WGU D027 Pharmacology OA actual actual 2026 Exam questions and
well detailed answers
1. A nurse is administering a medication with a narrow therapeutic index. Which
action is most critical for the nurse to perform?
• A) Monitor the client's vital signs once daily
• B) Draw peak and trough blood levels as prescribed to ensure safety and
efficacy
• C) Administer the medication with a full glass of milk
• D) Instruct the client to take the medication on an empty stomach
Answer: B — Drugs with a narrow therapeutic index have a small margin of safety
between therapeutic and toxic doses, requiring careful laboratory monitoring of
blood levels.
2. A client asks why a prescribed medication is administered via the intravenous
(IV) route rather than orally. What is the nurse's best explanation regarding first-
pass metabolism?
• A) "Oral medications are destroyed immediately by stomach acid before
reaching the liver."
• B) "Oral drugs pass through the liver via the portal circulation and may be
significantly inactivated before reaching systemic circulation, whereas IV
drugs bypass this completely."
• C) "IV medications are absorbed much slower than oral medications."
• D) "First-pass metabolism only affects subcutaneous injections."
Answer: B — Oral drugs undergo hepatic first-pass metabolism in the liver, which
can greatly reduce their bioavailability. Intravenous administration bypasses the GI
tract and liver entirely, providing 100% bioavailability.
3. A client is prescribed a medication that acts as an agonist at receptor sites. How
should the nurse understand the action of an agonist?
• A) It blocks receptor activation by endogenous substances.
,WGU D027 Pharmacology OA actual actual 2026 Exam questions and
well detailed answers
• B) It binds to receptors and mimics the body's own regulatory molecules,
producing a response.
• C) It permanently destroys cellular receptors.
• D) It prevents any chemical reactions from occurring in the body.
Answer: B — Agonists bind to receptors and activate them, mimicking the actions
of the body's natural neurotransmitters or hormones.
4. A nurse is reviewing a medication's half-life (𝑡1/2). If a drug has a half-life of 4
hours, approximately how long will it take for the drug to be almost completely
eliminated (approx. 97%) from the body?
• A) 4 hours
• B) 8 hours
• C) 12 hours
• D) 20 hours
Answer: D — It generally takes 4 to 5 half-lives for a drug to reach steady state and
to be virtually eliminated from the body (5 half-lives = 96.9% eliminated). 4 hours
× 5 = 20 hours.
5. A client is prescribed a cholinergic agonist (parasympathomimetic). Which
assessment finding should the nurse expect to observe?
• A) Tachycardia and dry mouth
• B) Bronchodilation and urinary retention
• C) Increased salivation, lacrimation, urination, and diarrhea (SLUDGE
symptoms)
• D) Pupil dilation (mydriasis) and constipation
Answer: C — Cholinergic agonists stimulate the parasympathetic nervous system
("rest and digest"), resulting in increased secretions, urination, GI motility, and
miosis.
,WGU D027 Pharmacology OA actual actual 2026 Exam questions and
well detailed answers
6. A nurse is preparing to administer an anticholinergic medication to a client.
Which medical condition in the client's history would require immediate
notification of the healthcare provider?
• A) Peptic ulcer disease
• B) Angle-closure glaucoma
• C) Hypertension
• D) Mild chronic back pain
Answer: B — Anticholinergic drugs cause mydriasis (pupil dilation) and can
increase intraocular pressure, which is dangerous and contraindicated in clients
with angle-closure glaucoma.
7. A client is experiencing anaphylactic shock. What is the primary adrenergic
agonist medication administered to reverse this life-threatening reaction?
• A) Atropine
• B) Epinephrine
• C) Propranolol
• D) Dopamine
Answer: B — Epinephrine is a non-selective adrenergic agonist (alpha-1, beta-1,
and beta-2) that rapidly reverses bronchospasm, vasodilation, and laryngeal
edema during anaphylaxis.
8. A client with chronic asthma is prescribed a non-selective beta-blocker for
hypertension. Which complication is most likely to occur?
• A) Severe tachycardia
• B) Bronchospasm and worsening asthma symptoms
• C) Extreme hyperglycemia
• D) Rapid weight loss
, WGU D027 Pharmacology OA actual actual 2026 Exam questions and
well detailed answers
Answer: B — Non-selective beta-blockers (like propranolol) block beta-2 receptors
in the lungs, causing bronchoconstriction, which can precipitate a severe asthma
attack.
9. A nurse is administering bethanechol, a direct-acting cholinergic agonist, to a
client with postoperative urinary retention. What is the priority nursing
assessment?
• A) Assess for bladder distension and monitor urine output
• B) Monitor for sudden hypertensive crisis
• C) Check for visual acuity changes
• D) Inspect skin for rashes
Answer: A — Bethanechol stimulates the detrusor muscle to relieve urinary
retention; monitoring for successful voiding and bladder emptying is essential.
10. A client is receiving an anticholinergic drug for Parkinson's disease. Which
common side effect should the nurse educate the client about?
• A) Excessive drooling and diarrhea
• B) Dry mouth, blurred vision, urinary retention, and constipation (drying
effects)
• C) Low blood pressure and excessive sweating
• D) Rapid heart rate reduction and sleepiness
Answer: B — Anticholinergics block parasympathetic responses, leading to classic
"drying" side effects: xerostomia, blurred vision, constipation, and urinary
retention.
11. A client is prescribed an alpha-1 adrenergic blocker for benign prostatic
hyperplasia (BPH) and hypertension. What is a key instruction the nurse should
provide regarding safety?
