NUR 210 Units 1, 2, 3 & 4 Practice
Questions and correct answers/ NUR 210
Principles of Pharmacology Units 1-4
Review
UNIT 1: FOUNDATIONAL PRINCIPLES (Questions 1-20)
1. The nurse is preparing to administer a medication that is a weak acid. In which
part of the GI tract will it be BEST absorbed?
A) Small intestine (pH 7-8)
B) Stomach (pH 1-3)
C) Large intestine (pH 5-7)
D) Buccal mucosa (pH 6-7)
Rationale: Weak acids are non-ionized (lipid-soluble) in acidic environments, allowing
them to cross cell membranes easily . Weak bases are better absorbed in the alkaline
environment of the small intestine .
2. The nurse is administering a drug that is known to be a weak base (alkaline).
The nurse understands this drug will be best absorbed in the:
A) Stomach (acidic environment)
B) Small intestine (slightly alkaline environment)
C) Large intestine
D) Sublingual mucosa
Rationale: Weak bases are better absorbed in the small intestine where the pH is more
alkaline . This is determined by the drug's pKa and the environmental pH.
3. A patient with liver disease is prescribed a medication with high first-pass
metabolism. The nurse should anticipate:
A) Decreased bioavailability requiring a higher dose
B) Increased bioavailability requiring a lower dose
C) No change in dosing
D) Decreased drug half-life
Rationale: Liver disease reduces first-pass metabolism, leading to a higher proportion
,of the drug reaching systemic circulation . Therefore, a lower dose is required to prevent
toxicity.
4. A patient asks the nurse, "What is the difference between drug tolerance and
drug dependence?" The BEST response is:
A) "Tolerance means you need more drug to get the same effect; dependence
means your body adapts and you have withdrawal if you stop."
B) "Tolerance and dependence are the same thing."
C) "Tolerance causes addiction; dependence does not."
D) "Dependence is psychological, tolerance is physical."
Rationale: Tolerance is a decreased response requiring higher doses . Dependence is a
physiologic adaptation that results in withdrawal upon abrupt discontinuation.
5. The nurse is preparing to administer a medication and notes the order reads
"Morphine ___ mg IV PRN pain." What should the nurse do FIRST?
A) Administer the standard dose
B) Ask the patient how much they usually take
C) Clarify the order with the prescriber
D) Give half the usual dose
Rationale: Incomplete orders (missing dose or route) must be clarified before
administration . Never administer a medication with an incomplete order.
6. The nurse is administering a drug that is an enzyme inhibitor. Which outcome
would the nurse expect?
A) Faster metabolism of other drugs
B) Increased levels of other drugs metabolized by the same enzyme
C) Decreased effectiveness of the inhibitor drug itself
D) Reduced absorption from the GI tract
Rationale: Enzyme inhibitors slow the metabolism of other drugs that use the same
enzyme pathway, leading to increased serum levels and potential toxicity.
7. Grapefruit juice interacts with many medications by:
A) Increasing drug absorption
B) Inhibiting CYP450 enzymes (especially CYP3A4)
C) Decreasing drug metabolism
D) Increasing drug excretion
Rationale: Grapefruit juice inhibits CYP3A4, leading to increased levels of medications
metabolized by this enzyme system.
8. The "First Pass Effect" refers to:
A) Drug absorption in the GI tract
, B) Drug metabolism in the liver before reaching systemic circulation
C) Drug distribution to tissues
D) Drug excretion by the kidneys
Rationale: The first-pass effect refers to the metabolism of a drug in the liver before it
reaches systemic circulation . Oral drugs are absorbed from the GI tract and travel via
the portal vein to the liver.
9. The therapeutic index of a drug refers to:
A) Its chemical structure
B) The margin between effective and toxic dose
C) Its absorption rate
D) Its shelf life
Rationale: A narrow therapeutic index means close monitoring is required . The
therapeutic index is the ratio between the toxic and therapeutic concentrations of a
drug.
10. Which factor slows drug metabolism in older adults?
A) Increased liver enzyme activity
B) Decreased hepatic blood flow and enzyme production
C) Higher muscle mass
D) Faster renal filtration
Rationale: Aging reduces liver function, slowing metabolism and increasing toxicity risk
. Decreased hepatic blood flow and enzyme production are age-related changes.
11. The "black box warning" on a medication label means:
A) Drug is over-the-counter
B) Risk of serious or life-threatening adverse effects
C) Drug is safe for children
D) Drug is safe during pregnancy
Rationale: A black box warning is the FDA's strongest warning for a medication,
indicating serious or life-threatening adverse effects.
12. The nurse verifies a patient's allergies before giving penicillin. This action
prevents:
A) Tachyphylaxis
B) Drug tolerance
C) Hypersensitivity reaction
D) Dependence
Rationale: Checking allergies prevents anaphylaxis or allergic response . Allergy
verification is a critical safety measure.
