Nursing Pharmacology 2026/2027 | Practice
Questions & Verified Answers | Comprehensive
Pharmacology Exam Review
Section 1: Principles of Pharmacology & Medication Administration
1. A nurse is preparing to administer a medication via the enteral route. Which
of the following is a primary advantage of this route?
A. It provides the most rapid onset of action.
B. It is the safest and most economical route.
C. It bypasses the first-pass effect of the liver.
D. It is the preferred route for unconscious clients.
Correct Answer: B
Rationale:
The enteral route (oral, NG, PEG) is considered the safest, most
convenient, and most economical route for medication administration. Its primary
disadvantages are a slower onset of action and the first-pass effect.
A is incorrect because the intravenous (IV) route provides the most rapid
onset. C is incorrect because the enteral route is subject to the first-pass effect,
whereas parenteral routes like IV bypass it. D is incorrect as oral medications are
contraindicated for unconscious clients due to the risk of aspiration.
2. A client is prescribed a medication with a narrow therapeutic index. Which of
the following nursing actions is most critical?
A. Administer the medication with food to reduce GI upset.
B. Monitor the client's serum drug levels closely.
C. Teach the client about common side effects.
D. Assess the client's renal and hepatic function annually.
Correct Answer: B
Rationale:
A narrow therapeutic index (NTI) means there is a small difference
,between the therapeutic dose and a toxic dose. Therefore, monitoring serum
drug levels (e.g., peak and trough) is crucial to ensure the drug concentration is
within the therapeutic range and to prevent toxicity.
A, C, and D are all important nursing considerations, but they are not the
most critical action specific to a drug with a narrow therapeutic index. Renal and
hepatic function would be monitored more frequently than annually for drugs
with an NTI.
3. Which of the following routes of medication administration has the highest
risk for infection?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
Correct Answer: D
Rationale:
The intravenous route is the most invasive and carries the highest risk of
infection (e.g., bacteremia, sepsis) because it directly accesses the bloodstream,
bypassing many of the body's natural defenses.
A, B, and C carry a risk of infection, but it is significantly lower than with
the IV route. Strict aseptic technique is paramount for IV therapy.
4. A nurse is teaching a client about a new prescription. Which statement by the
client indicates a need for further teaching regarding safe medication practices?
A. "I will keep a list of all my medications, including over-the-counter drugs and
supplements."
B. "I will use a pill organizer to help me remember to take my medications."
C. "If I miss a dose, I will just double the next dose to catch up."
D. "I will store my medications in a cool, dry place, away from direct sunlight."
Correct Answer: C
Rationale:
The client should never double a dose of medication unless specifically
,instructed to do so by a provider. Doubling a dose can lead to severe adverse
effects or toxicity.
A, B, and D are all correct statements that demonstrate safe medication
practices and understanding.
5. A nurse is reviewing a medication order that is illegible. What is the priority
nursing action?
A. Ask another nurse to interpret the order.
B. Call the prescriber to clarify the order.
C. Administer the medication based on the client's diagnosis.
D. Look up the medication in a drug guide and make an educated guess.
Correct Answer: B
Rationale:
The nurse is legally and ethically responsible for clarifying any medication
order that is unclear, illegible, or incomplete. The priority is to contact the
prescriber to clarify the order before administration to prevent a medication
error.
A is unsafe; another nurse cannot verify a prescription they did not write.
C and D are dangerous and illegal practices that could cause significant harm to
the client.
6. Which of the following factors would most likely increase the risk of drug
toxicity in an older adult client?
A. Increased gastric motility
B. Decreased body fat percentage
C. Decreased glomerular filtration rate
D. Increased serum albumin levels
Correct Answer: C
Rationale:
A decreased glomerular filtration rate (GFR) is a common age-related
change that reduces the kidney's ability to excrete drugs. This can lead to drug
accumulation and an increased risk of toxicity.
, A is incorrect; gastric motility often decreases with age. B is incorrect;
body fat percentage often increases, which can affect the distribution of fat-
soluble drugs. D is incorrect; serum albumin levels often decrease, leading to
more free (active) drug in the bloodstream and a potential for increased effects.
7. A nurse is preparing to administer a subcutaneous injection of heparin. Which
site is most appropriate?
A. Deltoid muscle
B. Vastus lateralis
C. Abdomen, 2 inches away from the umbilicus
D. Ventrogluteal site
Correct Answer: C
Rationale:
The abdomen is the preferred site for subcutaneous heparin injections.
The area 2 inches away from the umbilicus has a consistent layer of fatty tissue
and is easily accessible. The site should be rotated and not massaged to reduce
the risk of hematoma.
A, B, and D are incorrect as they are sites for intramuscular injections, not
the preferred site for subcutaneous heparin.
8. A medication is ordered to be given "AC." The nurse should plan to
administer this medication at which time?
A. Before meals
B. After meals
C. At bedtime
D. Every 4 hours
Correct Answer: A
Rationale:
The abbreviation "AC" stands for ante cibum, which means "before
meals." Medications given AC are typically administered 30 to 60 minutes before
a meal.
