NUR-NUR 641E Final Exam Questions and
Answers
UNIT 1: PHARMACOKINETICS & PHARMACODYNAMICS
1. Which process describes the movement of a drug from its site of
administration into the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
Answer: C
Rationale: Absorption is the movement of drug from administration site into
systemic circulation. Distribution (A) is movement to tissues; metabolism (B) is
biotransformation; excretion (D) is elimination.
2. A patient with liver cirrhosis requires a medication that is hepatically
metabolized. The nurse should anticipate:
A. No change in dosing
B. Increased drug effect and possible toxicity
C. Decreased drug effect
D. Faster elimination
Answer: B
Rationale: Impaired hepatic metabolism leads to drug accumulation, increasing
effect and toxicity risk. A is incorrect because dosing must be adjusted. C is wrong
because metabolism is reduced, not enhanced. D is wrong because elimination
slows.
3. Which route of administration has 100% bioavailability?
A. Oral
B. Intramuscular
,C. Intravenous
D. Subcutaneous
Answer: C
Rationale: IV administration bypasses absorption barriers, giving 100%
bioavailability. Oral (A) undergoes first-pass metabolism; IM (B) and SC (D) have
variable absorption.
4. A drug with a narrow therapeutic index requires:
A. No monitoring
B. Routine serum drug level monitoring
C. Higher doses
D. Shorter dosing intervals
Answer: B
Rationale: Narrow therapeutic index drugs (e.g., digoxin, warfarin, lithium) have
small margins between therapeutic and toxic levels, requiring monitoring. A is
unsafe. C increases toxicity risk. D is unrelated.
5. Which factor most affects drug distribution in older adults?
A. Increased body water
B. Decreased body fat
C. Decreased serum albumin
D. Increased gastric motility
Answer: C
Rationale: Decreased albumin means fewer binding sites, increasing free (active)
drug. A is wrong—older adults have decreased body water. B is wrong—fat
proportion increases. D is wrong—motility decreases.
6. The term "half-life" refers to:
A. Time to reach peak effect
B. Time for drug concentration to decrease by 50%
,C. Time to excrete all drug
D. Time to onset of action
Answer: B
Rationale: Half-life is the time required for plasma concentration to reduce by
half. A is Tmax; C is elimination time; D is onset.
7. A patient taking a drug that is a CYP450 inducer should be monitored for:
A. Increased effect of co-administered drugs
B. Decreased effect of co-administered drugs
C. No interaction
D. Toxicity of the inducer
Answer: B
Rationale: Inducers increase metabolism of other drugs, reducing their effect. A is
opposite. C is incorrect. D is not the primary concern.
8. Which statement about first-pass metabolism is correct?
A. It occurs with IV drugs
B. It reduces oral drug bioavailability
C. It increases drug absorption
D. It occurs in the kidneys
Answer: B
Rationale: Orally administered drugs pass through the liver before systemic
circulation, reducing bioavailability. A is wrong—IV bypasses it. C is wrong—it
decreases absorption. D is wrong—it occurs in the liver.
9. A patient asks why a generic drug is cheaper than the brand name. The nurse
explains:
A. Generic drugs are less effective
B. Generic drugs are chemically identical but cost less
C. Generic drugs have different active ingredients
D. Generic drugs are not FDA approved
, Answer: B
Rationale: Generics contain the same active ingredient and are bioequivalent but
cost less. A is false. C is false. D is false—generics are FDA approved.
10. Which patient is at highest risk for drug toxicity?
A. 25-year-old with normal renal function
B. 70-year-old with CKD
C. 30-year-old with asthma
D. 40-year-old with hypertension
Answer: B
Rationale: Older adults with impaired renal function have reduced drug clearance,
increasing toxicity risk. A, C, and D lack the same risk profile.
UNIT 2: CARDIOVASCULAR PHARMACOLOGY (Q11–Q25)
11. A patient on furosemide reports muscle cramps and fatigue. Which lab
should the nurse check first?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B
Rationale: Loop diuretics cause hypokalemia, leading to cramps and fatigue.
Sodium (A) can also drop but is less directly linked. Calcium (C) and magnesium
(D) are less common causes of these symptoms with furosemide.
12. Which medication is first-line for hypertension in a patient with diabetes
and proteinuria?
