NURS 508 EXAM QUESTIONS WITH ANSWERS
GRADED A+ (2025/2026)
Chapter .1
1. Clinical .judgment .in .prescribing .includes:
1 Factoring .in .the .cost .to .the .patient .of .the .medication .prescribed
2 Always .prescribing .the .newest .medication .available .for .the .disease .process
3 Handing .out .drug .samples .to .poor .patients
4 Prescribing .all .generic .medications .to .cut .costs
2. The .benefits .to .the .patient .of .having .an .Advanced .Practice .Registered .Nurse .(APRN) .prescriber .include:
1. Nurses .know .more .about .Pharmacology .than .other .prescribers .because .they .take
.it .both .in .their .basic .nursing .program .and .in .their .APRN .program.
2. Nurses .care .for .the .patient .from .a .holistic .approach .and .include .the
.patient .in .decision .making .regarding .their .care.
3. APRNs .are .less .likely .to .prescribe .narcotics .and .other .controlled .substances.
4. APRNs .are .able .to .prescribe .independently .in .all .states, .whereas .a
.physician’s .assistant .needs .to .have .a .physician .supervising .their
.practice.
3. Criteria .for .choosing .an .effective .drug .for .a .disorder .include:
1. Asking .the .patient .what .drug .they .think .would .work .best .for .them
2. Consulting .nationally .recognized .guidelines .for .disease .management
3. Prescribing .medications .that .are .available .as .samples .before .writing .a .prescription
4. Following .U.S. .Drug .Enforcement .Administration .guidelines .for .prescribing
4. Nurse .practitioner .prescriptive .authority .is .regulated .by:
1. The .National .Council .of .State .Boards .of .Nursing
.
2. The .U.S. .Drug .Enforcement .Administration
.
3. The .State .Board .of .Nursing .for .each .state
.
5. The .State .Board .of .Pharmacy
1. Nurse .practitioner .practice .may .thrive .under .health-care .reform .because .of:
1. The .demonstrated .ability .of .nurse .practitioners .to .control .costs
.and .improve .patient .outcomes
2. The .fact .that .nurse .practitioners .will .be .able .to .practice .independently
3. The .fact .that .nurse .practitioners .will .have .full .reimbursement .under
.health- .care .reform
4. The .ability .to .shift .accountability .for .Medicaid .to .the .state .level
Chapter .2. .Review .of .Basic .Principles .of .Pharmacology
,1.A patient’s .nutritional .intake .and .laboratory .results .reflect .hypoalbuminemia. .This .is .critical
.to .prescribing .because:
1. Distribution .of .drugs .to .target .tissue .may .be .affected.
2. The .solubility .of .the .drug .will .not .match .the .site .of .absorption.
3. There .will .be .less .free .drug .available .to .generate .an .effect.
, 4. Drugs .bound .to .albumin .are .readily .excreted .by .the .kidneys.
