GALEN NUR 210 EXAM: Principles of Pharmacology
Comprehensive Examination
Total Questions: 150
Difficulty Level: Advanced/Hard/Mixed
Target Audience: Nursing Students (Galen College of Nursing)
SECTION 1: FOUNDATIONAL PHARMACOKINETICS & PHARMACODYNAMICS
(Questions 1-25)
1. The pharmacist states that the patient's biotransformation of a drug was altered. The nurse
interprets this to mean that:
A. Absorption has affected the drug
B. Dilution has affected the drug
C. Excretion has affected the drug
D. Metabolism has affected the drug
Correct Answer: D
Rationale: Biotransformation is another term for drug metabolism, the process by which the body
chemically converts a drug into a form that can be excreted. This is one of the four phases of
pharmacokinetics (ADME). Altered biotransformation typically affects drug levels and duration of
action .
2. The nurse reads that the half-life of the medication being administered is 12 hours. What
interpretation will guide the nurse's care of this patient?
A. This medication will be 50% eliminated in 12 hours, so the dosing will be spread apart
B. The medication will be administered every 6 hours to maintain consistent blood levels
C. The medication will not work for the first 12 hours
D. The patient will require two doses of the medication before there is an effect
Correct Answer: A
Rationale: Half-life is the time required for the body to eliminate 50% of the drug. A 12-hour half-life
means after 12 hours, 50% of the drug remains. This knowledge guides dosing intervals to maintain
therapeutic levels while avoiding toxicity .
3. The nurse is administering medications to a patient with chronic renal failure. What is the nurse's
priority action?
A. Administer all medications via IV route
B. Assess drug levels daily
C. Assess the patient for toxicity to the medications
D. Hold medications for low urinary output
,Correct Answer: C
Rationale: In chronic renal failure, drug excretion is impaired, leading to drug accumulation and
increased risk of toxicity. The priority is assessing for signs of medication toxicity. Drug levels may be
monitored but not necessarily daily .
4. A patient asks the nurse, "What does 'first-pass effect' mean?" The best response is:
A. "The drug is absorbed faster when taken on an empty stomach"
B. "The drug is metabolized in the liver before reaching systemic circulation, reducing its
bioavailability"
C. "The drug is excreted unchanged by the kidneys"
D. "The drug binds to plasma proteins and becomes inactive"
Correct Answer: B
Rationale: First-pass effect refers to the metabolism of an oral drug by the liver before it reaches
systemic circulation, which reduces the amount of active drug available. This is why some drugs
require higher oral doses than IV doses .
5. Which term best describes "what the body does to the drug"?
A. Pharmacodynamics
B. Pharmacotherapeutics
C. Pharmacokinetics
D. Toxicology
Correct Answer: C
Rationale: Pharmacokinetics is the study of drug movement through the body, including absorption,
distribution, metabolism, and excretion (ADME). Pharmacodynamics is "what the drug does to the
body" .
6. A drug that binds to a receptor and produces a response is called a(n):
A. Antagonist
B. Agonist
C. Partial agonist
D. Competitive antagonist
Correct Answer: B
Rationale: An agonist activates a receptor and produces a biological response. An antagonist blocks
the receptor and produces no response. A partial agonist produces a weaker response than a full
agonist .
7. The nurse understands that the pharmaceutic phase of drug action involves:
A. Absorption of the drug into the bloodstream
B. Dissolution of the drug in the gastrointestinal tract
C. Distribution of the drug to target tissues
D. Excretion of the drug via the kidneys
Correct Answer: B
Rationale: The pharmaceutic phase is the first phase where the solid drug dissolves into a liquid so it
can be absorbed. Most oral absorption occurs in the small intestine .
,8. Which physiologic change that normally occurs in the older adult has implications for the nurse
assessing drug response?
A. Drug half-life is lengthened
B. Drug metabolism is faster
C. Drug elimination is better
D. Protein binding is more efficient
Correct Answer: A
Rationale: In older adults, physiologic changes include reduced renal function, decreased liver
metabolism, and altered distribution, all of which can lengthen drug half-life and increase the risk of
adverse effects .
9. A medication given by which route has 100% bioavailability?
A. Oral
B. Sublingual
C. Intravenous
D. Intramuscular
Correct Answer: C
Rationale: Intravenous administration places the drug directly into the bloodstream, bypassing
absorption and first-pass metabolism, resulting in 100% bioavailability .
10. The nurse is developing a teaching plan for a patient taking a medication that causes
photosensitivity. What is the most important information for the nurse to teach this patient?
A. "Do not take any over-the-counter medications while on this drug"
B. "Stay out of the sun when possible and use sunscreen when you are outside"
C. "Do not drink milk with this medication"
D. "Do not use vitamin supplements while taking this medication"
Correct Answer: B
Rationale: Photosensitivity increases the risk of severe sunburn and skin damage. Patients must be
taught to avoid sun exposure and use sun protection. This is a critical safety intervention .
