ESTUDYR
NUR 378 PHARMACOLOGY EXAM 1 PREP MOST
TESTED QUESTIONS AND ANSWERS GRADED A+
WITH RATIONALES
What is a protein-bound drug?
A. A drug that permanently binds to hemoglobin.
B. A drug that binds reversibly to plasma proteins (e.g., albumin), limiting tissue distribution.
C. A drug that is stored exclusively in adipose tissue.
D. A drug that cannot be metabolized.
Answer: B. A drug that binds reversibly to plasma proteins (e.g., albumin), limiting tissue
distribution. ✓
Rationale: Protein binding sequesters drug in the bloodstream; only unbound drug is
pharmacologically active and available for metabolism/excretion.
How does high protein binding affect drug toxicity?
A. Always prevents toxicity.
B. Increases free drug immediately.
C. Displacement from protein binding can increase free drug and cause toxicity. ✓
D. Has no clinical significance.
Rationale: Competition for binding sites (or low albumin) increases free fraction → more tissue
exposure → potential toxicity.
What effect does kidney disease have on drugs primarily excreted renally?
A. Increased excretion leading to subtherapeutic levels.
B. No change.
C. Decreased excretion causing accumulation and toxicity. ✓
D. Converts them to inactive forms faster.
Rationale: Impaired renal function reduces clearance; dosing adjustments often required.
Which is an advantage of PO administration?
A. Rapidest onset of action.
B. Requires sterile technique.
C. Convenient and commonly used. ✓
D. No variability in absorption.
Rationale: Oral route is easy and noninvasive, but has variable absorption.
,ESTUDYR
Which is an advantage of IM administration?
A. Ideal for highly water-insoluble drugs.
B. Fastest onset of all routes.
C. Good for poorly soluble medications that need slower absorption. ✓
D. No risk of pain.
Rationale: IM allows depot/slow release of some insoluble drugs.
Which is an advantage of IV administration?
A. Least expensive.
B. No infection risk.
C. Immediate onset and precise dosing. ✓
D. Greatest patient comfort.
Rationale: IV gives 100% bioavailability and fast effect, used in emergencies.
What is a major disadvantage of PO administration?
A. No first-pass effect.
B. Variable absorption (food, pH, motility). ✓
C. Immediate effect always.
D. No compliance issues.
Rationale: Oral absorption is influenced by many patient factors.
What is a major disadvantage of IM administration?
A. No risk of infection.
B. Pain and risk of local infection or muscle injury. ✓
C. Avoids first-pass metabolism.
D. Can be used for IV emergencies.
Rationale: IM injections can be painful and carry infection risks.
What is a major disadvantage of IV administration?
A. Slow onset.
B. No dosage control.
C. Increased infection risk and cost; difficult to reverse some effects rapidly. ✓
D. Always safe for all patients.
Rationale: IV route requires sterile technique and monitoring for complications.
How does poor medication compliance affect therapy?
A. Always increases therapeutic effect.
B. Causes therapeutic failure (missed doses, subtherapeutic levels). ✓
C. Eliminates adverse effects.
, ESTUDYR
D. Ensures better outcomes.
Rationale: Nonadherence reduces efficacy; interventions include simplification and reminders.
Which of the following is the most important characteristic of a drug?
A. Safety
B. Effectiveness. ✓
C. Selectivity
D. Cost
Rationale: A drug must produce the intended therapeutic effect to be useful; safety and
selectivity are also important.
How can nonpharmacologic treatments affect pharmacologic therapy?
A. Never interact.
B. They can modify therapeutic and adverse effects and produce unique responses. ✓
C. They always replace drugs.
D. They only affect psychological outcomes.
Rationale: Diet, exercise, herbal remedies, or procedures can alter drug absorption,
metabolism, or response.
What is absorption?
A. Drug leaving tissues for blood.
B. Movement of a drug from its site of administration into the bloodstream. ✓
C. Chemical alteration of drug.
D. Excretion via kidneys.
Rationale: Absorption determines onset and bioavailability.
What is distribution?
A. Conversion of pro-drug to active drug.
B. Movement of drug from blood into interstitial and intracellular fluids (tissues). ✓
C. Elimination by liver.
D. Protein synthesis.
Rationale: Distribution affected by blood flow, protein binding, and barriers.
What is metabolism (biotransformation)?
A. Drug excretion unchanged.
B. Chemical alteration of drugs (commonly in liver) to metabolites. ✓
C. Absorption into bloodstream.
D. Storage in bone.
Rationale: Liver enzymes (CYPs) often convert drugs to more polar forms for excretion.
