Nursing Pharmacology & Therapeutics
NURS 317 NURSING HUGE FINAL VERIFIED EXAM
QUESTIONS AND ANSWERS - LATEST VERSION 2026/2027
1. A client's drug has a half-life of 6 hours. Approximately how long will
it take for the drug to reach steady-state concentration with regular
dosing?
A. 6 hours
B. 24 to 30 hours
C. 12 hours
D. 72 hours
B. 24 to 30 hours
Steady state is reached after about four to five half-lives, so 4–5 × 6 hours
gives roughly 24–30 hours.
2. The nurse is reviewing a medication that undergoes extensive first-
pass metabolism. Which route would bypass this effect?
A. Enteric-coated capsule
B. Oral tablet
C. Sublingual
D. Oral suspension
C. Sublingual
Sublingual absorption enters the systemic circulation directly and avoids
the portal circulation through the liver.
Page 1 of 53
, Nursing Pharmacology & Therapeutics
3. A client with hypoalbuminemia is started on a highly protein-bound
drug. Which outcome should the nurse anticipate?
A. Faster renal reabsorption of the drug
B. Increased free drug and greater risk of toxicity
C. No change because albumin does not affect drug action
D. Decreased free drug and reduced effect
B. Increased free drug and greater risk of toxicity
Less albumin means less binding, so more unbound (active) drug
circulates and toxicity becomes more likely.
4. Which term best describes a drug's ability to produce the maximal
response regardless of dose?
A. Bioavailability
B. Affinity
C. Potency
D. Efficacy
D. Efficacy
Efficacy refers to the maximum effect a drug can produce; potency refers
to the amount needed to produce an effect.
5. A trough level for a drug should be drawn at which time?
A. Two hours after an oral dose
B. At any time during the dosing interval
C. Thirty minutes after an IV infusion ends
D. Just before the next scheduled dose
D. Just before the next scheduled dose
A trough reflects the lowest serum concentration, which occurs
immediately before the next dose.
Page 2 of 53
, Nursing Pharmacology & Therapeutics
6. The therapeutic index of a drug is narrow. What does this mean for
nursing care?
A. Close monitoring of serum levels is required because toxic and
therapeutic doses are close
B. The drug has no adverse effects at therapeutic doses
C. The drug can be given safely in a wide range of doses
D. The drug is only effective when given intravenously
A. Close monitoring of serum levels is required because toxic and
therapeutic doses are close
A narrow therapeutic index means a small margin between effective and
toxic concentrations, so drug levels must be watched carefully.
7. A client experiences an unexpected, genetically based reaction to a
first dose of a medication. This is best described as:
A. A side effect
B. An idiosyncratic reaction
C. Tolerance
D. An allergic reaction
B. An idiosyncratic reaction
Idiosyncratic reactions are unusual, unpredictable responses often linked
to genetic differences in drug metabolism.
8. Which assessment finding is most important before administering a
drug that is primarily excreted by the kidneys?
A. Serum creatinine and urine output
B. Blood glucose
C. Liver enzymes
D. Serum albumin
A. Serum creatinine and urine output
Renal function determines how well the drug is cleared; impaired
function can lead to accumulation.
Page 3 of 53
, Nursing Pharmacology & Therapeutics
9. An older adult is prescribed several new medications. Which age-
related change most increases the risk of drug accumulation?
A. Increased gastric acidity
B. Increased hepatic blood flow
C. Decreased glomerular filtration rate
D. Increased lean body mass
C. Decreased glomerular filtration rate
GFR declines with age, slowing elimination of renally cleared drugs and
increasing the risk of toxicity.
10. A drug that binds to a receptor and blocks the action of an
endogenous substance is called a(n):
A. Antagonist
B. Agonist
C. Partial agonist
D. Enzyme inducer
A. Antagonist
Antagonists occupy receptors without activating them, preventing
agonists from producing their effect.
11. The nurse knows that grapefruit juice can increase serum levels of
some drugs because it:
A. Binds the drug in the stomach
B. Speeds up gastric emptying
C. Increases renal excretion
D. Inhibits the CYP3A4 enzyme in the intestine
D. Inhibits the CYP3A4 enzyme in the intestine
Grapefruit juice inhibits intestinal CYP3A4, reducing metabolism and
raising blood levels of drugs such as some statins and calcium channel
blockers.