2. Drugs .that .have .a .significant .first-pass .effect:
1. Must .be .given .by .the .enteral .(oral) .route .only
2. Bypass .the .hepatic .circulation
3. Are .rapidly .metabolized .by .the .liver .and .may .have .little .if .any .desired .action
4. Are .converted .by .the .liver .to .more .active .and .fat-soluble .forms
3. The .route .of .excretion .of .a .volatile .drug .will .likely .be .the:
1. Kidneys
2. Lungs
3. Bile .and .feces
4. Skin
4. Medroxyprogesterone .(Depo .Provera) .is .prescribed .intramuscularly .(IM) .to .create .a .storage .reservoir
.of .the .drug. .Storage .reservoirs:
1. Assure .that .the .drug .will .reach .its .intended .target .tissue
2. Are .the .reason .for .giving .loading .doses
3. Increase .the .length .of .time .a .drug .is .available .and .active
4. Are .most .common .in .collagen .tissues
5. The .NP .chooses .to .give .cephalexin .every .8 .hours .based .on .knowledge .of .the .drug’s:
1. Propensity .to .go .to .the .target .receptor
2. Biological .half-life
3. Pharmacodynamics
4. Safety .and .side .effects
6. Azithromycin .dosing .requires .that .the .first .day’s .dosage .be .twice .those .of .the .other .4 .days
.of .the .prescription. .This .is .considered .a .loading .dose. .A .loading .dose:
1. Rapidly .achieves .drug .levels .in .the .therapeutic .range
2. Requires .four- .to .five-half-lives .to .attain
3. Is .influenced .by .renal .function
4. Is .directly .related .to .the .drug .circulating .to .the .target .tissues
7. The .point .in .time .on .the .drug .concentration .curve .that .indicates .the .first .sign .of .a .therapeutic .effect .is .the:
1. Minimum .adverse .effect .level
2. Peak .of .action
3. Onset .of .action
4. Therapeutic .range
8. Phenytoin .requires .that .a .trough .level .be .drawn. .Peak .and .trough .levels .are .done:
1. When .the .drug .has .a .wide .therapeutic .range
2. When .the .drug .will .be .administered .for .a .short .time .only
3. When .there .is .a .high .correlation .between .the .dose .and .saturation .of .receptor .sites
4. To .determine .if .a .drug .is .in .the .therapeutic .range
9. A .laboratory .result .indicates .that .the .peak .level .for .a .drug .is .above .the .minimum .toxic .concentration.
.This .means .that .the:
1. Concentration .will .produce .therapeutic .effects
, 2. Concentration .will .produce .an .adverse .response
3. Time .between .doses .must .be .shortened
4. Duration .of .action .of .the .drug .is .too .long
10. Drugs .that .are .receptor .agonists .may .demonstrate .what .property?
1. Irreversible .binding .to .the .drug .receptor .site
2. Upregulation .with .chronic .use
3. Desensitization .or .downregulation .with .continuous .use
4. Inverse .relationship .between .drug .concentration .and .drug .action
11. Drugs .that .are .receptor .antagonists, .such .as .beta .blockers, .may .cause:
1. Downregulation .of .the .drug .receptor
2. An .exaggerated .response .if .abruptly .discontinued
3. Partial .blockade .of .the .effects .of .agonist .drugs
4. An .exaggerated .response .to .competitive .drug .agonists
12. Factors .that .affect .gastric .drug .absorption .include:
1. Liver .enzyme .activity
2. Protein-binding .properties .of .the .drug .molecule
3. Lipid .solubility .of .the .drug
4. Ability .to .chew .and .swallow
13. Drugs .administered .via .IV:
1. Need .to .be .lipid .soluble .in .order .to .be .easily .absorbed
2. Begin .distribution .into .the .body .immediately
3. Are .easily .absorbed .if .they .are .nonionized
4. May .use .pinocytosis .to .be .absorbed
14. When .a .medication .is .added .to .a .regimen .for .a .synergistic .effect, .the .combined .effect .of .the .drugs .is:
1. The .sum .of .the .effects .of .each .drug .individually
2. Greater .than .the .sum .of .the .effects .of .each .drug .individually
3. Less .than .the .effect .of .each .drug .individually
4. Not .predictable, .as .it .varies .with .each .individual
15. Which .of .the .following .statements .about .bioavailability .is .true?
1. Bioavailability .issues .are .especially .important .for .drugs
.with .narrow .therapeutic .ranges .or .sustained-release
.mechanisms.
2. All .brands .of .a .drug .have .the .same .bioavailability.
3. Drugs .that .are .administered .more .than .once .a .day .have .greater
.bioavailability .than .drugs .given .once .daily.
4. Combining .an .active .drug .with .an .inert .substance .does .not .affect .bioavailability.
16. Which .of .the .following .statements .about .the .major .distribution .barriers .(blood-brain .or .fetal-placental)
.is .true?
1. Water .soluble .and .ionized .drugs .cross .these .barriers .rapidly.
2. The .blood-brain .barrier .slows .the .entry .of .many .drugs .into .and
.from .brain .cells.
