Pharma Prelim and Conceptual Exams
Pharma Prelim and Conceptual Exams
Pharma Prelim and Conceptual Exams
a. Distribution
b. Absorption
c. Biotransformation
d. Excretion
2. When administering a drug, the nurse understands that a drug administered by which route
would be absorbed most rapidly?
a. Oral
b. Intramuscular
c. Intravenous
d. Subcutaneous
3. This is the main organ for biotransformation
a. Brain
b. Kidneys
c. Lungs
d. Liver
4. Which of the following commonly occurs first when an oral drug is being absorbed?
a. Liver enzymes break down the drug into metabolites
b. The drug is delivered to the circulatory system for transport
c. The drug moves from the small intestine directly into the portal venous system
d. A portion of the drug reaches the tissues before getting into the liver
5. Which of the following pregnancy categories of drugs is against pregnancy?
a. Pregnancy category A
b. Pregnancy category B
c. Pregnancy category C
d. Pregnancy category X
6. Which of the following plays the largest role in drug excretion?
a. Skin
b. Kidneys
c. Feces
d. Lungs
7. Insulin is normally administered via which route?
a. Intramuscular
b. Intravenous
c. Oral
d. Subcutaneous
8. A nurse is preparing to administer a prescribed drug to a patient who has liver disease. The
nurse expects a reduction in dosage based on the understanding that which of the following
might be altered?
a. Absorption
b. Distribution
c. Metabolism
d. Filtration
9. Creams, ointments, and liniments are usually given
a. Orally
b. Subcutaneously
c. Topically
d. Optically
10. When assessing a patient for possible factors that may affect the pharmacokinetics of a drug, a
patient with a history of which of the following would lead the nurse to suspect that the patient
may experience an alteration in the distribution of the drug?
a. Gastrointestinal disease
b. Liver disease
c. Kidney disease
d. Vascular disease
11. Which of the following systems is responsible for the distribution of drugs in the body?
a. Vascular
b. Gastrointestinal
c. Respiratory
d. Urinary
12. A nurse is reading an article that describes predictable differences in the effects of drugs in
people of a particular culture background due to their genetic makeup. The nurse is reading
about which of the following?
a. Pharmacogenomics
b. Pharmacodynamics
c. Pharmacokinetics
d. Pharmacology
13. When instructing a patient who is taking an antibiotic about the possibility of nausea and
vomiting, the nurse understands that these effects are examples of which of the following?
a. Primary actions
b. Side effects
c. Drug allergy
d. Hypersensitivity
14. The nurse would assess a patient receiving which medication for possible superinfection?
a. Antibiotic
b. Antihistamines
c. Antihypertensives
d. Antineoplastics
15. The nurse is reviewing the laboratory test results of a patient receiving drug therapy. Which of
the following would the nurse suspect if the results reveal an elevation in the blood urea
nitrogen level and creatinine concentration?
a. Livery injury
b. Hypoglycemia
c. Hyperkalemia
d. Kidney injury
16. Which of the following would the nurse include in the teaching plan for a patient who is to
receive a drug that is associated with anticholinergic side effects?
a. Try to stay as warm as possible to prevent chilling
b. Be sure to drink plenty of fluids to prevent dehydration
c. Try using hard candy or lozenges to prevent dry mouth
d. Eat a low-fiber diet to prevent constipation
17. A patient is receiving a drug to lower his blood glucose level. Which of the following would lead
the nurse to suspect that his blood glucose level was too low?
a. Cold, clammy skin
b. Increased urination
c. Fruity breath odor
d. Increased hunger
18. A patient exhibits muscular tremors, drooling, gait changes, and spasms. When reviewing the
patient’s mediation history, which of the following would the nurse most likely to find?
a. Antipsychotic agent
b. Antidiabetic agent
c. General anesthetic
d. Anticholinergic agent
19. Which of the following is an example of a secondary action?
a. Anticoagulant that leads to excessive and spontaneous bleeding
b. Dizziness and weakness with a recommended dose of antihypertensive
c. An antihistamine that causes the patient to experience drowsiness
d. Urinary retention develops in patient taking an anticholinergic
20. Which of the following side effects is an anticholinergic side effect of antipsychotics?
a. Tremors, dizziness, hunger
b. Increased urination, fruity breath odor, clammy skin
c. Dry mouth, blurred vision, urinary retention
d. Resting hand tremors, pill rolling, shuffling gait
21. Which of the following are extrapyramidal signs of antipsychotics?
a. Tremors, dizziness, hunger
b. Increased urination, fruity breath odor, clammy skin
c. Dry mouth, blurred vision, urinary retention
d. Resting hand tremors, pill rolling, shuffling gait
22. Which of the following units of measure would a nurse expect to find when using the
apothecary system?
