NCLEX Practice Exam for Pharmacology Essential Principles and Drug Administration

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1. The name selected by the original manufacturer based on the chemical structure of the drug is the:

  1. Chemical name
  2. Drug name
  3. Generic name
  4. Trade name

2. The interaction of one drug increased by the presence of a second drug is known as:

  1. Potentiation
  2. Addictive effects
  3. Antagonism
  4. Synergism

3. When two drugs given together have an effect equal to the sum of their respective effects, the interaction is known as:

  1. Potentiated
  2. Antagonized
  3. Agonist
  4. Additive

4. Absorption, distribution, and excretion may be increased by which of the following diseases?

  1. Hyperthyroidism
  2. Renal insufficiency
  3. Liver disease
  4. Hypothyroidism

5. When a drug is 50% protein bound, it means that:

  1. 50% of the drug destroys protein
  2. 50% of the dose is at work
  3. 50% of the drug is excreted in the kidneys
  4. Protein must be restricted in the diet

6. Safety of a drug is determined by the degree between:

  1. Therapeutic and toxic doses
  2. Potency and efficacy
  3. Subtherapeutic and toxic levels
  4. Side and adverse effects

7. When a drug binds to a receptor to produce a pharmacologic effect, the drug may be called a(n):

  1. Agonist
  2. Antagonist
  3. Blocker
  4. Accelerator

8. The extent to which drug is absorbed and transported to target tissue is known as:

  1. Steady-state accumulation
  2. Therapeutic drug levels
  3. Bioavailability
  4. Distribution

9. Distribution is affected by:

  1. Biotransformation
  2. Excretion
  3. Protein binding
  4. Lipid binding

10. An unexpected effect of the drug is known as a(n):

  1. Side effect
  2. Adverse effect
  3. Toxic reaction
  4. Allergic reaction

11. As a knowledgeable nurse, you know that the following are part of the five rights except:

  1. Right dose
  2. Right route
  3. Right drug
  4. Right room

12. When performing an assessment about medication, the drug history should include:

  1. Complete vital signs
  2. Client’s goal of therapy
  3. Reason for medication
  4. Administration of OTC medications

13. The volume of SC medication must be no more than:

  1. 0.5 mL
  2. 1.0 mL
  3. 1.5 mL
  4. 3.0 mL

14. Which of the following muscles is a possible site for IM injections?

  1. Outer aspect of the hip
  2. Shoulder
  3. Vastus gluteus
  4. Vastus lateralis

15. When deciding on what time of day to give medications, the nurse pays closest attention to the client’s habits regarding:

  1. Eating
  2. Sleeping
  3. Elimination
  4. Activity

16. The client’s ability to take oral medications will be hindered by:

  1. Age
  2. Dental caries
  3. Dysphagia
  4. Lifestyle

17. Which of the following will determine nursing interventions for a client on medication?

  1. Assessment
  2. Diagnoses
  3. Implementation
  4. Evaluation

18. When performing an assessment to determine which medications can be used, which of the following elements is most important?

  1. Physical examination
  2. Allergies
  3. Presence of illness
  4. Weight

19. Central venous access devices are beneficial in pediatric therapy because:

  1. They are difficult to see.
  2. They cannot be dislodged.
  3. Use of the arms is not restricted.
  4. They don’t frighten children.

20. When considering the pharmacotherapeutic effects of drugs administered to clients, the nurse considers which property of most importance:

  1. Efficacy
  2. Interaction with other drugs
  3. Potency
  4. Toxicity
Answers and Rationale
  1. Answer: C. Generic name. The chemical name is the chemical name is the chemical structure of the compound. The trade name is a proprietary name owned by the company that creates and registers it. The drug name does not exist.
  2. Answer: A. Potentiation. Potentiation occurs when the action of one drug is increased by the action of another. Think of two words potentiate and potential together. The potential of one drug is higher when a second drug is added to it.
  3. Answer: D. Additive. An addictive effect occurs when two drugs are given together and their effects is equal to the sum of their respective effects.
  4. Answer: A. Hyperthyroidism. Diseases that speed up metabolism, such as hyperthyroidism, will increase absorption, distribution, and elimination. B, C, and D are incorrect because diseases that decrease metabolism, such as hypothyroidism, renal insufficiency, and liver disease, will slow these metabolic processes.
  5. Answer: B. 50% of the dose is at work. The percentage of drug NOT protein bound is the amount of drug that is free to exert its effect on the body’s issues. A, C, and D are incorrect because protein binding has nothing to do with the destruction of protein, drug excretion, or protein in the diet. Note that the concept of “50% bound” literally means that 50% is BOUND or connected to protein. This means that the remaining 50% is available.
  6. Answer: A. Therapeutic and toxic doses. Safety is determined by the degree between therapeutic and toxic doses. Potency and efficacy are not related to safety. Subtherapeutic levels are not part of safety determinations because if a drug is subtherapeutic it does not exert any desired effect. Side effects are expected, and adverse effects are often the result of toxicity.
  7. Answer: A. Agonist. An agonist is the action described in the stem. B and C are synonymous. ELiminate choice D because there is no such action described in drug nomenclature.
  8. Answer: C. Bioavailability. Bioavailability is the extent to which a drug is absorbed and transported to target tissue. Steady-state accumulation means that the amount of drug present is sufficient to exert its therapeutic effect. Therapeutic drug levels are serum blood tests used to measure the amount of circulating drug present. Distribution is the process by which drugs are transported to tissues.
  9. Answer: C. Protein binding. Distribution depends on protein binding as well as circulation. Biotransformation is the act of metabolizing the drug. Excretion describes the act of eliminating the drug. There is no such thing as lipid binding.
  10. Answer: B. Adverse effect. An adverse reaction is a harmful and unexpected reaction. A side effect is expected and predictable. C and D are incorrect because a toxic reaction is a type of adverse reaction.
  11. Answer: D. Right room. Right room is not one of the five rights.The five rights are right client, route, dose, drug, and time.
  12. Answer: D. Administration of OTC medications. The nurse should determine if the client is taking any other medications, especially OTC medications because their effects are often minimized. Other choices are important part of assessment, but choice D is the most accurate answer.
  13. Answer: B. 1.0 mL. The maximum amount of fluid that can be injected into the SC space is 1.0 mL.
  14. Answer: D. Vastus lateralis. Possible injection sites for IM administration include ventrogluteal, deltoid, dorsogluteal, vastus lateralis, and rectus femoris.
  15. Answer: A. Eating. Eating is the most important of these because food in the stomach must be a consideration.
  16. Answer: C. Dysphagia. Dysphagia is difficulty swallowing. This would make administration of oral medications impossible. Other choices do not impair ingestion.
  17. Answer: B. Diagnoses. The nursing diagnosis is the conclusion derived from the assessment, and it is the component of the nursing process that drives the interventions.
  18. Answer: B. Allergies. Allergies must be determined so that the nurse does not administer a drug that would be dangerous to the client.
  19. Answer: C. Use of the arms is not restricted.. The child can move his extremities and function in a normal fashion. This lessens stress associated with position restriction and promotes normal activity. Fear may not be eliminated. All lines can be dislodged. Even small catheters can be readily seen.
  20. Answer: A. Efficacy. In pharmacology, efficacy is the maximum response achievable from a drug.
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