A. Metoprolol
B. Lisinopril
C. Amlodipine
D. Hydrochlorothiazide
Answers
UNIT 1: PHARMACOKINETICS & PHARMACODYNAMICS
1. Which process describes the movement of a drug from its site of
administration into the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
Answer: C
Rationale: Absorption is the movement of drug from administration site into
systemic circulation. Distribution (A) is movement to tissues; metabolism (B) is
biotransformation; excretion (D) is elimination.
2. A patient with liver cirrhosis requires a medication that is hepatically
metabolized. The nurse should anticipate:
A. No change in dosing
B. Increased drug effect and possible toxicity
C. Decreased drug effect
D. Faster elimination
Answer: B
Rationale: Impaired hepatic metabolism leads to drug accumulation, increasing
effect and toxicity risk. A is incorrect because dosing must be adjusted. C is wrong
because metabolism is reduced, not enhanced. D is wrong because elimination
slows.
3. Which route of administration has 100% bioavailability?
A. Oral
B. Intramuscular
,C. Intravenous
D. Subcutaneous
Answer: C
Rationale: IV administration bypasses absorption barriers, giving 100%
bioavailability. Oral (A) undergoes first-pass metabolism; IM (B) and SC (D) have
variable absorption.
4. A drug with a narrow therapeutic index requires:
A. No monitoring
B. Routine serum drug level monitoring
C. Higher doses
D. Shorter dosing intervals
Answer: B
Rationale: Narrow therapeutic index drugs (e.g., digoxin, warfarin, lithium) have
small margins between therapeutic and toxic levels, requiring monitoring. A is
unsafe. C increases toxicity risk. D is unrelated.
5. Which factor most affects drug distribution in older adults?
A. Increased body water
B. Decreased body fat
C. Decreased serum albumin
D. Increased gastric motility
Answer: C
Rationale: Decreased albumin means fewer binding sites, increasing free (active)
drug. A is wrong—older adults have decreased body water. B is wrong—fat
proportion increases. D is wrong—motility decreases.
6. The term "half-life" refers to:
A. Time to reach peak effect
B. Time for drug concentration to decrease by 50%
,C. Time to excrete all drug
D. Time to onset of action
Answer: B
Rationale: Half-life is the time required for plasma concentration to reduce by
half. A is Tmax; C is elimination time; D is onset.
7. A patient taking a drug that is a CYP450 inducer should be monitored for:
A. Increased effect of co-administered drugs
B. Decreased effect of co-administered drugs
C. No interaction
D. Toxicity of the inducer
Answer: B
Rationale: Inducers increase metabolism of other drugs, reducing their effect. A is
opposite. C is incorrect. D is not the primary concern.
8. Which statement about first-pass metabolism is correct?
A. It occurs with IV drugs
B. It reduces oral drug bioavailability
C. It increases drug absorption
D. It occurs in the kidneys
Answer: B
Rationale: Orally administered drugs pass through the liver before systemic
circulation, reducing bioavailability. A is wrong—IV bypasses it. C is wrong—it
decreases absorption. D is wrong—it occurs in the liver.
9. A patient asks why a generic drug is cheaper than the brand name. The nurse
explains:
A. Generic drugs are less effective
B. Generic drugs are chemically identical but cost less
C. Generic drugs have different active ingredients
D. Generic drugs are not FDA approved
, Answer: B
Rationale: Generics contain the same active ingredient and are bioequivalent but
cost less. A is false. C is false. D is false—generics are FDA approved.
10. Which patient is at highest risk for drug toxicity?
A. 25-year-old with normal renal function
B. 70-year-old with CKD
C. 30-year-old with asthma
D. 40-year-old with hypertension
Answer: B
Rationale: Older adults with impaired renal function have reduced drug clearance,
increasing toxicity risk. A, C, and D lack the same risk profile.
UNIT 2: CARDIOVASCULAR PHARMACOLOGY (Q11–Q25)
11. A patient on furosemide reports muscle cramps and fatigue. Which lab
should the nurse check first?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B
Rationale: Loop diuretics cause hypokalemia, leading to cramps and fatigue.
Sodium (A) can also drop but is less directly linked. Calcium (C) and magnesium
(D) are less common causes of these symptoms with furosemide.
12. Which medication is first-line for hypertension in a patient with diabetes
and proteinuria?
A. Metoprolol
B. Lisinopril
C. Amlodipine
D. Hydrochlorothiazide
