NUR 378 Final Exam V3 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Final Exam) |
Concordia
1. PRINCIPLES OF PHARMACOLOGY - Question 1: A nurse is caring for a patient with chronic
liver failure. Which pharmacokinetic process is most likely to be significantly impaired,
requiring a dosage adjustment for highly protein-bound medications?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
Correct Answer: A
Metabolism primarily occurs in the liver, and impairment leads to toxic drug levels.
Reduced albumin production in liver failure also impacts distribution, but metabolism is
the primary process for chemical transformation. Dosage must be reduced to prevent
accumulation. This question evaluates the student’s ability to link pathophysiological states
to pharmacokinetic outcomes. It emphasizes the critical role of the liver in drug clearance
and safety. Understanding these principles is essential for preventing adverse drug
reactions in vulnerable populations.
,2. Question 2: A drug has a half-life of 4 hours. If the nurse administers a 400 mg dose at
08:00, how much of the drug will remain in the patient’s system at 20:00, assuming no further
doses are given?
A. 100 mg
B. 200 mg
C. 25 mg
D. 50 mg
Correct Answer: D
From 08:00 to 20:00 is 12 hours, which is 3 half-lives (12/4=3). After 1st half-life (12:00):
200mg; 2nd (16:00): 100mg; 3rd (20:00): 50mg. Half-life calculations are vital for
determining dosing intervals and predicting drug clearance. This application-level question
tests mathematical proficiency within a clinical context. Proficiency in these calculations
ensures nurses can anticipate drug effects and potential toxicity timelines.
3. Question 3 (Select All That Apply): Which factors should the nurse identify as significantly
influencing the rate of drug absorption in the gastrointestinal tract?
A. Gastric emptying time
B. Surface area available for absorption
C. Blood flow to the absorption site
D. Lipid solubility of the drug
,E. Plasma protein concentration
F. Presence of food or other drugs
Correct Answer: A, B, C, D, F
Absorption is influenced by physical properties of the drug and the environment of the GI
tract. Protein concentration (E) affects distribution, not absorption. Factors like surface
area and blood flow are physiological determinants of how fast a drug enters the
circulation. Identifying variables that affect absorption allows nurses to optimize
medication administration times. This SATA question requires comprehensive knowledge
of pharmacokinetics to distinguish between absorption and distribution factors. It mirrors
the complexity of multi-factorial clinical scenarios found on the Concordia final exam.
4. Question 4: The nurse is monitoring a patient receiving a drug with a narrow therapeutic
index. Which action is the highest priority?
A. Monitor for common side effects.
B. Educate the patient on the mechanism of action.
C. Evaluate serum drug levels frequently.
D. Administer the drug with a full glass of water.
Correct Answer: C
A narrow therapeutic index means the difference between a therapeutic dose and a toxic
dose is small. Serum level monitoring is critical for safety. While monitoring side effects is
important, biochemical monitoring provides objective data to prevent toxicity. Safety is the
, cornerstone of pharmacology in nursing practice. This question assesses the nurse’s
understanding of high-risk medication management and prioritization. Recognizing the
need for laboratory monitoring is a key competency for NUR 378 students.
5. Question 5: A patient is prescribed a medication that acts as a potent enzyme inducer of
the cytochrome P450 system. What should the nurse anticipate regarding other medications
the patient is taking?
A. Increased risk of toxicity of other drugs.
B. Increased duration of action of other drugs.
C. Decreased effectiveness of other drugs.
D. Reduced renal clearance of other drugs.
Correct Answer: C
Enzyme inducers increase the metabolic rate of other drugs, leading to faster clearance
and lower plasma levels. This results in therapeutic failure or decreased effectiveness.
Conversely, enzyme inhibitors increase toxicity risks. Drug-drug interactions involving the
P450 system are common and clinically significant. This question tests the student’s ability
to predict outcomes of metabolic interactions. Understanding these mechanisms is
essential for holistic patient assessment and medication reconciliation.