11. A drug with high efficacy:
A. Requires a large dose to be effective
B. Produces a strong maximal response, even if the dose is high
C. Is always safer than a drug with low efficacy
D. Has a narrow therapeutic index
Correct Answer: B
Rationale: Efficacy is the maximum effect a drug can produce. High efficacy means the drug can
achieve a strong response at the top of its dose-response curve. This is different from potency, which
refers to the dose required .
12. A patient refuses to take a prescribed medication because it causes nausea. The nurse's best
action is to:
A. Crush the medication and hide it in applesauce
B. Respect the patient's right to refuse and document the refusal
, C. Force the patient to take the medication
D. Discharge the patient from care
Correct Answer: B
Rationale: Patients have the right to refuse treatment. The nurse should respect autonomy, document
the refusal, notify the provider, and explore alternative options .
13. The nurse is reviewing a patient's medication list. Which drug would the nurse expect to have
the highest potential for toxicity based on its therapeutic index?
A. Drug A with TI of 10
B. Drug B with TI of 5
C. Drug C with TI of 2
D. Drug D with TI of 15
Correct Answer: C
Rationale: The therapeutic index is a ratio of toxic dose to effective dose. A lower TI (closer to 1)
indicates a narrower margin of safety. A TI of 2 is considered narrow and high risk .
14. A patient reports that after taking a new medication, they developed an itchy rash. The nurse
documents this as:
A. Idiosyncratic reaction
B. Allergic reaction
C. Toxic reaction
D. Side effect
Correct Answer: B
Rationale: An allergic reaction is an immune-mediated response to a drug, often presenting with rash,
hives, itching, or anaphylaxis. It is not dose-related .
15. The study of how drugs are used to treat, prevent, or diagnose disease is called:
A. Pharmacokinetics
B. Pharmacodynamics
C. Pharmacotherapeutics
D. Toxicology
Correct Answer: C
Rationale: Pharmacotherapeutics focuses on the clinical use of drugs to treat disease, including
indications, contraindications, and monitoring .
16. A patient is prescribed a drug that acts as a partial agonist. The nurse understands that a partial
agonist:
A. Produces a maximal response even at low doses
B. Blocks the receptor completely
C. Produces a weaker response than a full agonist, even at full receptor occupancy
D. Has no effect on the receptor
Correct Answer: C
Rationale: A partial agonist binds to a receptor but produces only a partial response compared to a
Comprehensive Examination
Total Questions: 150
Difficulty Level: Advanced/Hard/Mixed
Target Audience: Nursing Students (Galen College of Nursing)
SECTION 1: FOUNDATIONAL PHARMACOKINETICS & PHARMACODYNAMICS
(Questions 1-25)
1. The pharmacist states that the patient's biotransformation of a drug was altered. The nurse
interprets this to mean that:
A. Absorption has affected the drug
B. Dilution has affected the drug
C. Excretion has affected the drug
D. Metabolism has affected the drug
Correct Answer: D
Rationale: Biotransformation is another term for drug metabolism, the process by which the body
chemically converts a drug into a form that can be excreted. This is one of the four phases of
pharmacokinetics (ADME). Altered biotransformation typically affects drug levels and duration of
action .
2. The nurse reads that the half-life of the medication being administered is 12 hours. What
interpretation will guide the nurse's care of this patient?
A. This medication will be 50% eliminated in 12 hours, so the dosing will be spread apart
B. The medication will be administered every 6 hours to maintain consistent blood levels
C. The medication will not work for the first 12 hours
D. The patient will require two doses of the medication before there is an effect
Correct Answer: A
Rationale: Half-life is the time required for the body to eliminate 50% of the drug. A 12-hour half-life
means after 12 hours, 50% of the drug remains. This knowledge guides dosing intervals to maintain
therapeutic levels while avoiding toxicity .
3. The nurse is administering medications to a patient with chronic renal failure. What is the nurse's
priority action?
A. Administer all medications via IV route
B. Assess drug levels daily
C. Assess the patient for toxicity to the medications
D. Hold medications for low urinary output
,Correct Answer: C
Rationale: In chronic renal failure, drug excretion is impaired, leading to drug accumulation and
increased risk of toxicity. The priority is assessing for signs of medication toxicity. Drug levels may be
monitored but not necessarily daily .
4. A patient asks the nurse, "What does 'first-pass effect' mean?" The best response is:
A. "The drug is absorbed faster when taken on an empty stomach"
B. "The drug is metabolized in the liver before reaching systemic circulation, reducing its
bioavailability"
C. "The drug is excreted unchanged by the kidneys"
D. "The drug binds to plasma proteins and becomes inactive"
Correct Answer: B
Rationale: First-pass effect refers to the metabolism of an oral drug by the liver before it reaches
systemic circulation, which reduces the amount of active drug available. This is why some drugs
require higher oral doses than IV doses .
