NUR 378 Pharmacology study guide (exam 1,2 and
3) 100 questions and answers with rationale –
Concordia University St. Paul
Which pharmacokinetic process describes how a drug moves from the bloodstream
into tissues?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: B
Rationale: Distribution = movement of drug from blood to tissues; absorption is
entry into blood.
A drug with a high first-pass effect will have decreased:
A. Bioavailability
B. Half-life
C. Volume of distribution
D. Protein binding
Answer: A
Rationale: First-pass hepatic metabolism reduces the fraction of active drug
reaching systemic circulation (bioavailability).
Which organ is primarily responsible for drug metabolism?
A. Kidney
B. Liver
C. Lung
D. Spleen
Answer: B
Rationale: The liver (hepatic enzymes, CYP450) is the main organ for
biotransformation.
A narrow therapeutic index means:
,NUR 378 Pharmacology study guide (exam 1,2 and
3) 100 questions and answers with rationale –
Concordia University St. Paul
A. Drug is safe at all doses
B. Small range between therapeutic and toxic doses
C. Large volume of distribution
D. Minimal monitoring required
Answer: B
Rationale: Narrow therapeutic index drugs require careful dosing and monitoring
(e.g., digoxin, warfarin).
Which receptor type is G-protein coupled?
A. Nicotinic receptor
B. Muscarinic receptor
C. Voltage-gated sodium channel
D. Insulin receptor
Answer: B
Rationale: Muscarinic acetylcholine receptors are GPCRs; nicotinic are ligand-gated
ion channels.
A patient on warfarin should avoid which vitamin-rich food that can reverse its
effect?
A. Oranges
B. Leafy green vegetables (vitamin K)
C. Bananas
D. Milk
Answer: B
Rationale: Vitamin K (leafy greens) antagonizes warfarin anticoagulation.
Which antibiotic inhibits cell wall synthesis by binding penicillin-binding proteins?
A. Gentamicin
B. Ciprofloxacin
,NUR 378 Pharmacology study guide (exam 1,2 and
3) 100 questions and answers with rationale –
Concordia University St. Paul
C. Piperacillin (a penicillin)
D. Tetracycline
Answer: C
Rationale: Beta-lactams inhibit PBPs — block cell wall synthesis.
Aminoglycosides are known for causing which toxicities?
A. Hepatotoxicity and alopecia
B. Ototoxicity and nephrotoxicity
C. Cardiotoxicity and thrombocytopenia
D. Photosensitivity and anemia
Answer: B
Rationale: Aminoglycosides (e.g., gentamicin) can damage kidneys and hearing.
A client allergic to penicillin may also react to:
A. Aminoglycosides
B. Cephalosporins (possible cross-reactivity)
C. Macrolides
D. Sulfonamides
Answer: B
Rationale: Structural similarities can cause cross-reactivity, especially with first-
generation cephalosporins.
What is the mechanism of action of ACE inhibitors?
A. Block beta-1 receptors
B. Inhibit conversion of angiotensin I to II
C. Block calcium channels
D. Increase renin secretion
Answer: B
, NUR 378 Pharmacology study guide (exam 1,2 and
3) 100 questions and answers with rationale –
Concordia University St. Paul
Rationale: ACE inhibitors prevent formation of angiotensin II → vasodilation,
decreased aldosterone.
A common adverse effect of ACE inhibitors is:
A. Dry cough and hyperkalemia
B. Bradycardia and hypokalemia
C. Photosensitivity
D. Tinnitus
Answer: A
Rationale: ACE inhibitors increase bradykinin causing cough; reduce aldosterone →
hyperkalemia.
Which class of antihypertensive drugs works by blocking L-type calcium channels in
vascular smooth muscle?
A. ACE inhibitors
B. Beta blockers
C. Calcium channel blockers (e.g., amlodipine)
D. Diuretics
Answer: C
Rationale: CCBs inhibit calcium influx, causing vasodilation and decreased BP.
A fast-acting insulin given IV in DKA is:
A. Glargine
B. Aspart
C. Regular insulin (short-acting)
D. NPH
Answer: C
Rationale: Regular IV insulin used for DKA because of rapid onset and titratability.
