NUR 210 PHARMACOLOGY Actual Exam
2026/27 Complete Questions and Answers
| 100% Verified Detailed Rationales - Pass
Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Exam 1: Pharmacokinetics, Pharmacodynamics, and Medication Safety | Q1
– Q12
Section 2 | Exam 2: Autonomic Nervous System and Cardiovascular Drugs | Q13 – Q25
Section 3 | Exam 3: Antibiotics, Anti-infectives, and Respiratory Drugs | Q26 – Q37
Section 4 | Exam 4: Endocrine, Neurologic, and Psychiatric Medications | Q38 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: EXAM 1 — PHARMACOKINETICS, PHARMACODYNAMICS, AND
MEDICATION SAFETY Q1 – Q12
══════════════════════════════════════
Question 1 of 50
A 72-year-old patient with chronic heart failure is started on a new oral medication. The
nurse notes the patient's serum albumin level is 2.8 g/dL (low). The nurse should
recognize that this lab value most likely affects which pharmacokinetic process?
A. Absorption of the drug from the GI tract
B. Distribution of the drug to target tissues ✓ CORRECT
C. Metabolism of the drug by the liver
D. Excretion of the drug by the kidneys
Correct Answer: B
Rationale: Albumin is the primary plasma protein that binds many drugs; when albumin
is low, more free (unbound) drug remains in circulation, which increases the volume of
,distribution and can intensify drug effects. Absorption is not directly affected by serum
albumin levels, and metabolism and excretion are separate processes governed by
hepatic and renal function. This is especially important with highly protein-bound drugs
like warfarin, where low albumin can lead to toxicity.
Question 2 of 50
A 58-year-old patient with cirrhosis is prescribed lorazepam 1 mg PO at bedtime for
anxiety. The nurse knows that this patient's reduced hepatic function will most
significantly alter which phase of pharmacokinetics?
A. Absorption through the intestinal mucosa
B. Distribution into adipose tissue
C. Metabolism by hepatic enzymes ✓ CORRECT
D. Excretion via glomerular filtration
Correct Answer: C
Rationale: Lorazepam undergoes hepatic metabolism, and cirrhosis significantly
reduces the liver's ability to metabolize drugs through decreased enzyme activity and
impaired blood flow. Absorption and distribution are not primarily affected by cirrhosis,
and while some excretion pathways may be altered, metabolism is the most
significantly impacted phase. Nurses should anticipate lower starting doses and longer
dosing intervals in patients with liver disease.
Question 3 of 50
A nurse is preparing to administer digoxin 0.25 mg to a 68-year-old patient with atrial
fibrillation. Before giving the dose, the nurse checks the apical pulse and finds it to be
52 beats per minute. What is the nurse's priority action?
A. Administer the dose as ordered since the rhythm is regular
B. Hold the dose and notify the prescriber ✓ CORRECT
C. Recheck the pulse in 15 minutes and then administer
,D. Give half the dose and document the rationale
Correct Answer: B
Rationale: Digoxin slows the heart rate through its effects on the SA and AV nodes, and
a pulse below 60 bpm is a standard hold parameter due to the risk of bradycardia or
heart block. Administering the dose could worsen the bradycardia and lead to serious
conduction disturbances. Rechecking the pulse or giving a partial dose does not
address the immediate safety concern, and the prescriber must be notified to determine
the next steps.
Question 4 of 50
A 45-year-old patient receiving morphine via patient-controlled analgesia (PCA) pump
reports feeling dizzy and nauseated. The nurse assesses a respiratory rate of 10
breaths per minute and notes the patient is difficult to arouse. Which medication should
the nurse anticipate administering?
