NUR 378 Final Exam V1 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Final Exam) |
Concordia
1. PHARMACOKINETICS & PRINCIPLES: A patient is prescribed a medication with a half-life of
8 hours. If the first dose is administered at 08:00, at what time would approximately 25% of
the drug remain in the patient’s system?
A. 16:00
B. 00:00 (Midnight)
C. 08:00 the next day
D. 12:00 (Noon)
Correct Answer: B
The half-life is the time required for the concentration of a drug to decrease by half. After
one half-life (8 hours), 50% remains. After two half-lives (16 hours), 25% remains.
Therefore, 16 hours after 08:00 is midnight. B is the correct answer. This question assesses
the nurse’s ability to apply pharmacokinetic principles to clinical timing. Understanding
drug clearance is essential for preventing toxicity and maintaining therapeutic levels. This
reflects the standard Concordia assessment of foundational pharmacological concepts.
,2. Which pharmacokinetic phase is most significantly affected by the ‘first-pass effect’ in a
patient receiving oral medications?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
Correct Answer: A
The first-pass effect refers to the metabolism of a drug by the liver before it reaches
systemic circulation. This occurs after absorption but before the drug is distributed to
tissues. C is the correct answer. Metabolic efficiency determines the bioavailability of oral
medications compared to parenteral routes. Nurses must identify drugs with high first-pass
rates to understand dosing discrepancies. This application-level question is common in
pharmacology finals to ensure route safety.
3. Select All That Apply: A nurse is educating a student about factors that can decrease drug
absorption in the gastrointestinal tract. Which factors should be included?
A. Increased gastric motility
B. Administration with high-fat meals
C. Reduced blood flow to the small intestine
D. Presence of food in the stomach
,E. Increased surface area of the small intestine
Correct Answer: A,B,C,D
Increased motility leaves less time for absorption (A). High-fat meals (B) and the presence
of food (D) can delay gastric emptying or bind to drugs. Reduced blood flow (C) limits the
transport of drug molecules from the GI tract to the blood. A, B, C, and D are correct. Select
All That Apply (SATA) questions test the depth of a student’s knowledge across multiple
variables. This question specifically targets physiological barriers to effective drug therapy.
Understanding these factors allows for better timing of medication administration in
relation to meals.
4. A patient is receiving a drug with a narrow therapeutic index. Which nursing action is the
highest priority?
A. Monitor serum drug levels frequently
B. Assess the patient’s heart rate every 4 hours
C. Educate the patient on common side effects
D. Ensure the medication is given with food
Correct Answer: A
A narrow therapeutic index means there is little difference between a therapeutic dose
and a toxic dose. Frequent monitoring of blood levels is necessary to ensure safety. B is the
correct answer. Clinical safety is a major pillar of the NUR 378 curriculum. Prioritization
, questions often focus on medications like Digoxin or Lithium that require lab monitoring.
This reinforces the role of the nurse in identifying high-risk pharmacological interventions.
5. What is the clinical significance of a drug that is highly protein-bound?
A. The drug will be excreted more rapidly by the kidneys.
B. The drug will have a very short duration of action.
C. Only the free, unbound portion of the drug is pharmacologically active.
D. Protein binding increases the speed of drug absorption.
Correct Answer: C
Drug molecules bound to albumin are too large to leave the bloodstream; only ‘free’ drugs
can cross membranes to reach target tissues. Competition for binding sites can lead to
toxicity if another drug displaces it. B is the correct answer. Protein binding concepts are
crucial when managing patients with low albumin levels, such as the elderly or
malnourished. This knowledge prevents adverse events related to increased free drug
concentrations. Concordia exams frequently test this concept to ensure students
understand drug distribution.
6. AUTONOMIC NERVOUS SYSTEM: A patient is administered a non-selective beta-adrenergic
blocker. The nurse knows that this medication is contraindicated in which patient
population?
