NR 293 | Original Practice Examination | 2026/2027 Page 1
, NR 293 EXAM 1
Pharmacology for Nursing Practice
Chamberlain University
100-Question Original Practice Examination
2026/2027 Edition
1. An oral drug undergoes extensive first-pass metabolism. Compared with IV dosing, what
isexpected?
A) Greater than 100% bioavailability
B) No hepatic exposure
C) Lower systemic bioavailability
D) Instant renal clearance
Correct Answer: Lower systemic bioavailability
Rationale: Portal circulation delivers absorbed medication to the liver before systemic distribution. Presystemic
metabolism can reduce intact drug reaching the circulation. Intravenous administration bypasses gastrointestinal
absorption and first-pass loss.
2. A nurse gives an IV dose. Which bioavailability value describes the administered drug
initiallyentering circulation?
A) 0%
B) 100%
C) 25%
D) 50%
Correct Answer: 100%
Rationale: Intravenous delivery places the dose directly into systemic circulation. Bioavailability therefore equals 100%
by definition, although subsequent distribution and elimination begin immediately. Oral availability can be lower due to
incomplete absorption and first-pass metabolism.
3. A patient with delayed gastric emptying receives an oral analgesic. What change may occur?
A) Guaranteed immediate peak effect
B) No change in absorption timing ever
C) Automatic drug inactivation
D) Delayed onset of absorption and relief
Correct Answer: Delayed onset of absorption and relief
Rationale: Gastric emptying affects when many oral medicines reach the absorptive small intestine. Delay can
postpone onset even when total absorbed amount is similar. The effect depends on formulation and drug properties.
4. Two drugs have equal doses, but one produces a larger maximal response.
Whichpharmacodynamic property differs?
A) Elimination half-life only
NR 293 | Original Practice Examination | 2026/2027 Page 2
, B) Efficacy
C) Renal clearance only
D) Protein binding alone
Correct Answer: Efficacy
Rationale: Efficacy describes the maximal effect a drug can produce. Potency concerns the dose needed for a
particular effect. Two agents can differ in efficacy without having the same potency or kinetics.
5. One analgesic achieves similar relief at a smaller dose than another. Which characteristic
isgreater?
A) Maximal efficacy necessarily
B) Potency
C) Bioavailability necessarily
D) Duration necessarily
Correct Answer: Potency
Rationale: Greater potency means less drug is needed to achieve a specified response. It does not imply a higher
ceiling of effect or superior clinical safety. Dose comparisons require attention to the endpoints used.
6. A second drug blocks the action of a receptor agonist without activating the receptor itself.
Whatterm applies?
A) Full agonist
B) Antagonist
C) Prodrug
D) Active metabolite
Correct Answer: Antagonist
Rationale: Antagonists reduce agonist effects by interfering with receptor signaling or binding. A full agonist instead
activates a receptor. The clinical effect depends on receptor system and antagonist type.
7. A patient taking a narrow-therapeutic-index medication asks why blood levels are checked. What
isthe best explanation?
A) The drug is inactive in plasma
B) All levels remain unchanged between doses
C) Therapeutic index has no relation to toxicity
D) The effective and toxic concentration ranges are relatively close
Correct Answer: The effective and toxic concentration ranges are relatively close
Rationale: A narrow therapeutic index leaves little margin between benefit and harm. Monitoring can guide safer
dosing when concentrations correlate with effects. Clinical status and organ function must also be assessed.
8. When should a medication trough sample usually be obtained if ordered for routine
therapeuticmonitoring?
A) Immediately after swallowing the dose
B) Just before the next scheduled dose
NR 293 | Original Practice Examination | 2026/2027 Page 3
, NR 293 EXAM 1
Pharmacology for Nursing Practice
Chamberlain University
100-Question Original Practice Examination
2026/2027 Edition
1. An oral drug undergoes extensive first-pass metabolism. Compared with IV dosing, what
isexpected?
A) Greater than 100% bioavailability
B) No hepatic exposure
C) Lower systemic bioavailability
D) Instant renal clearance
Correct Answer: Lower systemic bioavailability
Rationale: Portal circulation delivers absorbed medication to the liver before systemic distribution. Presystemic
metabolism can reduce intact drug reaching the circulation. Intravenous administration bypasses gastrointestinal
absorption and first-pass loss.
2. A nurse gives an IV dose. Which bioavailability value describes the administered drug
initiallyentering circulation?
A) 0%
B) 100%
C) 25%
D) 50%
Correct Answer: 100%
Rationale: Intravenous delivery places the dose directly into systemic circulation. Bioavailability therefore equals 100%
by definition, although subsequent distribution and elimination begin immediately. Oral availability can be lower due to
incomplete absorption and first-pass metabolism.
3. A patient with delayed gastric emptying receives an oral analgesic. What change may occur?
A) Guaranteed immediate peak effect
B) No change in absorption timing ever
C) Automatic drug inactivation
D) Delayed onset of absorption and relief
Correct Answer: Delayed onset of absorption and relief
Rationale: Gastric emptying affects when many oral medicines reach the absorptive small intestine. Delay can
postpone onset even when total absorbed amount is similar. The effect depends on formulation and drug properties.
4. Two drugs have equal doses, but one produces a larger maximal response.
Whichpharmacodynamic property differs?
A) Elimination half-life only
NR 293 | Original Practice Examination | 2026/2027 Page 2
, B) Efficacy
C) Renal clearance only
D) Protein binding alone
Correct Answer: Efficacy
Rationale: Efficacy describes the maximal effect a drug can produce. Potency concerns the dose needed for a
particular effect. Two agents can differ in efficacy without having the same potency or kinetics.
5. One analgesic achieves similar relief at a smaller dose than another. Which characteristic
isgreater?
A) Maximal efficacy necessarily
B) Potency
C) Bioavailability necessarily
D) Duration necessarily
Correct Answer: Potency
Rationale: Greater potency means less drug is needed to achieve a specified response. It does not imply a higher
ceiling of effect or superior clinical safety. Dose comparisons require attention to the endpoints used.
6. A second drug blocks the action of a receptor agonist without activating the receptor itself.
Whatterm applies?
A) Full agonist
B) Antagonist
C) Prodrug
D) Active metabolite
Correct Answer: Antagonist
Rationale: Antagonists reduce agonist effects by interfering with receptor signaling or binding. A full agonist instead
activates a receptor. The clinical effect depends on receptor system and antagonist type.
7. A patient taking a narrow-therapeutic-index medication asks why blood levels are checked. What
isthe best explanation?
A) The drug is inactive in plasma
B) All levels remain unchanged between doses
C) Therapeutic index has no relation to toxicity
D) The effective and toxic concentration ranges are relatively close
Correct Answer: The effective and toxic concentration ranges are relatively close
Rationale: A narrow therapeutic index leaves little margin between benefit and harm. Monitoring can guide safer
dosing when concentrations correlate with effects. Clinical status and organ function must also be assessed.
8. When should a medication trough sample usually be obtained if ordered for routine
therapeuticmonitoring?
A) Immediately after swallowing the dose
B) Just before the next scheduled dose
NR 293 | Original Practice Examination | 2026/2027 Page 3
