McCuistion Pharmacology 11th Ed. Chapters 1-58 Actual Exam 2026/2027 –
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Section 1: Unit I - Introduction to Pharmacology
Q1: A nurse is using the Clinical Judgment Management Model (CJMM) to care for a
patient starting a new antihypertensive medication. Which CJMM cognitive skill
involves collecting the patient's blood pressure readings, medication history, and
reported dizziness?
A. Analyze Cues
B. Prioritize Hypotheses
C. Recognizing Cues (Assessment) [CORRECT]
D. Evaluate Outcomes
Correct Answer: C
Rationale: Recognizing Cues (Assessment) is the CJMM cognitive skill that involves
collecting subjective and objective data about the patient, including vital signs,
medication history, and patient-reported symptoms.
Q2: A nurse is reviewing the steps of the nursing process. Which of the following is NOT
a step of the nursing process?
A. Assessment
B. Planning
C. Implementation
D. Right drug [CORRECT]
Correct Answer: D
,Rationale: The five steps of the nursing process are assessment, diagnosis (patient
problem), planning, implementation, and evaluation; "right drug" is one of the rights of
medication administration, not a step of the nursing process.
Q3: A patient is prescribed a new medication that acts as a full agonist at
beta-adrenergic receptors. The nurse understands that an agonist:
A. Blocks the receptor without producing any effect
B. Binds to the receptor and produces a maximal response [CORRECT]
C. Binds to the receptor and produces a submaximal response
D. Prevents the endogenous neurotransmitter from binding
Correct Answer: B
Rationale: A full agonist binds to a receptor and produces the same maximal response
as the endogenous substance; partial agonists produce submaximal responses, while
antagonists block receptor activation without producing an effect.
Q4: A patient of Asian descent is prescribed carbamazepine. The nurse knows that
pharmacogenetic testing may be important because certain HLA-B alleles are
associated with increased risk of:
A. Nephrotoxicity
B. Stevens-Johnson syndrome [CORRECT]
C. Ototoxicity
D. Hepatotoxicity
Correct Answer: B
Rationale: Pharmacogenetic testing for HLA-B*1502 is recommended in patients of
Asian ancestry before starting carbamazepine because this allele is strongly associated
with increased risk of Stevens-Johnson syndrome and toxic epidermal necrolysis.
Q5: A patient asks the nurse about using St. John's wort for depression while also
taking a selective serotonin reuptake inhibitor (SSRI). The nurse's best response is:
A. "St. John's wort is safe to use with SSRIs."
B. "Combining St. John's wort with SSRIs can cause serotonin syndrome." [CORRECT]
,C. "St. John's wort will enhance the effectiveness of your SSRI."
D. "Herbal supplements do not interact with prescription medications."
Correct Answer: B
Rationale: St. John's wort is a serotonergic herbal supplement that can cause serotonin
syndrome when combined with SSRIs or other serotonergic medications; patients
should be educated about this potentially life-threatening interaction.
Q6: A nurse is teaching a patient about a new medication. The patient states, "I don't
understand why I need this drug." This statement represents which type of data?
A. Objective data
B. Subjective data [CORRECT]
C. Secondary data
D. Tertiary data
Correct Answer: B
Rationale: Subjective data are information obtained from the patient through
statements, descriptions, or expressions of feelings; objective data are observable and
measurable information such as vital signs and laboratory values.
Q7: A patient is prescribed a drug that undergoes extensive first-pass metabolism in the
liver. The nurse understands that this means:
A. The drug will have increased bioavailability when given orally
B. A significant portion of the drug is metabolized before reaching systemic circulation
[CORRECT]
C. The drug should only be given intravenously
D. First-pass metabolism increases the therapeutic effect of the drug
Correct Answer: B
Rationale: First-pass metabolism refers to the metabolism of a drug in the liver after
oral absorption and before it reaches systemic circulation; extensive first-pass
metabolism significantly reduces oral bioavailability, often requiring higher oral doses or
alternative routes.
, Q8: A nurse is using the nursing process to develop a patient-centered goal. Which goal
statement meets the criteria for being patient-centered, measurable, realistic, and
including a deadline?
A. "The patient will feel better soon."
B. "The patient will independently administer the medication using the metered-dose
inhaler at the end of the session." [CORRECT]
C. "The nurse will teach the patient about the medication."
D. "The patient will take the medication as prescribed."
Correct Answer: B
Rationale: Effective patient-centered goals must be specific, measurable, achievable,
relevant, and time-bound (SMART); this goal specifies the behavior (independent
administration), method (metered-dose inhaler), and timeframe (end of session).
Q9: A patient is prescribed a drug with a narrow therapeutic index. The nurse should
prioritize which nursing action?
A. Administering the drug with food
B. Monitoring serum drug levels and observing for toxicity [CORRECT]
C. Teaching the patient to take the drug at bedtime
D. Encouraging increased fluid intake
Correct Answer: B
Rationale: Drugs with a narrow therapeutic index (such as lithium, digoxin, and warfarin)
have a small margin between therapeutic and toxic doses; close monitoring of serum
drug levels and vigilant observation for signs of toxicity are essential nursing priorities.
Q10: A nurse is caring for a patient who reports using complementary therapies
including acupuncture and meditation for chronic pain. The nurse's best response is:
A. "Those therapies are not evidence-based and you should stop using them."
B. "Tell me more about how these therapies help you, and let's discuss how they fit with
your prescribed treatment plan." [CORRECT]
C. "Complementary therapies are always safe and can replace your medications."
D. "You should only use therapies prescribed by your physician."
Correct Answer: B
Comprehensive Test Bank with Detailed Rationales | 100% Verified | Pass
Guaranteed – A+ Graded
Section 1: Unit I - Introduction to Pharmacology
Q1: A nurse is using the Clinical Judgment Management Model (CJMM) to care for a
patient starting a new antihypertensive medication. Which CJMM cognitive skill
involves collecting the patient's blood pressure readings, medication history, and
reported dizziness?
