NR 509 EXAM 1 QUESTIONS WITH
VERIFIED ANSWERS 2026 | Practice
Questions | A+ Verified
• Side Effects -✓✓Undesirable drug effect, is a mild reaction.
• First Pass -✓✓the initial metabolism in the liver of a drug absorbed from the GI tract
before the drug reaches systemic circulation through the bloodstream
• first pass routes -✓✓Hepatic arterial
Oral/entral
Portal venous
• Half-Life -✓✓Time required for the body to eliminate 50% of a drug
• Approximately how many half lives does it take to remove a drug from the body? -
✓✓About 5 half-lives
• Off Label Drugs -✓✓Drug is FDA approved for one use, but is being prescribed for a
different purpose.
• FDA Approved Drugs -✓✓approved for a specific purpose
• Sublingual Route of Administration -✓✓absorbed more rapidly than enteric-coated
tablets. Sublingual medications are placed under the tongue and dissolve, allowing for
quick absorption through the mucous membranes and entry into the bloodstream.
• Enteral Route of Administration -✓✓enteric-coated tablets have a coating that
prevents them from being broken down in the acidic environment of the stomach. They
are not absorbed until they reach the higher pH of the intestines, resulting in slower
absorption.
• Intravenous Route of Administration -✓✓Medication administered via the veins,
produces the most rapid drug response , can produce an almost immediate onset of
action (bypasses the first past effect)
• Intramuscular Route of Administration -✓✓Requires a needle for administration,
medication is administered in the muscle, allows drug to diffuse slowly into the many
blood vessels within muscle tissue (bypasses the first pass effect).
• Subcutaneous Route of Administration -✓✓Medication administered under the skin
into the SUBCUTANEOUS tissue (bypasses the first pass effect)
,• Intradermal Route of Administration -✓✓Medication is administered into the DERMIS
of the skin (bypasses the first pass effect).
• Buccal Route of Administration -✓✓Medication is administered in the oral mucosa
between the cheek and gum (bypasses first pass effect)
• Rectal Route of Administration -✓✓The delivery of medication via the rectum, good
alternative when oral is not available (does NOT bypass first pass effect)
• Topical Route of Administration -✓✓Medication is applied directly on the skin via
ointment, gels, or creams (bypasses the first pass effect)
• Transdermal Route of Administration -✓✓Medication is administered via adhesive
patches, provide constant rate of absorption (bypasses first pass effect)
• Inhalation Route of Administration -✓✓Medication is directly delivered to the lungs for
rapid absorption (bypasses first pass effect)
• Schedule I Drug
schedule 2
schedule 3
schedule 4
schedule 5
potential for abuse or addiction -✓✓1: very high risk
2: high risk
3: moderate risk
4: low risk
5: very low risk
• Drug Distribution -✓✓The movement of the drug from the circulation to body tissues.
• Quick Distribution Sites -✓✓The heart, liver, and kidneys.
• Slow Distribution Sites -✓✓Bone, skin, muscle, fat, and brain (blood brain barrier).
• Drugs bound to protein (albumin) make the drug __________________________. -
✓✓Pharmacologically inactive and not available.
• Free Drug -✓✓An active drug or other compound that is not bound to a carrier protein.
• How do albumin levels potentially effect drug levels? -✓✓If levels are low, there is a
higher amount of free drug (increased drug activity). If levels are high, there there is
more bound drug than there is free drug (decreased drug activity).
, • What can affect albumin levels? -✓✓Low = Kidney/liver disease, inflammation, or
infections. High = Dehydration, stress, ore use of steroids/insulin/birth control
medications.
• Cytochrome P450 enzymes -✓✓Family of enzymes most predominant in liver but also
found in the intestines, lungs, and other organs, are essential for the metabolism of
many medications.
• CP450 Enzyme's Influence on Drug Interactions
-inhibitor
-inducer -✓✓-inhibitor: slows its activity leading to a reduction of metabolism resulting in
a higher concentration of the drug in the bloodstream
-inducer: increases its activity which increases metabolism and lowers concentration of
the drug
• Agonist -✓✓Attach and response is elicited
Mimics body's own regulatory molecules
• Antagonist -✓✓Attach and no response is elicited (blocks the mechanism)
Blocks receptor activation and prevents receptor from behaving its normal manner
• Partial Antagonist -✓✓Ability to activate receptor upon bonding
• Patient Rights of Drug Administration -✓✓Right drug, dose, time, route/form, patient,
documentation, reason for indication, response, refuse
• Ways to Prevent Medication Errors -✓✓Right drug, dose, patient, time, route,
documentation; check 3x before administering
• QSEN Medication Error Prevention -✓✓Patient-centered care, teamwork and
collaboration, evidence-based practice, quality improvement, safety, informatics.
• Most common med error children/elderly -✓✓children: dosing errors
elderly: not adhering to the medication schedule/ forgetting to take medications, dosing
mistakes
• Disease States that Increase Metabolic Needs -✓✓COPD, fever, burns, cancer,
diabetes, and hyperthyroidism.