A. Patients with bronchial asthma
B. Patients with hypertension
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Final Exam) |
Concordia
1. PHARMACOKINETICS & PRINCIPLES: A patient is prescribed a medication with a half-life of
8 hours. If the first dose is administered at 08:00, at what time would approximately 25% of
the drug remain in the patient’s system?
A. 16:00
B. 00:00 (Midnight)
C. 08:00 the next day
D. 12:00 (Noon)
Correct Answer: B
The half-life is the time required for the concentration of a drug to decrease by half. After
one half-life (8 hours), 50% remains. After two half-lives (16 hours), 25% remains.
Therefore, 16 hours after 08:00 is midnight. B is the correct answer. This question assesses
the nurse’s ability to apply pharmacokinetic principles to clinical timing. Understanding
drug clearance is essential for preventing toxicity and maintaining therapeutic levels. This
reflects the standard Concordia assessment of foundational pharmacological concepts.
,2. Which pharmacokinetic phase is most significantly affected by the ‘first-pass effect’ in a
patient receiving oral medications?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
Correct Answer: A
The first-pass effect refers to the metabolism of a drug by the liver before it reaches
systemic circulation. This occurs after absorption but before the drug is distributed to
tissues. C is the correct answer. Metabolic efficiency determines the bioavailability of oral
medications compared to parenteral routes. Nurses must identify drugs with high first-pass
rates to understand dosing discrepancies. This application-level question is common in
pharmacology finals to ensure route safety.
3. Select All That Apply: A nurse is educating a student about factors that can decrease drug
absorption in the gastrointestinal tract. Which factors should be included?
A. Increased gastric motility
B. Administration with high-fat meals
C. Reduced blood flow to the small intestine
D. Presence of food in the stomach
,E. Increased surface area of the small intestine
Correct Answer: A,B,C,D
Increased motility leaves less time for absorption (A). High-fat meals (B) and the presence
of food (D) can delay gastric emptying or bind to drugs. Reduced blood flow (C) limits the
transport of drug molecules from the GI tract to the blood. A, B, C, and D are correct. Select
All That Apply (SATA) questions test the depth of a student’s knowledge across multiple
variables. This question specifically targets physiological barriers to effective drug therapy.
Understanding these factors allows for better timing of medication administration in
relation to meals.
4. A patient is receiving a drug with a narrow therapeutic index. Which nursing action is the
highest priority?
A. Monitor serum drug levels frequently
B. Assess the patient’s heart rate every 4 hours
C. Educate the patient on common side effects
D. Ensure the medication is given with food
Correct Answer: A
A narrow therapeutic index means there is little difference between a therapeutic dose
and a toxic dose. Frequent monitoring of blood levels is necessary to ensure safety. B is the
correct answer. Clinical safety is a major pillar of the NUR 378 curriculum. Prioritization
, questions often focus on medications like Digoxin or Lithium that require lab monitoring.
This reinforces the role of the nurse in identifying high-risk pharmacological interventions.
5. What is the clinical significance of a drug that is highly protein-bound?
A. The drug will be excreted more rapidly by the kidneys.
B. The drug will have a very short duration of action.
C. Only the free, unbound portion of the drug is pharmacologically active.
D. Protein binding increases the speed of drug absorption.
Correct Answer: C
Drug molecules bound to albumin are too large to leave the bloodstream; only ‘free’ drugs
can cross membranes to reach target tissues. Competition for binding sites can lead to
toxicity if another drug displaces it. B is the correct answer. Protein binding concepts are
crucial when managing patients with low albumin levels, such as the elderly or
malnourished. This knowledge prevents adverse events related to increased free drug
concentrations. Concordia exams frequently test this concept to ensure students
understand drug distribution.
6. AUTONOMIC NERVOUS SYSTEM: A patient is administered a non-selective beta-adrenergic
blocker. The nurse knows that this medication is contraindicated in which patient
population?
A. Patients with bronchial asthma
B. Patients with hypertension
