Chamberlain
Pharmacology
Nursing Exam 2026
Practice Questions
Format: NCLEX-style multiple choice with rationales | Focus: Pharmacology for Nursing
Practice (NR-293)
Section 1: Pharmacokinetics & Pharmacodynamics
Question 1
A nurse is reviewing the pharmacokinetic process of a newly prescribed medication.
Which factor most directly affects the rate of drug absorption?
A. Protein binding
B. Hepatic enzyme activity
C. Route of administration
D. Renal clearance
Rationale: Route of administration directly affects the rate and extent of drug
absorption. IV administration bypasses absorption entirely, while oral medications must
undergo dissolution and passage through the GI tract. Protein binding affects
distribution; hepatic enzymes affect metabolism; renal clearance affects excretion .
,Question 2
A client is prescribed a highly lipid-soluble medication. Which characteristic should the
nurse expect regarding this drug's absorption?
A. It requires active transport for absorption
B. It crosses cell membranes readily by passive diffusion
C. It is poorly absorbed in the GI tract
D. It requires an acidic environment for absorption
Rationale: Highly lipid-soluble drugs cross biological membranes more easily by
passive diffusion, resulting in faster absorption compared to water-soluble drugs .
Question 3
A nurse is teaching a client about a medication with a narrow therapeutic index. Which
statement indicates correct understanding?
A. "This medication is safe at any dose."
B. "I need to have my blood levels checked regularly."
C. "I can take this with any other medication."
D. "Missing a dose won't cause problems."
Rationale: A narrow therapeutic index means there is a small difference between
therapeutic and toxic doses. Regular blood level monitoring is essential to ensure the
drug remains within the therapeutic range .
Question 4
A client is taking a medication that is a potent CYP450 inhibitor. The nurse should
monitor for which potential effect on other medications?
A. Decreased plasma levels of co-administered drugs
B. Increased plasma levels of co-administered drugs
,C. No effect on co-administered drugs
D. Increased renal excretion of co-administered drugs
Rationale: CYP450 inhibitors reduce the metabolism of other drugs, leading to
increased plasma levels and potential toxicity. A classic example is the interaction
between CYP2C9 inhibitors and warfarin, which increases INR and bleeding risk .
Question 5
A nurse is reviewing the half-life of a medication. Which statement best describes the
clinical significance of half-life?
A. The time it takes for the drug to be completely eliminated
B. The time required for the plasma concentration to decrease by 50%
C. The time it takes for the drug to reach therapeutic levels
D. The time required for the drug to be metabolized by the liver
Rationale: Half-life is the time required for the plasma concentration of a drug to
decrease by 50%. It determines dosing intervals and the time needed to reach steady-
state concentration .
Section 2: Cardiovascular Pharmacology
Question 6
A client on an ACE inhibitor develops a dry, persistent cough. Which medication can be
substituted while maintaining similar cardiovascular benefits?
A. Amlodipine, a calcium channel blocker
B. Losartan, an angiotensin II receptor blocker
C. Metoprolol, a beta-blocker
D. Hydrochlorothiazide, a thiazide diuretic
, Rationale: ARBs like losartan block angiotensin II receptors without increasing
bradykinin, thus avoiding the cough. ARBs are the standard substitution for ACE
inhibitor-induced cough. Amlodipine, metoprolol, and HCTZ do not provide the same
RAAS blockade .
Question 7
A nurse is administering digoxin to a client. Which finding indicates digoxin toxicity?
A. Heart rate of 88 beats/min
B. Visual disturbances such as yellow-green halos
C. Blood pressure of 120/80 mm Hg
D. Respiratory rate of 16 breaths/min
Rationale: Digoxin toxicity causes visual disturbances (yellow-green halos), nausea, and
bradycardia. The therapeutic range for digoxin is narrow (0.5–2.0 ng/mL) .
Question 8
An elderly client on digoxin and furosemide develops hypokalemia. This electrolyte
disturbance increases the risk of:
A. Digoxin toxicity
B. Digoxin ineffectiveness
C. Hypercalcemia
D. Hypertension
Rationale: Hypokalemia enhances digoxin binding to the myocardial Na+/K+-ATPase,
potentiating its toxic effects even at therapeutic serum levels. Potassium should be
normalized promptly, and digoxin levels monitored .
