NU 150 Exam 1 Pharmacology Tested Questions
(2026/2027) PDF | Nursing | Galen College, Exams of
Pharmacology
1. A patient is prescribed furosemide (Lasix) 40 mg IV push. The nurse knows
this medication is classified as:
A. Thiazide diuretic
B. Potassium-sparing diuretic
C. Loop diuretic
D. Osmotic diuretic
Correct Answer: C
Rationale: Furosemide is the prototype loop diuretic. It acts on the thick
ascending limb of the Loop of Henle to block sodium and chloride
reabsorption, resulting in profound diuresis.
2. A patient taking spironolactone (Aldactone) should be advised to avoid
which of the following due to the risk of hyperkalemia?
A. Bananas and oranges
B. White bread and pasta
C. Cheddar cheese
D. Caffeine
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic. Consuming
potassium-rich foods (bananas, oranges, potatoes, tomatoes) increases the
risk of life-threatening hyperkalemia.
3. A nurse is preparing to administer digoxin and furosemide to a patient
with heart failure. Which lab value is most critical to assess prior to
administration?
A. Serum Calcium
B. Serum Potassium
,C. Blood Urea Nitrogen (BUN)
D. Platelet Count
Correct Answer: B
Rationale: Hypokalemia (low potassium) caused by furosemide increases the
risk of digoxin toxicity. The nurse must ensure potassium levels are within
normal range before giving these medications together.
4. What is the primary site of drug metabolism in the body?
A. Kidneys
B. Lungs
C. Liver
D. Small Intestine
Correct Answer: C
*Rationale: The liver is the primary site for biotransformation (metabolism).
The cytochrome P450 enzyme system in the liver converts lipid-soluble
drugs into water-soluble metabolites for excretion.*
5. A patient with Type 1 diabetes is NPO for a surgical procedure. What is the
nurse's priority action regarding the patient's scheduled morning insulin
dose?
A. Administer the full dose of long-acting insulin as scheduled.
B. Hold all insulin until the patient returns from surgery.
C. Contact the healthcare provider for a specific insulin adjustment order.
D. Administer half the usual dose of regular insulin.
Correct Answer: C
Rationale: Insulin requirements change drastically when a patient is NPO.
Administering insulin without carbohydrate intake risks severe
hypoglycemia. The provider must give a specific order for that day.
6. A nurse is mixing Regular insulin and NPH insulin in one syringe. Which
action is correct?
A. Draw up the NPH (cloudy) first, then the Regular (clear).
B. Draw up the Regular (clear) first, then the NPH (cloudy).
,C. The order of drawing does not matter as long as it is injected immediately.
D. These two insulins cannot be mixed in the same syringe.
Correct Answer: B
Rationale: The mnemonic is "Clear before Cloudy." Regular insulin (clear) is
drawn up first to prevent contamination of the Regular insulin vial with the
NPH (cloudy) solution, which contains protamine.
7. A patient taking metformin (Glucophage) is scheduled for a CT scan with
IV contrast dye. What is the most important nursing action?
A. Administer the metformin with a full glass of water right before the scan.
B. Ensure the patient's blood sugar is below 200 mg/dL.
C. Hold the metformin for 48 hours prior to and after the procedure per
protocol.
D. Administer sodium bicarbonate before the scan.
Correct Answer: C
Rationale: IV contrast dye is nephrotoxic. Combining this with metformin
increases the risk of lactic acidosis and acute kidney injury. Metformin is
typically held 48 hours before and 48 hours after contrast procedures.
8. A patient has been taking an oral corticosteroid (prednisone) for 6 months
for an autoimmune disorder. The nurse teaches the patient that this
medication should never be:
A. Taken with food.
B. Abruptly discontinued.
C. Taken in the morning.
D. Refrigerated.
Correct Answer: B
Rationale: Long-term steroid use suppresses the adrenal gland's natural
production of cortisol. Abrupt cessation can cause an Addisonian crisis
(adrenal insufficiency) leading to severe hypotension and shock.
9. The "first-pass effect" significantly impacts the bioavailability of which
route of administration?
, A. Intravenous (IV)
B. Intramuscular (IM)
C. Oral (PO)
D. Subcutaneous (SubQ)
Correct Answer: C
Rationale: Oral medications are absorbed through the GI tract and travel via
the portal vein directly to the liver, where a large percentage of the drug may
be metabolized and inactivated before reaching systemic circulation.
10. A patient develops a rapid, pounding heartbeat and headache after taking
nitroglycerin sublingual. The nurse recognizes this as:
A. A sign of anaphylactic shock.
B. An expected side effect of vasodilation.
C. A sign of medication toxicity.
D. A paradoxical reaction.
Correct Answer: B
Rationale: Nitroglycerin is a potent vasodilator. The rapid drop in blood
pressure triggers a sympathetic reflex, causing tachycardia and headache.
This is expected with the first few doses.
11. What is the therapeutic range for INR for a patient taking warfarin
(Coumadin) for atrial fibrillation?
A. 0.5 - 1.0
B. 1.5 - 2.0
C. 2.0 - 3.0
D. 3.5 - 4.5
Correct Answer: C
*Rationale: For most indications (afib, DVT treatment), the target INR is 2.0
to 3.0. For mechanical heart valves, the range is often higher (2.5-3.5). An
INR below 2.0 indicates risk of clotting; above 3.0 indicates risk of bleeding.*
12. A patient is receiving gentamicin IV. Which assessment finding is the
earliest indicator of nephrotoxicity?