a. Liters
b. Kilograms
c. Drams
d. Pounds
23. A nurse is using the metric system for dosage calculations, which unit would the nurse use as
the basic unit for measuring liquids?
a. Gram
b. Kilogram
c. Milliliter
d. Minim
24. A drug label reads “1 tablet equals 1 gr.” The nurse understands that this one tablet is
equivalent to how many milligrams?
a. 30
b. 60
c. 240
d. 1000
25. A physician orders 250 mg of an antibiotic suspension, the label on the suspension read “500
mg/5 ml” how much would the nurse administer?
a. 2.5 ml
b. 5 ml
c. 7.5 ml
d. 10 ml
26. A nurse is to administer 500 mg of a drug intramuscularly. The label on the multidose vial reads
250 mg/ml. how much of the medication would the nurse prepare on the syringe?
a. 0.5 ml
b. 1 ml
c. 1.5 ml
d. 2 ml
27. The physician orders a patient to receive 1000 ml of intravenous fluid over the next 8 hours. The
intravenous delivery set is a macrodrip system. The nurse would set the infusion to run at which
rate?
a. 16 gtts/min
b. 32 gtts/min
c. 64 gtts/min
d. 125 gtts/min
28. A nurse needs to calculate a safe dose of medication for a child. Which of the following would
be most appropriate for the nurse to use?
a. Clark’s rule
b. Fried’s rule
c. Young’s rule
d. Body surface area
29. A nurse needs to convert 3 fluid ounces to the metric system equivalent; the nurse performs
calculation to find which result?
a. 90 ml
b. 180 ml
c. 240 ml
d. 360 ml
30. Which of the following medications is usually applied on the skin?
a. Suppositories
b. Creams
c. Elixirs
d. Tablets
31. When administering medication through the buccal route the nurse must know that the drug
must be given in which location?
a. Under the tongue
b. Nasally
c. Inside of the cheek
d. In the ear
32. Which of the following drug preparations contain alcohol?
a. Tablets
b. Capsule
c. Elixir
d. Syrup
33. Which of the following signs is an indicative of an allergic reaction to drugs?
a. Rashes
b. Difficulty of breathing
c. Dizziness
d. Diarrhea
34. What type of shock will the patient experience if the body’s immune system is hypersensitive to
a specific type of medication?
a. Anaphylactic
b. Neurogenic
c. Cardiogenic
d. Hypovolemic
35. Which of the following is a sign of hyperglycemia?
a. Excessive urination
b. Fruity breath
c. Cold and clammy skin
d. All of the above
36. When a drug is affected by the food taken in by a patient this is known as
a. Drug-drug interaction
b. Synergism
c. Palatability
d. Drug-food interaction
37. One of the important nursing responsibilities when the patient is taking several medications is to
check the
a. Availability of the drugs
b. Drug-drug interactions
c. Allergic reaction to the drugs
d. Mode of administration
38. A nurse is preparing a teaching plan for a patient who is receiving trimethoprim-
sulfamethoxazole. Which of the following would the nurse need to keep in mind when
describing how this drug works?
a. Interfering with bacterial cell wall
b. Preventing the organism’s cells from using substances
c. Interfering with folic acid synthesis
d. Altering the permeability of the cell membrane
39. A patient is taking an aminoglycoside antibiotic for an infection. The nurse would monitor the
patient closely for which of the following?
a. Tinnitus
b. Lethargy
c. Visual changes
d. Hallucination
40. A group of students are reviewing information about anti-infective agents. The students
demonstrate a need for additional review when they identify which of the following as an anti-
infective agent?
a. Antibiotic
b. Anthelmintic
c. Antiprotozoal
d. Anticoagulant
41. After teaching a group of students about resistance, the instructor determines that the students
need additional teaching when they identify need additional teaching when they identify which
of the following as a way that microorganisms develop resistance?
