NURSE PHARMACOLOGY II - EXAM 1
(NCLEX NGN PREP) QUESTIONS AND
ANSWERS 2026/2027 VERIFIED
1. A patient with chronic renal failure is prescribed a drug that is primarily excreted by the
kidneys. Which pharmacokinetic phase is most affected by this condition?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: C
Conceptual Explanation: Excretion is the process by which drugs are removed from the
body, primarily through the kidneys. Renal failure directly impairs this phase, leading to
potential toxicity.
2. An elderly patient has low serum albumin levels. When administering a highly protein-
bound medication, the nurse should monitor for:
A. Decreased therapeutic effect
B. Increased risk of drug toxicity
C. Faster renal excretion
,D. Delayed onset of action
Answer: B
Conceptual Explanation: Low albumin means fewer binding sites for the drug, resulting in
more ‘free’ active drug in the bloodstream, which increases the risk of toxicity.
3. The nurse is teaching a patient about the ‘first-pass effect.’ Which route of administration
is most affected by this process?
A. Sublingual
B. Intravenous
C. Oral
D. Subcutaneous
Answer: C
Conceptual Explanation: Oral medications are absorbed from the GI tract into the portal
circulation and metabolized by the liver before reaching systemic circulation, known as the
first-pass effect.
4. A drug has a half-life of 4 hours. If 100 mg is administered at 08:00, how much drug
remains in the body at 16:00?
A. 50 mg
B. 25 mg
C. 12.5 mg
, D. 0 mg
Answer: B
Conceptual Explanation: After 4 hours (12:00), 50 mg remains. After another 4 hours
(16:00), half of that (25 mg) remains.
5. Which term describes the ratio between a drug’s therapeutic benefits and its toxic effects?
A. Therapeutic Index
B. Potency
C. Bioavailability
D. Efficacy
Answer: A
Conceptual Explanation: The therapeutic index is a measure of a drug’s safety; a narrow
index indicates a small margin between effective and lethal doses.
6. When administering a beta-1 adrenergic antagonist, the nurse should expect which
physiological response?
A. Increased heart rate
B. Bronchodilation
C. Vasoconstriction
D. Decreased heart rate
(NCLEX NGN PREP) QUESTIONS AND
ANSWERS 2026/2027 VERIFIED
1. A patient with chronic renal failure is prescribed a drug that is primarily excreted by the
kidneys. Which pharmacokinetic phase is most affected by this condition?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: C
Conceptual Explanation: Excretion is the process by which drugs are removed from the
body, primarily through the kidneys. Renal failure directly impairs this phase, leading to
potential toxicity.
2. An elderly patient has low serum albumin levels. When administering a highly protein-
bound medication, the nurse should monitor for:
A. Decreased therapeutic effect
B. Increased risk of drug toxicity
C. Faster renal excretion
,D. Delayed onset of action
Answer: B
Conceptual Explanation: Low albumin means fewer binding sites for the drug, resulting in
more ‘free’ active drug in the bloodstream, which increases the risk of toxicity.
3. The nurse is teaching a patient about the ‘first-pass effect.’ Which route of administration
is most affected by this process?
A. Sublingual
B. Intravenous
C. Oral
D. Subcutaneous
Answer: C
Conceptual Explanation: Oral medications are absorbed from the GI tract into the portal
circulation and metabolized by the liver before reaching systemic circulation, known as the
first-pass effect.
4. A drug has a half-life of 4 hours. If 100 mg is administered at 08:00, how much drug
remains in the body at 16:00?
A. 50 mg
B. 25 mg
C. 12.5 mg
, D. 0 mg
Answer: B
Conceptual Explanation: After 4 hours (12:00), 50 mg remains. After another 4 hours
(16:00), half of that (25 mg) remains.
5. Which term describes the ratio between a drug’s therapeutic benefits and its toxic effects?
A. Therapeutic Index
B. Potency
C. Bioavailability
D. Efficacy
Answer: A
Conceptual Explanation: The therapeutic index is a measure of a drug’s safety; a narrow
index indicates a small margin between effective and lethal doses.
6. When administering a beta-1 adrenergic antagonist, the nurse should expect which
physiological response?
A. Increased heart rate
B. Bronchodilation
C. Vasoconstriction
D. Decreased heart rate