5. Which term best describes "what the body does to the drug"?
A. Pharmacodynamics
B. Pharmacotherapeutics
C. Pharmacokinetics
D. Toxicology
Correct Answer: C
Rationale: Pharmacokinetics is the study of drug movement through the body, including absorption,
distribution, metabolism, and excretion (ADME). Pharmacodynamics is "what the drug does to the
body" .
6. A drug that binds to a receptor and produces a response is called a(n):
A. Antagonist
B. Agonist
C. Partial agonist
D. Competitive antagonist
Correct Answer: B
Rationale: An agonist activates a receptor and produces a biological response. An antagonist blocks
the receptor and produces no response. A partial agonist produces a weaker response than a full
agonist .
7. The nurse understands that the pharmaceutic phase of drug action involves:
A. Absorption of the drug into the bloodstream
B. Dissolution of the drug in the gastrointestinal tract
C. Distribution of the drug to target tissues
D. Excretion of the drug via the kidneys
Correct Answer: B
Rationale: The pharmaceutic phase is the first phase where the solid drug dissolves into a liquid so it
can be absorbed. Most oral absorption occurs in the small intestine .
,8. Which physiologic change that normally occurs in the older adult has implications for the nurse
assessing drug response?
A. Drug half-life is lengthened
B. Drug metabolism is faster
C. Drug elimination is better
D. Protein binding is more efficient
Correct Answer: A
Rationale: In older adults, physiologic changes include reduced renal function, decreased liver
metabolism, and altered distribution, all of which can lengthen drug half-life and increase the risk of
adverse effects .
9. A medication given by which route has 100% bioavailability?
A. Oral
B. Sublingual
C. Intravenous
D. Intramuscular
Correct Answer: C
Rationale: Intravenous administration places the drug directly into the bloodstream, bypassing
absorption and first-pass metabolism, resulting in 100% bioavailability .
10. The nurse is developing a teaching plan for a patient taking a medication that causes
photosensitivity. What is the most important information for the nurse to teach this patient?
A. "Do not take any over-the-counter medications while on this drug"
B. "Stay out of the sun when possible and use sunscreen when you are outside"
C. "Do not drink milk with this medication"
D. "Do not use vitamin supplements while taking this medication"
Correct Answer: B
Rationale: Photosensitivity increases the risk of severe sunburn and skin damage. Patients must be
taught to avoid sun exposure and use sun protection. This is a critical safety intervention .
11. A drug with high efficacy:
A. Requires a large dose to be effective
B. Produces a strong maximal response, even if the dose is high
C. Is always safer than a drug with low efficacy
D. Has a narrow therapeutic index
Correct Answer: B
Rationale: Efficacy is the maximum effect a drug can produce. High efficacy means the drug can
achieve a strong response at the top of its dose-response curve. This is different from potency, which
refers to the dose required .
12. A patient refuses to take a prescribed medication because it causes nausea. The nurse's best
action is to:
A. Crush the medication and hide it in applesauce
B. Respect the patient's right to refuse and document the refusal
, C. Force the patient to take the medication
D. Discharge the patient from care
Correct Answer: B
Rationale: Patients have the right to refuse treatment. The nurse should respect autonomy, document
the refusal, notify the provider, and explore alternative options .
13. The nurse is reviewing a patient's medication list. Which drug would the nurse expect to have
the highest potential for toxicity based on its therapeutic index?
A. Drug A with TI of 10
B. Drug B with TI of 5
C. Drug C with TI of 2
D. Drug D with TI of 15
Correct Answer: C
Rationale: The therapeutic index is a ratio of toxic dose to effective dose. A lower TI (closer to 1)
indicates a narrower margin of safety. A TI of 2 is considered narrow and high risk .
14. A patient reports that after taking a new medication, they developed an itchy rash. The nurse
documents this as:
A. Idiosyncratic reaction
B. Allergic reaction
C. Toxic reaction
D. Side effect
Correct Answer: B
Rationale: An allergic reaction is an immune-mediated response to a drug, often presenting with rash,
hives, itching, or anaphylaxis. It is not dose-related .
15. The study of how drugs are used to treat, prevent, or diagnose disease is called:
A. Pharmacokinetics
B. Pharmacodynamics
C. Pharmacotherapeutics
D. Toxicology
Correct Answer: C
Rationale: Pharmacotherapeutics focuses on the clinical use of drugs to treat disease, including
indications, contraindications, and monitoring .
16. A patient is prescribed a drug that acts as a partial agonist. The nurse understands that a partial
agonist:
A. Produces a maximal response even at low doses
B. Blocks the receptor completely
C. Produces a weaker response than a full agonist, even at full receptor occupancy
D. Has no effect on the receptor
Correct Answer: C
Rationale: A partial agonist binds to a receptor but produces only a partial response compared to a
