NUR 210 Exams 1-4 Galen Pharmacology – (2026)
Actual Questions and Answers (PDF)
NUR 210 Pharmacology — Exams 1–4 Comprehensive Final
Instructions: Each question has one best answer. Select the single most appropriate response.
Q1. A nurse is reviewing the process by which a medication moves from the gastrointestinal tract
into the bloodstream after oral administration. This process is best described as:
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
Correct Answer: C. Absorption
Rationale: Absorption is the pharmacokinetic phase in which a drug moves from its site of
administration (the GI tract for oral medications) into the bloodstream. Distribution follows
absorption and involves transport to target tissues. Metabolism (biotransformation) primarily occurs
in the liver. Excretion is the removal of drug metabolites from the body, primarily via the kidneys.
Q2. A patient with both liver and kidney disease is prescribed a medication with a half-life of 30
hours. The nurse should anticipate that these conditions will most likely affect the drug in which
way?
A. The drug will be eliminated more quickly
B. The drug's duration of action will increase
C. The drug will not enter the bloodstream
D. The drug's half-life will remain unchanged
Correct Answer: B. The drug's duration of action will increase
Rationale: Impaired liver and kidney function prolong half-life because metabolism and excretion
are decreased. This leads to drug accumulation, prolonged duration of action, and increased risk of
toxicity. Clearance is slowed, not accelerated. Absorption into the bloodstream is not the primary
concern in this scenario.
Q3. The nurse explains to a patient that "steady state" for a medication is usually reached after
approximately four half-lives. What does this mean for a patient starting a new daily medication?
A. The medication will be fully excreted after four doses
B. The drug level will fluctuate widely after four doses
pg. 1
,C. The drug level will stabilize, with intake equaling elimination
D. The medication can be safely discontinued after four doses
Correct Answer: C. The drug level will stabilize, with intake equaling elimination
Rationale: Steady state is the point at which drug intake equals elimination, resulting in stable
therapeutic plasma levels. It is typically achieved after approximately four half-lives of consistent
dosing. Excretion is ongoing, not complete after four doses. Steady state implies stabilization, not
fluctuation. It is also not a signal to discontinue the medication.
Q4. A nurse is teaching about vancomycin, a drug with a narrow therapeutic index. Which
monitoring practice is most important?
A. Checking serum glucose before each dose
B. Measuring peak and trough levels as ordered
C. Monitoring orthostatic blood pressure changes only
D. Assessing visual acuity daily
Correct Answer: B. Measuring peak and trough levels as ordered
Rationale: Vancomycin has a narrow therapeutic index, meaning the difference between
therapeutic and toxic levels is small. Peak and trough serum level monitoring is essential to ensure
efficacy while preventing toxicity, particularly nephrotoxicity and ototoxicity. Glucose monitoring,
orthostatic vital signs, and visual acuity are not the primary monitoring parameters for vancomycin.
Q5. A patient is prescribed both aspirin and phenytoin. The nurse recognizes these drugs are highly
protein-bound. What is the key concern with this combination?
A. Aspirin will prevent phenytoin absorption in the stomach
B. Both drugs may compete for binding sites, increasing free drug and toxicity
C. Phenytoin will be completely excreted unchanged
D. Protein binding will have no effect on drug levels
Correct Answer: B. Both drugs may compete for binding sites, increasing free drug and toxicity
Rationale: Highly protein-bound drugs compete for albumin binding sites. When aspirin displaces
phenytoin from binding sites, the free (active) fraction of phenytoin increases, potentially causing
toxicity. This is not an absorption issue, and phenytoin is not excreted unchanged. Protein binding
has significant effects on active drug levels and safety.
Q6. A nurse teaches a patient: "Do not take antacids around the time of any of your medications."
This instruction is most related to which pharmacokinetic concept?
A. Distribution
B. Absorption
C. Metabolism
D. Excretion
Correct Answer: B. Absorption
pg. 2
, Rationale: Antacids alter gastric pH and can interfere with the absorption of many medications from
the GI tract. Distribution occurs after the drug enters the bloodstream. Metabolism is primarily
hepatic, and excretion is primarily renal or biliary; antacids act in the stomach and affect absorption.