Questions and correct answers/ NUR 210
Principles of Pharmacology Units 1-4
Review
UNIT 1: FOUNDATIONAL PRINCIPLES (Questions 1-20)
1. The nurse is preparing to administer a medication that is a weak acid. In which
part of the GI tract will it be BEST absorbed?
A) Small intestine (pH 7-8)
B) Stomach (pH 1-3)
C) Large intestine (pH 5-7)
D) Buccal mucosa (pH 6-7)
Rationale: Weak acids are non-ionized (lipid-soluble) in acidic environments, allowing
them to cross cell membranes easily . Weak bases are better absorbed in the alkaline
environment of the small intestine .
2. The nurse is administering a drug that is known to be a weak base (alkaline).
The nurse understands this drug will be best absorbed in the:
A) Stomach (acidic environment)
B) Small intestine (slightly alkaline environment)
C) Large intestine
D) Sublingual mucosa
Rationale: Weak bases are better absorbed in the small intestine where the pH is more
alkaline . This is determined by the drug's pKa and the environmental pH.
3. A patient with liver disease is prescribed a medication with high first-pass
metabolism. The nurse should anticipate:
A) Decreased bioavailability requiring a higher dose
B) Increased bioavailability requiring a lower dose
C) No change in dosing
D) Decreased drug half-life
Rationale: Liver disease reduces first-pass metabolism, leading to a higher proportion
,of the drug reaching systemic circulation . Therefore, a lower dose is required to prevent
toxicity.
4. A patient asks the nurse, "What is the difference between drug tolerance and
drug dependence?" The BEST response is:
A) "Tolerance means you need more drug to get the same effect; dependence
means your body adapts and you have withdrawal if you stop."
B) "Tolerance and dependence are the same thing."
C) "Tolerance causes addiction; dependence does not."
D) "Dependence is psychological, tolerance is physical."
Rationale: Tolerance is a decreased response requiring higher doses . Dependence is a
physiologic adaptation that results in withdrawal upon abrupt discontinuation.
5. The nurse is preparing to administer a medication and notes the order reads
"Morphine ___ mg IV PRN pain." What should the nurse do FIRST?
A) Administer the standard dose
B) Ask the patient how much they usually take
C) Clarify the order with the prescriber
D) Give half the usual dose
Rationale: Incomplete orders (missing dose or route) must be clarified before
administration . Never administer a medication with an incomplete order.
6. The nurse is administering a drug that is an enzyme inhibitor. Which outcome
would the nurse expect?
A) Faster metabolism of other drugs
B) Increased levels of other drugs metabolized by the same enzyme
C) Decreased effectiveness of the inhibitor drug itself
D) Reduced absorption from the GI tract
Rationale: Enzyme inhibitors slow the metabolism of other drugs that use the same
enzyme pathway, leading to increased serum levels and potential toxicity.
7. Grapefruit juice interacts with many medications by:
A) Increasing drug absorption
B) Inhibiting CYP450 enzymes (especially CYP3A4)
C) Decreasing drug metabolism
D) Increasing drug excretion
Rationale: Grapefruit juice inhibits CYP3A4, leading to increased levels of medications
metabolized by this enzyme system.
8. The "First Pass Effect" refers to:
A) Drug absorption in the GI tract
, B) Drug metabolism in the liver before reaching systemic circulation
C) Drug distribution to tissues
D) Drug excretion by the kidneys
Rationale: The first-pass effect refers to the metabolism of a drug in the liver before it
reaches systemic circulation . Oral drugs are absorbed from the GI tract and travel via
the portal vein to the liver.
9. The therapeutic index of a drug refers to:
A) Its chemical structure
B) The margin between effective and toxic dose
C) Its absorption rate
D) Its shelf life
Rationale: A narrow therapeutic index means close monitoring is required . The
therapeutic index is the ratio between the toxic and therapeutic concentrations of a
drug.
10. Which factor slows drug metabolism in older adults?
A) Increased liver enzyme activity
B) Decreased hepatic blood flow and enzyme production
C) Higher muscle mass
D) Faster renal filtration
Rationale: Aging reduces liver function, slowing metabolism and increasing toxicity risk
. Decreased hepatic blood flow and enzyme production are age-related changes.
11. The "black box warning" on a medication label means:
A) Drug is over-the-counter
B) Risk of serious or life-threatening adverse effects
C) Drug is safe for children
D) Drug is safe during pregnancy
Rationale: A black box warning is the FDA's strongest warning for a medication,
indicating serious or life-threatening adverse effects.
12. The nurse verifies a patient's allergies before giving penicillin. This action
prevents:
A) Tachyphylaxis
B) Drug tolerance
C) Hypersensitivity reaction
D) Dependence
Rationale: Checking allergies prevents anaphylaxis or allergic response . Allergy
verification is a critical safety measure.