a. Production of an enzyme that deactivates the drug
b. Change in cellular permeability preventing drug entrance
c. Altered binding sites that no longer accept the drug
d. Production of a chemical to act as an agonist
42. Which of the following would be classified as an aminoglycoside?
a. Levofloxacin
b. Clarithromycin
c. Gentamicin
d. Cefaclor
43. A patient is to receive gentamicin for treatment of an infection. Which of the following would be
most important for the nurse to assess to establish a baseline?
a. Nutritional status
b. Auditory function
c. Gastrointestinal function
d. Muscle strength
44. When teaching the side-effects of rifampicin the nurse must know to tell the patient that this
drug causes
a. Optic neuritis
b. Red-orange urine
c. Peripheral neuritis
d. Hepatotoxicity
45. Which of the following is an example of a monobactam antibiotic?
a. Azithromycin
b. Ethambutol
c. Aztreonam
d. Co-trimoxazole
46. A patient is prescribed streptomycin. The nurse understands that this drug can be given only by
which route?
a. Oral
b. Intravenous
c. Ophthalmic
d. Intramuscular
47. The nurse must know to tell the client taking cephalosporins to avoid which of the following
beverages?
a. Coffee
b. Tea
c. Soda
d. Beer
48. Cephalosporins can have cross-sensitivity with which of the following classifications of
antibiotic?
a. Monobactams
b. Penicillins
c. Tetracyclines
d. Sulfonamides
49. Which of the following classification of antibiotics is contraindicated to children below 12 years
old?
a. Aminoglycosides
b. Sulfonamides
c. Tetracyclines
d. Cephalosporins
50. Which of the following drugs would be classified as a third-generation cephalosporin?
a. Cefazolin
b. Cefaclor
c. Ceftriaxone
d. Cephalexin
51. Which of the following vitamins should be taken in together with isoniazid?
a. Niacin
b. Pyridoxine
c. Riboflavin
d. Thiamin
52. The drug’s effect on which of the following best reflects the major reason for avoiding the use of
tetracyclines in children under 12 years of age?
a. Teeth
b. Hearing
c. Vision
d. Kidneys
53. Which of the following antibiotics was the first to be introduced?
a. Penicillins
b. Lincosamides
c. Monobactams
d. Aminoglycosides
54. Which drug would a nurse least likely expect to be prescribed for a patient which chronic
hepatitis-B?
a. Entecavir
b. Telbivudine
c. Adefovir
d. Fosamprenavir
55. A nurse is explaining the rationale for the use of combination therapy in the treatment of HIV
infections. Which of the following would the nurse include as the primary reason?
a. More than one drug is needed to ensure sensitivity to the different forms of the virus
b. The use of multiple drugs allows attack on the virus at different points of its life cycle
c. One drug helps to control the virus, while the other drugs help to alleviate the adverse
effects
d. Using several drugs at once helps to improve the patient’s immune system
56. Which of the following antivirals is also used for people who have Parkinson’s disease?
a. Symmetrel
b. Enfuvirtide
c. Maraviroc
d. Didanosine
57. A patient states, “My doctor said that I had mycosis, but I thought I had a fungal infection.”
Which response would be most appropriate?
a. “You’re both correct because mycosis means a disease cause by a fungus.”
b. “Mycosis means that you have an underlying immune disease.”
c. “Let’s talk to the doctor so that we can find out what really is going on here.”
d. “Don’t worry, because mycosis is only a minor infection that is easily treatable.”
58. Which of the following statements best reflects topical antifungal agents?
a. They are most effective when applied in a thick manner
b. They rarely cause local irritation and burning
c. They are too toxic to be used systematically
d. They are associated with many drug-drug interactions.
59. Which agent would be given to patients who have schistosomiasis?
a. Chloroquine
b. Primaquine
c. Pyrantel
d. Praziquantel
60. Which of the following drugs is given to patients with amebiasis?
a. Pyrimethamine
b. Metronidazole
c. Chloroquine
d. Hydroxychloroquine
61. Which drug is a first-line antibiotic for malaria?
a. Chloroquine
b. Hydroxychloroquine
c. Quinine
d. Artemeter-lumefantrine
62. A patient who is receiving metronidazole therapy for trichomoniasis asks the nurse how this
infection occurred. Which response by the nurse would be most appropriate?
a. “You probably got bitten by a mosquito.”
b. “It is passed to humans by the common housefly.”
c. “The infection is spread during sexual intercourse.”
d. “You probably drank some contaminated water.”
