1
NUR 210 Exam 1 – Pharm Principles – (2026) Actual
Questions & Answers (Galen College) 100%
Guarantee Pass.
SECTION 1: PHARMACOKINETICS (12 Questions)
Q1: Which route of administration provides 100% bioavailability because the drug is delivered
directly into the systemic circulation?
• A. Oral administration
• B. Intramuscular injection
• C. Intravenous administration
• D. Subcutaneous injection
Correct Answer: C Rationale: Correct because intravenous administration bypasses all
absorption barriers and delivers the drug directly into the bloodstream, resulting in 100%
bioavailability. Oral, intramuscular, and subcutaneous routes all have absorption factors that
reduce bioavailability below 100%.
Q2: A patient is prescribed nitroglycerin for angina. The nurse knows this drug has a high first-
pass effect. Which route should the nurse expect the provider to order to avoid first-pass
metabolism?
• A. Oral
• B. Sublingual
• C. Rectal
• D. Intramuscular
, 2
Correct Answer: B Rationale: Correct because sublingual administration allows nitroglycerin to
be absorbed directly through the oral mucosa into the systemic circulation, completely
bypassing hepatic first-pass metabolism. Oral nitroglycerin would be extensively metabolized by
the liver before reaching systemic circulation, rendering it ineffective.
Q3: A patient with liver cirrhosis is prescribed propranolol. The nurse recognizes that
propranolol undergoes extensive first-pass metabolism. What is the primary concern for this
patient?
• A. Increased risk of drug toxicity due to decreased hepatic metabolism
• B. Decreased drug effectiveness due to increased first-pass metabolism
• C. No change in drug action because first-pass effect only affects oral drugs
• D. Increased bioavailability of the drug due to impaired liver function
Correct Answer: D Rationale: Correct because in hepatic impairment, the liver's ability to
metabolize drugs during first-pass is reduced, resulting in higher bioavailability of propranolol
than expected and increased risk of drug toxicity. The nurse must monitor for exaggerated drug
effects and report to the provider for possible dose adjustment.
Q4: Which factor would most likely INCREASE the absorption of a lipid-soluble drug
administered orally?
• A. High gastric pH
• B. Delayed gastric emptying
• C. Increased small intestinal blood flow
• D. Presence of P-glycoprotein efflux transporters
Correct Answer: C Rationale: Correct because increased blood flow to the small intestine
enhances the concentration gradient and facilitates greater absorption of lipid-soluble drugs
into the systemic circulation. P-glycoprotein actively pumps drugs out of cells, decreasing
absorption, while delayed gastric emptying and high gastric pH may alter but not necessarily
increase absorption.
, 3
Q5: A drug is 95% bound to albumin. The patient is also taking warfarin, which is 99% albumin-
bound. What is the nurse's primary concern regarding this drug interaction?
• A. The new drug will decrease warfarin's effectiveness
• B. Competition for albumin binding sites may increase free warfarin and cause bleeding
• C. Both drugs will be completely inactivated by protein binding
• D. Protein binding prevents any drug interaction from occurring
Correct Answer: B Rationale: Correct because drugs that are highly protein-bound compete for
limited albumin binding sites. When warfarin is displaced by another highly bound drug, the
increased free (unbound) warfarin becomes pharmacologically active and can potentiate
anticoagulant effects, leading to bleeding risk. The nurse must monitor INR closely.
Q6: A neonate is prescribed a drug that undergoes hepatic metabolism via the CYP450 system.
The nurse knows that neonates have immature hepatic enzyme systems. What is the primary
nursing implication?
• A. The drug will be metabolized faster, requiring increased dosing
• B. The drug will be metabolized slower, increasing the risk of drug toxicity
• C. Neonates have the same hepatic enzyme activity as adults
• D. Hepatic metabolism is not relevant in neonatal pharmacokinetics
Correct Answer: B Rationale: Correct because neonates have immature CYP450 enzyme
systems with significantly reduced metabolic capacity. Slower metabolism leads to prolonged
drug half-life and accumulation, increasing the risk of toxicity. The nurse must administer
reduced doses, extend dosing intervals, and closely monitor for adverse effects.
Q7: A patient with renal impairment has a creatinine clearance of 30 mL/min. The nurse is
administering gentamicin, an aminoglycoside. What is the most critical nursing action?
