(2026/2027) PDF | Nursing | Galen College
1. A nurse is preparing to administer a drug that has a
high first-pass effect. Which route would be least
effective for this medication?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Answer: C. Oral
Rationale: The first-pass effect involves hepatic
metabolism of a drug before it reaches systemic
circulation. Oral drugs are absorbed from the GI tract
and travel via the portal vein to the liver, where
significant metabolism can occur, reducing bioavailability.
2. A patient’s drug has a half-life of 12 hours. How long
will it take for the drug to reach steady state?
A. 24 hours
1
,B. 36 hours
C. 60 hours
D. 120 hours
Answer: C. 60 hours
Rationale: Steady state is achieved after approximately
4–5 half-lives. 12 × 5 = 60 hours.
3. Which term describes the amount of drug needed to
produce a therapeutic effect?
A. Potency
B. Efficacy
C. Toxicity
D. Half-life
Answer: A. Potency
Rationale: Potency refers to the dose required to achieve
a specific effect. Efficacy is the maximum effect a drug
can produce.
4. A nurse administers naloxone to a patient with
respiratory depression caused by morphine overdose.
2
,This is an example of:
A. Partial agonist
B. Antagonist
C. Synergism
D. Potentiation
Answer: B. Antagonist
Rationale: Naloxone is an opioid antagonist that blocks
opioid receptors, reversing the effects of morphine.
5. Which patient assessment is most critical before
administering a drug with a narrow therapeutic index?
A. Weight
B. Liver function tests
C. Serum drug levels
D. Allergy history
Answer: C. Serum drug levels
Rationale: Narrow therapeutic index drugs (e.g., digoxin,
warfarin, phenytoin) require monitoring of serum levels to
avoid toxicity.
3
, 6. A drug that causes a teratogenic effect is most
dangerous during which period of pregnancy?
A. First trimester
B. Second trimester
C. Third trimester
D. Labor and delivery
Answer: A. First trimester
Rationale: Organogenesis occurs during the first trimester,
making the fetus most vulnerable to teratogens.
7. The nurse understands that drug tolerance refers to:
A. An allergic reaction after repeated doses
B. Decreased response requiring higher dose for same
effect
C. Accumulation of drug in fatty tissues
D. Increased metabolism due to liver disease
Answer: B. Decreased response requiring higher dose for
same effect
4