NUR 210 – EXAM 2 – PRINCIPLES OF PHARMACOLOGY – GALEN COLLEGE OF NURSING QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Pharmacokinetics (Absorption, Distribution, Metabolism, Excretion)
Pharmacodynamics (Receptor binding, Agonists, Antagonists, Dose-response)
Medication Safety, Error Prevention, and High-Alert Medications
Autonomic Nervous System Drugs (Cholinergic and Adrenergic agents)
Central Nervous System Drugs (Sedatives, Antiepileptics, Anesthetics)
Legal, Ethical, and Professional Standards in Medication Administration
Lifespan Considerations (Pediatric, Pregnancy, Geriatric)
Drug Interactions, Adverse Effects, and Toxicity Management
Introduction
*This comprehensive examination is designed to assess mastery of core pharmacology principles essential for
safe and effective nursing practice. It evaluates foundational pharmacokinetic and pharmacodynamic concepts,
clinical application of autonomic and central nervous system agents, and high-level decision-making regarding
medication safety, adverse effects, and legal-ethical standards. The exam includes 200 multiple-choice
questions divided into two sections. Each question integrates real-world clinical scenarios to challenge critical
thinking and reinforce evidence-based medication administration. Emphasis is placed on regulatory compliance,
professional accountability, and patient-centered care. Answers are verified with rationales to support exam
readiness and immediate content reinforcement.*
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse administers a drug that primarily undergoes hepatic first-pass effect. Which route would result in the
lowest bioavailability for this drug?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
🟢C
🔴 RATIONALE: Oral administration subjects drugs to hepatic first-pass metabolism via the portal circulation,
significantly reducing bioavailability. IV, sublingual, and transdermal routes bypass the liver initially.
Question 2
A patient with myasthenia gravis is prescribed neostigmine. The nurse explains that this drug works by which
mechanism?
A. Blocking acetylcholine receptors at the motor end plate
B. Inhibiting acetylcholinesterase to increase acetylcholine availability
C. Directly stimulating nicotinic receptors in skeletal muscle
D. Promoting acetylcholine reuptake into the presynaptic neuron
🟢B
,🔴 RATIONALE: Neostigmine is an acetylcholinesterase inhibitor that prolongs acetylcholine action at nicotinic
receptors, improving muscle strength in myasthenia gravis.
Question 3
A patient taking digoxin develops nausea, blurred yellow vision, and a heart rate of 48 bpm. Which laboratory
value is most important to assess?
A. Serum sodium
B. Serum potassium
C. Serum magnesium
D. Serum calcium
🟢B
🔴 RATIONALE: Hypokalemia increases the risk of digoxin toxicity, which presents with GI symptoms, visual
disturbances, and bradycardia.
Question 4
Which drug class is associated with the highest risk of ototoxicity and nephrotoxicity?
A. Penicillins
B. Aminoglycosides
C. Macrolides
D. Tetracyclines
🟢B
🔴 RATIONALE: Aminoglycosides (e.g., gentamicin) accumulate in renal tubules and inner ear hair cells, causing
potentially irreversible toxicity.
, Question 5
A patient with a history of angioedema from lisinopril is prescribed a different antihypertensive. Which drug
should the nurse identify as contraindicated due to cross-reactivity risk?
A. Amlodipine
B. Losartan
C. Metoprolol
D. Hydrochlorothiazide
🟢B
🔴 RATIONALE: Angioedema can occur with any ACE inhibitor or ARB (losartan) due to similar effects on
bradykinin metabolism, though risk is lower with ARBs.
Question 6
A nurse is teaching a patient about warfarin therapy. Which statement by the patient indicates a need for
further teaching?
A. "I will avoid eating large amounts of spinach and kale."
B. "I can take ibuprofen for my occasional headaches."
C. "I will get my blood tested regularly as ordered."
D. "I should watch for bleeding gums or dark stools."
🟢B
🔴 RATIONALE: Ibuprofen (NSAID) increases bleeding risk by inhibiting platelet aggregation and should be
avoided with warfarin.
