PHARMACOLOGY NURS 251 MODULES
1-10 ADVANCED EXAM QUESTIONS
AND ANSWERS
1. A patient with a high body fat percentage is prescribed a highly lipophilic medication. How
will the volume of distribution (Vd) be affected?
A. The Vd will be significantly decreased.
B. The Vd will remain unchanged regardless of body composition.
C. The Vd will be significantly increased.
D. The Vd only changes for hydrophilic drugs.
Answer: C
Conceptual Explanation: Lipophilic drugs have a high affinity for adipose tissue;
therefore, a higher body fat percentage increases the volume of distribution for these
substances.
2. Which phase of hepatic metabolism involves conjugation reactions like glucuronidation to
make a drug more water-soluble?
A. Phase I
B. Phase III
,C. Phase II
D. Phase IV
Answer: C
Conceptual Explanation: Phase II metabolism involves conjugation (e.g., glucuronidation,
acetylation) to increase polarity for excretion, while Phase I involves oxidation, reduction,
or hydrolysis.
3. A drug with a narrow therapeutic index (TI) requires which of the following nursing
interventions?
A. Frequent serum drug level monitoring.
B. Occasional monitoring of vital signs only.
C. Administering the drug only on an as-needed (PRN) basis.
D. Encouraging the patient to double the dose if a day is missed.
Answer: A
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small, necessitating close monitoring of serum levels.
4. Which receptor is primarily responsible for increasing heart rate and contractility when
stimulated by an adrenergic agonist?
A. Alpha-1
B. Beta-1
, C. Beta-2
D. Alpha-2
Answer: B
Conceptual Explanation: Beta-1 receptors are primarily located in the heart; stimulation
leads to positive inotropic and chronotropic effects.
5. A patient is administered atropine, a cholinergic antagonist. Which of the following clinical
findings should the nurse expect?
A. Increased salivation
B. Pupillary constriction (miosis)
C. Tachycardia and dry mouth
D. Increased gastrointestinal motility
Answer: C
Conceptual Explanation: Atropine blocks acetylcholine, leading to ‘anticholinergic’ effects
such as tachycardia, dry mouth, blurred vision, and urinary retention.
6. Which medication is considered a non-selective beta-blocker and should be avoided in
patients with asthma?
A. Metoprolol
B. Atenolol
C. Esmolol
1-10 ADVANCED EXAM QUESTIONS
AND ANSWERS
1. A patient with a high body fat percentage is prescribed a highly lipophilic medication. How
will the volume of distribution (Vd) be affected?
A. The Vd will be significantly decreased.
B. The Vd will remain unchanged regardless of body composition.
C. The Vd will be significantly increased.
D. The Vd only changes for hydrophilic drugs.
Answer: C
Conceptual Explanation: Lipophilic drugs have a high affinity for adipose tissue;
therefore, a higher body fat percentage increases the volume of distribution for these
substances.
2. Which phase of hepatic metabolism involves conjugation reactions like glucuronidation to
make a drug more water-soluble?
A. Phase I
B. Phase III
,C. Phase II
D. Phase IV
Answer: C
Conceptual Explanation: Phase II metabolism involves conjugation (e.g., glucuronidation,
acetylation) to increase polarity for excretion, while Phase I involves oxidation, reduction,
or hydrolysis.
3. A drug with a narrow therapeutic index (TI) requires which of the following nursing
interventions?
A. Frequent serum drug level monitoring.
B. Occasional monitoring of vital signs only.
C. Administering the drug only on an as-needed (PRN) basis.
D. Encouraging the patient to double the dose if a day is missed.
Answer: A
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small, necessitating close monitoring of serum levels.
4. Which receptor is primarily responsible for increasing heart rate and contractility when
stimulated by an adrenergic agonist?
A. Alpha-1
B. Beta-1
, C. Beta-2
D. Alpha-2
Answer: B
Conceptual Explanation: Beta-1 receptors are primarily located in the heart; stimulation
leads to positive inotropic and chronotropic effects.
5. A patient is administered atropine, a cholinergic antagonist. Which of the following clinical
findings should the nurse expect?
A. Increased salivation
B. Pupillary constriction (miosis)
C. Tachycardia and dry mouth
D. Increased gastrointestinal motility
Answer: C
Conceptual Explanation: Atropine blocks acetylcholine, leading to ‘anticholinergic’ effects
such as tachycardia, dry mouth, blurred vision, and urinary retention.
6. Which medication is considered a non-selective beta-blocker and should be avoided in
patients with asthma?
A. Metoprolol
B. Atenolol
C. Esmolol
