PHARMACOLOGY NURS 251
COMPREHENSIVE EXAM (MODULES 1-
10) QUESTIONS AND ANSWERS 2026
1. A drug has a high first-pass effect. Which route of administration would be least effective
for achieving systemic bioavailability?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Answer: C
Conceptual Explanation: The first-pass effect occurs when a drug is metabolized by the
liver before reaching systemic circulation, which primarily affects drugs taken orally.
2. Which pharmacokinetic process is most affected by a patient with severe chronic renal
failure?
A. Absorption
B. Excretion
C. Metabolism
,D. Distribution
Answer: B
Conceptual Explanation: Excretion is primarily handled by the kidneys; renal failure leads
to drug accumulation and potential toxicity due to impaired clearance.
3. A patient is prescribed a drug with a narrow therapeutic index. What is the priority nursing
action?
A. Administer the drug only on an empty stomach.
B. Monitor serum drug levels frequently.
C. Encourage the patient to increase fluid intake.
D. Teach the patient to double the dose if one is missed.
Answer: B
Conceptual Explanation: Drugs with a narrow therapeutic index have a small margin
between a therapeutic dose and a toxic dose, requiring close monitoring of blood levels.
4. Which receptor activation causes bronchodilation in the lungs?
A. Beta-2
B. Beta-1
C. Alpha-1
D. Muscarinic-2
, Answer: A
Conceptual Explanation: Beta-2 adrenergic receptors are located in the smooth muscle of
the bronchioles; their activation leads to relaxation and bronchodilation.
5. A patient receiving a cholinergic agonist like Bethanechol should be monitored for which
side effect?
A. Dry mouth
B. Excessive salivation
C. Urinary retention
D. Tachycardia
Answer: B
Conceptual Explanation: Cholinergic agonists stimulate the ‘rest and digest’ response,
leading to increased secretions, bradycardia, and increased GI/GU motility.
6. What is the primary mechanism of action of Atropine?
A. Nicotinic agonist
B. Muscarinic antagonist
C. Alpha-2 blocker
D. Beta-blocker
Answer: B
COMPREHENSIVE EXAM (MODULES 1-
10) QUESTIONS AND ANSWERS 2026
1. A drug has a high first-pass effect. Which route of administration would be least effective
for achieving systemic bioavailability?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Answer: C
Conceptual Explanation: The first-pass effect occurs when a drug is metabolized by the
liver before reaching systemic circulation, which primarily affects drugs taken orally.
2. Which pharmacokinetic process is most affected by a patient with severe chronic renal
failure?
A. Absorption
B. Excretion
C. Metabolism
,D. Distribution
Answer: B
Conceptual Explanation: Excretion is primarily handled by the kidneys; renal failure leads
to drug accumulation and potential toxicity due to impaired clearance.
3. A patient is prescribed a drug with a narrow therapeutic index. What is the priority nursing
action?
A. Administer the drug only on an empty stomach.
B. Monitor serum drug levels frequently.
C. Encourage the patient to increase fluid intake.
D. Teach the patient to double the dose if one is missed.
Answer: B
Conceptual Explanation: Drugs with a narrow therapeutic index have a small margin
between a therapeutic dose and a toxic dose, requiring close monitoring of blood levels.
4. Which receptor activation causes bronchodilation in the lungs?
A. Beta-2
B. Beta-1
C. Alpha-1
D. Muscarinic-2
, Answer: A
Conceptual Explanation: Beta-2 adrenergic receptors are located in the smooth muscle of
the bronchioles; their activation leads to relaxation and bronchodilation.
5. A patient receiving a cholinergic agonist like Bethanechol should be monitored for which
side effect?
A. Dry mouth
B. Excessive salivation
C. Urinary retention
D. Tachycardia
Answer: B
Conceptual Explanation: Cholinergic agonists stimulate the ‘rest and digest’ response,
leading to increased secretions, bradycardia, and increased GI/GU motility.
6. What is the primary mechanism of action of Atropine?
A. Nicotinic agonist
B. Muscarinic antagonist
C. Alpha-2 blocker
D. Beta-blocker
Answer: B
