NURS 251 Final Exam V2 | NURS 251 Final
Exam – Pharmacology | Portage | Q&A with
Rationale (Portage NURS 251 Final Exam)
1. A patient is prescribed an enteric-coated medication. What instruction should the nurse
provide to ensure proper drug delivery?
A. Crush the tablet if it is too difficult to swallow.
B. Take the medication with an antacid.
C. Dissolve the tablet in a small glass of water.
D. Do not chew or crush the tablet.
Answer: D
Rationale: Enteric coatings are designed to protect the stomach from the drug or protect
the drug from stomach acid. Crushing or chewing the tablet destroys this coating, leading to
premature drug release and potential gastric irritation. This instruction is vital to maintain
the intended pharmacokinetics of the medication.
2. The nurse is monitoring a patient receiving intravenous gentamicin. Which assessment
finding is most concerning regarding potential toxicity?
A. Increased urine output.
B. Generalized skin rash.
C. Tinnitus or hearing loss.
,D. Elevated liver enzymes.
Answer: C
Rationale: Gentamicin is an aminoglycoside known for its narrow therapeutic index and
risk of ototoxicity and nephrotoxicity. Tinnitus or a sensation of fullness in the ears often
precedes permanent hearing loss. Nurses must monitor peak and trough levels closely to
prevent these irreversible adverse effects.
3. Which of the following describes the ‘first-pass effect’ in pharmacology?
A. The rapid excretion of drugs via the kidneys.
B. The distribution of drugs to the target tissues.
C. The metabolism of a drug by the liver before it reaches systemic circulation.
D. The binding of drug molecules to plasma proteins.
Answer: C
Rationale: The first-pass effect occurs when an oral medication is absorbed from the GI
tract and enters the portal circulation. The liver metabolizes a significant portion of the
drug before it can reach the rest of the body. This phenomenon explains why oral doses of
certain drugs are much higher than intravenous doses.
4. A patient is diagnosed with an opioid overdose. Which medication should the nurse
anticipate administering?
A. Flumazenil
, B. Protamine sulfate
C. Atropine
D. Naloxone
Answer: D
Rationale: Naloxone is a pure opioid antagonist that competes for opioid receptor sites. It
is the drug of choice for reversing respiratory depression caused by opioid toxicity.
Because its half-life is shorter than many opioids, repeated doses may be necessary to
prevent relapse into respiratory failure.
5. Which phase of pharmacokinetics is primarily affected by a patient’s renal function?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: D
Rationale: Excretion is the process by which drugs and their metabolites are removed
from the body, primarily through the kidneys. Impaired renal function leads to a decrease
in drug clearance and an increased risk for toxicity. Laboratory values like Serum
Creatinine and GFR are used to assess the safety of drug dosing in these patients.
Exam – Pharmacology | Portage | Q&A with
Rationale (Portage NURS 251 Final Exam)
1. A patient is prescribed an enteric-coated medication. What instruction should the nurse
provide to ensure proper drug delivery?
A. Crush the tablet if it is too difficult to swallow.
B. Take the medication with an antacid.
C. Dissolve the tablet in a small glass of water.
D. Do not chew or crush the tablet.
Answer: D
Rationale: Enteric coatings are designed to protect the stomach from the drug or protect
the drug from stomach acid. Crushing or chewing the tablet destroys this coating, leading to
premature drug release and potential gastric irritation. This instruction is vital to maintain
the intended pharmacokinetics of the medication.
2. The nurse is monitoring a patient receiving intravenous gentamicin. Which assessment
finding is most concerning regarding potential toxicity?
A. Increased urine output.
B. Generalized skin rash.
C. Tinnitus or hearing loss.
,D. Elevated liver enzymes.
Answer: C
Rationale: Gentamicin is an aminoglycoside known for its narrow therapeutic index and
risk of ototoxicity and nephrotoxicity. Tinnitus or a sensation of fullness in the ears often
precedes permanent hearing loss. Nurses must monitor peak and trough levels closely to
prevent these irreversible adverse effects.
3. Which of the following describes the ‘first-pass effect’ in pharmacology?
A. The rapid excretion of drugs via the kidneys.
B. The distribution of drugs to the target tissues.
C. The metabolism of a drug by the liver before it reaches systemic circulation.
D. The binding of drug molecules to plasma proteins.
Answer: C
Rationale: The first-pass effect occurs when an oral medication is absorbed from the GI
tract and enters the portal circulation. The liver metabolizes a significant portion of the
drug before it can reach the rest of the body. This phenomenon explains why oral doses of
certain drugs are much higher than intravenous doses.
4. A patient is diagnosed with an opioid overdose. Which medication should the nurse
anticipate administering?
A. Flumazenil
, B. Protamine sulfate
C. Atropine
D. Naloxone
Answer: D
Rationale: Naloxone is a pure opioid antagonist that competes for opioid receptor sites. It
is the drug of choice for reversing respiratory depression caused by opioid toxicity.
Because its half-life is shorter than many opioids, repeated doses may be necessary to
prevent relapse into respiratory failure.
5. Which phase of pharmacokinetics is primarily affected by a patient’s renal function?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: D
Rationale: Excretion is the process by which drugs and their metabolites are removed
from the body, primarily through the kidneys. Impaired renal function leads to a decrease
in drug clearance and an increased risk for toxicity. Laboratory values like Serum
Creatinine and GFR are used to assess the safety of drug dosing in these patients.