NUR 378 PHARMACOLOGY EXAM 1 PREP MOST
TESTED QUESTIONS AND ANSWERS GRADED A+
WITH RATIONALES
What is a protein-bound drug?
A. A drug that permanently binds to hemoglobin.
B. A drug that binds reversibly to plasma proteins (e.g., albumin), limiting tissue distribution.
C. A drug that is stored exclusively in adipose tissue.
D. A drug that cannot be metabolized.
Answer: B. A drug that binds reversibly to plasma proteins (e.g., albumin), limiting tissue
distribution. ✓
Rationale: Protein binding sequesters drug in the bloodstream; only unbound drug is
pharmacologically active and available for metabolism/excretion.
How does high protein binding affect drug toxicity?
A. Always prevents toxicity.
B. Increases free drug immediately.
C. Displacement from protein binding can increase free drug and cause toxicity. ✓
D. Has no clinical significance.
Rationale: Competition for binding sites (or low albumin) increases free fraction → more tissue
exposure → potential toxicity.
What effect does kidney disease have on drugs primarily excreted renally?
A. Increased excretion leading to subtherapeutic levels.
B. No change.
C. Decreased excretion causing accumulation and toxicity. ✓
D. Converts them to inactive forms faster.
Rationale: Impaired renal function reduces clearance; dosing adjustments often required.
Which is an advantage of PO administration?
A. Rapidest onset of action.
B. Requires sterile technique.
C. Convenient and commonly used. ✓
D. No variability in absorption.
Rationale: Oral route is easy and noninvasive, but has variable absorption.
,ESTUDYR
Which is an advantage of IM administration?
A. Ideal for highly water-insoluble drugs.
B. Fastest onset of all routes.
C. Good for poorly soluble medications that need slower absorption. ✓
D. No risk of pain.
Rationale: IM allows depot/slow release of some insoluble drugs.
Which is an advantage of IV administration?
A. Least expensive.
B. No infection risk.
C. Immediate onset and precise dosing. ✓
D. Greatest patient comfort.
Rationale: IV gives 100% bioavailability and fast effect, used in emergencies.
What is a major disadvantage of PO administration?
A. No first-pass effect.
B. Variable absorption (food, pH, motility). ✓
C. Immediate effect always.
D. No compliance issues.
Rationale: Oral absorption is influenced by many patient factors.
What is a major disadvantage of IM administration?
A. No risk of infection.
B. Pain and risk of local infection or muscle injury. ✓
C. Avoids first-pass metabolism.
D. Can be used for IV emergencies.
Rationale: IM injections can be painful and carry infection risks.
What is a major disadvantage of IV administration?
A. Slow onset.
B. No dosage control.
C. Increased infection risk and cost; difficult to reverse some effects rapidly. ✓
D. Always safe for all patients.
Rationale: IV route requires sterile technique and monitoring for complications.
How does poor medication compliance affect therapy?
A. Always increases therapeutic effect.
B. Causes therapeutic failure (missed doses, subtherapeutic levels). ✓
C. Eliminates adverse effects.
, ESTUDYR
D. Ensures better outcomes.
Rationale: Nonadherence reduces efficacy; interventions include simplification and reminders.
Which of the following is the most important characteristic of a drug?
A. Safety
B. Effectiveness. ✓
C. Selectivity
D. Cost
Rationale: A drug must produce the intended therapeutic effect to be useful; safety and
selectivity are also important.
How can nonpharmacologic treatments affect pharmacologic therapy?
A. Never interact.
B. They can modify therapeutic and adverse effects and produce unique responses. ✓
C. They always replace drugs.
D. They only affect psychological outcomes.
Rationale: Diet, exercise, herbal remedies, or procedures can alter drug absorption,
metabolism, or response.
What is absorption?
A. Drug leaving tissues for blood.
B. Movement of a drug from its site of administration into the bloodstream. ✓
C. Chemical alteration of drug.
D. Excretion via kidneys.
Rationale: Absorption determines onset and bioavailability.
What is distribution?
A. Conversion of pro-drug to active drug.
B. Movement of drug from blood into interstitial and intracellular fluids (tissues). ✓
C. Elimination by liver.
D. Protein synthesis.
Rationale: Distribution affected by blood flow, protein binding, and barriers.
What is metabolism (biotransformation)?
A. Drug excretion unchanged.
B. Chemical alteration of drugs (commonly in liver) to metabolites. ✓
C. Absorption into bloodstream.
D. Storage in bone.
Rationale: Liver enzymes (CYPs) often convert drugs to more polar forms for excretion.
