NUR 524 Pharmacology for AMNP Practice
Exam 2026/2027: Verified Questions &
Answers With Rationales | Instant PDF
Download
### Section 1: Pharmacokinetics & Pharmacodynamics
(Questions 1-20)
**1.** A nurse is reviewing the four phases of pharmacokinetics.
Which sequence represents the correct order of these phases?
A) Metabolism, Absorption, Distribution, Excretion
B) **Absorption, Distribution, Metabolism, Excretion**
C) Distribution, Absorption, Metabolism, Excretion
D) Absorption, Metabolism, Distribution, Excretion
**CORRECT ANSWER: B**
*EXPLANATION: The four phases of pharmacokinetics follow a
specific order: Absorption (drug enters bloodstream),
Distribution (drug moves to tissues), Metabolism (drug is broken
down, primarily in the liver), and Excretion (drug is eliminated,
primarily via kidneys). This sequence is often remembered by the
acronym ADME.*
**2.** A drug that is administered intravenously reaches the
bloodstream:
,A) Slowly over 30 minutes
B) **Immediately and completely**
C) Only after passing through the liver
D) After gastric absorption
**CORRECT ANSWER: B**
*EXPLANATION: IV administration places the drug directly into
the bloodstream, achieving 100% bioavailability and immediate
onset of action. There is no absorption phase, making IV the route
of choice for emergencies or when precise dosing is required.*
**3.** The term "first-pass effect" refers to:
A) The first dose of a medication given to a patient
B) **The rapid metabolism of an orally administered drug by the
liver before it reaches systemic circulation**
C) The initial binding of a drug to plasma proteins
D) The first sign of a drug's therapeutic effect
**CORRECT ANSWER: B**
*EXPLANATION: The first-pass effect occurs when orally
administered drugs are absorbed from the GI tract and carried via
the portal vein to the liver, where they may be extensively
metabolized before reaching systemic circulation. This reduces
bioavailability and explains why some drugs cannot be given
orally (e.g., lidocaine).*
,**4.** A patient asks why their oral medication must be taken on
an empty stomach. The nurse explains that food can affect:
A) Drug excretion only
B) **Drug absorption by delaying gastric emptying or binding to
the drug**
C) Drug metabolism in the liver
D) Protein binding exclusively
**CORRECT ANSWER: B**
*EXPLANATION: Food can significantly impact drug absorption.
It may delay gastric emptying (slowing absorption), bind to the
drug (reducing bioavailability), or alter gastric pH. Some drugs
require an empty stomach for optimal absorption; others should
be taken with food to reduce GI irritation.*
**5.** A patient with liver failure is prescribed a medication that
is extensively metabolized by the liver. The nurse anticipates that
the patient may require:
A) A higher dose of the medication
B) **A lower dose or longer dosing interval**
C) IV administration instead of oral
D) No change in dosing
**CORRECT ANSWER: B**
*EXPLANATION: Liver failure impairs drug metabolism, leading
to drug accumulation and increased risk of toxicity. Doses
typically need reduction or extended intervals. This is why liver
, function tests (AST, ALT) guide dosing for hepatically cleared
medications.*
**6.** Which organ is primarily responsible for drug excretion?
A) Liver
B) **Kidney**
C) Lungs
D) Skin
**CORRECT ANSWER: B**
*EXPLANATION: The kidneys are the primary organs of drug
excretion. Most drugs and their metabolites are eliminated via
urine through glomerular filtration and tubular secretion.
Impaired renal function requires dose adjustments to prevent
accumulation and toxicity.*
**7.** A patient with chronic kidney disease (CKD) is prescribed a
medication that is renally excreted. The nurse should monitor for:
A) Decreased therapeutic effect
B) **Signs of drug toxicity due to accumulation**
C) Allergic reaction
D) Rapid drug metabolism
**CORRECT ANSWER: B**
*EXPLANATION: When renal function is impaired, renally
excreted drugs are not effectively cleared from the body, leading
Exam 2026/2027: Verified Questions &
Answers With Rationales | Instant PDF
Download
### Section 1: Pharmacokinetics & Pharmacodynamics
(Questions 1-20)
**1.** A nurse is reviewing the four phases of pharmacokinetics.
Which sequence represents the correct order of these phases?
