PHARMACOLOGY NURS 251 MODULE 1-10 EXAM 2026/2027
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Graded
Module 1: Pharmacokinetics, Pharmacodynamics & Drug Regulations (Q1-15)
Q1. A patient asks why some medications are given by injection rather than orally. The
nurse explains that intravenous administration bypasses which pharmacokinetic
process that can significantly reduce the amount of active drug reaching systemic
circulation?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
C. Absorption [CORRECT]
Rationale: Absorption is the movement of drug from the site of administration into the
bloodstream; IV administration delivers drug directly into the circulation, bypassing
absorption barriers such as the gastrointestinal tract and first-pass hepatic metabolism.
Distribution (A) occurs after the drug enters the blood, metabolism (B) primarily refers
to biotransformation, and excretion (D) is the elimination of drug from the body.
"Correct Answer: C"
Q2. A drug has a half-life of 6 hours. Approximately how long will it take for 94% of the
drug to be eliminated from the body, assuming first-order kinetics?
A. 6 hours
,B. 12 hours
C. 18 hours
D. 30 hours
D. 30 hours [CORRECT]
Rationale: After five half-lives, approximately 97% of a drug is eliminated (50% after 1,
75% after 2, 87.5% after 3, 93.75% after 4, 96.875% after 5); 5 × 6 hours = 30 hours. Six
hours (A) represents one half-life, twelve hours (B) represents two half-lives, and
eighteen hours (C) represents three half-lives.
"Correct Answer: D"
Q3. A 78-year-old male patient with chronic kidney disease (eGFR 32 mL/min) is
prescribed gentamicin 5 mg/kg/day for a suspected gram-negative infection. The nurse
reviews the pharmacokinetic profile and recognizes that which adjustment is most
critical before administering the first dose?
A. Increase the dose by 50% due to decreased protein binding in elderly patients
B. Extend the dosing interval and/or reduce the dose due to impaired renal excretion
C. Administer the medication with food to enhance gastrointestinal absorption
D. Switch to the oral formulation to improve bioavailability
B. Extend the dosing interval and/or reduce the dose due to impaired renal excretion
[CORRECT]
Rationale: Gentamicin is primarily eliminated unchanged by the kidneys; in chronic
kidney disease with eGFR <60 mL/min, the drug accumulates, increasing the risk of
nephrotoxicity and ototoxicity, so dose reduction or interval extension is required.
Increasing the dose (A) would worsen toxicity, gentamicin is not given orally due to poor
absorption (C), and oral bioavailability is negligible (D).
"Correct Answer: B"
,Q4. A drug that binds to a receptor and produces a response equal to that of the
endogenous substance is classified as:
A. An antagonist
B. A partial agonist
C. A full agonist
D. An inverse agonist
C. A full agonist [CORRECT]
Rationale: A full agonist binds to a receptor and elicits a maximal biological response
equivalent to the endogenous ligand; an antagonist (A) blocks the receptor without
activating it, a partial agonist (B) produces a submaximal response, and an inverse
agonist (D) stabilizes the inactive receptor conformation, producing an effect opposite
to the agonist.
"Correct Answer: C"
Q5. Propranolol binds to beta-adrenergic receptors and prevents epinephrine from
binding. Propranolol is best described as:
A. A physiological agonist
B. A competitive antagonist
C. A non-competitive agonist
D. A chemical antagonist
B. A competitive antagonist [CORRECT]
Rationale: Propranolol competes with epinephrine for the same receptor binding site,
blocking agonist action without intrinsic activity; a physiological agonist (A) mimics
natural ligands, a non-competitive agonist (C) is not a standard pharmacological term,
and a chemical antagonist (D) inactivates the drug in solution rather than competing at
the receptor.
, "Correct Answer: B"
Q6. The therapeutic index of a drug is calculated as the ratio of the toxic dose to the
effective dose (TD50/ED50). A drug with a narrow therapeutic index requires:
A. Less frequent monitoring because the safe range is wide
B. More frequent monitoring of plasma drug levels to avoid toxicity
C. Higher loading doses to achieve therapeutic effect quickly
D. Administration with food to increase absorption
B. More frequent monitoring of plasma drug levels to avoid toxicity [CORRECT]
Rationale: A narrow therapeutic index indicates a small margin between the effective
dose and the toxic dose, necessitating careful therapeutic drug monitoring (e.g., digoxin,
lithium, aminoglycosides, warfarin); less monitoring (A) is dangerous, loading doses (C)
must be carefully calculated, and food administration (D) does not address the narrow
safety margin.
"Correct Answer: B"
Q7. A patient is taking a highly protein-bound drug (99% bound to albumin). If the
patient's albumin level drops significantly due to malnutrition, what is the primary
pharmacokinetic concern?