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Final Exam) |
Concordia
1. PRINCIPLES OF PHARMACOLOGY - Question 1: A nurse is caring for a patient with chronic
liver failure. Which pharmacokinetic process is most likely to be significantly impaired,
requiring a dosage adjustment for highly protein-bound medications?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
Correct Answer: A
Metabolism primarily occurs in the liver, and impairment leads to toxic drug levels.
Reduced albumin production in liver failure also impacts distribution, but metabolism is
the primary process for chemical transformation. Dosage must be reduced to prevent
accumulation. This question evaluates the student’s ability to link pathophysiological states
to pharmacokinetic outcomes. It emphasizes the critical role of the liver in drug clearance
and safety. Understanding these principles is essential for preventing adverse drug
reactions in vulnerable populations.
,2. Question 2: A drug has a half-life of 4 hours. If the nurse administers a 400 mg dose at
08:00, how much of the drug will remain in the patient’s system at 20:00, assuming no further
doses are given?
A. 100 mg
B. 200 mg
C. 25 mg
D. 50 mg
Correct Answer: D
From 08:00 to 20:00 is 12 hours, which is 3 half-lives (12/4=3). After 1st half-life (12:00):
200mg; 2nd (16:00): 100mg; 3rd (20:00): 50mg. Half-life calculations are vital for
determining dosing intervals and predicting drug clearance. This application-level question
tests mathematical proficiency within a clinical context. Proficiency in these calculations
ensures nurses can anticipate drug effects and potential toxicity timelines.
3. Question 3 (Select All That Apply): Which factors should the nurse identify as significantly
influencing the rate of drug absorption in the gastrointestinal tract?
A. Gastric emptying time
B. Surface area available for absorption
C. Blood flow to the absorption site
D. Lipid solubility of the drug
,E. Plasma protein concentration
F. Presence of food or other drugs
Correct Answer: A, B, C, D, F
Absorption is influenced by physical properties of the drug and the environment of the GI
tract. Protein concentration (E) affects distribution, not absorption. Factors like surface
area and blood flow are physiological determinants of how fast a drug enters the
circulation. Identifying variables that affect absorption allows nurses to optimize
medication administration times. This SATA question requires comprehensive knowledge
of pharmacokinetics to distinguish between absorption and distribution factors. It mirrors
the complexity of multi-factorial clinical scenarios found on the Concordia final exam.
4. Question 4: The nurse is monitoring a patient receiving a drug with a narrow therapeutic
index. Which action is the highest priority?
A. Monitor for common side effects.
B. Educate the patient on the mechanism of action.
C. Evaluate serum drug levels frequently.
D. Administer the drug with a full glass of water.
Correct Answer: C
A narrow therapeutic index means the difference between a therapeutic dose and a toxic
dose is small. Serum level monitoring is critical for safety. While monitoring side effects is
important, biochemical monitoring provides objective data to prevent toxicity. Safety is the
, cornerstone of pharmacology in nursing practice. This question assesses the nurse’s
understanding of high-risk medication management and prioritization. Recognizing the
need for laboratory monitoring is a key competency for NUR 378 students.
5. Question 5: A patient is prescribed a medication that acts as a potent enzyme inducer of
the cytochrome P450 system. What should the nurse anticipate regarding other medications
the patient is taking?
A. Increased risk of toxicity of other drugs.
B. Increased duration of action of other drugs.
C. Decreased effectiveness of other drugs.
D. Reduced renal clearance of other drugs.
Correct Answer: C
Enzyme inducers increase the metabolic rate of other drugs, leading to faster clearance
and lower plasma levels. This results in therapeutic failure or decreased effectiveness.
Conversely, enzyme inhibitors increase toxicity risks. Drug-drug interactions involving the
P450 system are common and clinically significant. This question tests the student’s ability
to predict outcomes of metabolic interactions. Understanding these mechanisms is
essential for holistic patient assessment and medication reconciliation.
