NUR 100/NUR100 Exam 1 V1 | Pharmacology Q&A
with Rationale | Fortis College
1. A nurse is administering a drug that has a high first-pass effect. Which route of
administration would most likely be avoided to ensure maximum bioavailability?
A. Intravenous
B. Sublingual
C. Transdermal
D. Oral
Correct Answer: D
Explanation: Drugs taken orally are absorbed from the intestinal tract and transported via
the portal vein to the liver. The first-pass effect refers to the metabolism of a drug by the
liver before it reaches the systemic circulation. To bypass this effect and achieve higher
bioavailability, routes such as intravenous or sublingual are preferred.
2. Which pharmacokinetic phase is most affected in a patient with end-stage renal disease?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: D
,Explanation: The kidneys are the primary organs responsible for the excretion of drugs
and their metabolites. In renal disease, the ability of the kidneys to clear substances is
significantly impaired. This leads to drug accumulation and an increased risk for toxicity if
dosages are not adjusted.
3. The nurse is reviewing the concept of half-life. If a drug has a half-life of 4 hours and a dose
of 100 mg is given at 0800, how much drug remains in the body at 1600?
A. 25 mg
B. 50 mg
C. 12.5 mg
D. 6.25 mg
Correct Answer: A
Explanation: Half-life is the time required for half of the drug to be eliminated from the
body. From 0800 to 1600 is 8 hours, which equals two half-lives. After 4 hours (one half-
life), 50 mg remains; after another 4 hours (two half-lives), 25 mg remains.
4. A patient with low serum albumin levels is receiving a drug that is highly protein-bound.
What is the most significant risk for this patient?
A. Increased risk of drug toxicity
B. Reduced drug efficacy
C. Rapid drug excretion
, D. Decreased drug absorption
Correct Answer: A
Explanation: Albumin is the most common blood protein and carries the majority of
protein-bound drug molecules. If albumin levels are low, there are fewer binding sites
available, leading to a higher concentration of ‘free’ or active drug. Increased free drug
levels significantly elevate the risk for adverse effects and toxicity.
5. An elderly patient is being started on a new medication. The nurse knows that
physiological changes in the elderly usually necessitate which dosing strategy?
A. Higher doses due to increased body fat
B. Lower doses due to decreased renal clearance
C. More frequent dosing due to faster metabolism
D. Standard adult dosing based on weight
Correct Answer: B
Explanation: Aging is associated with a decline in hepatic and renal function, which slows
the metabolism and excretion of drugs. These changes increase the risk of drug
accumulation and toxicity in the elderly population. Consequently, the clinical guideline
‘start low and go slow’ is used for this demographic.
6. The FDA Pregnancy Category ‘X’ signifies which of the following regarding a medication?
A. No risk to the fetus in human studies
with Rationale | Fortis College
1. A nurse is administering a drug that has a high first-pass effect. Which route of
administration would most likely be avoided to ensure maximum bioavailability?
A. Intravenous
B. Sublingual
C. Transdermal
D. Oral
Correct Answer: D
Explanation: Drugs taken orally are absorbed from the intestinal tract and transported via
the portal vein to the liver. The first-pass effect refers to the metabolism of a drug by the
liver before it reaches the systemic circulation. To bypass this effect and achieve higher
bioavailability, routes such as intravenous or sublingual are preferred.
2. Which pharmacokinetic phase is most affected in a patient with end-stage renal disease?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Correct Answer: D
,Explanation: The kidneys are the primary organs responsible for the excretion of drugs
and their metabolites. In renal disease, the ability of the kidneys to clear substances is
significantly impaired. This leads to drug accumulation and an increased risk for toxicity if
dosages are not adjusted.
3. The nurse is reviewing the concept of half-life. If a drug has a half-life of 4 hours and a dose
of 100 mg is given at 0800, how much drug remains in the body at 1600?
A. 25 mg
B. 50 mg
C. 12.5 mg
D. 6.25 mg
Correct Answer: A
Explanation: Half-life is the time required for half of the drug to be eliminated from the
body. From 0800 to 1600 is 8 hours, which equals two half-lives. After 4 hours (one half-
life), 50 mg remains; after another 4 hours (two half-lives), 25 mg remains.
4. A patient with low serum albumin levels is receiving a drug that is highly protein-bound.
What is the most significant risk for this patient?
A. Increased risk of drug toxicity
B. Reduced drug efficacy
C. Rapid drug excretion
, D. Decreased drug absorption
Correct Answer: A
Explanation: Albumin is the most common blood protein and carries the majority of
protein-bound drug molecules. If albumin levels are low, there are fewer binding sites
available, leading to a higher concentration of ‘free’ or active drug. Increased free drug
levels significantly elevate the risk for adverse effects and toxicity.
5. An elderly patient is being started on a new medication. The nurse knows that
physiological changes in the elderly usually necessitate which dosing strategy?
A. Higher doses due to increased body fat
B. Lower doses due to decreased renal clearance
C. More frequent dosing due to faster metabolism
D. Standard adult dosing based on weight
Correct Answer: B
Explanation: Aging is associated with a decline in hepatic and renal function, which slows
the metabolism and excretion of drugs. These changes increase the risk of drug
accumulation and toxicity in the elderly population. Consequently, the clinical guideline
‘start low and go slow’ is used for this demographic.
6. The FDA Pregnancy Category ‘X’ signifies which of the following regarding a medication?
A. No risk to the fetus in human studies
