PRN 1381/PRN1381 Final Exam V1 |
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would be most likely to result in the lowest bioavailability?
A. Oral (PO)
B. Sublingual
C. Intravenous (IV)
D. Transdermal
Answer: A
Rationale: The first-pass effect occurs when a drug is metabolized by the liver before
reaching systemic circulation. Drugs taken orally are absorbed from the GI tract and
transported via the portal vein directly to the liver. This significantly reduces the
concentration of the active drug before it reaches the rest of the body.
2. A nurse is preparing to administer Digoxin to a patient. Which of the following assessment
findings would require the nurse to hold the medication?
A. Blood pressure of 110/70 mmHg
B. Potassium level of 4.5 mEq/L
C. Respiratory rate of 18 breaths per minute
,D. Apical pulse of 52 beats per minute
Answer: D
Rationale: Digoxin is a cardiac glycoside that slows the heart rate while increasing the
force of contraction. The standard nursing protocol is to hold Digoxin if the apical pulse is
less than 60 beats per minute in an adult. Administering the drug to a patient with
bradycardia could further depress the heart rate to dangerous levels.
3. Which of the following laboratory values is the primary indicator used to monitor the
effectiveness and safety of Heparin therapy?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Activated partial thromboplastin time (aPTT)
Answer: D
Rationale: The aPTT test measures how long it takes for blood to clot and is specifically
used to monitor unfractionated heparin. PT and INR are typically used to monitor Warfarin
therapy rather than Heparin. Maintaining the aPTT within a therapeutic range is critical to
prevent both clotting and excessive bleeding.
4. A patient with a history of heart failure is prescribed Furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor for most closely?
A. Hypercalcemia
, B. Hypermagnesemia
C. Hypernatremia
D. Hypokalemia
Answer: D
Rationale: Furosemide is a loop diuretic that promotes the excretion of water, sodium, and
potassium. Because it is a non-potassium-sparing diuretic, patients are at high risk for low
serum potassium levels. Hypokalemia can lead to serious cardiac arrhythmias and muscle
weakness if not addressed.
5. What is the specific antidote used for a patient experiencing an overdose of Warfarin
(Coumadin)?
A. Naloxone
B. Protamine sulfate
C. Vitamin K
D. Flumazenil
Answer: C
Rationale: Vitamin K is the antagonist used to reverse the anticoagulant effects of Warfarin
by promoting the synthesis of clotting factors. Protamine sulfate is used for Heparin
reversal, while Naloxone is for opioids. It can take several hours for Vitamin K to become
effective, so fresh frozen plasma may also be needed in emergencies.
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would be most likely to result in the lowest bioavailability?
A. Oral (PO)
B. Sublingual
C. Intravenous (IV)
D. Transdermal
Answer: A
Rationale: The first-pass effect occurs when a drug is metabolized by the liver before
reaching systemic circulation. Drugs taken orally are absorbed from the GI tract and
transported via the portal vein directly to the liver. This significantly reduces the
concentration of the active drug before it reaches the rest of the body.
2. A nurse is preparing to administer Digoxin to a patient. Which of the following assessment
findings would require the nurse to hold the medication?
A. Blood pressure of 110/70 mmHg
B. Potassium level of 4.5 mEq/L
C. Respiratory rate of 18 breaths per minute
,D. Apical pulse of 52 beats per minute
Answer: D
Rationale: Digoxin is a cardiac glycoside that slows the heart rate while increasing the
force of contraction. The standard nursing protocol is to hold Digoxin if the apical pulse is
less than 60 beats per minute in an adult. Administering the drug to a patient with
bradycardia could further depress the heart rate to dangerous levels.
3. Which of the following laboratory values is the primary indicator used to monitor the
effectiveness and safety of Heparin therapy?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Activated partial thromboplastin time (aPTT)
Answer: D
Rationale: The aPTT test measures how long it takes for blood to clot and is specifically
used to monitor unfractionated heparin. PT and INR are typically used to monitor Warfarin
therapy rather than Heparin. Maintaining the aPTT within a therapeutic range is critical to
prevent both clotting and excessive bleeding.
4. A patient with a history of heart failure is prescribed Furosemide (Lasix). Which electrolyte
imbalance should the nurse monitor for most closely?
A. Hypercalcemia
, B. Hypermagnesemia
C. Hypernatremia
D. Hypokalemia
Answer: D
Rationale: Furosemide is a loop diuretic that promotes the excretion of water, sodium, and
potassium. Because it is a non-potassium-sparing diuretic, patients are at high risk for low
serum potassium levels. Hypokalemia can lead to serious cardiac arrhythmias and muscle
weakness if not addressed.
5. What is the specific antidote used for a patient experiencing an overdose of Warfarin
(Coumadin)?
A. Naloxone
B. Protamine sulfate
C. Vitamin K
D. Flumazenil
Answer: C
Rationale: Vitamin K is the antagonist used to reverse the anticoagulant effects of Warfarin
by promoting the synthesis of clotting factors. Protamine sulfate is used for Heparin
reversal, while Naloxone is for opioids. It can take several hours for Vitamin K to become
effective, so fresh frozen plasma may also be needed in emergencies.
