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PHARMACOLOGY – 12TH EDITION BY LINDA E. MCCUISTION EXAM
2026 QUESTIONS LATEST VERSION QUESTIONS AND ANSWERS
Pharmacology – 12th Edition by Linda E. McCuistion Exam
250 Questions with Detailed Rationales
SECTION 1: CORE PHARMACOLOGICAL PRINCIPLES (Questions 1-30)
Question 1
A nurse is preparing to administer a medication. According to the nursing process,
which step should occur first?
A) Planning
B) Implementation
C) Assessment
D) Evaluation
Answer: C
Rationale: The nursing process begins with assessment (collecting patient data, including
allergies, vital signs, lab values, and medication history). Assessment is the foundation for all
subsequent steps of the nursing process .
Question 2
Which action best demonstrates the evaluation phase of the nursing process when
administering medication?
A) Asking the patient about their medication history
B) Setting a goal to reduce pain to 3/10 within 1 hour
C) Administering the medication via the prescribed route
D) Assessing the patient's response 30 minutes after administration
Answer: D
Rationale: Evaluation involves assessing the patient's response to the medication after
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administration and determining if outcomes were met. This includes monitoring for
therapeutic effects and adverse reactions .
Question 3
A nurse is writing a nursing diagnosis for a patient who is prescribed a diuretic. Which
nursing diagnosis is most appropriate?
A) Acute pain related to drug administration
B) Risk for injury related to adverse effects
C) Impaired physical mobility related to medication
D) Disturbed body image related to drug therapy
Answer: B
Rationale: Diuretics can cause electrolyte imbalances, hypotension, and dizziness, increasing
the risk for falls and injury. "Risk for injury" is an appropriate nursing diagnosis .
Question 4
During the planning phase of the nursing process, the nurse should:
A) Administer the medication
B) Assess the patient's response to the medication
C) Set measurable goals and outcomes
D) Document the patient's allergies
Answer: C
Rationale: Planning involves developing patient-centered goals and expected outcomes.
Goals should be specific, measurable, achievable, realistic, and time-bound (SMART) .
Question 5
A nurse is evaluating the effectiveness of an antihypertensive medication. Which finding
indicates a therapeutic response?
A) Heart rate 100 bpm
B) Blood pressure 145/92 mm Hg
C) Blood pressure 128/76 mm Hg
D) Report of headache
Answer: C
Rationale: A therapeutic response to an antihypertensive medication is indicated by a
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reduction in blood pressure toward the target goal (typically <130/80 mm Hg for most
patients). A blood pressure of 128/76 mm Hg demonstrates a therapeutic response .
Question 6
The nurse understands that the FDA Pregnancy Risk Categories have been replaced by
the:
A) Pregnancy and Lactation Labeling Rule (PLLR)
B) Teratogen Risk Index
C) Maternal Drug Safety Score
D) Lactation Risk Rating
Answer: A
Rationale: The PLLR provides descriptive risk summaries and clinical considerations,
replacing the letter categories (A, B, C, D, X). This provides more detailed, actionable
information for clinicians and patients .
Question 7
A client is prescribed a medication with a narrow therapeutic index. Which nursing
action is most appropriate?
A) Reassure the client that this medication is very safe
B) Monitor the client closely for signs of toxicity and therapeutic effect
C) Tell the client not to worry about side effects
D) Administer the medication without any special monitoring
Answer: B
Rationale: Medications with a narrow therapeutic index (e.g., lithium, digoxin, warfarin)
have a small range between therapeutic and toxic doses. The nurse must monitor closely for
both therapeutic effects and signs of toxicity .
Question 8
A patient is receiving a drug that is a weak acid. The nurse knows that this drug will be
better absorbed in which part of the gastrointestinal tract?
A) Mouth
B) Stomach
C) Small intestine
D) Colon
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Answer: B
Rationale: Weak acids are better absorbed in the acidic environment of the stomach because
they are non-ionized and more lipid-soluble, allowing them to cross cell membranes more
easily .
Question 9
Low serum albumin levels affect drug therapy by:
A) Decreasing drug absorption
B) Increasing the free (active) fraction of highly protein-bound drugs
C) Decreasing drug metabolism
D) Increasing drug excretion
Answer: B
Rationale: Low albumin levels increase the free (active) fraction of highly protein-bound
drugs, increasing the risk of adverse effects. Only unbound (free) drug is pharmacologically
active .
Question 10
The nurse is administering a medication via the sublingual route. Which instruction
should the nurse provide to the client?
A) "Swallow the tablet with a full glass of water."
B) "Place the tablet under your tongue and allow it to dissolve completely; do not swallow
it."
C) "Chew the tablet before swallowing."
D) "Crush the tablet and mix it with applesauce."
Answer: B
Rationale: Sublingual medications (e.g., nitroglycerin) are placed under the tongue and
allowed to dissolve completely. They are absorbed directly into the bloodstream through the
oral mucosa, bypassing first-pass metabolism .
Question 11
A drug given intravenously (IV) has what bioavailability?
