NR 293 EXAM 3 PHARMACOLOGY FOR NURSING
PRACTICE QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 |
INSTANT DOWNLOAD PDF
Core Domains
• Pharmacokinetics and Pharmacodynamics
• Anti-infective Pharmacology
• Cardiovascular Pharmacology
• Endocrine Pharmacology
• Gastrointestinal Pharmacology
• Respiratory Pharmacology
• Medication Safety and Nursing Implications
Introduction
This examination assesses the nursing student's knowledge of
pharmacology for nursing practice at Chamberlain University. It
evaluates drug classifications, mechanisms of action, adverse effects,
nursing interventions, and safe medication administration principles.
Questions include multiple-choice and scenario-based formats designed
to test clinical judgment and decision-making. Candidates must
demonstrate competency in prioritizing care, monitoring for therapeutic
and adverse effects, and applying the nursing process to promote
optimal patient outcomes across diverse clinical populations.
,Section One: Questions 1–100
1. A 68-year-old male receives an intravenous dose of gentamicin for
a Gram-negative infection. Which pharmacokinetic property
explains why aminoglycosides have a relatively small volume of
distribution?
A. High water solubility with low tissue protein binding
B. High lipid solubility with extensive adipose accumulation
C. Active transport across the blood-brain barrier
D. Rapid hepatic metabolism before reaching tissues
A. High water solubility with low tissue protein binding
RATIONALE: Aminoglycosides such as gentamicin are highly
water-soluble and poorly bind plasma proteins, restricting distribution
primarily to extracellular fluid and giving a small volume of distribution
.
2. A 55-year-old female takes oral levothyroxine each morning. Most
oral medications are absorbed primarily in which segment of the
gastrointestinal tract?
A. The stomach, where acidity activates most drugs
B. The small intestine, especially the duodenum and jejunum
C. The colon, where bacterial flora metabolize drugs
D. The esophagus, where contact time is longest
B. The small intestine, especially the duodenum and jejunum
RATIONALE: The small intestine, particularly the duodenum and
jejunum, has the largest absorptive surface area and is the primary site of
drug absorption due to villi and microvilli .
3. A 42-year-old male receives IV morphine for postoperative pain.
The first-pass effect primarily reduces bioavailability through
metabolism in which organ?
,A. The lungs via pulmonary endothelial enzymes before cardiac output
B. The kidneys via glomerular filtration before tubular secretion
C. The liver via the portal circulation before systemic distribution
D. The stomach via gastric acid hydrolysis before intestinal absorption
C. The liver via the portal circulation before systemic distribution
RATIONALE: The first-pass effect describes hepatic metabolism of
orally administered drugs before they reach systemic circulation,
significantly reducing bioavailability for drugs like morphine and
propranolol .
4. A 72-year-old female with hepatic cirrhosis is started on a
normally low-extraction benzodiazepine. Phase I hepatic
metabolism primarily involves which biochemical reaction?
A. Biliary excretion of unchanged parent drug
B. Conjugation with glucuronic acid or sulfate to increase water
solubility
C. Active tubular secretion into the renal proximal tubule
D. Oxidation, reduction, and hydrolysis reactions often catalyzed by
cytochrome P450
D. Oxidation, reduction, and hydrolysis reactions often catalyzed by
cytochrome P450
RATIONALE: Phase I metabolism involves oxidation, reduction,
and hydrolysis, frequently catalyzed by cytochrome P450 enzymes, and
is impaired in older adults and liver disease .
5. A neonate receives morphine for postoperative analgesia and the
dose must be reduced because glucuronidation is immature at birth.
Phase II hepatic metabolism primarily accomplishes which
pharmacokinetic outcome?
A. Conjugation with glucuronide, sulfate, or glycine to increase water
solubility for renal excretion
, B. Oxidation by cytochrome P450 enzymes to activate prodrugs
C. Reduction of nitro groups to active metabolites
D. Plasma protein binding to albumin
A. Conjugation with glucuronide, sulfate, or glycine to increase
water solubility for renal excretion
RATIONALE: Phase II metabolism involves conjugation reactions
that increase water solubility, facilitating renal excretion. This pathway
is immature in neonates .
6. A patient has a lithium level of 1.2 mEq/L. Based on this value,
what is the nurse's priority action regarding the scheduled daily
dose?
A. Hold the dose and notify the provider due to toxicity
B. Administer the dose as scheduled, as this level is within the
therapeutic range
C. Administer half the dose to prevent toxicity
D. Hold the dose and check the level again in 4 hours
B. Administer the dose as scheduled, as this level is within the
therapeutic range
RATIONALE: The therapeutic range for lithium is typically 0.6-1.2
mEq/L. Always give scheduled dosage if the patient is within
therapeutic range unless they are showing signs of toxicity .
