NUR 210 Exams 1 Pharmacology (2026)
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2026\2027 update
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1. The nurse is preparing to administer an oral analgesic to a patient reporting
pain. Which form of the medication will have the most rapid onset of action?
A. Extended-release tablet
B. Enteric-coated capsule
C. Liquid suspension
D. Compressed powder tablet
Correct Answer: C. Liquid suspension
Expert Explanation: The rate of absorption directly impacts the onset of drug
action. Oral medications must first undergo disintegration (breakdown into
small particles) and dissolution (combining with liquid to form a solution)
before absorption can occur in the gastrointestinal tract . A liquid suspension
bypasses the disintegration and dissolution phases because the drug is already
in a soluble form, allowing for immediate absorption once it reaches the small
intestine. Tablets, capsules, and especially enteric-coated pills require time to
break down, delaying the therapeutic effect. Therefore, when rapid relief is
needed (such as for acute pain), liquid formulations are preferred over solid
oral dosage forms.
2. A patient with Type 1 Diabetes Mellitus asks why their insulin must be
injected rather than taken as a pill. Which response by the nurse is most
accurate?
A. "Insulin is destroyed by digestive enzymes in the stomach and intestines."
B. "Oral insulin causes severe liver damage due to the first-pass effect."
C. "Injected insulin works faster than any pill possibly could."
D. "The pill form is too expensive to manufacture and not cost-effective."
Correct Answer: A. "Insulin is destroyed by digestive enzymes in the stomach
and intestines."
Expert Explanation: Insulin is a protein-based hormone. When administered
orally, it would be treated like dietary protein by the body. The acidic
,environment of the stomach and proteolytic digestive enzymes in the
gastrointestinal tract would break down and destroy the insulin molecule before
it could be absorbed into the bloodstream . This renders the drug inactive.
While first-pass metabolism in the liver affects many oral drugs, proteins like
insulin never survive long enough in the GI tract to even reach the liver.
Therefore, parenteral routes (such as subcutaneous injection) are necessary to
bypass the GI tract entirely and deliver the intact drug to the circulation.
3. The nurse is caring for a patient with severe malnutrition and low serum
albumin levels. The patient requires a highly protein-bound medication. What is
the priority nursing consideration regarding drug dosing for this patient?
A. The patient will require a higher dose to achieve a therapeutic effect.
B. The patient is at increased risk for drug toxicity and adverse effects.
C. The drug will be excreted rapidly, requiring more frequent administration.
D. Malnutrition does not affect protein-binding capacity.
Correct Answer: B. The patient is at increased risk for drug toxicity and
adverse effects.
Expert Explanation: In the bloodstream, many drugs bind to plasma
proteins, primarily albumin. Bound drug molecules are pharmacologically
inactive. Only the "free" or unbound portion of the drug can exert a therapeutic
effect . When a patient has low albumin (hypoalbuminemia) due to malnutrition
or liver disease, there are fewer protein-binding sites available. Consequently, a
standard dose will result in a much higher percentage of free, active drug
circulating in the plasma. This significantly increases the risk of drug toxicity.
Nurses must monitor these patients closely for signs of adverse reactions, as
they may require a lower dose than a well-nourished patient.
4. A patient is being discharged with a prescription for an enteric-coated
potassium supplement. Which statement by the patient indicates a need for
further teaching?
A. "I should expect the medication to start working a little while after I take it."
B. "I cannot crush or chew this tablet."
C. "I should take this on an empty stomach with only water."
D. "This coating protects my stomach from irritation."
Correct Answer: C. "I should take this on an empty stomach with only water."
Expert Explanation: Enteric-coated tablets are designed with a special
coating that resists dissolution in the acidic pH of the stomach. Instead, they
pass into the more alkaline environment of the small intestine before
disintegrating . This is done to protect the stomach lining from irritating drugs
, or to protect the drug from being destroyed by stomach acid. There is an
inherent delay in the onset of action with these formulations. Patients must not
crush or chew these tablets, as this destroys the protective coating and leads to
premature drug release in the stomach. While food may delay gastric emptying,
there is no specific requirement to take all enteric-coated drugs on an empty
stomach; some are better tolerated with food.