Questions & Verified Answers | Comprehensive
Pharmacology Exam Review
Section 1: Principles of Pharmacology & Medication Administration
1. A nurse is preparing to administer a medication via the enteral route. Which
of the following is a primary advantage of this route?
A. It provides the most rapid onset of action.
B. It is the safest and most economical route.
C. It bypasses the first-pass effect of the liver.
D. It is the preferred route for unconscious clients.
Correct Answer: B
Rationale:
The enteral route (oral, NG, PEG) is considered the safest, most
convenient, and most economical route for medication administration. Its primary
disadvantages are a slower onset of action and the first-pass effect.
A is incorrect because the intravenous (IV) route provides the most rapid
onset. C is incorrect because the enteral route is subject to the first-pass effect,
whereas parenteral routes like IV bypass it. D is incorrect as oral medications are
contraindicated for unconscious clients due to the risk of aspiration.
2. A client is prescribed a medication with a narrow therapeutic index. Which of
the following nursing actions is most critical?
A. Administer the medication with food to reduce GI upset.
B. Monitor the client's serum drug levels closely.
C. Teach the client about common side effects.
D. Assess the client's renal and hepatic function annually.
Correct Answer: B
Rationale:
A narrow therapeutic index (NTI) means there is a small difference
,between the therapeutic dose and a toxic dose. Therefore, monitoring serum
drug levels (e.g., peak and trough) is crucial to ensure the drug concentration is
within the therapeutic range and to prevent toxicity.
A, C, and D are all important nursing considerations, but they are not the
most critical action specific to a drug with a narrow therapeutic index. Renal and
hepatic function would be monitored more frequently than annually for drugs
with an NTI.
3. Which of the following routes of medication administration has the highest
risk for infection?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
Correct Answer: D
Rationale:
The intravenous route is the most invasive and carries the highest risk of
infection (e.g., bacteremia, sepsis) because it directly accesses the bloodstream,
bypassing many of the body's natural defenses.
A, B, and C carry a risk of infection, but it is significantly lower than with
the IV route. Strict aseptic technique is paramount for IV therapy.
4. A nurse is teaching a client about a new prescription. Which statement by the
client indicates a need for further teaching regarding safe medication practices?
A. "I will keep a list of all my medications, including over-the-counter drugs and
supplements."
B. "I will use a pill organizer to help me remember to take my medications."
C. "If I miss a dose, I will just double the next dose to catch up."
D. "I will store my medications in a cool, dry place, away from direct sunlight."
Correct Answer: C
Rationale:
The client should never double a dose of medication unless specifically
,instructed to do so by a provider. Doubling a dose can lead to severe adverse
effects or toxicity.
A, B, and D are all correct statements that demonstrate safe medication
practices and understanding.
5. A nurse is reviewing a medication order that is illegible. What is the priority
nursing action?
A. Ask another nurse to interpret the order.
B. Call the prescriber to clarify the order.
C. Administer the medication based on the client's diagnosis.
D. Look up the medication in a drug guide and make an educated guess.
Correct Answer: B
Rationale:
The nurse is legally and ethically responsible for clarifying any medication
order that is unclear, illegible, or incomplete. The priority is to contact the
prescriber to clarify the order before administration to prevent a medication
error.
A is unsafe; another nurse cannot verify a prescription they did not write.
C and D are dangerous and illegal practices that could cause significant harm to
the client.
6. Which of the following factors would most likely increase the risk of drug
toxicity in an older adult client?
A. Increased gastric motility
B. Decreased body fat percentage
C. Decreased glomerular filtration rate
D. Increased serum albumin levels
Correct Answer: C
Rationale:
A decreased glomerular filtration rate (GFR) is a common age-related
change that reduces the kidney's ability to excrete drugs. This can lead to drug
accumulation and an increased risk of toxicity.
, A is incorrect; gastric motility often decreases with age. B is incorrect;
body fat percentage often increases, which can affect the distribution of fat-
soluble drugs. D is incorrect; serum albumin levels often decrease, leading to
more free (active) drug in the bloodstream and a potential for increased effects.
7. A nurse is preparing to administer a subcutaneous injection of heparin. Which
site is most appropriate?
A. Deltoid muscle
B. Vastus lateralis
C. Abdomen, 2 inches away from the umbilicus
D. Ventrogluteal site
Correct Answer: C
Rationale:
The abdomen is the preferred site for subcutaneous heparin injections.
The area 2 inches away from the umbilicus has a consistent layer of fatty tissue
and is easily accessible. The site should be rotated and not massaged to reduce
the risk of hematoma.
A, B, and D are incorrect as they are sites for intramuscular injections, not
the preferred site for subcutaneous heparin.
8. A medication is ordered to be given "AC." The nurse should plan to
administer this medication at which time?
A. Before meals
B. After meals
C. At bedtime
D. Every 4 hours
Correct Answer: A
Rationale:
The abbreviation "AC" stands for ante cibum, which means "before
meals." Medications given AC are typically administered 30 to 60 minutes before
a meal.