7. Which route of administration has the FASTEST onset of action?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
D. Intravenous
RATIONALE: Intravenous administration delivers the drug directly
PRACTICE QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 |
INSTANT DOWNLOAD PDF
Core Domains
• Pharmacokinetics and Pharmacodynamics
• Anti-infective Pharmacology
• Cardiovascular Pharmacology
• Endocrine Pharmacology
• Gastrointestinal Pharmacology
• Respiratory Pharmacology
• Medication Safety and Nursing Implications
Introduction
This examination assesses the nursing student's knowledge of
pharmacology for nursing practice at Chamberlain University. It
evaluates drug classifications, mechanisms of action, adverse effects,
nursing interventions, and safe medication administration principles.
Questions include multiple-choice and scenario-based formats designed
to test clinical judgment and decision-making. Candidates must
demonstrate competency in prioritizing care, monitoring for therapeutic
and adverse effects, and applying the nursing process to promote
optimal patient outcomes across diverse clinical populations.
,Section One: Questions 1–100
1. A 68-year-old male receives an intravenous dose of gentamicin for
a Gram-negative infection. Which pharmacokinetic property
explains why aminoglycosides have a relatively small volume of
distribution?
A. High water solubility with low tissue protein binding
B. High lipid solubility with extensive adipose accumulation
C. Active transport across the blood-brain barrier
D. Rapid hepatic metabolism before reaching tissues
A. High water solubility with low tissue protein binding
RATIONALE: Aminoglycosides such as gentamicin are highly
water-soluble and poorly bind plasma proteins, restricting distribution
primarily to extracellular fluid and giving a small volume of distribution
.
2. A 55-year-old female takes oral levothyroxine each morning. Most
oral medications are absorbed primarily in which segment of the
gastrointestinal tract?
A. The stomach, where acidity activates most drugs
B. The small intestine, especially the duodenum and jejunum
C. The colon, where bacterial flora metabolize drugs
D. The esophagus, where contact time is longest
B. The small intestine, especially the duodenum and jejunum
RATIONALE: The small intestine, particularly the duodenum and
jejunum, has the largest absorptive surface area and is the primary site of
drug absorption due to villi and microvilli .
3. A 42-year-old male receives IV morphine for postoperative pain.
The first-pass effect primarily reduces bioavailability through
metabolism in which organ?
,A. The lungs via pulmonary endothelial enzymes before cardiac output
B. The kidneys via glomerular filtration before tubular secretion
C. The liver via the portal circulation before systemic distribution
D. The stomach via gastric acid hydrolysis before intestinal absorption
C. The liver via the portal circulation before systemic distribution
RATIONALE: The first-pass effect describes hepatic metabolism of
orally administered drugs before they reach systemic circulation,
significantly reducing bioavailability for drugs like morphine and
propranolol .
4. A 72-year-old female with hepatic cirrhosis is started on a
normally low-extraction benzodiazepine. Phase I hepatic
metabolism primarily involves which biochemical reaction?
A. Biliary excretion of unchanged parent drug
B. Conjugation with glucuronic acid or sulfate to increase water
solubility
C. Active tubular secretion into the renal proximal tubule
D. Oxidation, reduction, and hydrolysis reactions often catalyzed by
cytochrome P450
D. Oxidation, reduction, and hydrolysis reactions often catalyzed by
cytochrome P450
RATIONALE: Phase I metabolism involves oxidation, reduction,
and hydrolysis, frequently catalyzed by cytochrome P450 enzymes, and
is impaired in older adults and liver disease .
5. A neonate receives morphine for postoperative analgesia and the
dose must be reduced because glucuronidation is immature at birth.
Phase II hepatic metabolism primarily accomplishes which
pharmacokinetic outcome?
A. Conjugation with glucuronide, sulfate, or glycine to increase water
solubility for renal excretion
, B. Oxidation by cytochrome P450 enzymes to activate prodrugs
C. Reduction of nitro groups to active metabolites
D. Plasma protein binding to albumin
A. Conjugation with glucuronide, sulfate, or glycine to increase
water solubility for renal excretion
RATIONALE: Phase II metabolism involves conjugation reactions
that increase water solubility, facilitating renal excretion. This pathway
is immature in neonates .
6. A patient has a lithium level of 1.2 mEq/L. Based on this value,
what is the nurse's priority action regarding the scheduled daily
dose?
A. Hold the dose and notify the provider due to toxicity
B. Administer the dose as scheduled, as this level is within the
therapeutic range
C. Administer half the dose to prevent toxicity
D. Hold the dose and check the level again in 4 hours
B. Administer the dose as scheduled, as this level is within the
therapeutic range
RATIONALE: The therapeutic range for lithium is typically 0.6-1.2
mEq/L. Always give scheduled dosage if the patient is within
therapeutic range unless they are showing signs of toxicity .
7. Which route of administration has the FASTEST onset of action?
A. Oral
B. Subcutaneous
C. Intramuscular
D. Intravenous
D. Intravenous
RATIONALE: Intravenous administration delivers the drug directly
