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NUR 378 PHARMACOLOGY IN NURSING EXAM PREP 2026 QUESTIONS WITH
VERIFIED ANSWERS DETAILED RATIONALES GRADED A+
Section 1: Foundations of Pharmacology & Pharmacokinetics (Questions 1–30)
1. A nurse is preparing to administer a drug that is classified as a Schedule II
controlled substance. Which of the following is a requirement for this
prescription?
A. It can be refilled up to 5 times.
B. It requires a DEA number and no refills.
C. It can be called into the pharmacy.
D. It can be prescribed by any licensed nurse.
Rationale: B. Schedule II controlled substances require a DEA number and do not
allow refills; a new prescription is required.
2. The nurse is reviewing factors that influence pharmacokinetics in the neonatal
patient. Which factor puts the neonate at greater risk for drug toxicity?
A. The kidneys are small.
B. The liver is not fully developed.
C. Excretion of the drug occurs quickly.
D. The bowel is not fully developed.
Rationale: B. The neonate's liver is not fully developed, which slows drug
metabolism and increases the risk of toxicity.
3. The first-pass effect refers to the:
A. Metabolism of a drug in the liver before it reaches systemic circulation.
B. Excretion of a drug through the kidneys.
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C. Distribution of a drug to the brain.
D. Binding of a drug to plasma proteins.
Rationale: A. The first-pass effect is the metabolism of an oral drug by the liver
before it enters systemic circulation, reducing bioavailability.
4. What is the primary goal of pharmacodynamics?
A. Drug absorption
B. Drug effects on the body
C. Drug metabolism
D. Drug excretion
Rationale: B. Pharmacodynamics is the study of what the drug does to the body,
including receptor interactions and effects.
5. A patient is prescribed lisinopril. Which electrolyte imbalance should the
nurse monitor for?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Rationale: B. ACE inhibitors like lisinopril can cause hyperkalemia due to their
effect on the renin-angiotensin-aldosterone system.
6. A nurse is assessing a newly admitted 83-year-old patient and determines that
the patient is experiencing polypharmacy. Which statement most accurately
illustrates polypharmacy?
A. The patient has lower risk for drug interactions.
B. The patient takes multiple medications simultaneously.
C. The patient takes one medication for an illness several times a day.
D. The patient risks problems only if over-the-counter medications are also taken.
Rationale: B. Polypharmacy is the use of multiple medications concurrently,
which increases the risk of drug interactions.
7. Why is the excretion phase of pharmacokinetics particularly problematic for
patients with end-stage renal disease?
A. The kidneys are unable to effectively eliminate drugs, leading to toxicity.
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B. The distribution phase is problematic due to increased blood volume.
C. The metabolism phase is problematic due to liver dysfunction.
D. The absorption phase is problematic due to altered GI function.
Rationale: A. In end-stage renal disease, the kidneys cannot effectively excrete
drugs, leading to accumulation and toxicity.
8. A nurse is preparing to administer a medication that is highly protein-bound.
What effect does low albumin have on the drug's action?
A. Decreased free drug
B. Increased free drug and risk of toxicity
C. No effect
D. Increased excretion
Rationale: B. Low albumin increases the unbound (active) fraction of the drug,
increasing the risk of toxicity.
9. Which of the following best describes a drug's half-life?
A. The time it takes for the drug to be absorbed.
B. The time it takes for half of the drug to be eliminated.
C. The time it takes for the drug to reach peak effect.
D. The time it takes for the drug to be metabolized.
Rationale: B. Half-life is the time required for the body to eliminate 50% of the
drug.
10. A drug with a narrow therapeutic index requires:
A. No monitoring
B. Routine serum drug level monitoring
C. Higher doses
D. Shorter dosing intervals
Rationale: B. A narrow therapeutic index means small differences between
therapeutic and toxic doses, requiring serum level monitoring.
11. Which route of administration has 100% bioavailability?
A. Oral
B. Subcutaneous
C. Intravenous
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D. Rectal
Rationale: C. IV administration bypasses absorption barriers, providing 100%
bioavailability.
12. A nurse is teaching a patient about a medication that is a potent enzyme
inducer. What effect will this have on other medications?
A. Increased serum levels of other medications
B. Decreased serum levels of other medications
C. No effect
D. Increased toxicity
Rationale: B. Enzyme inducers increase the metabolism of other drugs, leading
to decreased serum levels.
13. What is the purpose of a loading dose?
A. To maintain steady-state levels
B. To rapidly achieve therapeutic drug concentrations
C. To reduce the risk of adverse effects
D. To prolong the drug's half-life
Rationale: B. A loading dose rapidly achieves therapeutic plasma concentrations.
14. A patient is taking a medication that is 90% protein-bound. What percentage
of the drug is pharmacologically active?
A. 90%
B. 50%
C. 10%
D. 100%
Rationale: C. Only the free (unbound) fraction is active; 10% is free.
15. Which of the following is a Phase II metabolic reaction?
A. Oxidation
B. Reduction
C. Hydrolysis
D. Glucuronidation
Rationale: D. Phase II reactions involve conjugation, such as glucuronidation.
