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PHARMACOLOGY NURSING – 2026 FINAL EXAM REVIEW:
DRUGS, DOSAGES & KEY CONCEPTS QUESTIONS WITH
DETAILED RATIONALES
Nursing Practice and Safe Medication Administration / pharmacology
Exam coverage:
I. Section 1, Questions 1-25: Pharmacokinetics &
Pharmacodynamics: Covers drug absorption, distribution,
metabolism, excretion, and receptor theory.
II. Section 2, Questions 26-50: Cardiovascular & Hematologic:
Focuses on antihypertensives, anticoagulants,
antiarrhythmics, and related nursing implications.
III. Section 3, Questions 51-75: Endocrine & Respiratory:
Emphasizes diabetes drugs, thyroid medications,
asthma/COPD treatments, and monitoring.
IV. Section 4, Questions 76-100: Antimicrobials, CNS, GI &
Nursing Implications: Covers antibiotics,
psychotherapeutics, GI medications, and medication safety.
Section 1: Question 1-25: Pharmacokinetics &
Pharmacodynamics Fundamentals
1. A drug with a high first-pass effect will have which
characteristic?
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A. Higher bioavailability when given orally
B. Lower bioavailability when given orally
C. Rapid onset of action with oral administration
D. No difference in bioavailability between routes
CORRECT ANSWER: B
RATIONALE: The first-pass effect refers to the metabolism of a
drug by the liver before it reaches systemic circulation after oral
administration. This significantly reduces bioavailability,
meaning a larger oral dose is needed compared to IV. Drugs
with high first-pass effect have much lower oral bioavailability
than parenteral bioavailability .
2. The nurse understands that a drug with a narrow
therapeutic index requires which nursing action?
A. Administering the drug with meals
B. Monitoring drug levels closely and assessing for toxicity
C. Giving the drug at bedtime only
D. Administering the drug only via the oral route
CORRECT ANSWER: B
RATIONALE: A narrow therapeutic index means the difference
between a therapeutic dose and a toxic dose is small. Drugs
with narrow TI (e.g., digoxin, lithium, warfarin, theophylline)
require close monitoring of serum drug levels, patient
assessment for signs of toxicity, and precise dosing .
3. It takes approximately how long for a drug to reach steady
state if its half-life is 6 hours?
A. 12 hours
B. 24 to 30 hours
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C. 48 hours
D. 6 hours
CORRECT ANSWER: B
RATIONALE: Steady state is achieved in approximately 4 to 5
half-lives. For a drug with a 6-hour half-life: 4 × 6 = 24 hours, 5 ×
6 = 30 hours. At steady state, the rate of drug administration
equals the rate of elimination .
4. Which term describes the time it takes for a drug to
produce its therapeutic effect after administration?
A. Peak action
B. Duration of action
C. Onset of action
D. Half-life
CORRECT ANSWER: C
RATIONALE: Onset of action is the time from drug
administration until the first observable therapeutic effect. Peak
action is when the drug reaches its maximum concentration
and effect, duration is the length of time the drug produces a
therapeutic effect .
5. A patient asks the nurse why a medication must be given
intravenously instead of by mouth. Which response by the
nurse best explains the rationale?
A. "IV medications are less expensive than oral medications."
B. "IV administration provides immediate and complete drug
absorption."
C. "Oral medications are always less effective than IV
medications."
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D. "IV medications have fewer side effects than oral
medications."
CORRECT ANSWER: B
RATIONALE: Intravenous administration delivers the drug
directly into the bloodstream, bypassing absorption barriers
and first-pass metabolism. This provides 100% bioavailability
and the most rapid onset of action compared to other routes .
6. Which phase of pharmacokinetics involves the movement
of a drug from the GI tract into the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
CORRECT ANSWER: C
RATIONALE: Absorption is the process by which a drug moves
from its site of administration into the bloodstream. The
gastrointestinal tract is a common site of drug absorption
following oral administration .
7. Which organ is primarily responsible for drug
metabolism?