A. Flumazenil 0.2 mg IV
B. Naloxone 0.4 mg IV ✓ CORRECT
C. Naltrexone 50 mg PO
D. Acetylcysteine 140 mg/kg PO
Correct Answer: B
Naloxone is the specific opioid antagonist used to reverse respiratory depression and
sedation caused by morphine overdose or excessive dosing. Flumazenil reverses
benzodiazepine effects, naltrexone is an oral opioid antagonist used for maintenance
therapy and acts too slowly for acute reversal, and acetylcysteine is the antidote for
acetaminophen toxicity. The nurse should have naloxone readily available whenever
administering opioid analgesics.
Question 5 of 50
, A nurse is teaching a 35-year-old patient about a new prescription for warfarin 5 mg
daily. The patient asks why regular blood tests are necessary. Which response by the
nurse is most accurate?
A. "The blood tests monitor how well your kidneys are filtering the drug."
B. "We need to check your liver enzymes to prevent damage from the medication."
C. "The INR tells us if your blood is clotting too much or too little so we can adjust the
dose." ✓ CORRECT
D. "We are checking for signs of infection that the drug might cause."
Correct Answer: C
Rationale: Warfarin requires INR monitoring because its therapeutic window is narrow
and the drug's effect can vary with diet, other medications, and illness; the INR directly
measures the extrinsic pathway of coagulation that warfarin affects. Kidney function
tests and liver enzymes are important for other medications but do not guide warfarin
dosing, and warfarin does not cause infection. Patients should understand that
consistent INR monitoring is essential for both preventing clots and avoiding bleeding.
Question 6 of 50
A 62-year-old patient with renal impairment is prescribed gentamicin. The nurse reviews
the drug's pharmacokinetic profile and recognizes that the primary concern with this
patient is related to which process?
A. Increased absorption from the GI tract
B. Decreased protein binding in the plasma
C. Reduced renal excretion leading to drug accumulation ✓ CORRECT
D. Enhanced hepatic metabolism of the drug
Correct Answer: C
Rationale: Gentamicin is an aminoglycoside antibiotic that is eliminated almost entirely
by glomerular filtration; impaired renal function dramatically reduces clearance and
causes the drug to accumulate, increasing the risk of nephrotoxicity and ototoxicity.
2026/27 Complete Questions and Answers
| 100% Verified Detailed Rationales - Pass
Guaranteed - A+ Graded
TABLE OF CONTENTS
Section 1 | Exam 1: Pharmacokinetics, Pharmacodynamics, and Medication Safety | Q1
– Q12
Section 2 | Exam 2: Autonomic Nervous System and Cardiovascular Drugs | Q13 – Q25
Section 3 | Exam 3: Antibiotics, Anti-infectives, and Respiratory Drugs | Q26 – Q37
Section 4 | Exam 4: Endocrine, Neurologic, and Psychiatric Medications | Q38 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: EXAM 1 — PHARMACOKINETICS, PHARMACODYNAMICS, AND
MEDICATION SAFETY Q1 – Q12
══════════════════════════════════════
Question 1 of 50
A 72-year-old patient with chronic heart failure is started on a new oral medication. The
nurse notes the patient's serum albumin level is 2.8 g/dL (low). The nurse should
recognize that this lab value most likely affects which pharmacokinetic process?
A. Absorption of the drug from the GI tract
B. Distribution of the drug to target tissues ✓ CORRECT
C. Metabolism of the drug by the liver
D. Excretion of the drug by the kidneys
Correct Answer: B
Rationale: Albumin is the primary plasma protein that binds many drugs; when albumin
is low, more free (unbound) drug remains in circulation, which increases the volume of
,distribution and can intensify drug effects. Absorption is not directly affected by serum
albumin levels, and metabolism and excretion are separate processes governed by
hepatic and renal function. This is especially important with highly protein-bound drugs
like warfarin, where low albumin can lead to toxicity.
Question 2 of 50
A 58-year-old patient with cirrhosis is prescribed lorazepam 1 mg PO at bedtime for
anxiety. The nurse knows that this patient's reduced hepatic function will most
significantly alter which phase of pharmacokinetics?