5. The nurse administers a dose of intravenous (IV) pain medication. When
should the nurse plan to reassess the patient for peak effect?
A. Immediately after the injection
B. Within 30 to 60 minutes
C. 2 to 3 hours after administration
D. Right before the next scheduled dose
Correct Answer: B. Within 30 to 60 minutes
Expert Explanation: The peak effect refers to the time required for a drug to
reach its maximum therapeutic concentration in the bloodstream. The route of
administration dramatically affects this timing. Intravenous (IV) administration
introduces the drug directly into the circulation, bypassing the need for
absorption. Therefore, IV drugs have the fastest onset and reach their peak
concentration very quickly, generally within 30 to 60 minutes . In contrast, an
oral medication must undergo absorption through the GI tract, taking
significantly longer to reach peak levels, often 2 to 3 hours after ingestion . The
trough level is the lowest concentration, measured right before the next dose.
6. The nurse is preparing to administer a new oral medication. The patient
states, "I can't swallow pills whole, I always chew them." What is the nurse's first
and most appropriate action?
A. Document the patient's preference and allow them to chew the pill.
B. Crush the medication and mix it into a small amount of applesauce.
C. Hold the medication and verify if it is safe to crush or chew.
D. Instruct the patient that they must learn to swallow pills whole.
Correct Answer: C. Hold the medication and verify if it is safe to crush or
chew.
Expert Explanation: Altering the form of an oral medication by crushing or
chewing it can have serious and unintended consequences. It can destroy
enteric coatings, leading to gastric irritation, or disrupt extended-release
mechanisms, causing a rapid and potentially toxic "dose dumping" of the entire
drug supply into the bloodstream at once . The nurse's first action must always
be patient safety. The medication should be held until the nurse can consult a
PDF | Galen College of Nursing Questions
and Ansẉers with
Expert-Verified Explanation
2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
, Expert-Verified Explanation
Verified ẉith trusted textbooks
───────────────────────────────────────────────────────
─
1. The nurse is preparing to administer an oral analgesic to a patient reporting
pain. Which form of the medication will have the most rapid onset of action?
A. Extended-release tablet
B. Enteric-coated capsule
C. Liquid suspension
D. Compressed powder tablet
Correct Answer: C. Liquid suspension
Expert Explanation: The rate of absorption directly impacts the onset of drug
action. Oral medications must first undergo disintegration (breakdown into
small particles) and dissolution (combining with liquid to form a solution)
before absorption can occur in the gastrointestinal tract . A liquid suspension
bypasses the disintegration and dissolution phases because the drug is already
in a soluble form, allowing for immediate absorption once it reaches the small
intestine. Tablets, capsules, and especially enteric-coated pills require time to
break down, delaying the therapeutic effect. Therefore, when rapid relief is
needed (such as for acute pain), liquid formulations are preferred over solid
oral dosage forms.
2. A patient with Type 1 Diabetes Mellitus asks why their insulin must be
injected rather than taken as a pill. Which response by the nurse is most
accurate?
A. "Insulin is destroyed by digestive enzymes in the stomach and intestines."
B. "Oral insulin causes severe liver damage due to the first-pass effect."
C. "Injected insulin works faster than any pill possibly could."
D. "The pill form is too expensive to manufacture and not cost-effective."
Correct Answer: A. "Insulin is destroyed by digestive enzymes in the stomach
and intestines."
Expert Explanation: Insulin is a protein-based hormone. When administered
orally, it would be treated like dietary protein by the body. The acidic
,environment of the stomach and proteolytic digestive enzymes in the
gastrointestinal tract would break down and destroy the insulin molecule before
it could be absorbed into the bloodstream . This renders the drug inactive.
While first-pass metabolism in the liver affects many oral drugs, proteins like
insulin never survive long enough in the GI tract to even reach the liver.
Therefore, parenteral routes (such as subcutaneous injection) are necessary to
bypass the GI tract entirely and deliver the intact drug to the circulation.
3. The nurse is caring for a patient with severe malnutrition and low serum
albumin levels. The patient requires a highly protein-bound medication. What is
the priority nursing consideration regarding drug dosing for this patient?
A. The patient will require a higher dose to achieve a therapeutic effect.
B. The patient is at increased risk for drug toxicity and adverse effects.
C. The drug will be excreted rapidly, requiring more frequent administration.
D. Malnutrition does not affect protein-binding capacity.
Correct Answer: B. The patient is at increased risk for drug toxicity and
adverse effects.
Expert Explanation: In the bloodstream, many drugs bind to plasma
proteins, primarily albumin. Bound drug molecules are pharmacologically
inactive. Only the "free" or unbound portion of the drug can exert a therapeutic
effect . When a patient has low albumin (hypoalbuminemia) due to malnutrition
or liver disease, there are fewer protein-binding sites available. Consequently, a
standard dose will result in a much higher percentage of free, active drug
circulating in the plasma. This significantly increases the risk of drug toxicity.
Nurses must monitor these patients closely for signs of adverse reactions, as
they may require a lower dose than a well-nourished patient.
4. A patient is being discharged with a prescription for an enteric-coated
potassium supplement. Which statement by the patient indicates a need for
further teaching?
A. "I should expect the medication to start working a little while after I take it."
B. "I cannot crush or chew this tablet."
C. "I should take this on an empty stomach with only water."
D. "This coating protects my stomach from irritation."
Correct Answer: C. "I should take this on an empty stomach with only water."
Expert Explanation: Enteric-coated tablets are designed with a special
coating that resists dissolution in the acidic pH of the stomach. Instead, they
pass into the more alkaline environment of the small intestine before
disintegrating . This is done to protect the stomach lining from irritating drugs
, or to protect the drug from being destroyed by stomach acid. There is an
inherent delay in the onset of action with these formulations. Patients must not
crush or chew these tablets, as this destroys the protective coating and leads to
premature drug release in the stomach. While food may delay gastric emptying,
there is no specific requirement to take all enteric-coated drugs on an empty
stomach; some are better tolerated with food.
5. The nurse administers a dose of intravenous (IV) pain medication. When
should the nurse plan to reassess the patient for peak effect?
A. Immediately after the injection
B. Within 30 to 60 minutes
C. 2 to 3 hours after administration
D. Right before the next scheduled dose
Correct Answer: B. Within 30 to 60 minutes
Expert Explanation: The peak effect refers to the time required for a drug to
reach its maximum therapeutic concentration in the bloodstream. The route of
administration dramatically affects this timing. Intravenous (IV) administration
introduces the drug directly into the circulation, bypassing the need for
absorption. Therefore, IV drugs have the fastest onset and reach their peak
concentration very quickly, generally within 30 to 60 minutes . In contrast, an
oral medication must undergo absorption through the GI tract, taking
significantly longer to reach peak levels, often 2 to 3 hours after ingestion . The
trough level is the lowest concentration, measured right before the next dose.
6. The nurse is preparing to administer a new oral medication. The patient
states, "I can't swallow pills whole, I always chew them." What is the nurse's first
and most appropriate action?
A. Document the patient's preference and allow them to chew the pill.
B. Crush the medication and mix it into a small amount of applesauce.
C. Hold the medication and verify if it is safe to crush or chew.
D. Instruct the patient that they must learn to swallow pills whole.
Correct Answer: C. Hold the medication and verify if it is safe to crush or
chew.
Expert Explanation: Altering the form of an oral medication by crushing or
chewing it can have serious and unintended consequences. It can destroy
enteric coatings, leading to gastric irritation, or disrupt extended-release
mechanisms, causing a rapid and potentially toxic "dose dumping" of the entire
drug supply into the bloodstream at once . The nurse's first action must always
be patient safety. The medication should be held until the nurse can consult a