• BMI scale -✓✓Underweight <18.5
Normal 18.5-24.9
Obese greater than equal to 30
Class 1 30-34.9
Class2 35-39.9
VERIFIED ANSWERS 2026 | Practice
Questions | A+ Verified
• Side Effects -✓✓Undesirable drug effect, is a mild reaction.
• First Pass -✓✓the initial metabolism in the liver of a drug absorbed from the GI tract
before the drug reaches systemic circulation through the bloodstream
• first pass routes -✓✓Hepatic arterial
Oral/entral
Portal venous
• Half-Life -✓✓Time required for the body to eliminate 50% of a drug
• Approximately how many half lives does it take to remove a drug from the body? -
✓✓About 5 half-lives
• Off Label Drugs -✓✓Drug is FDA approved for one use, but is being prescribed for a
different purpose.
• FDA Approved Drugs -✓✓approved for a specific purpose
• Sublingual Route of Administration -✓✓absorbed more rapidly than enteric-coated
tablets. Sublingual medications are placed under the tongue and dissolve, allowing for
quick absorption through the mucous membranes and entry into the bloodstream.
• Enteral Route of Administration -✓✓enteric-coated tablets have a coating that
prevents them from being broken down in the acidic environment of the stomach. They
are not absorbed until they reach the higher pH of the intestines, resulting in slower
absorption.
• Intravenous Route of Administration -✓✓Medication administered via the veins,
produces the most rapid drug response , can produce an almost immediate onset of
action (bypasses the first past effect)
• Intramuscular Route of Administration -✓✓Requires a needle for administration,
medication is administered in the muscle, allows drug to diffuse slowly into the many
blood vessels within muscle tissue (bypasses the first pass effect).
• Subcutaneous Route of Administration -✓✓Medication administered under the skin
into the SUBCUTANEOUS tissue (bypasses the first pass effect)
,• Intradermal Route of Administration -✓✓Medication is administered into the DERMIS
of the skin (bypasses the first pass effect).
• Buccal Route of Administration -✓✓Medication is administered in the oral mucosa
between the cheek and gum (bypasses first pass effect)
• Rectal Route of Administration -✓✓The delivery of medication via the rectum, good
alternative when oral is not available (does NOT bypass first pass effect)
• Topical Route of Administration -✓✓Medication is applied directly on the skin via
ointment, gels, or creams (bypasses the first pass effect)
• Transdermal Route of Administration -✓✓Medication is administered via adhesive
patches, provide constant rate of absorption (bypasses first pass effect)
• Inhalation Route of Administration -✓✓Medication is directly delivered to the lungs for
rapid absorption (bypasses first pass effect)
• Schedule I Drug
schedule 2
schedule 3
schedule 4
schedule 5
potential for abuse or addiction -✓✓1: very high risk
2: high risk
3: moderate risk
4: low risk
5: very low risk
• Drug Distribution -✓✓The movement of the drug from the circulation to body tissues.
• Quick Distribution Sites -✓✓The heart, liver, and kidneys.
• Slow Distribution Sites -✓✓Bone, skin, muscle, fat, and brain (blood brain barrier).
• Drugs bound to protein (albumin) make the drug __________________________. -
✓✓Pharmacologically inactive and not available.
• Free Drug -✓✓An active drug or other compound that is not bound to a carrier protein.
• How do albumin levels potentially effect drug levels? -✓✓If levels are low, there is a
higher amount of free drug (increased drug activity). If levels are high, there there is
more bound drug than there is free drug (decreased drug activity).
, • What can affect albumin levels? -✓✓Low = Kidney/liver disease, inflammation, or
infections. High = Dehydration, stress, ore use of steroids/insulin/birth control
medications.
• Cytochrome P450 enzymes -✓✓Family of enzymes most predominant in liver but also
found in the intestines, lungs, and other organs, are essential for the metabolism of
many medications.
• CP450 Enzyme's Influence on Drug Interactions
-inhibitor
-inducer -✓✓-inhibitor: slows its activity leading to a reduction of metabolism resulting in
a higher concentration of the drug in the bloodstream
-inducer: increases its activity which increases metabolism and lowers concentration of
the drug
• Agonist -✓✓Attach and response is elicited
Mimics body's own regulatory molecules
• Antagonist -✓✓Attach and no response is elicited (blocks the mechanism)
Blocks receptor activation and prevents receptor from behaving its normal manner
• Partial Antagonist -✓✓Ability to activate receptor upon bonding
• Patient Rights of Drug Administration -✓✓Right drug, dose, time, route/form, patient,
documentation, reason for indication, response, refuse
• Ways to Prevent Medication Errors -✓✓Right drug, dose, patient, time, route,
documentation; check 3x before administering
• QSEN Medication Error Prevention -✓✓Patient-centered care, teamwork and
collaboration, evidence-based practice, quality improvement, safety, informatics.
• Most common med error children/elderly -✓✓children: dosing errors
elderly: not adhering to the medication schedule/ forgetting to take medications, dosing
mistakes
• Disease States that Increase Metabolic Needs -✓✓COPD, fever, burns, cancer,
diabetes, and hyperthyroidism.
• BMI scale -✓✓Underweight <18.5
Normal 18.5-24.9
Obese greater than equal to 30
Class 1 30-34.9
Class2 35-39.9
