NURS 300 (Pharmacology) Unit Exam 1
Latest 2026/2027 | Newly Released
San Diego State University (SDSU).
50 Questions and Answers With Expert Rationales
Guaranteed Pass | Graded A +
Q1. A nurse is preparing to administer intravenous potassium chloride to a patient. Before
administration, the nurse must verify the order with another nurse and use barcode scanning.
This protocol is required because potassium chloride is classified as:
A. A high-alert medication
B. A controlled substance
C. A chemotherapy agent
D. An investigational drug
Correct Answer: A
Potassium chloride is classified as a high-alert medication because errors can cause fatal cardiac
arrhythmias. Independent double-check verification and barcode scanning are institutional safety
requirements for high-alert drugs. Controlled substances require different documentation,
chemotherapy requires specialized handling, and investigational drugs require protocol-specific
consent.
Q2. Which pharmacokinetic process describes the movement of a drug from the bloodstream
into tissues and organs throughout the body?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: B
Distribution is the process by which a drug moves from the systemic circulation into body tissues
and organs. Factors affecting distribution include blood flow, protein binding, and lipid
solubility. Absorption refers to entry into the bloodstream, metabolism to chemical
biotransformation, and excretion to elimination from the body.
,Q3. The therapeutic index of a drug is calculated by dividing the median lethal dose by the
median effective dose. A drug with a high therapeutic index is considered:
A. More potent than other drugs in its class
B. Safer because the toxic dose is much higher than the effective dose
C. Less effective because it requires a higher dose to work
D. More likely to cause severe adverse reactions
Correct Answer: C
A high therapeutic index indicates a wide margin of safety between the dose that produces the
desired effect and the dose that produces toxicity. Drugs with a low therapeutic index, such as
digoxin or lithium, require frequent monitoring because small changes in blood concentration
can lead to toxicity. Understanding the therapeutic index helps nurses prioritize monitoring
requirements and patient education for high-risk medications.
Q4. A patient is prescribed 500 mg of a drug orally. The drug has a bioavailability of 50%. How
many milligrams of active drug will reach the systemic circulation?
A. 100 mg
B. 125 mg
C. 250 mg
D. 375 mg
Correct Answer: D
The amount of drug reaching systemic circulation is calculated by multiplying the administered
dose by the bioavailability fraction: 500 mg × 0.50 = 250 mg. Bioavailability represents the
proportion of an administered dose that enters the systemic circulation unchanged. This
calculation is essential when determining equivalent dosages across different routes of
administration.
Q5. A drug that binds to a receptor and produces a biological response similar to the endogenous
ligand is classified as:
A. An agonist
B. An antagonist
C. A partial agonist
D. An inverse agonist
Correct Answer: A
, An agonist binds to a receptor and activates it to produce a full biological response. An
antagonist binds to the receptor without activating it, thereby blocking agonist action. Partial
agonists produce a submaximal response even at full receptor occupancy, while inverse agonists
stabilize the inactive receptor conformation and reduce baseline activity.
Q6. A patient taking an ACE inhibitor develops a persistent dry cough. The nurse recognizes this
as:
A. An expected therapeutic effect
B. A common adverse effect of ACE inhibitors
C. An indication to increase the dosage
D. An allergic reaction requiring immediate epinephrine
Correct Answer: B
ACE inhibitors block the breakdown of bradykinin, which accumulates in the lungs and causes a
persistent dry cough in approximately 5 to 20 percent of patients. This adverse effect is not an
indication of drug efficacy or an allergic reaction mediated by histamine. Patients who cannot
tolerate the cough may be switched to an angiotensin receptor blocker, which does not affect
bradykinin metabolism.
Q7. A patient taking warfarin is prescribed trimethoprim-sulfamethoxazole for a urinary tract
infection. The nurse is most concerned about which potential outcome?
A. Decreased absorption of warfarin
B. Induction of hepatic enzymes that metabolize warfarin
C. Increased risk of bleeding due to potentiation of warfarin's effect
D. Hyperkalemia from blocked potassium excretion
Correct Answer: C
Trimethoprim-sulfamethoxazole inhibits CYP2C9 and displaces warfarin from albumin binding
sites, increasing the free fraction and anticoagulant effect. This pharmacokinetic interaction
significantly raises the INR and increases the risk of bleeding complications. Nurses should
monitor INR closely and assess for signs of bleeding, such as bruising, hematuria, or melena,
when these drugs are combined.