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
Pharmacokinetics (Absorption, Distribution, Metabolism, Excretion)
Pharmacodynamics (Receptor binding, Agonists, Antagonists, Dose-response)
Medication Safety, Error Prevention, and High-Alert Medications
Autonomic Nervous System Drugs (Cholinergic and Adrenergic agents)
Central Nervous System Drugs (Sedatives, Antiepileptics, Anesthetics)
Legal, Ethical, and Professional Standards in Medication Administration
Lifespan Considerations (Pediatric, Pregnancy, Geriatric)
Drug Interactions, Adverse Effects, and Toxicity Management
Introduction
*This comprehensive examination is designed to assess mastery of core pharmacology principles essential for
safe and effective nursing practice. It evaluates foundational pharmacokinetic and pharmacodynamic concepts,
clinical application of autonomic and central nervous system agents, and high-level decision-making regarding
medication safety, adverse effects, and legal-ethical standards. The exam includes 200 multiple-choice
questions divided into two sections. Each question integrates real-world clinical scenarios to challenge critical
thinking and reinforce evidence-based medication administration. Emphasis is placed on regulatory compliance,
professional accountability, and patient-centered care. Answers are verified with rationales to support exam
readiness and immediate content reinforcement.*
,SECTION ONE: QUESTIONS 1–100
Question 1
A nurse administers a drug that primarily undergoes hepatic first-pass effect. Which route would result in the
lowest bioavailability for this drug?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
🟢C
🔴 RATIONALE: Oral administration subjects drugs to hepatic first-pass metabolism via the portal circulation,
significantly reducing bioavailability. IV, sublingual, and transdermal routes bypass the liver initially.
Question 2
A patient with myasthenia gravis is prescribed neostigmine. The nurse explains that this drug works by which
mechanism?
A. Blocking acetylcholine receptors at the motor end plate
B. Inhibiting acetylcholinesterase to increase acetylcholine availability
C. Directly stimulating nicotinic receptors in skeletal muscle
D. Promoting acetylcholine reuptake into the presynaptic neuron
🟢B
,🔴 RATIONALE: Neostigmine is an acetylcholinesterase inhibitor that prolongs acetylcholine action at nicotinic
receptors, improving muscle strength in myasthenia gravis.
Question 3
A patient taking digoxin develops nausea, blurred yellow vision, and a heart rate of 48 bpm. Which laboratory
value is most important to assess?
A. Serum sodium
B. Serum potassium
C. Serum magnesium
D. Serum calcium
🟢B
🔴 RATIONALE: Hypokalemia increases the risk of digoxin toxicity, which presents with GI symptoms, visual
disturbances, and bradycardia.
Question 4
Which drug class is associated with the highest risk of ototoxicity and nephrotoxicity?
A. Penicillins
B. Aminoglycosides
C. Macrolides
D. Tetracyclines
🟢B
🔴 RATIONALE: Aminoglycosides (e.g., gentamicin) accumulate in renal tubules and inner ear hair cells, causing
potentially irreversible toxicity.
, Question 5
A patient with a history of angioedema from lisinopril is prescribed a different antihypertensive. Which drug
should the nurse identify as contraindicated due to cross-reactivity risk?
A. Amlodipine
B. Losartan
C. Metoprolol
D. Hydrochlorothiazide
🟢B
🔴 RATIONALE: Angioedema can occur with any ACE inhibitor or ARB (losartan) due to similar effects on
bradykinin metabolism, though risk is lower with ARBs.
Question 6
A nurse is teaching a patient about warfarin therapy. Which statement by the patient indicates a need for
further teaching?
A. "I will avoid eating large amounts of spinach and kale."
B. "I can take ibuprofen for my occasional headaches."
C. "I will get my blood tested regularly as ordered."
D. "I should watch for bleeding gums or dark stools."
🟢B
🔴 RATIONALE: Ibuprofen (NSAID) increases bleeding risk by inhibiting platelet aggregation and should be
avoided with warfarin.