A. Absorption through the intestinal mucosa
B. Distribution into adipose tissue
C. Metabolism by hepatic enzymes ✓ CORRECT
D. Excretion via glomerular filtration
Correct Answer: C
Rationale: Lorazepam undergoes hepatic metabolism, and cirrhosis significantly
reduces the liver's ability to metabolize drugs through decreased enzyme activity and
impaired blood flow. Absorption and distribution are not primarily affected by cirrhosis,
and while some excretion pathways may be altered, metabolism is the most
significantly impacted phase. Nurses should anticipate lower starting doses and longer
dosing intervals in patients with liver disease.
Question 3 of 50
A nurse is preparing to administer digoxin 0.25 mg to a 68-year-old patient with atrial
fibrillation. Before giving the dose, the nurse checks the apical pulse and finds it to be
52 beats per minute. What is the nurse's priority action?
A. Administer the dose as ordered since the rhythm is regular
B. Hold the dose and notify the prescriber ✓ CORRECT
C. Recheck the pulse in 15 minutes and then administer
,D. Give half the dose and document the rationale
Correct Answer: B
Rationale: Digoxin slows the heart rate through its effects on the SA and AV nodes, and
a pulse below 60 bpm is a standard hold parameter due to the risk of bradycardia or
heart block. Administering the dose could worsen the bradycardia and lead to serious
conduction disturbances. Rechecking the pulse or giving a partial dose does not
address the immediate safety concern, and the prescriber must be notified to determine
the next steps.
Question 4 of 50
A 45-year-old patient receiving morphine via patient-controlled analgesia (PCA) pump
reports feeling dizzy and nauseated. The nurse assesses a respiratory rate of 10
breaths per minute and notes the patient is difficult to arouse. Which medication should
the nurse anticipate administering?
A. Flumazenil 0.2 mg IV
B. Naloxone 0.4 mg IV ✓ CORRECT
C. Naltrexone 50 mg PO
D. Acetylcysteine 140 mg/kg PO
Correct Answer: B
Naloxone is the specific opioid antagonist used to reverse respiratory depression and
sedation caused by morphine overdose or excessive dosing. Flumazenil reverses
benzodiazepine effects, naltrexone is an oral opioid antagonist used for maintenance
therapy and acts too slowly for acute reversal, and acetylcysteine is the antidote for
acetaminophen toxicity. The nurse should have naloxone readily available whenever
administering opioid analgesics.
Question 5 of 50
, A nurse is teaching a 35-year-old patient about a new prescription for warfarin 5 mg
daily. The patient asks why regular blood tests are necessary. Which response by the
nurse is most accurate?
A. "The blood tests monitor how well your kidneys are filtering the drug."
B. "We need to check your liver enzymes to prevent damage from the medication."
C. "The INR tells us if your blood is clotting too much or too little so we can adjust the
dose." ✓ CORRECT
D. "We are checking for signs of infection that the drug might cause."
Correct Answer: C
Rationale: Warfarin requires INR monitoring because its therapeutic window is narrow
and the drug's effect can vary with diet, other medications, and illness; the INR directly
measures the extrinsic pathway of coagulation that warfarin affects. Kidney function
tests and liver enzymes are important for other medications but do not guide warfarin
dosing, and warfarin does not cause infection. Patients should understand that
consistent INR monitoring is essential for both preventing clots and avoiding bleeding.
Question 6 of 50
A 62-year-old patient with renal impairment is prescribed gentamicin. The nurse reviews
the drug's pharmacokinetic profile and recognizes that the primary concern with this
patient is related to which process?
A. Increased absorption from the GI tract
B. Decreased protein binding in the plasma
C. Reduced renal excretion leading to drug accumulation ✓ CORRECT
D. Enhanced hepatic metabolism of the drug
Correct Answer: C
Rationale: Gentamicin is an aminoglycoside antibiotic that is eliminated almost entirely
by glomerular filtration; impaired renal function dramatically reduces clearance and
causes the drug to accumulate, increasing the risk of nephrotoxicity and ototoxicity.
