affiliated with Any Publisher
,Pharmacology & Medication Safety | Original Practice Bank Self-Study Material
8. Therapeutic index is a measure of:
A. Cost
B. Drug safety margin (ratio of toxic to therapeutic dose)
C. Color of the tablet
D. Route only
Answer: B
Rationale: A narrow therapeutic index means small differences between effective and toxic doses.
9. Which route typically has the fastest onset?
A. Oral
B. Intramuscular
C. Intravenous
D. Transdermal
Answer: C
Rationale: IV administration delivers drug directly into the bloodstream.
10. Protein-bound drug is generally:
A. Immediately active
B. Inactive while bound; only free drug is active
C. Always excreted unchanged
D. Unable to be metabolized ever
Answer: B
Rationale: Only unbound (free) drug can exert pharmacologic effect.
Unit 2: Antibiotics & Anti-Infectives
11. Before starting antibiotics, the nurse should ideally obtain:
A. A meal tray
B. Cultures as ordered
C. Only vital signs
D. Consent for surgery
Answer: B
Rationale: Cultures help identify the organism and guide therapy; obtain before first dose when possible.
12. A common adverse effect of many antibiotics that requires patient teaching is:
A. Improved appetite always
B. Superinfection (e.g., C. difficile, thrush) and GI upset
C. Immediate immunity
D. No need for full course
Answer: B
Rationale: Antibiotics disrupt normal flora; complete the full course as prescribed.
13. Aminoglycosides (e.g., gentamicin) require monitoring for:
A. Only rash
B. Ototoxicity and nephrotoxicity
C. Hyperglycemia only
D. Hypertension only
Answer: B
Rationale: Peak/trough levels and renal/hearing monitoring are important.
14. Vancomycin trough levels are monitored to reduce risk of:
A. Hyperkalemia
B. Nephrotoxicity and ototoxicity
C. Hypoglycemia
D. Bradycardia only
Answer: B
Rationale: Vancomycin can cause renal and hearing toxicity; troughs guide dosing.
Educational Use Only Page 3 Not Affiliated with Any Publisher
, Pharmacology & Medication Safety | Original Practice Bank Self-Study Material
15. Metronidazole teaching includes avoiding:
A. Water
B. Alcohol (disulfiram-like reaction)
C. All foods
D. Exercise
Answer: B
Rationale: Alcohol with metronidazole can cause severe nausea/vomiting and other reactions.
16. Tetracyclines are generally avoided in children and pregnancy because of risk to:
A. Liver only
B. Teeth and bone development
C. Hair growth
D. Vision only
Answer: B
Rationale: Tetracyclines can discolor developing teeth and affect bone.
17. A patient on sulfonamides should be taught to:
A. Avoid fluids
B. Increase fluid intake to reduce crystalluria risk
C. Stop if urine is yellow
D. Take with only dairy
Answer: B
Rationale: Adequate hydration helps prevent crystalluria.
18. Red man syndrome is associated with rapid infusion of:
A. Penicillin
B. Vancomycin
C. Ciprofloxacin
D. Metronidazole
Answer: B
Rationale: Rapid vancomycin infusion can cause histamine release (red man syndrome).
19. Fluoroquinolones carry a risk of:
A. Only mild headache
B. Tendonitis/tendon rupture and CNS effects
C. Hyperglycemia exclusively
D. No black-box warnings
Answer: B
Rationale: BBW includes tendinopathy and other serious risks.
20. Penicillin allergy cross-sensitivity is most concerning with which class?
A. Macrolides
B. Cephalosporins (especially earlier generations)
C. Aminoglycosides
D. Tetracyclines
Answer: B
Rationale: Cross-reactivity exists between penicillins and cephalosporins; assess allergy history carefully.
Unit 3: Cardiovascular Medications
21. ACE inhibitors commonly end in:
A. -olol
B. -pril
C. -sartan
D. -dipine
Answer: B
Rationale: ACE inhibitors: -pril (lisinopril, enalapril, etc.).
Educational Use Only Page 4 Not Affiliated with Any Publisher