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NUR 378 PHARMACOLOGY IN NURSING EXAM PREP 2026 QUESTIONS WITH
VERIFIED ANSWERS DETAILED RATIONALES GRADED A+
Section 1: Foundations of Pharmacology & Pharmacokinetics (Questions 1–30)
1. A nurse is preparing to administer a drug that is classified as a Schedule II
controlled substance. Which of the following is a requirement for this
prescription?
A. It can be refilled up to 5 times.
B. It requires a DEA number and no refills.
C. It can be called into the pharmacy.
D. It can be prescribed by any licensed nurse.
Rationale: B. Schedule II controlled substances require a DEA number and do not
allow refills; a new prescription is required.
2. The nurse is reviewing factors that influence pharmacokinetics in the neonatal
patient. Which factor puts the neonate at greater risk for drug toxicity?
A. The kidneys are small.
B. The liver is not fully developed.
C. Excretion of the drug occurs quickly.
D. The bowel is not fully developed.
Rationale: B. The neonate's liver is not fully developed, which slows drug
metabolism and increases the risk of toxicity.
3. The first-pass effect refers to the:
A. Metabolism of a drug in the liver before it reaches systemic circulation.
B. Excretion of a drug through the kidneys.
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C. Distribution of a drug to the brain.
D. Binding of a drug to plasma proteins.
Rationale: A. The first-pass effect is the metabolism of an oral drug by the liver
before it enters systemic circulation, reducing bioavailability.
4. What is the primary goal of pharmacodynamics?
A. Drug absorption
B. Drug effects on the body
C. Drug metabolism
D. Drug excretion
Rationale: B. Pharmacodynamics is the study of what the drug does to the body,
including receptor interactions and effects.
5. A patient is prescribed lisinopril. Which electrolyte imbalance should the
nurse monitor for?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Rationale: B. ACE inhibitors like lisinopril can cause hyperkalemia due to their
effect on the renin-angiotensin-aldosterone system.
6. A nurse is assessing a newly admitted 83-year-old patient and determines that
the patient is experiencing polypharmacy. Which statement most accurately
illustrates polypharmacy?
A. The patient has lower risk for drug interactions.
B. The patient takes multiple medications simultaneously.
C. The patient takes one medication for an illness several times a day.
D. The patient risks problems only if over-the-counter medications are also taken.
Rationale: B. Polypharmacy is the use of multiple medications concurrently,
which increases the risk of drug interactions.
7. Why is the excretion phase of pharmacokinetics particularly problematic for
patients with end-stage renal disease?
A. The kidneys are unable to effectively eliminate drugs, leading to toxicity.
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B. The distribution phase is problematic due to increased blood volume.
C. The metabolism phase is problematic due to liver dysfunction.
D. The absorption phase is problematic due to altered GI function.
Rationale: A. In end-stage renal disease, the kidneys cannot effectively excrete
drugs, leading to accumulation and toxicity.
8. A nurse is preparing to administer a medication that is highly protein-bound.
What effect does low albumin have on the drug's action?
A. Decreased free drug
B. Increased free drug and risk of toxicity
C. No effect
D. Increased excretion
Rationale: B. Low albumin increases the unbound (active) fraction of the drug,
increasing the risk of toxicity.
9. Which of the following best describes a drug's half-life?
A. The time it takes for the drug to be absorbed.
B. The time it takes for half of the drug to be eliminated.
C. The time it takes for the drug to reach peak effect.
D. The time it takes for the drug to be metabolized.
Rationale: B. Half-life is the time required for the body to eliminate 50% of the
drug.
10. A drug with a narrow therapeutic index requires:
A. No monitoring
B. Routine serum drug level monitoring
C. Higher doses
D. Shorter dosing intervals
Rationale: B. A narrow therapeutic index means small differences between
therapeutic and toxic doses, requiring serum level monitoring.
11. Which route of administration has 100% bioavailability?
A. Oral
B. Subcutaneous
C. Intravenous
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D. Rectal
Rationale: C. IV administration bypasses absorption barriers, providing 100%
bioavailability.
12. A nurse is teaching a patient about a medication that is a potent enzyme
inducer. What effect will this have on other medications?
A. Increased serum levels of other medications
B. Decreased serum levels of other medications
C. No effect
D. Increased toxicity
Rationale: B. Enzyme inducers increase the metabolism of other drugs, leading
to decreased serum levels.
13. What is the purpose of a loading dose?
A. To maintain steady-state levels
B. To rapidly achieve therapeutic drug concentrations
C. To reduce the risk of adverse effects
D. To prolong the drug's half-life
Rationale: B. A loading dose rapidly achieves therapeutic plasma concentrations.
14. A patient is taking a medication that is 90% protein-bound. What percentage
of the drug is pharmacologically active?
A. 90%
B. 50%
C. 10%
D. 100%
Rationale: C. Only the free (unbound) fraction is active; 10% is free.
15. Which of the following is a Phase II metabolic reaction?
A. Oxidation
B. Reduction
C. Hydrolysis
D. Glucuronidation
Rationale: D. Phase II reactions involve conjugation, such as glucuronidation.
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