• A) "Take the medication immediately before running a marathon."
well detailed answers
1. A nurse is administering a medication with a narrow therapeutic index. Which
action is most critical for the nurse to perform?
• A) Monitor the client's vital signs once daily
• B) Draw peak and trough blood levels as prescribed to ensure safety and
efficacy
• C) Administer the medication with a full glass of milk
• D) Instruct the client to take the medication on an empty stomach
Answer: B — Drugs with a narrow therapeutic index have a small margin of safety
between therapeutic and toxic doses, requiring careful laboratory monitoring of
blood levels.
2. A client asks why a prescribed medication is administered via the intravenous
(IV) route rather than orally. What is the nurse's best explanation regarding first-
pass metabolism?
• A) "Oral medications are destroyed immediately by stomach acid before
reaching the liver."
• B) "Oral drugs pass through the liver via the portal circulation and may be
significantly inactivated before reaching systemic circulation, whereas IV
drugs bypass this completely."
• C) "IV medications are absorbed much slower than oral medications."
• D) "First-pass metabolism only affects subcutaneous injections."
Answer: B — Oral drugs undergo hepatic first-pass metabolism in the liver, which
can greatly reduce their bioavailability. Intravenous administration bypasses the GI
tract and liver entirely, providing 100% bioavailability.
3. A client is prescribed a medication that acts as an agonist at receptor sites. How
should the nurse understand the action of an agonist?
• A) It blocks receptor activation by endogenous substances.
,WGU D027 Pharmacology OA actual actual 2026 Exam questions and
well detailed answers
• B) It binds to receptors and mimics the body's own regulatory molecules,
producing a response.
• C) It permanently destroys cellular receptors.
• D) It prevents any chemical reactions from occurring in the body.
Answer: B — Agonists bind to receptors and activate them, mimicking the actions
of the body's natural neurotransmitters or hormones.
4. A nurse is reviewing a medication's half-life (𝑡1/2). If a drug has a half-life of 4
hours, approximately how long will it take for the drug to be almost completely
eliminated (approx. 97%) from the body?
• A) 4 hours
• B) 8 hours
• C) 12 hours
• D) 20 hours
Answer: D — It generally takes 4 to 5 half-lives for a drug to reach steady state and
to be virtually eliminated from the body (5 half-lives = 96.9% eliminated). 4 hours
× 5 = 20 hours.
5. A client is prescribed a cholinergic agonist (parasympathomimetic). Which
assessment finding should the nurse expect to observe?
• A) Tachycardia and dry mouth
• B) Bronchodilation and urinary retention
• C) Increased salivation, lacrimation, urination, and diarrhea (SLUDGE
symptoms)
• D) Pupil dilation (mydriasis) and constipation
Answer: C — Cholinergic agonists stimulate the parasympathetic nervous system
("rest and digest"), resulting in increased secretions, urination, GI motility, and
miosis.
,WGU D027 Pharmacology OA actual actual 2026 Exam questions and
well detailed answers
6. A nurse is preparing to administer an anticholinergic medication to a client.
Which medical condition in the client's history would require immediate
notification of the healthcare provider?
• A) Peptic ulcer disease
• B) Angle-closure glaucoma
• C) Hypertension
• D) Mild chronic back pain
Answer: B — Anticholinergic drugs cause mydriasis (pupil dilation) and can
increase intraocular pressure, which is dangerous and contraindicated in clients
with angle-closure glaucoma.
7. A client is experiencing anaphylactic shock. What is the primary adrenergic
agonist medication administered to reverse this life-threatening reaction?
• A) Atropine
• B) Epinephrine
• C) Propranolol
• D) Dopamine
Answer: B — Epinephrine is a non-selective adrenergic agonist (alpha-1, beta-1,
and beta-2) that rapidly reverses bronchospasm, vasodilation, and laryngeal
edema during anaphylaxis.
8. A client with chronic asthma is prescribed a non-selective beta-blocker for
hypertension. Which complication is most likely to occur?
• A) Severe tachycardia
• B) Bronchospasm and worsening asthma symptoms
• C) Extreme hyperglycemia
• D) Rapid weight loss
, WGU D027 Pharmacology OA actual actual 2026 Exam questions and
well detailed answers
Answer: B — Non-selective beta-blockers (like propranolol) block beta-2 receptors
in the lungs, causing bronchoconstriction, which can precipitate a severe asthma
attack.
9. A nurse is administering bethanechol, a direct-acting cholinergic agonist, to a
client with postoperative urinary retention. What is the priority nursing
assessment?
• A) Assess for bladder distension and monitor urine output
• B) Monitor for sudden hypertensive crisis
• C) Check for visual acuity changes
• D) Inspect skin for rashes
Answer: A — Bethanechol stimulates the detrusor muscle to relieve urinary
retention; monitoring for successful voiding and bladder emptying is essential.
10. A client is receiving an anticholinergic drug for Parkinson's disease. Which
common side effect should the nurse educate the client about?
• A) Excessive drooling and diarrhea
• B) Dry mouth, blurred vision, urinary retention, and constipation (drying
effects)
• C) Low blood pressure and excessive sweating
• D) Rapid heart rate reduction and sleepiness
Answer: B — Anticholinergics block parasympathetic responses, leading to classic
"drying" side effects: xerostomia, blurred vision, constipation, and urinary
retention.
11. A client is prescribed an alpha-1 adrenergic blocker for benign prostatic
hyperplasia (BPH) and hypertension. What is a key instruction the nurse should
provide regarding safety?
• A) "Take the medication immediately before running a marathon."