3) 100 questions and answers with rationale –
Concordia University St. Paul
Which pharmacokinetic process describes how a drug moves from the bloodstream
into tissues?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: B
Rationale: Distribution = movement of drug from blood to tissues; absorption is
entry into blood.
A drug with a high first-pass effect will have decreased:
A. Bioavailability
B. Half-life
C. Volume of distribution
D. Protein binding
Answer: A
Rationale: First-pass hepatic metabolism reduces the fraction of active drug
reaching systemic circulation (bioavailability).
Which organ is primarily responsible for drug metabolism?
A. Kidney
B. Liver
C. Lung
D. Spleen
Answer: B
Rationale: The liver (hepatic enzymes, CYP450) is the main organ for
biotransformation.
A narrow therapeutic index means:
,NUR 378 Pharmacology study guide (exam 1,2 and
3) 100 questions and answers with rationale –
Concordia University St. Paul
A. Drug is safe at all doses
B. Small range between therapeutic and toxic doses
C. Large volume of distribution
D. Minimal monitoring required
Answer: B
Rationale: Narrow therapeutic index drugs require careful dosing and monitoring
(e.g., digoxin, warfarin).
Which receptor type is G-protein coupled?
A. Nicotinic receptor
B. Muscarinic receptor
C. Voltage-gated sodium channel
D. Insulin receptor
Answer: B
Rationale: Muscarinic acetylcholine receptors are GPCRs; nicotinic are ligand-gated
ion channels.
A patient on warfarin should avoid which vitamin-rich food that can reverse its
effect?
A. Oranges
B. Leafy green vegetables (vitamin K)
C. Bananas
D. Milk
Answer: B
Rationale: Vitamin K (leafy greens) antagonizes warfarin anticoagulation.
Which antibiotic inhibits cell wall synthesis by binding penicillin-binding proteins?
A. Gentamicin
B. Ciprofloxacin
,NUR 378 Pharmacology study guide (exam 1,2 and
3) 100 questions and answers with rationale –
Concordia University St. Paul
C. Piperacillin (a penicillin)
D. Tetracycline
Answer: C
Rationale: Beta-lactams inhibit PBPs — block cell wall synthesis.
Aminoglycosides are known for causing which toxicities?
A. Hepatotoxicity and alopecia
B. Ototoxicity and nephrotoxicity
C. Cardiotoxicity and thrombocytopenia
D. Photosensitivity and anemia
Answer: B
Rationale: Aminoglycosides (e.g., gentamicin) can damage kidneys and hearing.
A client allergic to penicillin may also react to:
A. Aminoglycosides
B. Cephalosporins (possible cross-reactivity)
C. Macrolides
D. Sulfonamides
Answer: B
Rationale: Structural similarities can cause cross-reactivity, especially with first-
generation cephalosporins.
What is the mechanism of action of ACE inhibitors?
A. Block beta-1 receptors
B. Inhibit conversion of angiotensin I to II
C. Block calcium channels
D. Increase renin secretion
Answer: B
, NUR 378 Pharmacology study guide (exam 1,2 and
3) 100 questions and answers with rationale –
Concordia University St. Paul
Rationale: ACE inhibitors prevent formation of angiotensin II → vasodilation,
decreased aldosterone.
A common adverse effect of ACE inhibitors is:
A. Dry cough and hyperkalemia
B. Bradycardia and hypokalemia
C. Photosensitivity
D. Tinnitus
Answer: A
Rationale: ACE inhibitors increase bradykinin causing cough; reduce aldosterone →
hyperkalemia.
Which class of antihypertensive drugs works by blocking L-type calcium channels in
vascular smooth muscle?
A. ACE inhibitors
B. Beta blockers
C. Calcium channel blockers (e.g., amlodipine)
D. Diuretics
Answer: C
Rationale: CCBs inhibit calcium influx, causing vasodilation and decreased BP.
A fast-acting insulin given IV in DKA is:
A. Glargine
B. Aspart
C. Regular insulin (short-acting)
D. NPH
Answer: C
Rationale: Regular IV insulin used for DKA because of rapid onset and titratability.