• A. Administer the standard dose because aminoglycosides are not renally excreted
NUR 210 Exam 1 – Pharm Principles – (2026) Actual
Questions & Answers (Galen College) 100%
Guarantee Pass.
SECTION 1: PHARMACOKINETICS (12 Questions)
Q1: Which route of administration provides 100% bioavailability because the drug is delivered
directly into the systemic circulation?
• A. Oral administration
• B. Intramuscular injection
• C. Intravenous administration
• D. Subcutaneous injection
Correct Answer: C Rationale: Correct because intravenous administration bypasses all
absorption barriers and delivers the drug directly into the bloodstream, resulting in 100%
bioavailability. Oral, intramuscular, and subcutaneous routes all have absorption factors that
reduce bioavailability below 100%.
Q2: A patient is prescribed nitroglycerin for angina. The nurse knows this drug has a high first-
pass effect. Which route should the nurse expect the provider to order to avoid first-pass
metabolism?
• A. Oral
• B. Sublingual
• C. Rectal
• D. Intramuscular
, 2
Correct Answer: B Rationale: Correct because sublingual administration allows nitroglycerin to
be absorbed directly through the oral mucosa into the systemic circulation, completely
bypassing hepatic first-pass metabolism. Oral nitroglycerin would be extensively metabolized by
the liver before reaching systemic circulation, rendering it ineffective.
Q3: A patient with liver cirrhosis is prescribed propranolol. The nurse recognizes that
propranolol undergoes extensive first-pass metabolism. What is the primary concern for this
patient?
• A. Increased risk of drug toxicity due to decreased hepatic metabolism
• B. Decreased drug effectiveness due to increased first-pass metabolism
• C. No change in drug action because first-pass effect only affects oral drugs
• D. Increased bioavailability of the drug due to impaired liver function
Correct Answer: D Rationale: Correct because in hepatic impairment, the liver's ability to
metabolize drugs during first-pass is reduced, resulting in higher bioavailability of propranolol
than expected and increased risk of drug toxicity. The nurse must monitor for exaggerated drug
effects and report to the provider for possible dose adjustment.
Q4: Which factor would most likely INCREASE the absorption of a lipid-soluble drug
administered orally?
• A. High gastric pH
• B. Delayed gastric emptying
• C. Increased small intestinal blood flow
• D. Presence of P-glycoprotein efflux transporters
Correct Answer: C Rationale: Correct because increased blood flow to the small intestine
enhances the concentration gradient and facilitates greater absorption of lipid-soluble drugs
into the systemic circulation. P-glycoprotein actively pumps drugs out of cells, decreasing
absorption, while delayed gastric emptying and high gastric pH may alter but not necessarily
increase absorption.
, 3
Q5: A drug is 95% bound to albumin. The patient is also taking warfarin, which is 99% albumin-
bound. What is the nurse's primary concern regarding this drug interaction?
• A. The new drug will decrease warfarin's effectiveness
• B. Competition for albumin binding sites may increase free warfarin and cause bleeding
• C. Both drugs will be completely inactivated by protein binding
• D. Protein binding prevents any drug interaction from occurring
Correct Answer: B Rationale: Correct because drugs that are highly protein-bound compete for
limited albumin binding sites. When warfarin is displaced by another highly bound drug, the
increased free (unbound) warfarin becomes pharmacologically active and can potentiate
anticoagulant effects, leading to bleeding risk. The nurse must monitor INR closely.
Q6: A neonate is prescribed a drug that undergoes hepatic metabolism via the CYP450 system.
The nurse knows that neonates have immature hepatic enzyme systems. What is the primary
nursing implication?
• A. The drug will be metabolized faster, requiring increased dosing
• B. The drug will be metabolized slower, increasing the risk of drug toxicity
• C. Neonates have the same hepatic enzyme activity as adults
• D. Hepatic metabolism is not relevant in neonatal pharmacokinetics
Correct Answer: B Rationale: Correct because neonates have immature CYP450 enzyme
systems with significantly reduced metabolic capacity. Slower metabolism leads to prolonged
drug half-life and accumulation, increasing the risk of toxicity. The nurse must administer
reduced doses, extend dosing intervals, and closely monitor for adverse effects.
Q7: A patient with renal impairment has a creatinine clearance of 30 mL/min. The nurse is
administering gentamicin, an aminoglycoside. What is the most critical nursing action?
• A. Administer the standard dose because aminoglycosides are not renally excreted
