NSG 318 INTRODUCTION TO PHARMACOLOGY – FINAL EXAM
STUDY RESOURCE 2026
SECTION 1: BASIC PRINCIPLES OF
PHARMACOLOGY (Questions 1–30)
Question 1: A drug that binds to a receptor site and produces a
submaximal response even at full receptor occupancy is called a:
A) Full agonist
B) Partial agonist
C) Competitive antagonist
D) Noncompetitive antagonist
Correct Answer: B) Partial agonist
Rationale: A partial agonist binds to a receptor but produces a submaximal
response even when all receptors are occupied. A full agonist (A) produces a
maximal response. A competitive antagonist (C) binds reversibly and
competes with agonists. A noncompetitive antagonist (D) binds irreversibly
and reduces maximal response.
Question 2: The volume of distribution of a drug is affected by which of
the following factors?
A) Lipid solubility
B) Protein binding
C) Tissue perfusion
D) All of the above
Correct Answer: D) All of the above
,Rationale: Volume of distribution (Vd) is affected by lipid solubility (lipophilic
drugs have larger Vd), protein binding (highly bound drugs stay in vascular
compartment, smaller Vd), and tissue perfusion (well-perfused organs receive
more drug). All three factors influence drug distribution.
Question 3: A drug that is primarily excreted unchanged in the urine would
require dose adjustment in which patient population?
A) Patients with hepatic impairment
B) Patients with renal impairment
C) Patients with heart failure
D) Patients with diabetes
Correct Answer: B) Patients with renal impairment
Rationale: Drugs excreted unchanged by the kidneys require dose adjustment
in renal impairment to prevent accumulation and toxicity. Hepatic
impairment (A) affects drugs metabolized by the liver. Heart failure (C) and
diabetes (D) may affect renal function but do not automatically require
adjustment unless renal function is impaired.
Question 4: The maximum effect a drug can produce, regardless of dose, is
called:
A) Potency
B) Efficacy
C) Affinity
D) Specificity
Correct Answer: B) Efficacy
,Rationale: Efficacy is the maximum effect a drug can produce. Potency (A) is
the amount of drug required to produce a given effect (lower dose = higher
potency). Affinity (C) is the strength of drug-receptor binding. Specificity (D) is
the selectivity for a particular receptor type.
Question 5: A patient's serum drug level is below the minimum effective
concentration. This indicates the patient is:
A) Experiencing toxicity
B) Not receiving therapeutic benefit
C) Experiencing an allergic reaction
D) Developing drug tolerance
Correct Answer: B) Not receiving therapeutic benefit
Rationale: The minimum effective concentration (MEC) is the lowest serum
drug concentration needed to produce a therapeutic effect. If the drug level is
below the MEC, the patient is not receiving therapeutic benefit. Toxicity (A)
occurs above the toxic concentration. Tolerance (D) may require higher doses
but does not directly relate to MEC.
Question 6: The nurse identifies that a patient is experiencing a drug side
effect. Which of the following best describes a side effect?
A) An unintended, expected effect that occurs at therapeutic doses
B) A life-threatening reaction requiring immediate intervention
C) An effect that only occurs at toxic doses
D) An immune-mediated response
Correct Answer: A) An unintended, expected effect that occurs at
therapeutic doses
, Rationale: Side effects are unintended, expected effects that occur at
therapeutic doses (e.g., drowsiness with antihistamines). Adverse reactions (B)
are more severe and may be life-threatening. Toxic effects (C) occur at high
doses. Allergic reactions (D) are immune-mediated.
Question 7: Which of the following is a medication with a narrow
therapeutic index?
A) Amoxicillin
B) Ibuprofen
C) Digoxin
D) Acetaminophen
Correct Answer: C) Digoxin
Rationale: Digoxin has a narrow therapeutic index, meaning the difference
between therapeutic and toxic doses is small. Serum levels must be monitored
carefully (therapeutic range 0.5-1 ng/mL). Amoxicillin (A), ibuprofen (B), and
acetaminophen (D) have wider therapeutic indices.
