Nursing Pharmacology 2E (Open Rn): Ultimate Test
Bank 2026
SECTION I: Pharmacokinetics & Pharmacodynamics (Questions 1–25)
1. A nurse is teaching a client about how a medication is absorbed, distributed,
metabolized, and excreted. Which term best describes this process?
A. Pharmacodynamics
B. Pharmacokinetics
C. Pharmacogenomics
D. Pharmacotherapeutics
Correct Answer: B
Rationale: Pharmacokinetics describes what the body does to a
medication, including absorption, distribution, metabolism, and excretion.
Pharmacodynamics describes what the medication does to the body.
Pharmacogenomics studies how genes affect drug response.
Pharmacotherapeutics is the use of drugs to treat disease.
2. A nurse is preparing to administer a medication with a narrow therapeutic
index. Which action is most important?
A. Administer the medication with food
B. Monitor serum medication levels as prescribed
C. Hold the medication if the heart rate is below 100
D. Crush the medication for easier swallowing
Correct Answer: B
Rationale: Medications with a narrow therapeutic index have a small
range between therapeutic and toxic levels, requiring close serum level
monitoring. Administering with food, holding based on heart rate, or crushing are
not universal requirements for narrow therapeutic index medications.
3. Which factors increase the risk of drug toxicity in an older adult? Select all that
apply.
,A. Decreased renal function
B. Increased body water percentage
C. Polypharmacy
D. Decreased hepatic blood flow
E. Increased gastric motility
Correct Answers: A, C, D
Rationale: Older adults have decreased renal and hepatic function, leading
to prolonged drug effects and increased toxicity risk. Polypharmacy increases
interaction risk. Body water decreases with age, and gastric motility typically
decreases—not increases.
4. A client asks why a medication prescribed for blood pressure also causes
dizziness when standing. The nurse explains this is due to:
A. Therapeutic effect
B. Adverse effect
C. Side effect
D. Allergic reaction
Correct Answer: B
Rationale: An adverse effect is an unintended, harmful effect that occurs
at therapeutic doses. Dizziness upon standing (orthostatic hypotension) is an
adverse effect of many antihypertensives. A side effect is a predictable secondary
effect; an allergic reaction involves immune response.
5. A nurse is reviewing a medication order for a client with hypoalbuminemia.
Which pharmacokinetic phase is most affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: B
Rationale: Albumin is a primary carrier protein for many drugs.
Hypoalbuminemia reduces protein binding, increasing free drug concentration
and risk of toxicity—this affects the distribution phase.
,6. The nurse administers 500 mg of a medication that has a half-life of 6 hours.
Approximately how much medication remains in the body after 12 hours?
A. 250 mg
B. 125 mg
C. 62.5 mg
D. 500 mg
Correct Answer: B
Rationale: After one half-life (6 hours), 250 mg remains. After two half-
lives (12 hours), 125 mg remains. Half-life is the time required for the amount of
drug in the body to decrease by 50%.
7. Which statement by a nursing student indicates correct understanding of
pharmacodynamics?
A. “It describes how the body processes a drug.”
B. “It describes how a drug affects the body.”
C. “It measures the rate of drug excretion.”
D. “It determines the drug's bioavailability.”
Correct Answer: B
Rationale: Pharmacodynamics is the study of how a drug affects the body,
including receptor interactions, dose-response relationships, and therapeutic
effects. Pharmacokinetics describes how the body processes a drug.
8. A nurse is assessing a client who reports taking St. John's wort. Which potential
interaction is most concerning?
A. Increased risk of serotonin syndrome with SSRIs
B. Decreased anticoagulant effect of warfarin
C. Increased antihypertensive effect
D. Decreased risk of bleeding
Correct Answer: A
Rationale: St. John's wort is a potent inducer of CYP3A4 and can increase
serotonin levels. When combined with SSRIs, it significantly increases the risk of
serotonin syndrome, a potentially life-threatening condition.
, 9. The nurse is administering a medication that is highly protein-bound. Which
laboratory result should the nurse monitor most closely?
A. Serum potassium
B. Serum albumin
C. Hemoglobin
D. Platelet count
Correct Answer: B
Rationale: Highly protein-bound drugs rely on albumin for transport. Low
albumin levels increase free drug concentration, raising toxicity risk. Monitoring
serum albumin is essential.
10. Which route of administration has the highest bioavailability?
A. Oral
B. Rectal
C. Intravenous
D. Subcutaneous
Correct Answer: C
Rationale: Intravenous administration bypasses absorption barriers,
providing 100% bioavailability. Oral medications undergo first-pass metabolism,
reducing bioavailability. Rectal and subcutaneous routes have variable
absorption.
11. A nurse is preparing to administer a medication that is a known CYP450
enzyme inducer. Which effect should the nurse anticipate?
A. Increased levels of co-administered drugs
B. Decreased levels of co-administered drugs
C. No effect on co-administered drugs
D. Increased risk of allergic reaction
Correct Answer: B
Rationale: Enzyme inducers increase the metabolism of drugs metabolized
by the same enzymes, decreasing their serum levels and potentially reducing
therapeutic effect. Rifampin, phenytoin, and carbamazepine are examples.