3. The .fetal-placental .barrier .protects .the .fetus .from .drugs .taken .by .the .mother.
4. Lipid-soluble .drugs .do .not .pass .these .barriers .and .are .safe .for .pregnant .women.
GRADED A+ (2025/2026)
Chapter .1
1. Clinical .judgment .in .prescribing .includes:
1 Factoring .in .the .cost .to .the .patient .of .the .medication .prescribed
2 Always .prescribing .the .newest .medication .available .for .the .disease .process
3 Handing .out .drug .samples .to .poor .patients
4 Prescribing .all .generic .medications .to .cut .costs
2. The .benefits .to .the .patient .of .having .an .Advanced .Practice .Registered .Nurse .(APRN) .prescriber .include:
1. Nurses .know .more .about .Pharmacology .than .other .prescribers .because .they .take
.it .both .in .their .basic .nursing .program .and .in .their .APRN .program.
2. Nurses .care .for .the .patient .from .a .holistic .approach .and .include .the
.patient .in .decision .making .regarding .their .care.
3. APRNs .are .less .likely .to .prescribe .narcotics .and .other .controlled .substances.
4. APRNs .are .able .to .prescribe .independently .in .all .states, .whereas .a
.physician’s .assistant .needs .to .have .a .physician .supervising .their
.practice.
3. Criteria .for .choosing .an .effective .drug .for .a .disorder .include:
1. Asking .the .patient .what .drug .they .think .would .work .best .for .them
2. Consulting .nationally .recognized .guidelines .for .disease .management
3. Prescribing .medications .that .are .available .as .samples .before .writing .a .prescription
4. Following .U.S. .Drug .Enforcement .Administration .guidelines .for .prescribing
4. Nurse .practitioner .prescriptive .authority .is .regulated .by:
1. The .National .Council .of .State .Boards .of .Nursing
.
2. The .U.S. .Drug .Enforcement .Administration
.
3. The .State .Board .of .Nursing .for .each .state
.
5. The .State .Board .of .Pharmacy
1. Nurse .practitioner .practice .may .thrive .under .health-care .reform .because .of:
1. The .demonstrated .ability .of .nurse .practitioners .to .control .costs
.and .improve .patient .outcomes
2. The .fact .that .nurse .practitioners .will .be .able .to .practice .independently
3. The .fact .that .nurse .practitioners .will .have .full .reimbursement .under
.health- .care .reform
4. The .ability .to .shift .accountability .for .Medicaid .to .the .state .level
Chapter .2. .Review .of .Basic .Principles .of .Pharmacology
,1.A patient’s .nutritional .intake .and .laboratory .results .reflect .hypoalbuminemia. .This .is .critical
.to .prescribing .because:
1. Distribution .of .drugs .to .target .tissue .may .be .affected.
2. The .solubility .of .the .drug .will .not .match .the .site .of .absorption.
3. There .will .be .less .free .drug .available .to .generate .an .effect.
, 4. Drugs .bound .to .albumin .are .readily .excreted .by .the .kidneys.
2. Drugs .that .have .a .significant .first-pass .effect:
1. Must .be .given .by .the .enteral .(oral) .route .only
2. Bypass .the .hepatic .circulation
3. Are .rapidly .metabolized .by .the .liver .and .may .have .little .if .any .desired .action
4. Are .converted .by .the .liver .to .more .active .and .fat-soluble .forms
3. The .route .of .excretion .of .a .volatile .drug .will .likely .be .the:
1. Kidneys
2. Lungs
3. Bile .and .feces
4. Skin
4. Medroxyprogesterone .(Depo .Provera) .is .prescribed .intramuscularly .(IM) .to .create .a .storage .reservoir
.of .the .drug. .Storage .reservoirs:
1. Assure .that .the .drug .will .reach .its .intended .target .tissue
2. Are .the .reason .for .giving .loading .doses
3. Increase .the .length .of .time .a .drug .is .available .and .active
4. Are .most .common .in .collagen .tissues
5. The .NP .chooses .to .give .cephalexin .every .8 .hours .based .on .knowledge .of .the .drug’s:
1. Propensity .to .go .to .the .target .receptor
2. Biological .half-life