A) 50%
B) 75%
PHARMACOLOGY – 12TH EDITION BY LINDA E. MCCUISTION EXAM
2026 QUESTIONS LATEST VERSION QUESTIONS AND ANSWERS
Pharmacology – 12th Edition by Linda E. McCuistion Exam
250 Questions with Detailed Rationales
SECTION 1: CORE PHARMACOLOGICAL PRINCIPLES (Questions 1-30)
Question 1
A nurse is preparing to administer a medication. According to the nursing process,
which step should occur first?
A) Planning
B) Implementation
C) Assessment
D) Evaluation
Answer: C
Rationale: The nursing process begins with assessment (collecting patient data, including
allergies, vital signs, lab values, and medication history). Assessment is the foundation for all
subsequent steps of the nursing process .
Question 2
Which action best demonstrates the evaluation phase of the nursing process when
administering medication?
A) Asking the patient about their medication history
B) Setting a goal to reduce pain to 3/10 within 1 hour
C) Administering the medication via the prescribed route
D) Assessing the patient's response 30 minutes after administration
Answer: D
Rationale: Evaluation involves assessing the patient's response to the medication after
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administration and determining if outcomes were met. This includes monitoring for
therapeutic effects and adverse reactions .
Question 3
A nurse is writing a nursing diagnosis for a patient who is prescribed a diuretic. Which
nursing diagnosis is most appropriate?
A) Acute pain related to drug administration
B) Risk for injury related to adverse effects
C) Impaired physical mobility related to medication
D) Disturbed body image related to drug therapy
Answer: B
Rationale: Diuretics can cause electrolyte imbalances, hypotension, and dizziness, increasing
the risk for falls and injury. "Risk for injury" is an appropriate nursing diagnosis .
Question 4
During the planning phase of the nursing process, the nurse should:
A) Administer the medication
B) Assess the patient's response to the medication
C) Set measurable goals and outcomes
D) Document the patient's allergies
Answer: C
Rationale: Planning involves developing patient-centered goals and expected outcomes.
Goals should be specific, measurable, achievable, realistic, and time-bound (SMART) .
Question 5
A nurse is evaluating the effectiveness of an antihypertensive medication. Which finding
indicates a therapeutic response?
A) Heart rate 100 bpm
B) Blood pressure 145/92 mm Hg
C) Blood pressure 128/76 mm Hg
D) Report of headache
Answer: C
Rationale: A therapeutic response to an antihypertensive medication is indicated by a
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reduction in blood pressure toward the target goal (typically <130/80 mm Hg for most
patients). A blood pressure of 128/76 mm Hg demonstrates a therapeutic response .
Question 6
The nurse understands that the FDA Pregnancy Risk Categories have been replaced by
the:
A) Pregnancy and Lactation Labeling Rule (PLLR)
B) Teratogen Risk Index
C) Maternal Drug Safety Score
D) Lactation Risk Rating
Answer: A
Rationale: The PLLR provides descriptive risk summaries and clinical considerations,
replacing the letter categories (A, B, C, D, X). This provides more detailed, actionable
information for clinicians and patients .
Question 7
A client is prescribed a medication with a narrow therapeutic index. Which nursing
action is most appropriate?
A) Reassure the client that this medication is very safe
B) Monitor the client closely for signs of toxicity and therapeutic effect
C) Tell the client not to worry about side effects
D) Administer the medication without any special monitoring
Answer: B
Rationale: Medications with a narrow therapeutic index (e.g., lithium, digoxin, warfarin)
have a small range between therapeutic and toxic doses. The nurse must monitor closely for
both therapeutic effects and signs of toxicity .
Question 8
A patient is receiving a drug that is a weak acid. The nurse knows that this drug will be
better absorbed in which part of the gastrointestinal tract?
A) Mouth
B) Stomach
C) Small intestine
D) Colon
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Answer: B
Rationale: Weak acids are better absorbed in the acidic environment of the stomach because
they are non-ionized and more lipid-soluble, allowing them to cross cell membranes more
easily .
Question 9
Low serum albumin levels affect drug therapy by:
A) Decreasing drug absorption
B) Increasing the free (active) fraction of highly protein-bound drugs
C) Decreasing drug metabolism
D) Increasing drug excretion
Answer: B
Rationale: Low albumin levels increase the free (active) fraction of highly protein-bound
drugs, increasing the risk of adverse effects. Only unbound (free) drug is pharmacologically
active .
Question 10
The nurse is administering a medication via the sublingual route. Which instruction
should the nurse provide to the client?
A) "Swallow the tablet with a full glass of water."
B) "Place the tablet under your tongue and allow it to dissolve completely; do not swallow
it."
C) "Chew the tablet before swallowing."
D) "Crush the tablet and mix it with applesauce."
Answer: B
Rationale: Sublingual medications (e.g., nitroglycerin) are placed under the tongue and
allowed to dissolve completely. They are absorbed directly into the bloodstream through the
oral mucosa, bypassing first-pass metabolism .
Question 11
A drug given intravenously (IV) has what bioavailability?
A) 50%
B) 75%