A. Kidney
B. Liver
C. Lungs
D. Intestine
CORRECT ANSWER: B
RATIONALE: The liver contains cytochrome P450 enzymes that
metabolize most drugs. Metabolism converts lipophilic drugs
PHARMACOLOGY NURSING – 2026 FINAL EXAM REVIEW:
DRUGS, DOSAGES & KEY CONCEPTS QUESTIONS WITH
DETAILED RATIONALES
Nursing Practice and Safe Medication Administration / pharmacology
Exam coverage:
I. Section 1, Questions 1-25: Pharmacokinetics &
Pharmacodynamics: Covers drug absorption, distribution,
metabolism, excretion, and receptor theory.
II. Section 2, Questions 26-50: Cardiovascular & Hematologic:
Focuses on antihypertensives, anticoagulants,
antiarrhythmics, and related nursing implications.
III. Section 3, Questions 51-75: Endocrine & Respiratory:
Emphasizes diabetes drugs, thyroid medications,
asthma/COPD treatments, and monitoring.
IV. Section 4, Questions 76-100: Antimicrobials, CNS, GI &
Nursing Implications: Covers antibiotics,
psychotherapeutics, GI medications, and medication safety.
Section 1: Question 1-25: Pharmacokinetics &
Pharmacodynamics Fundamentals
1. A drug with a high first-pass effect will have which
characteristic?
, Page 2 of 45
A. Higher bioavailability when given orally
B. Lower bioavailability when given orally
C. Rapid onset of action with oral administration
D. No difference in bioavailability between routes
CORRECT ANSWER: B
RATIONALE: The first-pass effect refers to the metabolism of a
drug by the liver before it reaches systemic circulation after oral
administration. This significantly reduces bioavailability,
meaning a larger oral dose is needed compared to IV. Drugs
with high first-pass effect have much lower oral bioavailability
than parenteral bioavailability .
2. The nurse understands that a drug with a narrow
therapeutic index requires which nursing action?
A. Administering the drug with meals
B. Monitoring drug levels closely and assessing for toxicity
C. Giving the drug at bedtime only
D. Administering the drug only via the oral route
CORRECT ANSWER: B
RATIONALE: A narrow therapeutic index means the difference
between a therapeutic dose and a toxic dose is small. Drugs
with narrow TI (e.g., digoxin, lithium, warfarin, theophylline)
require close monitoring of serum drug levels, patient
assessment for signs of toxicity, and precise dosing .
3. It takes approximately how long for a drug to reach steady
state if its half-life is 6 hours?
A. 12 hours
B. 24 to 30 hours
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C. 48 hours
D. 6 hours
CORRECT ANSWER: B
RATIONALE: Steady state is achieved in approximately 4 to 5
half-lives. For a drug with a 6-hour half-life: 4 × 6 = 24 hours, 5 ×
6 = 30 hours. At steady state, the rate of drug administration
equals the rate of elimination .
4. Which term describes the time it takes for a drug to
produce its therapeutic effect after administration?
A. Peak action
B. Duration of action
C. Onset of action
D. Half-life
CORRECT ANSWER: C
RATIONALE: Onset of action is the time from drug
administration until the first observable therapeutic effect. Peak
action is when the drug reaches its maximum concentration
and effect, duration is the length of time the drug produces a
therapeutic effect .
5. A patient asks the nurse why a medication must be given
intravenously instead of by mouth. Which response by the
nurse best explains the rationale?
A. "IV medications are less expensive than oral medications."
B. "IV administration provides immediate and complete drug
absorption."
C. "Oral medications are always less effective than IV
medications."
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D. "IV medications have fewer side effects than oral
medications."
CORRECT ANSWER: B
RATIONALE: Intravenous administration delivers the drug
directly into the bloodstream, bypassing absorption barriers
and first-pass metabolism. This provides 100% bioavailability
and the most rapid onset of action compared to other routes .
6. Which phase of pharmacokinetics involves the movement
of a drug from the GI tract into the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
CORRECT ANSWER: C
RATIONALE: Absorption is the process by which a drug moves
from its site of administration into the bloodstream. The
gastrointestinal tract is a common site of drug absorption
following oral administration .
7. Which organ is primarily responsible for drug
metabolism?
A. Kidney
B. Liver
C. Lungs
D. Intestine
CORRECT ANSWER: B
RATIONALE: The liver contains cytochrome P450 enzymes that
metabolize most drugs. Metabolism converts lipophilic drugs