A) Metabolism, Absorption, Distribution, Excretion
B) **Absorption, Distribution, Metabolism, Excretion**
C) Distribution, Absorption, Metabolism, Excretion
D) Absorption, Metabolism, Distribution, Excretion
**CORRECT ANSWER: B**
*EXPLANATION: The four phases of pharmacokinetics follow a
specific order: Absorption (drug enters bloodstream),
Distribution (drug moves to tissues), Metabolism (drug is broken
down, primarily in the liver), and Excretion (drug is eliminated,
primarily via kidneys). This sequence is often remembered by the
acronym ADME.*
**2.** A drug that is administered intravenously reaches the
bloodstream:
,A) Slowly over 30 minutes
B) **Immediately and completely**
C) Only after passing through the liver
D) After gastric absorption
**CORRECT ANSWER: B**
*EXPLANATION: IV administration places the drug directly into
the bloodstream, achieving 100% bioavailability and immediate
onset of action. There is no absorption phase, making IV the route
of choice for emergencies or when precise dosing is required.*
**3.** The term "first-pass effect" refers to:
A) The first dose of a medication given to a patient
B) **The rapid metabolism of an orally administered drug by the
liver before it reaches systemic circulation**
C) The initial binding of a drug to plasma proteins
D) The first sign of a drug's therapeutic effect
**CORRECT ANSWER: B**
*EXPLANATION: The first-pass effect occurs when orally
administered drugs are absorbed from the GI tract and carried via
the portal vein to the liver, where they may be extensively
metabolized before reaching systemic circulation. This reduces
bioavailability and explains why some drugs cannot be given
orally (e.g., lidocaine).*
,**4.** A patient asks why their oral medication must be taken on
an empty stomach. The nurse explains that food can affect:
A) Drug excretion only
B) **Drug absorption by delaying gastric emptying or binding to
the drug**
C) Drug metabolism in the liver
D) Protein binding exclusively
**CORRECT ANSWER: B**
*EXPLANATION: Food can significantly impact drug absorption.
It may delay gastric emptying (slowing absorption), bind to the
drug (reducing bioavailability), or alter gastric pH. Some drugs
require an empty stomach for optimal absorption; others should
be taken with food to reduce GI irritation.*
**5.** A patient with liver failure is prescribed a medication that
is extensively metabolized by the liver. The nurse anticipates that
the patient may require:
A) A higher dose of the medication
B) **A lower dose or longer dosing interval**
C) IV administration instead of oral
D) No change in dosing
**CORRECT ANSWER: B**
*EXPLANATION: Liver failure impairs drug metabolism, leading
to drug accumulation and increased risk of toxicity. Doses
typically need reduction or extended intervals. This is why liver
, function tests (AST, ALT) guide dosing for hepatically cleared
medications.*
**6.** Which organ is primarily responsible for drug excretion?
A) Liver
B) **Kidney**
C) Lungs
D) Skin
**CORRECT ANSWER: B**
*EXPLANATION: The kidneys are the primary organs of drug
excretion. Most drugs and their metabolites are eliminated via
urine through glomerular filtration and tubular secretion.
Impaired renal function requires dose adjustments to prevent
accumulation and toxicity.*
**7.** A patient with chronic kidney disease (CKD) is prescribed a
medication that is renally excreted. The nurse should monitor for:
A) Decreased therapeutic effect
B) **Signs of drug toxicity due to accumulation**
C) Allergic reaction
D) Rapid drug metabolism
**CORRECT ANSWER: B**
*EXPLANATION: When renal function is impaired, renally
excreted drugs are not effectively cleared from the body, leading