3. Pharmacodynamics
4. Safety .and .side .effects
6. Azithromycin .dosing .requires .that .the .first .day’s .dosage .be .twice .those .of .the .other .4 .days
.of .the .prescription. .This .is .considered .a .loading .dose. .A .loading .dose:
1. Rapidly .achieves .drug .levels .in .the .therapeutic .range
2. Requires .four- .to .five-half-lives .to .attain
3. Is .influenced .by .renal .function
4. Is .directly .related .to .the .drug .circulating .to .the .target .tissues
7. The .point .in .time .on .the .drug .concentration .curve .that .indicates .the .first .sign .of .a .therapeutic .effect .is .the:
1. Minimum .adverse .effect .level
2. Peak .of .action
3. Onset .of .action
4. Therapeutic .range
8. Phenytoin .requires .that .a .trough .level .be .drawn. .Peak .and .trough .levels .are .done:
1. When .the .drug .has .a .wide .therapeutic .range
2. When .the .drug .will .be .administered .for .a .short .time .only
3. When .there .is .a .high .correlation .between .the .dose .and .saturation .of .receptor .sites
4. To .determine .if .a .drug .is .in .the .therapeutic .range
9. A .laboratory .result .indicates .that .the .peak .level .for .a .drug .is .above .the .minimum .toxic .concentration.
.This .means .that .the:
1. Concentration .will .produce .therapeutic .effects
, 2. Concentration .will .produce .an .adverse .response
3. Time .between .doses .must .be .shortened
4. Duration .of .action .of .the .drug .is .too .long
10. Drugs .that .are .receptor .agonists .may .demonstrate .what .property?
1. Irreversible .binding .to .the .drug .receptor .site
2. Upregulation .with .chronic .use
3. Desensitization .or .downregulation .with .continuous .use
4. Inverse .relationship .between .drug .concentration .and .drug .action
11. Drugs .that .are .receptor .antagonists, .such .as .beta .blockers, .may .cause:
1. Downregulation .of .the .drug .receptor
2. An .exaggerated .response .if .abruptly .discontinued
3. Partial .blockade .of .the .effects .of .agonist .drugs
4. An .exaggerated .response .to .competitive .drug .agonists
12. Factors .that .affect .gastric .drug .absorption .include:
1. Liver .enzyme .activity
2. Protein-binding .properties .of .the .drug .molecule
3. Lipid .solubility .of .the .drug
4. Ability .to .chew .and .swallow
13. Drugs .administered .via .IV:
1. Need .to .be .lipid .soluble .in .order .to .be .easily .absorbed
2. Begin .distribution .into .the .body .immediately
3. Are .easily .absorbed .if .they .are .nonionized
4. May .use .pinocytosis .to .be .absorbed
14. When .a .medication .is .added .to .a .regimen .for .a .synergistic .effect, .the .combined .effect .of .the .drugs .is:
1. The .sum .of .the .effects .of .each .drug .individually
2. Greater .than .the .sum .of .the .effects .of .each .drug .individually
3. Less .than .the .effect .of .each .drug .individually
4. Not .predictable, .as .it .varies .with .each .individual
15. Which .of .the .following .statements .about .bioavailability .is .true?
1. Bioavailability .issues .are .especially .important .for .drugs
.with .narrow .therapeutic .ranges .or .sustained-release
.mechanisms.
2. All .brands .of .a .drug .have .the .same .bioavailability.
3. Drugs .that .are .administered .more .than .once .a .day .have .greater
.bioavailability .than .drugs .given .once .daily.
4. Combining .an .active .drug .with .an .inert .substance .does .not .affect .bioavailability.
16. Which .of .the .following .statements .about .the .major .distribution .barriers .(blood-brain .or .fetal-placental)
.is .true?
1. Water .soluble .and .ionized .drugs .cross .these .barriers .rapidly.
2. The .blood-brain .barrier .slows .the .entry .of .many .drugs .into .and
.from .brain .cells.
3. The .fetal-placental .barrier .protects .the .fetus .from .drugs .taken .by .the .mother.
4. Lipid-soluble .drugs .do .not .pass .these .barriers .and .are .safe .for .pregnant .women.
