NURS 251 Pharmacology Final Exam (pdf) | 2026/2027 |
Pharmacology Q&A | Nursing
Questions 1–100
1. The study of drug absorption, distribution, metabolism, and excretion is known as:
A) Pharmacodynamics
B) Pharmacokinetics
C) Pharmacotherapeutics
D) Posology
Correct Answer: Pharmacokinetics
Rationale: Pharmacokinetics describes what the body does to a drug, encompassing absorption,
distribution, metabolism, and excretion (ADME). Pharmacodynamics describes what the drug does to
the body. Pharmacotherapeutics focuses on clinical use of drugs for disease treatment, and posology
is the study of drug dosages.
2. A condition in which a drug should not be administered is referred to as:
A) Side effect
B) Adverse effect
C) Drug allergy
D) Contraindication
Correct Answer: Contraindication
Rationale: A contraindication is any condition or factor that makes a particular treatment unsafe or
inappropriate. Side effects and adverse effects may occur during therapy but do not necessarily
prevent drug administration. Drug allergy refers to immune-mediated reactions.
3. The time required for the plasma concentration of a drug to decrease by 50% is called:
A) Onset of action
B) Duration of action
C) Half-life
D) Peak effect
Correct Answer: Half-life
Rationale: Half-life is the time required for the plasma concentration of a drug to decrease by 50%. It
determines dosing frequency and the time needed to reach steady state. Onset is the time to first
effect, and duration is how long the effect lasts.
4. A drug that binds to a receptor and blocks the action of an agonist is called a(n):
A) Agonist
,B) Partial agonist
C) Antagonist
D) Inverse agonist
Correct Answer: Antagonist
Rationale: An antagonist binds to a receptor and blocks the action of an agonist, preventing a
biological response. Agonists activate receptors, while antagonists have no intrinsic activity. This is a
fundamental pharmacodynamic principle.
5. Which of the following is a CYP450 enzyme inducer?
A) Ketoconazole
B) Cimetidine
C) Rifampin
D) Erythromycin
Correct Answer: Rifampin
Rationale: Rifampin is a potent CYP450 enzyme inducer that increases metabolism of other drugs,
decreasing their serum levels and potentially reducing effectiveness. Ketoconazole, cimetidine, and
erythromycin are CYP450 inhibitors that increase drug levels.
6. The therapeutic index of a drug is the ratio of:
A) Effective dose to lethal dose
B) Toxic dose to therapeutic dose
C) Therapeutic dose to toxic dose
D) Dose required for 50% response
Correct Answer: Toxic dose to therapeutic dose
Rationale: The therapeutic index (TI) is the ratio of the toxic dose (TD50) to the therapeutic dose
(ED50). A narrow TI indicates a small margin between therapeutic and toxic doses, requiring careful
monitoring. Drugs like digoxin and lithium have narrow therapeutic indices.
7. A patient is prescribed enteric-coated tablets but cannot swallow pills. What is the
appropriate nursing action?
A) Crush the tablets and mix with applesauce
B) Call the pharmacy for a liquid form
C) Cut the tablet in half
D) Dissolve the tablet in water
Correct Answer: Call the pharmacy for a liquid form
Rationale: Enteric-coated tablets should never be crushed because the coating protects the stomach
from irritation or protects the drug from stomach acid. The appropriate action is to request an
, alternative formulation from pharmacy. Crushing would compromise the intended drug release
mechanism.
8. The first-pass effect refers to:
A) Metabolism of a drug before it reaches systemic circulation
B) Absorption through the gastrointestinal tract
C) Distribution to body tissues
D) Excretion through the kidneys
Correct Answer: Metabolism of a drug before it reaches systemic circulation
Rationale: The first-pass effect is the metabolism of a drug in the liver before it reaches systemic
circulation. Orally administered drugs are absorbed from the GI tract and pass through the portal
circulation, where they may be extensively metabolized. This reduces bioavailability.
9. Which route of administration bypasses the first-pass effect completely?
A) Oral
B) Rectal
C) Intravenous
D) Enteral
Correct Answer: Intravenous
Rationale: Intravenous administration delivers drug directly into the bloodstream, completely
bypassing the gastrointestinal tract and first-pass hepatic metabolism. Oral and rectal routes involve
some degree of first-pass effect. This results in 100% bioavailability for IV drugs.
10. A patient taking a highly protein-bound drug develops hypoalbuminemia. What is the
expected effect?
A) Decreased drug effect
B) Increased free drug levels
C) Faster drug elimination
D) Reduced risk of toxicity
Correct Answer: Increased free drug levels
Rationale: Highly protein-bound drugs attach to plasma proteins, primarily albumin. When albumin is
low, fewer binding sites are available, leading to higher levels of free (active) drug in the
bloodstream. This increases the risk of toxicity despite normal total drug levels.