A. Analyze Cues
B. Prioritize Hypotheses
C. Recognizing Cues (Assessment) [CORRECT]
D. Evaluate Outcomes
Correct Answer: C
Rationale: Recognizing Cues (Assessment) is the CJMM cognitive skill that involves
collecting subjective and objective data about the patient, including vital signs,
medication history, and patient-reported symptoms.
Q2: A nurse is reviewing the steps of the nursing process. Which of the following is NOT
a step of the nursing process?
A. Assessment
B. Planning
C. Implementation
D. Right drug [CORRECT]
Correct Answer: D
,Rationale: The five steps of the nursing process are assessment, diagnosis (patient
problem), planning, implementation, and evaluation; "right drug" is one of the rights of
medication administration, not a step of the nursing process.
Q3: A patient is prescribed a new medication that acts as a full agonist at
beta-adrenergic receptors. The nurse understands that an agonist:
A. Blocks the receptor without producing any effect
B. Binds to the receptor and produces a maximal response [CORRECT]
C. Binds to the receptor and produces a submaximal response
D. Prevents the endogenous neurotransmitter from binding
Correct Answer: B
Rationale: A full agonist binds to a receptor and produces the same maximal response
as the endogenous substance; partial agonists produce submaximal responses, while
antagonists block receptor activation without producing an effect.
Q4: A patient of Asian descent is prescribed carbamazepine. The nurse knows that
pharmacogenetic testing may be important because certain HLA-B alleles are
associated with increased risk of:
A. Nephrotoxicity
B. Stevens-Johnson syndrome [CORRECT]
C. Ototoxicity
D. Hepatotoxicity
Correct Answer: B
Rationale: Pharmacogenetic testing for HLA-B*1502 is recommended in patients of
Asian ancestry before starting carbamazepine because this allele is strongly associated
with increased risk of Stevens-Johnson syndrome and toxic epidermal necrolysis.
Q5: A patient asks the nurse about using St. John's wort for depression while also
taking a selective serotonin reuptake inhibitor (SSRI). The nurse's best response is:
A. "St. John's wort is safe to use with SSRIs."
B. "Combining St. John's wort with SSRIs can cause serotonin syndrome." [CORRECT]
,C. "St. John's wort will enhance the effectiveness of your SSRI."
D. "Herbal supplements do not interact with prescription medications."
Correct Answer: B
Rationale: St. John's wort is a serotonergic herbal supplement that can cause serotonin
syndrome when combined with SSRIs or other serotonergic medications; patients
should be educated about this potentially life-threatening interaction.
Q6: A nurse is teaching a patient about a new medication. The patient states, "I don't
understand why I need this drug." This statement represents which type of data?
A. Objective data
B. Subjective data [CORRECT]
C. Secondary data
D. Tertiary data
Correct Answer: B
Rationale: Subjective data are information obtained from the patient through
statements, descriptions, or expressions of feelings; objective data are observable and
measurable information such as vital signs and laboratory values.
Q7: A patient is prescribed a drug that undergoes extensive first-pass metabolism in the
liver. The nurse understands that this means:
A. The drug will have increased bioavailability when given orally
B. A significant portion of the drug is metabolized before reaching systemic circulation
[CORRECT]
C. The drug should only be given intravenously
D. First-pass metabolism increases the therapeutic effect of the drug
Correct Answer: B
Rationale: First-pass metabolism refers to the metabolism of a drug in the liver after
oral absorption and before it reaches systemic circulation; extensive first-pass
metabolism significantly reduces oral bioavailability, often requiring higher oral doses or
alternative routes.
, Q8: A nurse is using the nursing process to develop a patient-centered goal. Which goal
statement meets the criteria for being patient-centered, measurable, realistic, and
including a deadline?
A. "The patient will feel better soon."
B. "The patient will independently administer the medication using the metered-dose
inhaler at the end of the session." [CORRECT]
C. "The nurse will teach the patient about the medication."
D. "The patient will take the medication as prescribed."
Correct Answer: B
Rationale: Effective patient-centered goals must be specific, measurable, achievable,
relevant, and time-bound (SMART); this goal specifies the behavior (independent
administration), method (metered-dose inhaler), and timeframe (end of session).
Q9: A patient is prescribed a drug with a narrow therapeutic index. The nurse should
prioritize which nursing action?
A. Administering the drug with food
B. Monitoring serum drug levels and observing for toxicity [CORRECT]
C. Teaching the patient to take the drug at bedtime
D. Encouraging increased fluid intake
Correct Answer: B
Rationale: Drugs with a narrow therapeutic index (such as lithium, digoxin, and warfarin)
have a small margin between therapeutic and toxic doses; close monitoring of serum
drug levels and vigilant observation for signs of toxicity are essential nursing priorities.
Q10: A nurse is caring for a patient who reports using complementary therapies
including acupuncture and meditation for chronic pain. The nurse's best response is:
A. "Those therapies are not evidence-based and you should stop using them."
B. "Tell me more about how these therapies help you, and let's discuss how they fit with
your prescribed treatment plan." [CORRECT]
C. "Complementary therapies are always safe and can replace your medications."
D. "You should only use therapies prescribed by your physician."
Correct Answer: B