Q7. A patient with chronic alcohol use is taking acetaminophen 1,000 mg four times daily. The nurse
should be most concerned about which potential effect?
A. Enhanced therapeutic effect of acetaminophen
B. Increased risk of hepatotoxicity
C. Decreased renal clearance of acetaminophen
D. Reduced absorption of acetaminophen
Correct Answer: B. Increased risk of hepatotoxicity
Rationale: Chronic alcohol use induces CYP2E1, which increases the production of the toxic
metabolite NAPQI from acetaminophen. Combined with high-dose acetaminophen, this significantly
increases the risk of hepatotoxicity. Alcohol does not enhance the therapeutic effect or reduce
absorption in this context.
Q8. The nurse reviews lab results for a patient taking nephrotoxic medications. Which result is most
concerning?
A. BUN 18 mg/dL and creatinine clearance 100 mL/min
B. BUN 15 mg/dL and creatinine clearance 90 mL/min
C. BUN 45 mg/dL and creatinine clearance 50 mL/min
D. BUN 10 mg/dL and creatinine clearance 120 mL/min
Correct Answer: C. BUN 45 mg/dL and creatinine clearance 50 mL/min
Rationale: Normal BUN is approximately 7–20 mg/dL, and normal creatinine clearance is
approximately 85–135 mL/min. A BUN of 45 and creatinine clearance of 50 indicate significant renal
impairment, increasing the risk of drug accumulation and toxicity. The other values fall within or
near normal ranges.
Q9. A nurse is preparing to administer a medication via the enteral route to a patient with a
nasogastric tube. Which action is most appropriate?
A. Crush all medications together and administer as a single bolus
B. Use liquid formulations whenever possible
C. Administer medications without flushing the tube
D. Mix medications with enteral feeding formula
Correct Answer: B. Use liquid formulations whenever possible
Rationale: Liquid formulations are preferred for enteral tube administration because they reduce
the risk of tube clogging. Medications should not be mixed together unless compatibility is
established, and the tube should be flushed before and after each medication. Mixing medications
with formula can cause interactions and tube obstruction.
pg. 3
Actual Questions and Answers (PDF)
NUR 210 Pharmacology — Exams 1–4 Comprehensive Final
Instructions: Each question has one best answer. Select the single most appropriate response.
Q1. A nurse is reviewing the process by which a medication moves from the gastrointestinal tract
into the bloodstream after oral administration. This process is best described as:
A. Distribution
B. Metabolism
C. Absorption
D. Excretion
Correct Answer: C. Absorption
Rationale: Absorption is the pharmacokinetic phase in which a drug moves from its site of
administration (the GI tract for oral medications) into the bloodstream. Distribution follows
absorption and involves transport to target tissues. Metabolism (biotransformation) primarily occurs
in the liver. Excretion is the removal of drug metabolites from the body, primarily via the kidneys.
Q2. A patient with both liver and kidney disease is prescribed a medication with a half-life of 30
hours. The nurse should anticipate that these conditions will most likely affect the drug in which
way?
A. The drug will be eliminated more quickly
B. The drug's duration of action will increase
C. The drug will not enter the bloodstream
D. The drug's half-life will remain unchanged
Correct Answer: B. The drug's duration of action will increase
Rationale: Impaired liver and kidney function prolong half-life because metabolism and excretion
are decreased. This leads to drug accumulation, prolonged duration of action, and increased risk of
toxicity. Clearance is slowed, not accelerated. Absorption into the bloodstream is not the primary
concern in this scenario.
Q3. The nurse explains to a patient that "steady state" for a medication is usually reached after
approximately four half-lives. What does this mean for a patient starting a new daily medication?
A. The medication will be fully excreted after four doses
B. The drug level will fluctuate widely after four doses
pg. 1
,C. The drug level will stabilize, with intake equaling elimination
D. The medication can be safely discontinued after four doses
Correct Answer: C. The drug level will stabilize, with intake equaling elimination
Rationale: Steady state is the point at which drug intake equals elimination, resulting in stable
therapeutic plasma levels. It is typically achieved after approximately four half-lives of consistent
dosing. Excretion is ongoing, not complete after four doses. Steady state implies stabilization, not
fluctuation. It is also not a signal to discontinue the medication.