Question 8: A patient is taking a drug that is a CYP3A4 inhibitor. This will
likely:
A) Increase the metabolism of other drugs, decreasing their effects
B) Decrease the metabolism of other drugs, increasing their effects
C) Have no effect on other drugs
D) Increase protein binding of other drugs
Correct Answer: B) Decrease the metabolism of other drugs, increasing
their effects
STUDY RESOURCE 2026
SECTION 1: BASIC PRINCIPLES OF
PHARMACOLOGY (Questions 1–30)
Question 1: A drug that binds to a receptor site and produces a
submaximal response even at full receptor occupancy is called a:
A) Full agonist
B) Partial agonist
C) Competitive antagonist
D) Noncompetitive antagonist
Correct Answer: B) Partial agonist
Rationale: A partial agonist binds to a receptor but produces a submaximal
response even when all receptors are occupied. A full agonist (A) produces a
maximal response. A competitive antagonist (C) binds reversibly and
competes with agonists. A noncompetitive antagonist (D) binds irreversibly
and reduces maximal response.
Question 2: The volume of distribution of a drug is affected by which of
the following factors?
A) Lipid solubility
B) Protein binding
C) Tissue perfusion
D) All of the above
Correct Answer: D) All of the above
,Rationale: Volume of distribution (Vd) is affected by lipid solubility (lipophilic
drugs have larger Vd), protein binding (highly bound drugs stay in vascular
compartment, smaller Vd), and tissue perfusion (well-perfused organs receive
more drug). All three factors influence drug distribution.
Question 3: A drug that is primarily excreted unchanged in the urine would
require dose adjustment in which patient population?
A) Patients with hepatic impairment
B) Patients with renal impairment
C) Patients with heart failure
D) Patients with diabetes
Correct Answer: B) Patients with renal impairment
Rationale: Drugs excreted unchanged by the kidneys require dose adjustment
in renal impairment to prevent accumulation and toxicity. Hepatic
impairment (A) affects drugs metabolized by the liver. Heart failure (C) and
diabetes (D) may affect renal function but do not automatically require
adjustment unless renal function is impaired.
Question 4: The maximum effect a drug can produce, regardless of dose, is
called:
A) Potency
B) Efficacy
C) Affinity
D) Specificity
Correct Answer: B) Efficacy
,Rationale: Efficacy is the maximum effect a drug can produce. Potency (A) is
the amount of drug required to produce a given effect (lower dose = higher
potency). Affinity (C) is the strength of drug-receptor binding. Specificity (D) is
the selectivity for a particular receptor type.
Question 5: A patient's serum drug level is below the minimum effective
concentration. This indicates the patient is:
A) Experiencing toxicity
B) Not receiving therapeutic benefit
C) Experiencing an allergic reaction
D) Developing drug tolerance
Correct Answer: B) Not receiving therapeutic benefit
Rationale: The minimum effective concentration (MEC) is the lowest serum
drug concentration needed to produce a therapeutic effect. If the drug level is
below the MEC, the patient is not receiving therapeutic benefit. Toxicity (A)
occurs above the toxic concentration. Tolerance (D) may require higher doses
but does not directly relate to MEC.
Question 6: The nurse identifies that a patient is experiencing a drug side
effect. Which of the following best describes a side effect?
A) An unintended, expected effect that occurs at therapeutic doses
B) A life-threatening reaction requiring immediate intervention
C) An effect that only occurs at toxic doses
D) An immune-mediated response
Correct Answer: A) An unintended, expected effect that occurs at
therapeutic doses
, Rationale: Side effects are unintended, expected effects that occur at
therapeutic doses (e.g., drowsiness with antihistamines). Adverse reactions (B)
are more severe and may be life-threatening. Toxic effects (C) occur at high
doses. Allergic reactions (D) are immune-mediated.
Question 7: Which of the following is a medication with a narrow
therapeutic index?
A) Amoxicillin
B) Ibuprofen
C) Digoxin
D) Acetaminophen
Correct Answer: C) Digoxin
Rationale: Digoxin has a narrow therapeutic index, meaning the difference
between therapeutic and toxic doses is small. Serum levels must be monitored
carefully (therapeutic range 0.5-1 ng/mL). Amoxicillin (A), ibuprofen (B), and
acetaminophen (D) have wider therapeutic indices.
Question 8: A patient is taking a drug that is a CYP3A4 inhibitor. This will
likely:
A) Increase the metabolism of other drugs, decreasing their effects
B) Decrease the metabolism of other drugs, increasing their effects
C) Have no effect on other drugs
D) Increase protein binding of other drugs
Correct Answer: B) Decrease the metabolism of other drugs, increasing
their effects
