NR293 Exam 1 Actual Exam Style V2 | NR
293 Pharmacology for Nursing Practice |
Chamberlain
1. A nurse is administering a medication that is highly protein-bound. If the patient’s albumin
levels are significantly low, what effect should the nurse expect?
A. The drug will be less effective because there is nothing to carry it.
B. There will be an increased risk of drug toxicity due to more free drug in the blood.
C. The drug will be excreted more quickly by the kidneys.
D. The drug’s metabolism in the liver will be accelerated.
Answer: B
Rationale: When a drug is highly protein-bound, it normally hitches a ride on albumin,
leaving only a small amount of ‘free’ drug to exert an effect. If albumin is low, more of the
drug remains free and active in the bloodstream, which significantly increases the risk of
toxic effects. The nurse must monitor patients with malnutrition or liver disease closely
when they take these types of medications.
2. Which of the following describes the ‘first-pass effect’ in pharmacology?
A. The rapid distribution of a drug to the brain and heart.
B. The movement of a drug from the stomach into the small intestine.
C. The metabolism of a drug by the liver before it reaches systemic circulation.
,D. The excretion of a drug through the first urination after administration.
Answer: C
Rationale: The first-pass effect occurs when an oral medication is absorbed from the GI
tract and carried to the liver via the portal vein. In the liver, a large portion of the drug may
be metabolized into inactive metabolites before it ever reaches the rest of the body. This is
why some drugs require much higher oral doses compared to intravenous doses to achieve
the same therapeutic effect.
3. A drug has a half-life of 4 hours. If a patient takes a 200 mg dose at 12:00 PM, how much
drug will remain in the system at 8:00 PM?
A. 100 mg
B. 25 mg
C. 50 mg
D. 12.5 mg
Answer: C
Rationale: Half-life is the time required for half of the drug to be eliminated from the body.
From 12:00 PM to 8:00 PM is 8 hours, which represents two half-lives (4 hours + 4 hours).
After the first half-life, 100 mg remains, and after the second half-life, 50 mg remains.
4. What is the primary purpose of the ‘Assessment’ phase of the nursing process in
pharmacology?
A. To evaluate the effectiveness of the drug after administration.
, B. To gather data such as drug history, allergies, and lab values before giving medication.
C. To formulate a nursing diagnosis related to medication side effects.
D. To teach the patient about the potential adverse effects of the drug.
Answer: B
Rationale: Assessment is the first step where the nurse collects subjective and objective
data to ensure medication safety. This includes checking for allergies, current medications,
and baseline vital signs or lab results like renal function. Proper assessment prevents
medication errors and identifies potential contraindications before the drug is
administered.
5. A patient experiences an ‘idiosyncratic reaction’ to a medication. How would the nurse
define this to the family?
A. It is a common side effect mentioned in the drug manual.
B. It is an unpredictable and unexplained reaction unique to the individual.
C. It is an expected allergic reaction involving hives and itching.
D. It is a reaction caused by taking too much of the medication.
Answer: B
Rationale: An idiosyncratic reaction is a highly unusual and unexpected response to a drug
that is not related to the drug’s known pharmacological properties. These reactions are
293 Pharmacology for Nursing Practice |
Chamberlain
1. A nurse is administering a medication that is highly protein-bound. If the patient’s albumin
levels are significantly low, what effect should the nurse expect?
A. The drug will be less effective because there is nothing to carry it.
B. There will be an increased risk of drug toxicity due to more free drug in the blood.
C. The drug will be excreted more quickly by the kidneys.
D. The drug’s metabolism in the liver will be accelerated.
Answer: B
Rationale: When a drug is highly protein-bound, it normally hitches a ride on albumin,
leaving only a small amount of ‘free’ drug to exert an effect. If albumin is low, more of the
drug remains free and active in the bloodstream, which significantly increases the risk of
toxic effects. The nurse must monitor patients with malnutrition or liver disease closely
when they take these types of medications.
2. Which of the following describes the ‘first-pass effect’ in pharmacology?
A. The rapid distribution of a drug to the brain and heart.
B. The movement of a drug from the stomach into the small intestine.
C. The metabolism of a drug by the liver before it reaches systemic circulation.
,D. The excretion of a drug through the first urination after administration.
Answer: C
Rationale: The first-pass effect occurs when an oral medication is absorbed from the GI
tract and carried to the liver via the portal vein. In the liver, a large portion of the drug may
be metabolized into inactive metabolites before it ever reaches the rest of the body. This is
why some drugs require much higher oral doses compared to intravenous doses to achieve
the same therapeutic effect.
3. A drug has a half-life of 4 hours. If a patient takes a 200 mg dose at 12:00 PM, how much
drug will remain in the system at 8:00 PM?
A. 100 mg
B. 25 mg
C. 50 mg
D. 12.5 mg
Answer: C
Rationale: Half-life is the time required for half of the drug to be eliminated from the body.
From 12:00 PM to 8:00 PM is 8 hours, which represents two half-lives (4 hours + 4 hours).
After the first half-life, 100 mg remains, and after the second half-life, 50 mg remains.
4. What is the primary purpose of the ‘Assessment’ phase of the nursing process in
pharmacology?
A. To evaluate the effectiveness of the drug after administration.
, B. To gather data such as drug history, allergies, and lab values before giving medication.
C. To formulate a nursing diagnosis related to medication side effects.
D. To teach the patient about the potential adverse effects of the drug.
Answer: B
Rationale: Assessment is the first step where the nurse collects subjective and objective
data to ensure medication safety. This includes checking for allergies, current medications,
and baseline vital signs or lab results like renal function. Proper assessment prevents
medication errors and identifies potential contraindications before the drug is
administered.
5. A patient experiences an ‘idiosyncratic reaction’ to a medication. How would the nurse
define this to the family?
A. It is a common side effect mentioned in the drug manual.
B. It is an unpredictable and unexplained reaction unique to the individual.
C. It is an expected allergic reaction involving hives and itching.
D. It is a reaction caused by taking too much of the medication.
Answer: B
Rationale: An idiosyncratic reaction is a highly unusual and unexpected response to a drug
that is not related to the drug’s known pharmacological properties. These reactions are