Q4. A nurse is teaching about vancomycin, a drug with a narrow therapeutic index. Which
monitoring practice is most important?
A. Checking serum glucose before each dose
B. Measuring peak and trough levels as ordered
C. Monitoring orthostatic blood pressure changes only
D. Assessing visual acuity daily
Correct Answer: B. Measuring peak and trough levels as ordered
Rationale: Vancomycin has a narrow therapeutic index, meaning the difference between
therapeutic and toxic levels is small. Peak and trough serum level monitoring is essential to ensure
efficacy while preventing toxicity, particularly nephrotoxicity and ototoxicity. Glucose monitoring,
orthostatic vital signs, and visual acuity are not the primary monitoring parameters for vancomycin.
Q5. A patient is prescribed both aspirin and phenytoin. The nurse recognizes these drugs are highly
protein-bound. What is the key concern with this combination?
A. Aspirin will prevent phenytoin absorption in the stomach
B. Both drugs may compete for binding sites, increasing free drug and toxicity
C. Phenytoin will be completely excreted unchanged
D. Protein binding will have no effect on drug levels
Correct Answer: B. Both drugs may compete for binding sites, increasing free drug and toxicity
Rationale: Highly protein-bound drugs compete for albumin binding sites. When aspirin displaces
phenytoin from binding sites, the free (active) fraction of phenytoin increases, potentially causing
toxicity. This is not an absorption issue, and phenytoin is not excreted unchanged. Protein binding
has significant effects on active drug levels and safety.
Q6. A nurse teaches a patient: "Do not take antacids around the time of any of your medications."
This instruction is most related to which pharmacokinetic concept?
A. Distribution
B. Absorption
C. Metabolism
D. Excretion
Correct Answer: B. Absorption
pg. 2
, Rationale: Antacids alter gastric pH and can interfere with the absorption of many medications from
the GI tract. Distribution occurs after the drug enters the bloodstream. Metabolism is primarily
hepatic, and excretion is primarily renal or biliary; antacids act in the stomach and affect absorption.
Q7. A patient with chronic alcohol use is taking acetaminophen 1,000 mg four times daily. The nurse
should be most concerned about which potential effect?
A. Enhanced therapeutic effect of acetaminophen
B. Increased risk of hepatotoxicity
C. Decreased renal clearance of acetaminophen
D. Reduced absorption of acetaminophen
Correct Answer: B. Increased risk of hepatotoxicity
Rationale: Chronic alcohol use induces CYP2E1, which increases the production of the toxic
metabolite NAPQI from acetaminophen. Combined with high-dose acetaminophen, this significantly
increases the risk of hepatotoxicity. Alcohol does not enhance the therapeutic effect or reduce
absorption in this context.
Q8. The nurse reviews lab results for a patient taking nephrotoxic medications. Which result is most
concerning?
A. BUN 18 mg/dL and creatinine clearance 100 mL/min
B. BUN 15 mg/dL and creatinine clearance 90 mL/min
C. BUN 45 mg/dL and creatinine clearance 50 mL/min
D. BUN 10 mg/dL and creatinine clearance 120 mL/min
Correct Answer: C. BUN 45 mg/dL and creatinine clearance 50 mL/min
Rationale: Normal BUN is approximately 7–20 mg/dL, and normal creatinine clearance is
approximately 85–135 mL/min. A BUN of 45 and creatinine clearance of 50 indicate significant renal
impairment, increasing the risk of drug accumulation and toxicity. The other values fall within or
near normal ranges.
Q9. A nurse is preparing to administer a medication via the enteral route to a patient with a
nasogastric tube. Which action is most appropriate?
A. Crush all medications together and administer as a single bolus
B. Use liquid formulations whenever possible
C. Administer medications without flushing the tube
D. Mix medications with enteral feeding formula
Correct Answer: B. Use liquid formulations whenever possible
Rationale: Liquid formulations are preferred for enteral tube administration because they reduce
the risk of tube clogging. Medications should not be mixed together unless compatibility is
established, and the tube should be flushed before and after each medication. Mixing medications
with formula can cause interactions and tube obstruction.
pg. 3