Question 9
Pharmacology
Nursing Exam 2026
Practice Questions
Format: NCLEX-style multiple choice with rationales | Focus: Pharmacology for Nursing
Practice (NR-293)
Section 1: Pharmacokinetics & Pharmacodynamics
Question 1
A nurse is reviewing the pharmacokinetic process of a newly prescribed medication.
Which factor most directly affects the rate of drug absorption?
A. Protein binding
B. Hepatic enzyme activity
C. Route of administration
D. Renal clearance
Rationale: Route of administration directly affects the rate and extent of drug
absorption. IV administration bypasses absorption entirely, while oral medications must
undergo dissolution and passage through the GI tract. Protein binding affects
distribution; hepatic enzymes affect metabolism; renal clearance affects excretion .
,Question 2
A client is prescribed a highly lipid-soluble medication. Which characteristic should the
nurse expect regarding this drug's absorption?
A. It requires active transport for absorption
B. It crosses cell membranes readily by passive diffusion
C. It is poorly absorbed in the GI tract
D. It requires an acidic environment for absorption
Rationale: Highly lipid-soluble drugs cross biological membranes more easily by
passive diffusion, resulting in faster absorption compared to water-soluble drugs .
Question 3
A nurse is teaching a client about a medication with a narrow therapeutic index. Which
statement indicates correct understanding?
A. "This medication is safe at any dose."
B. "I need to have my blood levels checked regularly."
C. "I can take this with any other medication."
D. "Missing a dose won't cause problems."
Rationale: A narrow therapeutic index means there is a small difference between
therapeutic and toxic doses. Regular blood level monitoring is essential to ensure the
drug remains within the therapeutic range .
Question 4
A client is taking a medication that is a potent CYP450 inhibitor. The nurse should
monitor for which potential effect on other medications?
A. Decreased plasma levels of co-administered drugs
B. Increased plasma levels of co-administered drugs
,C. No effect on co-administered drugs
D. Increased renal excretion of co-administered drugs
Rationale: CYP450 inhibitors reduce the metabolism of other drugs, leading to
increased plasma levels and potential toxicity. A classic example is the interaction
between CYP2C9 inhibitors and warfarin, which increases INR and bleeding risk .
Question 5
A nurse is reviewing the half-life of a medication. Which statement best describes the
clinical significance of half-life?
A. The time it takes for the drug to be completely eliminated
B. The time required for the plasma concentration to decrease by 50%
C. The time it takes for the drug to reach therapeutic levels
D. The time required for the drug to be metabolized by the liver
Rationale: Half-life is the time required for the plasma concentration of a drug to
decrease by 50%. It determines dosing intervals and the time needed to reach steady-
state concentration .
Section 2: Cardiovascular Pharmacology
Question 6
A client on an ACE inhibitor develops a dry, persistent cough. Which medication can be
substituted while maintaining similar cardiovascular benefits?
A. Amlodipine, a calcium channel blocker
B. Losartan, an angiotensin II receptor blocker
C. Metoprolol, a beta-blocker
D. Hydrochlorothiazide, a thiazide diuretic
, Rationale: ARBs like losartan block angiotensin II receptors without increasing
bradykinin, thus avoiding the cough. ARBs are the standard substitution for ACE
inhibitor-induced cough. Amlodipine, metoprolol, and HCTZ do not provide the same
RAAS blockade .
Question 7
A nurse is administering digoxin to a client. Which finding indicates digoxin toxicity?
A. Heart rate of 88 beats/min
B. Visual disturbances such as yellow-green halos
C. Blood pressure of 120/80 mm Hg
D. Respiratory rate of 16 breaths/min
Rationale: Digoxin toxicity causes visual disturbances (yellow-green halos), nausea, and
bradycardia. The therapeutic range for digoxin is narrow (0.5–2.0 ng/mL) .
Question 8
An elderly client on digoxin and furosemide develops hypokalemia. This electrolyte
disturbance increases the risk of:
A. Digoxin toxicity
B. Digoxin ineffectiveness
C. Hypercalcemia
D. Hypertension
Rationale: Hypokalemia enhances digoxin binding to the myocardial Na+/K+-ATPase,
potentiating its toxic effects even at therapeutic serum levels. Potassium should be
normalized promptly, and digoxin levels monitored .
Question 9
