NU 150 Exam 1 Pharmacology – (2026/2027) Galen
Actual Questions, Verified Answers with Rationales |
Guarantee Pass
SECTION 1: PHARMACOKINETICS
Q1: A drug administered intravenously has 100% bioavailability. Which route of
administration has the fastest onset of action?
A. Oral
B. Subcutaneous
C. Intravenous
D. Intramuscular
Correct Answer: C. Intravenous
Rationale: IV administration delivers the drug directly into the bloodstream,
bypassing absorption barriers. This results in the fastest onset of action
(immediate) and 100% bioavailability. Oral has delayed onset due to GI
absorption and first-pass metabolism.
Q2: A patient with liver cirrhosis is prescribed a medication that undergoes
extensive first-pass metabolism. The nurse anticipates:
A. Decreased drug effect
B. Increased drug effect and prolonged duration
C. No change in drug effect
D. Increased renal excretion
Correct Answer: B. Increased drug effect and prolonged duration
Rationale: First-pass metabolism occurs in the liver. In cirrhosis, hepatic function
is impaired, reducing metabolism. This leads to higher serum drug levels,
increased effects, and prolonged duration of action. Dose reduction is often
necessary.
Q3: The nurse understands that the primary site of drug metabolism is the:
,A. Kidney
B. Liver
C. Lungs
D. Skin
Correct Answer: B. Liver
Rationale: The liver is the primary organ for drug metabolism through Phase I
(oxidation, reduction, hydrolysis via CYP450 enzymes) and Phase II (conjugation)
reactions. The kidneys primarily excrete drugs.
Q4: A patient is taking a drug with a half-life of 4 hours. How long will it take for
the drug to reach steady state?
A. 4 hours
B. 8 hours
C. 16 hours
D. 20 hours
Correct Answer: D. 20 hours
Rationale: Steady state is reached after approximately 4-5 half-lives. 4 hours × 5 =
20 hours. At this point, drug administration and elimination are equal, producing
consistent therapeutic levels.
Q5: The nurse is administering a medication that is highly protein-bound (95%).
A second medication that competes for protein binding sites is administered.
What effect should the nurse anticipate?
A. Decreased free drug concentration of the first drug
B. Increased free drug concentration and potential toxicity of the first drug
C. No significant interaction
D. Increased protein binding of both drugs
Correct Answer: B. Increased free drug concentration and potential toxicity of
the first drug
Rationale: When two highly protein-bound drugs compete for binding sites on
albumin, the first drug is displaced, increasing its free (unbound) concentration.
,Only free drug is pharmacologically active, so this can lead to enhanced effects
and toxicity.
Q6: Which age group is most susceptible to adverse drug reactions due to
decreased renal function?
A. Neonates
B. Adolescents
C. Middle-aged adults
D. Older adults
Correct Answer: D. Older adults
Rationale: Older adults (geriatric patients) experience age-related decline in renal
function, reducing drug clearance and increasing half-life. They are at highest risk
for drug accumulation and toxicity, necessitating lower doses.
Q7: A drug with a narrow therapeutic index requires:
A. Less frequent monitoring
B. Frequent serum drug level monitoring
C. Administration with food only
D. No special precautions
Correct Answer: B. Frequent serum drug level monitoring
Rationale: A narrow therapeutic index means the difference between therapeutic
and toxic doses is small (e.g., digoxin, warfarin, phenytoin). Frequent monitoring
of serum drug levels is essential to maintain safe, therapeutic concentrations.
Q8: Which phase of pharmacokinetics involves the movement of a drug from
the site of administration into the bloodstream?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
, Correct Answer: A. Absorption
Rationale: Absorption is the first phase of pharmacokinetics, referring to the
movement of the drug from its administration site into systemic circulation. IV
administration bypasses absorption.
Q9: An acidic drug will be better absorbed in which part of the gastrointestinal
tract?
A. Stomach (acidic environment)
B. Small intestine (basic environment)
C. Colon
D. Rectum
Correct Answer: A. Stomach (acidic environment)
Rationale: Acidic drugs remain non-ionized in acidic environments (like the
stomach), making them lipid-soluble and easily absorbed across cell membranes.
Basic drugs are better absorbed in the basic environment of the small intestine.
Q10: The nurse recognizes that distribution of a drug throughout the body is
influenced by:
A. Lipid solubility
B. Protein binding
C. Blood flow to tissues
D. All of the above
Correct Answer: D. All of the above
Rationale: Drug distribution depends on lipid solubility (lipophilic drugs cross
membranes easily), protein binding (bound drugs remain in vascular space), and
tissue blood flow (highly perfused organs receive more drug).
