NUR 524
NUR 524 Pharmacology for
AMNP Practice
Exam 2026/2027: Verified
Questions & Answers With
Rationales
### Section 1: Pharmacokinetics &
Pharmacodynamics (Questions 1-20)
**1.** A nurse is reviewing the four phases of
pharmacokinetics. Which sequence represents the
correct order of these phases?
A) Metabolism, Absorption, Distribution, Excretion
B) **Absorption, Distribution, Metabolism, Excretion**
C) Distribution, Absorption, Metabolism, Excretion
D)Absorption, Metabolism, Distribution, Excretion
**CORRECT ANSWER: B**
*EXPLANATION: The four phases of
pharmacokinetics follow a specific order: Absorption
(drug enters bloodstream),
Distribution (drug moves to tissues), Metabolism (drug
is broken down, primarily in the liver), and Excretion
(drug is eliminated, primarily via kidneys). This
sequence is often remembered by the acronym
ADME.*
NUR 524 Pharmacology
,NUR 524
**2.** A drug that is administered intravenously
reaches the bloodstream:
A) Slowly over 30 minutes
B) **Immediately and completely**
C) Only after passing through the liver
D)After gastric absorption
**CORRECT ANSWER: B**
*EXPLANATION: IV administration places the drug
directly into the bloodstream, achieving 100%
bioavailability and immediate onset of action. There is
no absorption phase, making IV the route of choice for
emergencies or when precise dosing is required.*
**3.** The term "first-pass effect" refers to:
A) The first dose of a medication given to a patient
B) **The rapid metabolism of an orally administered
drug by the liver before it reaches systemic
circulation**
C) The initial binding of a drug to plasma proteins
D)The first sign of a drug's therapeutic effect
**CORRECT ANSWER: B**
*EXPLANATION: The first-pass effect occurs when
orally administered drugs are absorbed from the GI
tract and carried via the portal vein to the liver, where
NUR 524 Pharmacology
,NUR 524
they may be extensively metabolized before reaching
systemic circulation. This reduces bioavailability and
explains why some drugs cannot be given orally (e.g.,
lidocaine).*
**4.** A patient asks why their oral medication must
be taken on an empty stomach. The nurse explains that
food can affect:
A) Drug excretion only
B) **Drug absorption by delaying gastric emptying or
binding to the drug**
C) Drug metabolism in the liver
D)Protein binding exclusively
**CORRECT ANSWER: B**
*EXPLANATION: Food can significantly impact drug
absorption. It may delay gastric emptying (slowing
absorption), bind to the drug (reducing bioavailability),
or alter gastric pH. Some drugs require an empty
stomach for optimal absorption; others should be
taken with food to reduce GI irritation.*
**5.** A patient with liver failure is prescribed a
medication that is extensively metabolized by the
liver. The nurse anticipates that the patient may
require:
A) A higher dose of the medication
B) **A lower dose or longer dosing interval**
C) IV administration instead of oral
NUR 524 Pharmacology
, NUR 524
D)No change in dosing
**CORRECT ANSWER: B**
*EXPLANATION: Liver failure impairs drug
metabolism, leading to drug accumulation and
increased risk of toxicity. Doses typically need
reduction or extended intervals. This is why liver
function tests (AST, ALT) guide dosing for hepatically
cleared medications.*
**6.** Which organ is primarily responsible for drug
excretion?
A) Liver
B) **Kidney**
C) Lungs
D)Skin
**CORRECT ANSWER: B**
*EXPLANATION: The kidneys are the primary organs
of drug excretion. Most drugs and their metabolites
are eliminated via urine through glomerular filtration
and tubular secretion. Impaired renal function
requires dose adjustments to prevent accumulation
and toxicity.*
**7.** A patient with chronic kidney disease (CKD) is
prescribed a medication that is renally excreted. The
nurse should monitor for:
NUR 524 Pharmacology
NUR 524 Pharmacology for
AMNP Practice
Exam 2026/2027: Verified
Questions & Answers With
Rationales
### Section 1: Pharmacokinetics &
Pharmacodynamics (Questions 1-20)
**1.** A nurse is reviewing the four phases of
pharmacokinetics. Which sequence represents the
correct order of these phases?
A) Metabolism, Absorption, Distribution, Excretion
B) **Absorption, Distribution, Metabolism, Excretion**
C) Distribution, Absorption, Metabolism, Excretion
D)Absorption, Metabolism, Distribution, Excretion
**CORRECT ANSWER: B**
*EXPLANATION: The four phases of
pharmacokinetics follow a specific order: Absorption
(drug enters bloodstream),
Distribution (drug moves to tissues), Metabolism (drug
is broken down, primarily in the liver), and Excretion
(drug is eliminated, primarily via kidneys). This
sequence is often remembered by the acronym
ADME.*
NUR 524 Pharmacology
,NUR 524
**2.** A drug that is administered intravenously
reaches the bloodstream:
A) Slowly over 30 minutes
B) **Immediately and completely**
C) Only after passing through the liver
D)After gastric absorption
**CORRECT ANSWER: B**
*EXPLANATION: IV administration places the drug
directly into the bloodstream, achieving 100%
bioavailability and immediate onset of action. There is
no absorption phase, making IV the route of choice for
emergencies or when precise dosing is required.*
**3.** The term "first-pass effect" refers to:
A) The first dose of a medication given to a patient
B) **The rapid metabolism of an orally administered
drug by the liver before it reaches systemic
circulation**
C) The initial binding of a drug to plasma proteins
D)The first sign of a drug's therapeutic effect
**CORRECT ANSWER: B**
*EXPLANATION: The first-pass effect occurs when
orally administered drugs are absorbed from the GI
tract and carried via the portal vein to the liver, where
NUR 524 Pharmacology
,NUR 524
they may be extensively metabolized before reaching
systemic circulation. This reduces bioavailability and
explains why some drugs cannot be given orally (e.g.,
lidocaine).*
**4.** A patient asks why their oral medication must
be taken on an empty stomach. The nurse explains that
food can affect:
A) Drug excretion only
B) **Drug absorption by delaying gastric emptying or
binding to the drug**
C) Drug metabolism in the liver
D)Protein binding exclusively
**CORRECT ANSWER: B**
*EXPLANATION: Food can significantly impact drug
absorption. It may delay gastric emptying (slowing
absorption), bind to the drug (reducing bioavailability),
or alter gastric pH. Some drugs require an empty
stomach for optimal absorption; others should be
taken with food to reduce GI irritation.*
**5.** A patient with liver failure is prescribed a
medication that is extensively metabolized by the
liver. The nurse anticipates that the patient may
require:
A) A higher dose of the medication
B) **A lower dose or longer dosing interval**
C) IV administration instead of oral
NUR 524 Pharmacology
, NUR 524
D)No change in dosing
**CORRECT ANSWER: B**
*EXPLANATION: Liver failure impairs drug
metabolism, leading to drug accumulation and
increased risk of toxicity. Doses typically need
reduction or extended intervals. This is why liver
function tests (AST, ALT) guide dosing for hepatically
cleared medications.*
**6.** Which organ is primarily responsible for drug
excretion?
A) Liver
B) **Kidney**
C) Lungs
D)Skin
**CORRECT ANSWER: B**
*EXPLANATION: The kidneys are the primary organs
of drug excretion. Most drugs and their metabolites
are eliminated via urine through glomerular filtration
and tubular secretion. Impaired renal function
requires dose adjustments to prevent accumulation
and toxicity.*
**7.** A patient with chronic kidney disease (CKD) is
prescribed a medication that is renally excreted. The
nurse should monitor for:
NUR 524 Pharmacology
