Nursing Pharmacology 2026 Study Guide
Practice Questions Answer Explanations Drug
Classifications Pharmacokinetics
Pharmacodynamics Safety Administration
Clinical Preparation Review
SECTION 1: Pharmacokinetics (Questions 1–20)
1. Which process describes the movement of a drug from its site of
administration into the bloodstream?
• A) Distribution
• B) Metabolism
• C) Absorption
• D) Excretion
Absorption is the pharmacokinetic phase where a drug moves from its
administration site into systemic circulation. Distribution follows absorption,
metabolism biotransforms the drug, and excretion eliminates it.
2. A nurse administers a drug intravenously. Which pharmacokinetic phase is
bypassed?
• A) Distribution
• B) Absorption
• C) Metabolism
• D) Excretion
, IV administration bypasses absorption because the drug enters the
bloodstream directly. This results in 100% bioavailability and immediate onset of
action.
3. Which organ is primarily responsible for drug metabolism?
• A) Kidneys
• B) Lungs
• C) Liver
• D) Spleen
The liver is the primary site of drug metabolism, largely through the
cytochrome P450 enzyme system. The kidneys are primarily responsible for
excretion.
4. What does the term "bioavailability" refer to?
• A) The speed at which a drug is excreted
• B) The fraction of an administered drug that reaches systemic circulation
unchanged
• C) The volume of blood cleared of drug per unit time
• D) The time required for a drug to achieve half its plasma concentration
Bioavailability is the proportion of a drug that enters systemic circulation in an
active form. IV drugs have 100% bioavailability; oral drugs are affected by first-
pass metabolism.
5. Which route of administration is subject to the first-pass effect?
• A) Intravenous
, • B) Sublingual
• C) Oral
• D) Transdermal
Orally administered drugs are absorbed through the GI tract and pass through
the portal vein to the liver, where they undergo first-pass metabolism before
reaching systemic circulation. Sublingual and transdermal routes bypass this
effect.
6. A drug with a narrow therapeutic index requires:
• A) No monitoring
• B) Routine monitoring of plasma drug levels
• C) Administration with food only
• D) Once-weekly dosing
A narrow therapeutic index means the difference between therapeutic and
toxic doses is small. Drugs like digoxin, warfarin, and phenytoin require
therapeutic drug monitoring to prevent toxicity or subtherapeutic effects.
7. Which factor most significantly affects drug distribution?
• A) Protein binding
• B) Gastric pH
• C) Hepatic blood flow
• D) Renal clearance
Protein binding affects distribution because only unbound (free) drug can
cross membranes and exert pharmacologic effects. Drugs bound to albumin
remain in the vascular space.
, 8. The "half-life" of a drug is:
• A) The time for the drug to be completely eliminated
• B) The time for plasma concentration to decrease by 50%
• C) The time to reach peak plasma concentration
• D) The duration of therapeutic effect
Half-life (t½) is the time required for plasma drug concentration to decrease
by half. It determines dosing intervals and the time to reach steady state
(approximately 4–5 half-lives).
9. Which statement about zero-order kinetics is correct?
• A) A constant fraction of drug is eliminated per unit time
• B) A constant amount of drug is eliminated per unit time
• C) Elimination is independent of drug concentration
• D) It applies to most drugs
Zero-order kinetics (saturation kinetics) eliminates a constant amount of drug
per unit time, regardless of concentration. Ethanol, phenytoin, and high-dose
aspirin follow zero-order kinetics.
10. A patient with renal impairment may require:
• A) Higher doses of renally excreted drugs
• B) Lower doses of renally excreted drugs
• C) No change in dosing
• D) IV administration only
Practice Questions Answer Explanations Drug
Classifications Pharmacokinetics
Pharmacodynamics Safety Administration
Clinical Preparation Review
SECTION 1: Pharmacokinetics (Questions 1–20)
1. Which process describes the movement of a drug from its site of
administration into the bloodstream?
• A) Distribution
• B) Metabolism
• C) Absorption
• D) Excretion
Absorption is the pharmacokinetic phase where a drug moves from its
administration site into systemic circulation. Distribution follows absorption,
metabolism biotransforms the drug, and excretion eliminates it.
2. A nurse administers a drug intravenously. Which pharmacokinetic phase is
bypassed?
• A) Distribution
• B) Absorption
• C) Metabolism
• D) Excretion
, IV administration bypasses absorption because the drug enters the
bloodstream directly. This results in 100% bioavailability and immediate onset of
action.
3. Which organ is primarily responsible for drug metabolism?
• A) Kidneys
• B) Lungs
• C) Liver
• D) Spleen
The liver is the primary site of drug metabolism, largely through the
cytochrome P450 enzyme system. The kidneys are primarily responsible for
excretion.
4. What does the term "bioavailability" refer to?
• A) The speed at which a drug is excreted
• B) The fraction of an administered drug that reaches systemic circulation
unchanged
• C) The volume of blood cleared of drug per unit time
• D) The time required for a drug to achieve half its plasma concentration
Bioavailability is the proportion of a drug that enters systemic circulation in an
active form. IV drugs have 100% bioavailability; oral drugs are affected by first-
pass metabolism.
5. Which route of administration is subject to the first-pass effect?
• A) Intravenous
, • B) Sublingual
• C) Oral
• D) Transdermal
Orally administered drugs are absorbed through the GI tract and pass through
the portal vein to the liver, where they undergo first-pass metabolism before
reaching systemic circulation. Sublingual and transdermal routes bypass this
effect.
6. A drug with a narrow therapeutic index requires:
• A) No monitoring
• B) Routine monitoring of plasma drug levels
• C) Administration with food only
• D) Once-weekly dosing
A narrow therapeutic index means the difference between therapeutic and
toxic doses is small. Drugs like digoxin, warfarin, and phenytoin require
therapeutic drug monitoring to prevent toxicity or subtherapeutic effects.
7. Which factor most significantly affects drug distribution?
• A) Protein binding
• B) Gastric pH
• C) Hepatic blood flow
• D) Renal clearance
Protein binding affects distribution because only unbound (free) drug can
cross membranes and exert pharmacologic effects. Drugs bound to albumin
remain in the vascular space.
, 8. The "half-life" of a drug is:
• A) The time for the drug to be completely eliminated
• B) The time for plasma concentration to decrease by 50%
• C) The time to reach peak plasma concentration
• D) The duration of therapeutic effect
Half-life (t½) is the time required for plasma drug concentration to decrease
by half. It determines dosing intervals and the time to reach steady state
(approximately 4–5 half-lives).
9. Which statement about zero-order kinetics is correct?
• A) A constant fraction of drug is eliminated per unit time
• B) A constant amount of drug is eliminated per unit time
• C) Elimination is independent of drug concentration
• D) It applies to most drugs
Zero-order kinetics (saturation kinetics) eliminates a constant amount of drug
per unit time, regardless of concentration. Ethanol, phenytoin, and high-dose
aspirin follow zero-order kinetics.
10. A patient with renal impairment may require:
• A) Higher doses of renally excreted drugs
• B) Lower doses of renally excreted drugs
• C) No change in dosing
• D) IV administration only