(2026/2027) PDF | Nursing | Galen College, Exams of
Pharmacology
1. A patient is prescribed furosemide (Lasix) 40 mg IV push. The nurse knows
this medication is classified as:
A. Thiazide diuretic
B. Potassium-sparing diuretic
C. Loop diuretic
D. Osmotic diuretic
Correct Answer: C
Rationale: Furosemide is the prototype loop diuretic. It acts on the thick
ascending limb of the Loop of Henle to block sodium and chloride
reabsorption, resulting in profound diuresis.
2. A patient taking spironolactone (Aldactone) should be advised to avoid
which of the following due to the risk of hyperkalemia?
A. Bananas and oranges
B. White bread and pasta
C. Cheddar cheese
D. Caffeine
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic. Consuming
potassium-rich foods (bananas, oranges, potatoes, tomatoes) increases the
risk of life-threatening hyperkalemia.
3. A nurse is preparing to administer digoxin and furosemide to a patient
with heart failure. Which lab value is most critical to assess prior to
administration?
A. Serum Calcium
B. Serum Potassium
,C. Blood Urea Nitrogen (BUN)
D. Platelet Count
Correct Answer: B
Rationale: Hypokalemia (low potassium) caused by furosemide increases the
risk of digoxin toxicity. The nurse must ensure potassium levels are within
normal range before giving these medications together.
4. What is the primary site of drug metabolism in the body?
A. Kidneys
B. Lungs
C. Liver
D. Small Intestine
Correct Answer: C
*Rationale: The liver is the primary site for biotransformation (metabolism).
The cytochrome P450 enzyme system in the liver converts lipid-soluble
drugs into water-soluble metabolites for excretion.*
5. A patient with Type 1 diabetes is NPO for a surgical procedure. What is the
nurse's priority action regarding the patient's scheduled morning insulin
dose?
A. Administer the full dose of long-acting insulin as scheduled.
B. Hold all insulin until the patient returns from surgery.
C. Contact the healthcare provider for a specific insulin adjustment order.
D. Administer half the usual dose of regular insulin.
Correct Answer: C
Rationale: Insulin requirements change drastically when a patient is NPO.
Administering insulin without carbohydrate intake risks severe
hypoglycemia. The provider must give a specific order for that day.
6. A nurse is mixing Regular insulin and NPH insulin in one syringe. Which
action is correct?
A. Draw up the NPH (cloudy) first, then the Regular (clear).
B. Draw up the Regular (clear) first, then the NPH (cloudy).
,C. The order of drawing does not matter as long as it is injected immediately.
D. These two insulins cannot be mixed in the same syringe.
Correct Answer: B
Rationale: The mnemonic is "Clear before Cloudy." Regular insulin (clear) is
drawn up first to prevent contamination of the Regular insulin vial with the
NPH (cloudy) solution, which contains protamine.
7. A patient taking metformin (Glucophage) is scheduled for a CT scan with
IV contrast dye. What is the most important nursing action?
A. Administer the metformin with a full glass of water right before the scan.
B. Ensure the patient's blood sugar is below 200 mg/dL.
C. Hold the metformin for 48 hours prior to and after the procedure per
protocol.
D. Administer sodium bicarbonate before the scan.
Correct Answer: C
Rationale: IV contrast dye is nephrotoxic. Combining this with metformin
increases the risk of lactic acidosis and acute kidney injury. Metformin is
typically held 48 hours before and 48 hours after contrast procedures.
8. A patient has been taking an oral corticosteroid (prednisone) for 6 months
for an autoimmune disorder. The nurse teaches the patient that this
medication should never be:
A. Taken with food.
B. Abruptly discontinued.
C. Taken in the morning.
D. Refrigerated.
Correct Answer: B
Rationale: Long-term steroid use suppresses the adrenal gland's natural
production of cortisol. Abrupt cessation can cause an Addisonian crisis
(adrenal insufficiency) leading to severe hypotension and shock.
9. The "first-pass effect" significantly impacts the bioavailability of which
route of administration?
, A. Intravenous (IV)
B. Intramuscular (IM)
C. Oral (PO)
D. Subcutaneous (SubQ)
Correct Answer: C
Rationale: Oral medications are absorbed through the GI tract and travel via
the portal vein directly to the liver, where a large percentage of the drug may
be metabolized and inactivated before reaching systemic circulation.
10. A patient develops a rapid, pounding heartbeat and headache after taking
nitroglycerin sublingual. The nurse recognizes this as:
A. A sign of anaphylactic shock.
B. An expected side effect of vasodilation.
C. A sign of medication toxicity.
D. A paradoxical reaction.
Correct Answer: B
Rationale: Nitroglycerin is a potent vasodilator. The rapid drop in blood
pressure triggers a sympathetic reflex, causing tachycardia and headache.
This is expected with the first few doses.
11. What is the therapeutic range for INR for a patient taking warfarin
(Coumadin) for atrial fibrillation?
A. 0.5 - 1.0
B. 1.5 - 2.0
C. 2.0 - 3.0
D. 3.5 - 4.5
Correct Answer: C
*Rationale: For most indications (afib, DVT treatment), the target INR is 2.0
to 3.0. For mechanical heart valves, the range is often higher (2.5-3.5). An
INR below 2.0 indicates risk of clotting; above 3.0 indicates risk of bleeding.*
12. A patient is receiving gentamicin IV. Which assessment finding is the
earliest indicator of nephrotoxicity?