Q11: A patient with renal failure is receiving a medication excreted primarily by
the kidneys. The nurse expects:
Actual Questions, Verified Answers with Rationales |
Guarantee Pass
SECTION 1: PHARMACOKINETICS
Q1: A drug administered intravenously has 100% bioavailability. Which route of
administration has the fastest onset of action?
A. Oral
B. Subcutaneous
C. Intravenous
D. Intramuscular
Correct Answer: C. Intravenous
Rationale: IV administration delivers the drug directly into the bloodstream,
bypassing absorption barriers. This results in the fastest onset of action
(immediate) and 100% bioavailability. Oral has delayed onset due to GI
absorption and first-pass metabolism.
Q2: A patient with liver cirrhosis is prescribed a medication that undergoes
extensive first-pass metabolism. The nurse anticipates:
A. Decreased drug effect
B. Increased drug effect and prolonged duration
C. No change in drug effect
D. Increased renal excretion
Correct Answer: B. Increased drug effect and prolonged duration
Rationale: First-pass metabolism occurs in the liver. In cirrhosis, hepatic function
is impaired, reducing metabolism. This leads to higher serum drug levels,
increased effects, and prolonged duration of action. Dose reduction is often
necessary.
Q3: The nurse understands that the primary site of drug metabolism is the:
,A. Kidney
B. Liver
C. Lungs
D. Skin
Correct Answer: B. Liver
Rationale: The liver is the primary organ for drug metabolism through Phase I
(oxidation, reduction, hydrolysis via CYP450 enzymes) and Phase II (conjugation)
reactions. The kidneys primarily excrete drugs.
Q4: A patient is taking a drug with a half-life of 4 hours. How long will it take for
the drug to reach steady state?
A. 4 hours
B. 8 hours
C. 16 hours
D. 20 hours
Correct Answer: D. 20 hours
Rationale: Steady state is reached after approximately 4-5 half-lives. 4 hours × 5 =
20 hours. At this point, drug administration and elimination are equal, producing
consistent therapeutic levels.
Q5: The nurse is administering a medication that is highly protein-bound (95%).
A second medication that competes for protein binding sites is administered.
What effect should the nurse anticipate?
A. Decreased free drug concentration of the first drug
B. Increased free drug concentration and potential toxicity of the first drug
C. No significant interaction
D. Increased protein binding of both drugs
Correct Answer: B. Increased free drug concentration and potential toxicity of
the first drug
Rationale: When two highly protein-bound drugs compete for binding sites on
albumin, the first drug is displaced, increasing its free (unbound) concentration.
,Only free drug is pharmacologically active, so this can lead to enhanced effects
and toxicity.
Q6: Which age group is most susceptible to adverse drug reactions due to
decreased renal function?
A. Neonates
B. Adolescents
C. Middle-aged adults
D. Older adults
Correct Answer: D. Older adults
Rationale: Older adults (geriatric patients) experience age-related decline in renal
function, reducing drug clearance and increasing half-life. They are at highest risk
for drug accumulation and toxicity, necessitating lower doses.
Q7: A drug with a narrow therapeutic index requires:
A. Less frequent monitoring
B. Frequent serum drug level monitoring
C. Administration with food only
D. No special precautions
Correct Answer: B. Frequent serum drug level monitoring
Rationale: A narrow therapeutic index means the difference between therapeutic
and toxic doses is small (e.g., digoxin, warfarin, phenytoin). Frequent monitoring
of serum drug levels is essential to maintain safe, therapeutic concentrations.
Q8: Which phase of pharmacokinetics involves the movement of a drug from
the site of administration into the bloodstream?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
, Correct Answer: A. Absorption
Rationale: Absorption is the first phase of pharmacokinetics, referring to the
movement of the drug from its administration site into systemic circulation. IV
administration bypasses absorption.
Q9: An acidic drug will be better absorbed in which part of the gastrointestinal
tract?
A. Stomach (acidic environment)
B. Small intestine (basic environment)
C. Colon
D. Rectum
Correct Answer: A. Stomach (acidic environment)
Rationale: Acidic drugs remain non-ionized in acidic environments (like the
stomach), making them lipid-soluble and easily absorbed across cell membranes.
Basic drugs are better absorbed in the basic environment of the small intestine.
Q10: The nurse recognizes that distribution of a drug throughout the body is
influenced by:
A. Lipid solubility
B. Protein binding
C. Blood flow to tissues
D. All of the above
Correct Answer: D. All of the above
Rationale: Drug distribution depends on lipid solubility (lipophilic drugs cross
membranes easily), protein binding (bound drugs remain in vascular space), and
tissue blood flow (highly perfused organs receive more drug).
Q11: A patient with renal failure is receiving a medication excreted primarily by
the kidneys. The nurse expects:
