NURS220 PHARMACOLOGY PRACTICE EXAM
2026 | VERIFIED Q&A WITH RATIONALES
• This 200-question verified practice exam covers all core NURS220 Pharmacology
topics with bold answers and detailed EXPERT RATIONALE — ideal for self-testing,
timed mock exams, or targeted topic review.
• Use this material by attempting each question independently before checking the
correct answer and EXPERT RATIONALE, focusing extra review time on any topic
area where you score below 70%.
NURS220 PHARMACOLOGY PRACTICE EXAM 2026 | VERIFIED Q&A WITH EXPERT
RATIONALE
1. A nurse is preparing to administer a drug with a narrow therapeutic index.
Which action is most important?
A. Administer the drug with food to enhance absorption
B. Double the prescribed dose to ensure therapeutic effect
C. Monitor the patient's serum drug levels closely
D. Switch to an over-the-counter alternative
E. Administer the drug only at bedtime
CORRECT ANSWER: C. Monitor the patient's serum drug levels closely
EXPERT RATIONALE: Drugs with a narrow therapeutic index have a small margin
between therapeutic and toxic doses. Close monitoring of serum levels ensures the drug
remains within the safe and effective range, preventing toxicity.
2. Which pharmacokinetic process refers to the movement of a drug from the
bloodstream into body tissues?
A. Absorption
B. Metabolism
,C. Excretion
D. Distribution
E. Elimination
CORRECT ANSWER: D. Distribution
EXPERT RATIONALE: Distribution is the process by which a drug moves from the
systemic circulation into body tissues and fluids. It is influenced by factors such as blood
flow, protein binding, and tissue permeability.
3. A patient is prescribed a drug that undergoes first-pass metabolism. The
nurse understands that this means the drug:
A. Is eliminated unchanged through the kidneys
B. Is significantly metabolized by the liver before reaching systemic circulation
C. Must be administered intravenously to be effective
D. Has a very long half-life
E. Requires renal dose adjustment only
CORRECT ANSWER: B. Is significantly metabolized by the liver before
reaching systemic circulation
EXPERT RATIONALE: First-pass metabolism (first-pass effect) occurs when an orally
administered drug is absorbed from the GI tract and passes through the portal
circulation to the liver, where it is partially or extensively metabolized before reaching
systemic circulation, reducing bioavailability.
4. A nurse is administering morphine to a patient in pain. Which assessment
finding requires immediate intervention?
A. Respiratory rate of 8 breaths per minute
B. Pain score of 6/10
,C. Blood pressure of 118/76 mmHg
D. Heart rate of 72 beats per minute
E. Oxygen saturation of 97%
CORRECT ANSWER: A. Respiratory rate of 8 breaths per minute
EXPERT RATIONALE: Opioids such as morphine cause CNS and respiratory depression. A
respiratory rate below 12 breaths per minute indicates significant respiratory depression
and requires immediate intervention, including possible administration of naloxone
(Narcan).
5. Which drug is the antidote for acetaminophen overdose?
A. Naloxone
B. Flumazenil
C. Atropine
D. N-acetylcysteine (NAC)
E. Protamine sulfate
CORRECT ANSWER: D. N-acetylcysteine (NAC)
EXPERT RATIONALE: N-acetylcysteine replenishes glutathione stores in the liver, which
are depleted during acetaminophen (paracetamol) overdose. It prevents hepatotoxicity
by neutralizing the toxic metabolite NAPQI.
6. A patient is receiving heparin therapy. Which laboratory value does the
nurse monitor to evaluate its effectiveness?
A. PT/INR
B. Platelet count
C. aPTT
D. Serum creatinine
, E. Hemoglobin
CORRECT ANSWER: C. aPTT
EXPERT RATIONALE: Heparin's anticoagulant effect is monitored using the activated
partial thromboplastin time (aPTT). The therapeutic goal is typically 1.5–2.5 times the
control value. PT/INR is used to monitor warfarin therapy.
7. A nurse is teaching a patient about warfarin. Which food should the patient
be advised to keep consistent in their diet?
A. High-sodium foods
B. Vitamin K-rich foods such as leafy green vegetables
C. High-fat dairy products
D. Citrus fruits
E. Red meat
CORRECT ANSWER: B. Vitamin K-rich foods such as leafy green vegetables
EXPERT RATIONALE: Vitamin K antagonizes warfarin's anticoagulant effect. Patients do
not need to avoid vitamin K entirely but should maintain a consistent intake so that INR
levels remain stable and predictable.
8. Which class of drugs works by inhibiting the enzyme HMG-CoA reductase?
A. Fibrates
B. Bile acid sequestrants
C. Statins
D. Niacin derivatives
E. Omega-3 fatty acids
CORRECT ANSWER: C. Statins
2026 | VERIFIED Q&A WITH RATIONALES
• This 200-question verified practice exam covers all core NURS220 Pharmacology
topics with bold answers and detailed EXPERT RATIONALE — ideal for self-testing,
timed mock exams, or targeted topic review.
• Use this material by attempting each question independently before checking the
correct answer and EXPERT RATIONALE, focusing extra review time on any topic
area where you score below 70%.
NURS220 PHARMACOLOGY PRACTICE EXAM 2026 | VERIFIED Q&A WITH EXPERT
RATIONALE
1. A nurse is preparing to administer a drug with a narrow therapeutic index.
Which action is most important?
A. Administer the drug with food to enhance absorption
B. Double the prescribed dose to ensure therapeutic effect
C. Monitor the patient's serum drug levels closely
D. Switch to an over-the-counter alternative
E. Administer the drug only at bedtime
CORRECT ANSWER: C. Monitor the patient's serum drug levels closely
EXPERT RATIONALE: Drugs with a narrow therapeutic index have a small margin
between therapeutic and toxic doses. Close monitoring of serum levels ensures the drug
remains within the safe and effective range, preventing toxicity.
2. Which pharmacokinetic process refers to the movement of a drug from the
bloodstream into body tissues?
A. Absorption
B. Metabolism
,C. Excretion
D. Distribution
E. Elimination
CORRECT ANSWER: D. Distribution
EXPERT RATIONALE: Distribution is the process by which a drug moves from the
systemic circulation into body tissues and fluids. It is influenced by factors such as blood
flow, protein binding, and tissue permeability.
3. A patient is prescribed a drug that undergoes first-pass metabolism. The
nurse understands that this means the drug:
A. Is eliminated unchanged through the kidneys
B. Is significantly metabolized by the liver before reaching systemic circulation
C. Must be administered intravenously to be effective
D. Has a very long half-life
E. Requires renal dose adjustment only
CORRECT ANSWER: B. Is significantly metabolized by the liver before
reaching systemic circulation
EXPERT RATIONALE: First-pass metabolism (first-pass effect) occurs when an orally
administered drug is absorbed from the GI tract and passes through the portal
circulation to the liver, where it is partially or extensively metabolized before reaching
systemic circulation, reducing bioavailability.
4. A nurse is administering morphine to a patient in pain. Which assessment
finding requires immediate intervention?
A. Respiratory rate of 8 breaths per minute
B. Pain score of 6/10
,C. Blood pressure of 118/76 mmHg
D. Heart rate of 72 beats per minute
E. Oxygen saturation of 97%
CORRECT ANSWER: A. Respiratory rate of 8 breaths per minute
EXPERT RATIONALE: Opioids such as morphine cause CNS and respiratory depression. A
respiratory rate below 12 breaths per minute indicates significant respiratory depression
and requires immediate intervention, including possible administration of naloxone
(Narcan).
5. Which drug is the antidote for acetaminophen overdose?
A. Naloxone
B. Flumazenil
C. Atropine
D. N-acetylcysteine (NAC)
E. Protamine sulfate
CORRECT ANSWER: D. N-acetylcysteine (NAC)
EXPERT RATIONALE: N-acetylcysteine replenishes glutathione stores in the liver, which
are depleted during acetaminophen (paracetamol) overdose. It prevents hepatotoxicity
by neutralizing the toxic metabolite NAPQI.
6. A patient is receiving heparin therapy. Which laboratory value does the
nurse monitor to evaluate its effectiveness?
A. PT/INR
B. Platelet count
C. aPTT
D. Serum creatinine
, E. Hemoglobin
CORRECT ANSWER: C. aPTT
EXPERT RATIONALE: Heparin's anticoagulant effect is monitored using the activated
partial thromboplastin time (aPTT). The therapeutic goal is typically 1.5–2.5 times the
control value. PT/INR is used to monitor warfarin therapy.
7. A nurse is teaching a patient about warfarin. Which food should the patient
be advised to keep consistent in their diet?
A. High-sodium foods
B. Vitamin K-rich foods such as leafy green vegetables
C. High-fat dairy products
D. Citrus fruits
E. Red meat
CORRECT ANSWER: B. Vitamin K-rich foods such as leafy green vegetables
EXPERT RATIONALE: Vitamin K antagonizes warfarin's anticoagulant effect. Patients do
not need to avoid vitamin K entirely but should maintain a consistent intake so that INR
levels remain stable and predictable.
8. Which class of drugs works by inhibiting the enzyme HMG-CoA reductase?
A. Fibrates
B. Bile acid sequestrants
C. Statins
D. Niacin derivatives
E. Omega-3 fatty acids
CORRECT ANSWER: C. Statins