63. Which of the following would be associated with an infection caused by a flatworm?
a. Pinworm
b. Whipworm
c. Ascaris
d. Tapeworm
64. Anthelmintics are required by children under 5 years old to take it every
a. 4 months
b. 3 months
c. 6 months
d. 8 months
65. Which drug would the nurse identify as the drug of choice for treating a threadworm infection?
a. Pyrantel
b. Praziquantel
c. Ketoconazole
d. Ivermectine
66. Which of the following would be most important to obtain for a patient who is suspected to
have helminthes?
a. Complete blood count
b. Urinalysis
c. Liver functions tests
d. Stool examination
67. Which of the following would the nurse identify as causing more damage to humans than most
other helminthes?
a. Ascaris
b. Threadworms
c. Schistosomiasis
d. Pinworm
68. A nurse administers metoclopramide to a patient receiving chemotherapy or which reason?
a. Reduce vomiting
b. Prevent hypersensitivity
c. Relieve inflammation
d. Decrease secretions
69. A patient develops leukopenia after receiving chemotherapy. Which nursing diagnosis would be
most appropriate?
a. Disturbed body image
b. Imbalanced nutrition
c. Risk for infection
d. Deficient fluid volume
70. Which of the following would be the drug of choice for breast cancer?
a. Mitomycin
b. Tamoxifen
c. Vinblastine
d. Docetaxel
71. Which agent would be least appropriate to administer to a patient with joint inflammation and
pain?
a. Ibuprofen
b. Naproxen
c. Acetaminophen
d. Diclofenac
72. Which of the following beverages would increase the absorption of NSAIDs?
a. Tea
b. Coffee
c. Soda
d. Orange juice
73. A nurse suspects that a patient is experiencing aspirin toxicity. Which of the following would the
nurse assess?
a. Excitement
b. Ringing in the ears
c. Tachypnea
d. Convulsions
74. When the patient is experiencing salicylate toxicity, the nurse must know which of the following
antidotes to give to the patient?
a. Vitamin K
b. Protamine sulfate
c. Naloxone hydrochloride
d. Acetylcysteine
75. Which of the following best describes the action of NSAIDs?
a. Blocks prostaglandin activity
b. Acts directly on thermoregulatory cells
c. Inhibits phagocytosis
d. Inhibits prostaglandin synthesis
76. Which of the following is the action of acetylsalicylic acid?
a. Antipyretic
b. Analgesic
c. Anticoagulant
d. All of the above
77. Which benzodiazepine would a nurse expect to administer as a hypnotic?
a. Lorazepam
b. Flurazepam
c. Diazepam
d. Alprazolam
78. Which of the following would lead the nurse to suspect that a patient is experiencing withdrawal
symptoms associated with benzodiazepine use?
a. Dry mouth
b. Nightmares
c. Hypotension
d. Urinary retention
79. A patient is preparing to administer an anxiolytic to a patient. Which of the following would be
most appropriate for the nurse to do before administering the drug?
a. Raise the side rails
b. Institute a bowel program
c. Dim the lights
d. Have the patient void
80. Which of the following groups of antidepressant is the first in line?
a. Mono-amine oxidase inhibitors
b. Tricyclic antidepressant
c. Selective serotonin reuptake inhibitors
d. Acyclic antidepressants
81. Which of the following SSRIs is also indicated for clients who are experiencing premature
ejaculation?
a. Zoloft
b. Prozac
c. Paxil
d. Celexa
82. Which of the following is contraindicated to patients who are taking Parnate?
a. Pizza
b. Beer
c. Tofu
d. All of the above
83. The nurse must instruct the patient to take which of the following drugs when the patient will
experience hypertension brought about by drug-food interaction in MAOIs?
a. Regitine
b. Atenolol
c. Furosemide
d. Captopril
84. Which of the following is not a tricyclic antidepressant?
a. Norpramine
b. Marplan
c. Vivactyl
d. Surmontil
85. A patient tells the nurse, “My antidepressant is not working. I have been taking it for 5 days now
but nothing happens.” What would be the best response by the nurse?
a. “The doctor must increase the dosage of your antidepressant.”
b. “The doctor must change it to another type of antidepressant.”
c. “Please wait for your antidepressant to take effect after 2 to 4 weeks.”
d. “We will have the check the levels of the antidepressant in your blood.”
86. Which of the following would be an intervention to a patient experiencing dry mouth brought
about by antidepressant?
a. Offer hard candy
b. Restrict fluid intake
c. Lower the dosage of the drug
d. Eat a low-fiber diet