11. Which factor can affect drug absorption after oral administration?
A) Gastric emptying time
B) Serum albumin level
C) Renal function
Pharmacology Q&A | Nursing
Questions 1–100
1. The study of drug absorption, distribution, metabolism, and excretion is known as:
A) Pharmacodynamics
B) Pharmacokinetics
C) Pharmacotherapeutics
D) Posology
Correct Answer: Pharmacokinetics
Rationale: Pharmacokinetics describes what the body does to a drug, encompassing absorption,
distribution, metabolism, and excretion (ADME). Pharmacodynamics describes what the drug does to
the body. Pharmacotherapeutics focuses on clinical use of drugs for disease treatment, and posology
is the study of drug dosages.
2. A condition in which a drug should not be administered is referred to as:
A) Side effect
B) Adverse effect
C) Drug allergy
D) Contraindication
Correct Answer: Contraindication
Rationale: A contraindication is any condition or factor that makes a particular treatment unsafe or
inappropriate. Side effects and adverse effects may occur during therapy but do not necessarily
prevent drug administration. Drug allergy refers to immune-mediated reactions.
3. The time required for the plasma concentration of a drug to decrease by 50% is called:
A) Onset of action
B) Duration of action
C) Half-life
D) Peak effect
Correct Answer: Half-life
Rationale: Half-life is the time required for the plasma concentration of a drug to decrease by 50%. It
determines dosing frequency and the time needed to reach steady state. Onset is the time to first
effect, and duration is how long the effect lasts.
4. A drug that binds to a receptor and blocks the action of an agonist is called a(n):
A) Agonist
,B) Partial agonist
C) Antagonist
D) Inverse agonist
Correct Answer: Antagonist
Rationale: An antagonist binds to a receptor and blocks the action of an agonist, preventing a
biological response. Agonists activate receptors, while antagonists have no intrinsic activity. This is a
fundamental pharmacodynamic principle.
5. Which of the following is a CYP450 enzyme inducer?
A) Ketoconazole
B) Cimetidine
C) Rifampin
D) Erythromycin
Correct Answer: Rifampin
Rationale: Rifampin is a potent CYP450 enzyme inducer that increases metabolism of other drugs,
decreasing their serum levels and potentially reducing effectiveness. Ketoconazole, cimetidine, and
erythromycin are CYP450 inhibitors that increase drug levels.
6. The therapeutic index of a drug is the ratio of:
A) Effective dose to lethal dose
B) Toxic dose to therapeutic dose
C) Therapeutic dose to toxic dose
D) Dose required for 50% response
Correct Answer: Toxic dose to therapeutic dose
Rationale: The therapeutic index (TI) is the ratio of the toxic dose (TD50) to the therapeutic dose
(ED50). A narrow TI indicates a small margin between therapeutic and toxic doses, requiring careful
monitoring. Drugs like digoxin and lithium have narrow therapeutic indices.
7. A patient is prescribed enteric-coated tablets but cannot swallow pills. What is the
appropriate nursing action?
A) Crush the tablets and mix with applesauce
B) Call the pharmacy for a liquid form
C) Cut the tablet in half
D) Dissolve the tablet in water
Correct Answer: Call the pharmacy for a liquid form
Rationale: Enteric-coated tablets should never be crushed because the coating protects the stomach
from irritation or protects the drug from stomach acid. The appropriate action is to request an
, alternative formulation from pharmacy. Crushing would compromise the intended drug release
mechanism.
8. The first-pass effect refers to:
A) Metabolism of a drug before it reaches systemic circulation
B) Absorption through the gastrointestinal tract
C) Distribution to body tissues
D) Excretion through the kidneys
Correct Answer: Metabolism of a drug before it reaches systemic circulation
Rationale: The first-pass effect is the metabolism of a drug in the liver before it reaches systemic
circulation. Orally administered drugs are absorbed from the GI tract and pass through the portal
circulation, where they may be extensively metabolized. This reduces bioavailability.
9. Which route of administration bypasses the first-pass effect completely?
A) Oral
B) Rectal
C) Intravenous
D) Enteral
Correct Answer: Intravenous
Rationale: Intravenous administration delivers drug directly into the bloodstream, completely
bypassing the gastrointestinal tract and first-pass hepatic metabolism. Oral and rectal routes involve
some degree of first-pass effect. This results in 100% bioavailability for IV drugs.
10. A patient taking a highly protein-bound drug develops hypoalbuminemia. What is the
expected effect?
A) Decreased drug effect
B) Increased free drug levels
C) Faster drug elimination
D) Reduced risk of toxicity
Correct Answer: Increased free drug levels
Rationale: Highly protein-bound drugs attach to plasma proteins, primarily albumin. When albumin is
low, fewer binding sites are available, leading to higher levels of free (active) drug in the
bloodstream. This increases the risk of toxicity despite normal total drug levels.
11. Which factor can affect drug absorption after oral administration?
A) Gastric emptying time
B) Serum albumin level
C) Renal function