Page 4 of 53
NURS 317 NURSING HUGE FINAL VERIFIED EXAM
QUESTIONS AND ANSWERS - LATEST VERSION 2026/2027
1. A client's drug has a half-life of 6 hours. Approximately how long will
it take for the drug to reach steady-state concentration with regular
dosing?
A. 6 hours
B. 24 to 30 hours
C. 12 hours
D. 72 hours
B. 24 to 30 hours
Steady state is reached after about four to five half-lives, so 4–5 × 6 hours
gives roughly 24–30 hours.
2. The nurse is reviewing a medication that undergoes extensive first-
pass metabolism. Which route would bypass this effect?
A. Enteric-coated capsule
B. Oral tablet
C. Sublingual
D. Oral suspension
C. Sublingual
Sublingual absorption enters the systemic circulation directly and avoids
the portal circulation through the liver.
Page 1 of 53
, Nursing Pharmacology & Therapeutics
3. A client with hypoalbuminemia is started on a highly protein-bound
drug. Which outcome should the nurse anticipate?
A. Faster renal reabsorption of the drug
B. Increased free drug and greater risk of toxicity
C. No change because albumin does not affect drug action
D. Decreased free drug and reduced effect
B. Increased free drug and greater risk of toxicity
Less albumin means less binding, so more unbound (active) drug
circulates and toxicity becomes more likely.
4. Which term best describes a drug's ability to produce the maximal
response regardless of dose?
A. Bioavailability
B. Affinity
C. Potency
D. Efficacy
D. Efficacy
Efficacy refers to the maximum effect a drug can produce; potency refers
to the amount needed to produce an effect.
5. A trough level for a drug should be drawn at which time?
A. Two hours after an oral dose
B. At any time during the dosing interval
C. Thirty minutes after an IV infusion ends
D. Just before the next scheduled dose
D. Just before the next scheduled dose
A trough reflects the lowest serum concentration, which occurs
immediately before the next dose.
Page 2 of 53
, Nursing Pharmacology & Therapeutics
6. The therapeutic index of a drug is narrow. What does this mean for
nursing care?
A. Close monitoring of serum levels is required because toxic and
therapeutic doses are close
B. The drug has no adverse effects at therapeutic doses
C. The drug can be given safely in a wide range of doses
D. The drug is only effective when given intravenously
A. Close monitoring of serum levels is required because toxic and
therapeutic doses are close
A narrow therapeutic index means a small margin between effective and
toxic concentrations, so drug levels must be watched carefully.
7. A client experiences an unexpected, genetically based reaction to a
first dose of a medication. This is best described as:
A. A side effect
B. An idiosyncratic reaction
C. Tolerance
D. An allergic reaction
B. An idiosyncratic reaction
Idiosyncratic reactions are unusual, unpredictable responses often linked
to genetic differences in drug metabolism.
8. Which assessment finding is most important before administering a
drug that is primarily excreted by the kidneys?
A. Serum creatinine and urine output
B. Blood glucose
C. Liver enzymes
D. Serum albumin
A. Serum creatinine and urine output
Renal function determines how well the drug is cleared; impaired
function can lead to accumulation.
Page 3 of 53
, Nursing Pharmacology & Therapeutics
9. An older adult is prescribed several new medications. Which age-
related change most increases the risk of drug accumulation?
A. Increased gastric acidity
B. Increased hepatic blood flow
C. Decreased glomerular filtration rate
D. Increased lean body mass
C. Decreased glomerular filtration rate
GFR declines with age, slowing elimination of renally cleared drugs and
increasing the risk of toxicity.
10. A drug that binds to a receptor and blocks the action of an
endogenous substance is called a(n):
A. Antagonist
B. Agonist
C. Partial agonist
D. Enzyme inducer
A. Antagonist
Antagonists occupy receptors without activating them, preventing
agonists from producing their effect.
11. The nurse knows that grapefruit juice can increase serum levels of
some drugs because it:
A. Binds the drug in the stomach
B. Speeds up gastric emptying
C. Increases renal excretion
D. Inhibits the CYP3A4 enzyme in the intestine
D. Inhibits the CYP3A4 enzyme in the intestine
Grapefruit juice inhibits intestinal CYP3A4, reducing metabolism and
raising blood levels of drugs such as some statins and calcium channel
blockers.
Page 4 of 53