Latest 2026/2027 | Newly Released
San Diego State University (SDSU).
50 Questions and Answers With Expert Rationales
Guaranteed Pass | Graded A +
Q1. A nurse is preparing to administer intravenous potassium chloride to a patient. Before
administration, the nurse must verify the order with another nurse and use barcode scanning.
This protocol is required because potassium chloride is classified as:
A. A high-alert medication
B. A controlled substance
C. A chemotherapy agent
D. An investigational drug
Correct Answer: A
Potassium chloride is classified as a high-alert medication because errors can cause fatal cardiac
arrhythmias. Independent double-check verification and barcode scanning are institutional safety
requirements for high-alert drugs. Controlled substances require different documentation,
chemotherapy requires specialized handling, and investigational drugs require protocol-specific
consent.
Q2. Which pharmacokinetic process describes the movement of a drug from the bloodstream
into tissues and organs throughout the body?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: B
Distribution is the process by which a drug moves from the systemic circulation into body tissues
and organs. Factors affecting distribution include blood flow, protein binding, and lipid
solubility. Absorption refers to entry into the bloodstream, metabolism to chemical
biotransformation, and excretion to elimination from the body.
,Q3. The therapeutic index of a drug is calculated by dividing the median lethal dose by the
median effective dose. A drug with a high therapeutic index is considered:
A. More potent than other drugs in its class
B. Safer because the toxic dose is much higher than the effective dose
C. Less effective because it requires a higher dose to work
D. More likely to cause severe adverse reactions
Correct Answer: C
A high therapeutic index indicates a wide margin of safety between the dose that produces the
desired effect and the dose that produces toxicity. Drugs with a low therapeutic index, such as
digoxin or lithium, require frequent monitoring because small changes in blood concentration
can lead to toxicity. Understanding the therapeutic index helps nurses prioritize monitoring
requirements and patient education for high-risk medications.
Q4. A patient is prescribed 500 mg of a drug orally. The drug has a bioavailability of 50%. How
many milligrams of active drug will reach the systemic circulation?
A. 100 mg
B. 125 mg
C. 250 mg
D. 375 mg
Correct Answer: D
The amount of drug reaching systemic circulation is calculated by multiplying the administered
dose by the bioavailability fraction: 500 mg × 0.50 = 250 mg. Bioavailability represents the
proportion of an administered dose that enters the systemic circulation unchanged. This
calculation is essential when determining equivalent dosages across different routes of
administration.
Q5. A drug that binds to a receptor and produces a biological response similar to the endogenous
ligand is classified as:
A. An agonist
B. An antagonist
C. A partial agonist
D. An inverse agonist
Correct Answer: A
, An agonist binds to a receptor and activates it to produce a full biological response. An
antagonist binds to the receptor without activating it, thereby blocking agonist action. Partial
agonists produce a submaximal response even at full receptor occupancy, while inverse agonists
stabilize the inactive receptor conformation and reduce baseline activity.
Q6. A patient taking an ACE inhibitor develops a persistent dry cough. The nurse recognizes this
as:
A. An expected therapeutic effect
B. A common adverse effect of ACE inhibitors
C. An indication to increase the dosage
D. An allergic reaction requiring immediate epinephrine
Correct Answer: B
ACE inhibitors block the breakdown of bradykinin, which accumulates in the lungs and causes a
persistent dry cough in approximately 5 to 20 percent of patients. This adverse effect is not an
indication of drug efficacy or an allergic reaction mediated by histamine. Patients who cannot
tolerate the cough may be switched to an angiotensin receptor blocker, which does not affect
bradykinin metabolism.
Q7. A patient taking warfarin is prescribed trimethoprim-sulfamethoxazole for a urinary tract
infection. The nurse is most concerned about which potential outcome?
A. Decreased absorption of warfarin
B. Induction of hepatic enzymes that metabolize warfarin
C. Increased risk of bleeding due to potentiation of warfarin's effect
D. Hyperkalemia from blocked potassium excretion
Correct Answer: C
Trimethoprim-sulfamethoxazole inhibits CYP2C9 and displaces warfarin from albumin binding
sites, increasing the free fraction and anticoagulant effect. This pharmacokinetic interaction
significantly raises the INR and increases the risk of bleeding complications. Nurses should
monitor INR closely and assess for signs of bleeding, such as bruising, hematuria, or melena,
when these drugs are combined.
