NUR 2407 FINAL EXAM
Pharmacology – Pharmacokinetics,
Cardiovascular, Endocrine, Neurological, and
Antimicrobials Questions with Answers and
Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on the
NUR 2407 Final Exam at Rasmussen University. Topics include pharmacokinetics, medication safety,
cardiovascular and hematologic medications, endocrine drugs, neurological and psychiatric medications,
respiratory and GI agents, and antimicrobials.
1. A nurse explains to a patient that a drug's half-life is 8 hours.
Approximately how long will it take to reach steady state?
A. 8 hours
B. 16 hours
C. 24 hours
D. 40 hours
Correct Answer: D — 40 hours
Rationale: Steady state is achieved after approximately 4–5 half-lives.
For a drug with an 8-hour half-life, 5 × 8 = 40 hours. At steady state,
the rate of drug administration equals the rate of elimination,
producing stable peak and trough levels .
,2. Which phase of pharmacokinetics involves the movement of a drug
from the GI tract into the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
Correct Answer: C — Absorption
Rationale: Absorption is the process by which a drug moves from the
site of administration into the bloodstream. Distribution is movement
to tissues, metabolism is biotransformation (primarily hepatic), and
excretion is elimination (primarily renal) .
3. A patient with hepatic cirrhosis has a reduced ability to metabolize
medications. Which pharmacokinetic process is primarily affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: C — Metabolism
,Rationale: The liver is the primary site of drug metabolism
(biotransformation), primarily via the cytochrome P450 enzyme
system. Cirrhosis impairs this function, leading to decreased first-pass
metabolism, increased bioavailability, and a prolonged half-life for
heavily metabolized drugs .
4. A patient asks the nurse why their oral blood pressure medication is
prescribed instead of the intravenous (IV) form. Which response
correctly explains the first-pass effect?
A. "The IV form bypasses the liver, so more of the drug reaches your bloodstream
compared to the oral form."
B. "The oral form is absorbed faster because it goes directly into the systemic
circulation."
C. "The IV form is broken down by stomach acids before it can work."
D. "The oral form is safer because it bypasses the liver completely."
Correct Answer: A — "The IV form bypasses the liver, so more of the
drug reaches your bloodstream compared to the oral form."
Rationale: The first-pass effect occurs when oral drugs are absorbed in
the GI tract and transported directly to the liver via the portal vein,
, where a significant portion is metabolized before reaching systemic
circulation. IV drugs bypass this, resulting in higher initial
bioavailability .
5. A highly protein-bound drug (98%) is administered to a patient who
is malnourished and has low albumin levels. What is the expected
pharmacodynamic effect?
A. Decreased risk of toxicity
B. Increased therapeutic effect
C. Decreased half-life of the drug
D. Increased excretion of the drug
Correct Answer: B — Increased therapeutic effect
Rationale: Protein binding acts as a reservoir, keeping drugs inactive.
In a malnourished patient with low albumin, fewer protein-binding
sites are available, increasing the free (active) drug concentration. This
can intensify both therapeutic and toxic effects .
6. Which of the following are included in the "Rights" of medication
administration? (Select all that apply.)
Pharmacology – Pharmacokinetics,
Cardiovascular, Endocrine, Neurological, and
Antimicrobials Questions with Answers and
Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on the
NUR 2407 Final Exam at Rasmussen University. Topics include pharmacokinetics, medication safety,
cardiovascular and hematologic medications, endocrine drugs, neurological and psychiatric medications,
respiratory and GI agents, and antimicrobials.
1. A nurse explains to a patient that a drug's half-life is 8 hours.
Approximately how long will it take to reach steady state?
A. 8 hours
B. 16 hours
C. 24 hours
D. 40 hours
Correct Answer: D — 40 hours
Rationale: Steady state is achieved after approximately 4–5 half-lives.
For a drug with an 8-hour half-life, 5 × 8 = 40 hours. At steady state,
the rate of drug administration equals the rate of elimination,
producing stable peak and trough levels .
,2. Which phase of pharmacokinetics involves the movement of a drug
from the GI tract into the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
Correct Answer: C — Absorption
Rationale: Absorption is the process by which a drug moves from the
site of administration into the bloodstream. Distribution is movement
to tissues, metabolism is biotransformation (primarily hepatic), and
excretion is elimination (primarily renal) .
3. A patient with hepatic cirrhosis has a reduced ability to metabolize
medications. Which pharmacokinetic process is primarily affected?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: C — Metabolism
,Rationale: The liver is the primary site of drug metabolism
(biotransformation), primarily via the cytochrome P450 enzyme
system. Cirrhosis impairs this function, leading to decreased first-pass
metabolism, increased bioavailability, and a prolonged half-life for
heavily metabolized drugs .
4. A patient asks the nurse why their oral blood pressure medication is
prescribed instead of the intravenous (IV) form. Which response
correctly explains the first-pass effect?
A. "The IV form bypasses the liver, so more of the drug reaches your bloodstream
compared to the oral form."
B. "The oral form is absorbed faster because it goes directly into the systemic
circulation."
C. "The IV form is broken down by stomach acids before it can work."
D. "The oral form is safer because it bypasses the liver completely."
Correct Answer: A — "The IV form bypasses the liver, so more of the
drug reaches your bloodstream compared to the oral form."
Rationale: The first-pass effect occurs when oral drugs are absorbed in
the GI tract and transported directly to the liver via the portal vein,
, where a significant portion is metabolized before reaching systemic
circulation. IV drugs bypass this, resulting in higher initial
bioavailability .
5. A highly protein-bound drug (98%) is administered to a patient who
is malnourished and has low albumin levels. What is the expected
pharmacodynamic effect?
A. Decreased risk of toxicity
B. Increased therapeutic effect
C. Decreased half-life of the drug
D. Increased excretion of the drug
Correct Answer: B — Increased therapeutic effect
Rationale: Protein binding acts as a reservoir, keeping drugs inactive.
In a malnourished patient with low albumin, fewer protein-binding
sites are available, increasing the free (active) drug concentration. This
can intensify both therapeutic and toxic effects .
6. Which of the following are included in the "Rights" of medication
administration? (Select all that apply.)