A. Decreased drug metabolism in the liver
B. Increased free (unbound) active drug concentration, raising the risk of toxicity
C. Decreased drug absorption from the gastrointestinal tract
D. Increased renal excretion of the bound drug complex
B. Increased free (unbound) active drug concentration, raising the risk of toxicity
[CORRECT]
Rationale: Only the unbound (free) fraction of a drug is pharmacologically active; when
albumin levels fall, less drug is bound, increasing the free fraction and the risk of
| Portage Learning / ABCNursing / Geneva College | Verified
Answers | Complete Q&A | 100% Pass Guarantee - A+
Graded
Module 1: Pharmacokinetics, Pharmacodynamics & Drug Regulations (Q1-15)
Q1. A patient asks why some medications are given by injection rather than orally. The
nurse explains that intravenous administration bypasses which pharmacokinetic
process that can significantly reduce the amount of active drug reaching systemic
circulation?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
C. Absorption [CORRECT]
Rationale: Absorption is the movement of drug from the site of administration into the
bloodstream; IV administration delivers drug directly into the circulation, bypassing
absorption barriers such as the gastrointestinal tract and first-pass hepatic metabolism.
Distribution (A) occurs after the drug enters the blood, metabolism (B) primarily refers
to biotransformation, and excretion (D) is the elimination of drug from the body.
"Correct Answer: C"
Q2. A drug has a half-life of 6 hours. Approximately how long will it take for 94% of the
drug to be eliminated from the body, assuming first-order kinetics?
A. 6 hours
,B. 12 hours
C. 18 hours
D. 30 hours
D. 30 hours [CORRECT]
Rationale: After five half-lives, approximately 97% of a drug is eliminated (50% after 1,
75% after 2, 87.5% after 3, 93.75% after 4, 96.875% after 5); 5 × 6 hours = 30 hours. Six
hours (A) represents one half-life, twelve hours (B) represents two half-lives, and
eighteen hours (C) represents three half-lives.
"Correct Answer: D"
Q3. A 78-year-old male patient with chronic kidney disease (eGFR 32 mL/min) is
prescribed gentamicin 5 mg/kg/day for a suspected gram-negative infection. The nurse
reviews the pharmacokinetic profile and recognizes that which adjustment is most
critical before administering the first dose?
A. Increase the dose by 50% due to decreased protein binding in elderly patients
B. Extend the dosing interval and/or reduce the dose due to impaired renal excretion
C. Administer the medication with food to enhance gastrointestinal absorption
D. Switch to the oral formulation to improve bioavailability
B. Extend the dosing interval and/or reduce the dose due to impaired renal excretion
[CORRECT]
Rationale: Gentamicin is primarily eliminated unchanged by the kidneys; in chronic
kidney disease with eGFR <60 mL/min, the drug accumulates, increasing the risk of
nephrotoxicity and ototoxicity, so dose reduction or interval extension is required.
Increasing the dose (A) would worsen toxicity, gentamicin is not given orally due to poor
absorption (C), and oral bioavailability is negligible (D).
"Correct Answer: B"
,Q4. A drug that binds to a receptor and produces a response equal to that of the
endogenous substance is classified as:
A. An antagonist
B. A partial agonist
C. A full agonist
D. An inverse agonist
C. A full agonist [CORRECT]
Rationale: A full agonist binds to a receptor and elicits a maximal biological response
equivalent to the endogenous ligand; an antagonist (A) blocks the receptor without
activating it, a partial agonist (B) produces a submaximal response, and an inverse
agonist (D) stabilizes the inactive receptor conformation, producing an effect opposite
to the agonist.
"Correct Answer: C"
Q5. Propranolol binds to beta-adrenergic receptors and prevents epinephrine from
binding. Propranolol is best described as:
A. A physiological agonist
B. A competitive antagonist
C. A non-competitive agonist
D. A chemical antagonist
B. A competitive antagonist [CORRECT]
Rationale: Propranolol competes with epinephrine for the same receptor binding site,
blocking agonist action without intrinsic activity; a physiological agonist (A) mimics
natural ligands, a non-competitive agonist (C) is not a standard pharmacological term,
and a chemical antagonist (D) inactivates the drug in solution rather than competing at
the receptor.
, "Correct Answer: B"
Q6. The therapeutic index of a drug is calculated as the ratio of the toxic dose to the
effective dose (TD50/ED50). A drug with a narrow therapeutic index requires:
A. Less frequent monitoring because the safe range is wide
B. More frequent monitoring of plasma drug levels to avoid toxicity
C. Higher loading doses to achieve therapeutic effect quickly
D. Administration with food to increase absorption
B. More frequent monitoring of plasma drug levels to avoid toxicity [CORRECT]
Rationale: A narrow therapeutic index indicates a small margin between the effective
dose and the toxic dose, necessitating careful therapeutic drug monitoring (e.g., digoxin,
lithium, aminoglycosides, warfarin); less monitoring (A) is dangerous, loading doses (C)
must be carefully calculated, and food administration (D) does not address the narrow
safety margin.
"Correct Answer: B"
Q7. A patient is taking a highly protein-bound drug (99% bound to albumin). If the
patient's albumin level drops significantly due to malnutrition, what is the primary
pharmacokinetic concern?
A. Decreased drug metabolism in the liver
B. Increased free (unbound) active drug concentration, raising the risk of toxicity
C. Decreased drug absorption from the gastrointestinal tract
D. Increased renal excretion of the bound drug complex
B. Increased free (unbound) active drug concentration, raising the risk of toxicity
[CORRECT]
Rationale: Only the unbound (free) fraction of a drug is pharmacologically active; when
albumin levels fall, less drug is bound, increasing the free fraction and the risk of