Bank 2026
SECTION I: Pharmacokinetics & Pharmacodynamics (Questions 1–25)
1. A nurse is teaching a client about how a medication is absorbed, distributed,
metabolized, and excreted. Which term best describes this process?
A. Pharmacodynamics
B. Pharmacokinetics
C. Pharmacogenomics
D. Pharmacotherapeutics
Correct Answer: B
Rationale: Pharmacokinetics describes what the body does to a
medication, including absorption, distribution, metabolism, and excretion.
Pharmacodynamics describes what the medication does to the body.
Pharmacogenomics studies how genes affect drug response.
Pharmacotherapeutics is the use of drugs to treat disease.
2. A nurse is preparing to administer a medication with a narrow therapeutic
index. Which action is most important?
A. Administer the medication with food
B. Monitor serum medication levels as prescribed
C. Hold the medication if the heart rate is below 100
D. Crush the medication for easier swallowing
Correct Answer: B
Rationale: Medications with a narrow therapeutic index have a small
range between therapeutic and toxic levels, requiring close serum level
monitoring. Administering with food, holding based on heart rate, or crushing are
not universal requirements for narrow therapeutic index medications.
3. Which factors increase the risk of drug toxicity in an older adult? Select all that
apply.
,A. Decreased renal function
B. Increased body water percentage
C. Polypharmacy
D. Decreased hepatic blood flow
E. Increased gastric motility
Correct Answers: A, C, D
Rationale: Older adults have decreased renal and hepatic function, leading
to prolonged drug effects and increased toxicity risk. Polypharmacy increases
interaction risk. Body water decreases with age, and gastric motility typically
decreases—not increases.
4. A client asks why a medication prescribed for blood pressure also causes
dizziness when standing. The nurse explains this is due to:
A. Therapeutic effect
B. Adverse effect
C. Side effect
D. Allergic reaction
Correct Answer: B
Rationale: An adverse effect is an unintended, harmful effect that occurs
at therapeutic doses. Dizziness upon standing (orthostatic hypotension) is an
adverse effect of many antihypertensives. A side effect is a predictable secondary
effect; an allergic reaction involves immune response.
5. A nurse is reviewing a medication order for a client with hypoalbuminemia.
Which pharmacokinetic phase is most affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: B
Rationale: Albumin is a primary carrier protein for many drugs.
Hypoalbuminemia reduces protein binding, increasing free drug concentration
and risk of toxicity—this affects the distribution phase.
,6. The nurse administers 500 mg of a medication that has a half-life of 6 hours.
Approximately how much medication remains in the body after 12 hours?
A. 250 mg
B. 125 mg
C. 62.5 mg
D. 500 mg
Correct Answer: B
Rationale: After one half-life (6 hours), 250 mg remains. After two half-
lives (12 hours), 125 mg remains. Half-life is the time required for the amount of
drug in the body to decrease by 50%.
7. Which statement by a nursing student indicates correct understanding of
pharmacodynamics?
A. “It describes how the body processes a drug.”
B. “It describes how a drug affects the body.”
C. “It measures the rate of drug excretion.”
D. “It determines the drug's bioavailability.”
Correct Answer: B
Rationale: Pharmacodynamics is the study of how a drug affects the body,
including receptor interactions, dose-response relationships, and therapeutic
effects. Pharmacokinetics describes how the body processes a drug.
8. A nurse is assessing a client who reports taking St. John's wort. Which potential
interaction is most concerning?
A. Increased risk of serotonin syndrome with SSRIs
B. Decreased anticoagulant effect of warfarin
C. Increased antihypertensive effect
D. Decreased risk of bleeding
Correct Answer: A
Rationale: St. John's wort is a potent inducer of CYP3A4 and can increase
serotonin levels. When combined with SSRIs, it significantly increases the risk of
serotonin syndrome, a potentially life-threatening condition.
, 9. The nurse is administering a medication that is highly protein-bound. Which
laboratory result should the nurse monitor most closely?
A. Serum potassium
B. Serum albumin
C. Hemoglobin
D. Platelet count
Correct Answer: B
Rationale: Highly protein-bound drugs rely on albumin for transport. Low
albumin levels increase free drug concentration, raising toxicity risk. Monitoring
serum albumin is essential.
10. Which route of administration has the highest bioavailability?
A. Oral
B. Rectal
C. Intravenous
D. Subcutaneous
Correct Answer: C
Rationale: Intravenous administration bypasses absorption barriers,
providing 100% bioavailability. Oral medications undergo first-pass metabolism,
reducing bioavailability. Rectal and subcutaneous routes have variable
absorption.
11. A nurse is preparing to administer a medication that is a known CYP450
enzyme inducer. Which effect should the nurse anticipate?
A. Increased levels of co-administered drugs
B. Decreased levels of co-administered drugs
C. No effect on co-administered drugs
D. Increased risk of allergic reaction
Correct Answer: B
Rationale: Enzyme inducers increase the metabolism of drugs metabolized
by the same enzymes, decreasing their serum levels and potentially reducing
therapeutic effect. Rifampin, phenytoin, and carbamazepine are examples.
