NUR 100/NUR100 Exam 2 V2 | Pharmacology Q&A
with Rationale | Fortis College
1. A nurse is administering an oral medication that has a high ‘first-pass effect.’ What is the
nurse’s primary understanding of this pharmacological concept?
A. The drug is rapidly excreted by the kidneys after the first dose.
B. The drug has a short half-life and must be administered frequently.
C. The drug is highly protein-bound and requires a loading dose.
D. The drug is extensively metabolized by the liver before reaching systemic circulation.
Correct Answer: D
Explanation: The first-pass effect occurs when an oral drug is absorbed from the GI tract
and passes through the liver via the portal vein. During this passage, the liver metabolizes a
large portion of the drug, which significantly reduces the amount of active drug that
reaches the systemic circulation. Consequently, drugs with a high first-pass effect often
require higher oral doses compared to parenteral routes to achieve the same therapeutic
effect.
2. When assessing a patient for the risk of drug toxicity, which laboratory value is most
critical for the nurse to monitor regarding drug excretion?
A. Alanine aminotransferase (ALT)
B. Glomerular Filtration Rate (GFR)
,C. Serum Albumin
D. Hemoglobin and Hematocrit
Correct Answer: B
Explanation: The kidneys are the primary organ responsible for the excretion of drugs
from the body. A decrease in the Glomerular Filtration Rate (GFR) indicates impaired renal
function, which can lead to the accumulation of drugs and increased toxicity risk. Nurses
must monitor renal function tests, such as GFR and Creatinine, to ensure patients are
clearing medications effectively.
3. A patient is prescribed a medication that is an ‘agonist.’ How should the nurse explain the
action of this drug to the patient?
A. The drug binds to a receptor and mimics a natural response.
B. The drug blocks receptors to prevent a response.
C. The drug chemically neutralizes toxins in the blood.
D. The drug prevents the liver from metabolizing other medications.
Correct Answer: A
Explanation: An agonist is a drug that binds to a specific receptor and produces a
functional response by mimicking the body’s own regulatory molecules. This action
activates the receptor to produce a desired physiological effect. In contrast, an antagonist
would bind to the receptor to block or inhibit a response.
,4. A nurse is preparing to administer Digoxin to a patient. Which assessment is the priority
before giving the medication?
A. Blood pressure in both arms
B. Apical pulse for one full minute
C. Respiratory rate for one full minute
D. Temperature and oxygen saturation
Correct Answer: B
Explanation: Digoxin is a cardiac glycoside that slows the heart rate and increases the
force of contraction. It is a standard nursing priority to assess the apical pulse for a full 60
seconds before administration. If the pulse is below 60 beats per minute in an adult, the
dose is typically withheld and the provider is notified to prevent bradycardia.
5. A patient is receiving Vancomycin intravenously. The nurse notes the patient’s face and
neck are becoming flushed and red. What is the nurse’s immediate action?
A. Stop the infusion and notify the provider immediately.
B. Apply cold compresses to the reddened areas.
C. Slow the rate of the infusion and monitor the patient.
D. Administer an immediate dose of epinephrine.
Correct Answer: C
, Explanation: The reddening of the face and neck, known as ‘Red Man Syndrome,’ is a
common infusion-related reaction to Vancomycin, not a true allergic reaction. It is typically
caused by administering the drug too rapidly, leading to histamine release. The standard
nursing intervention is to slow the infusion rate and continue to monitor the patient’s vitals
and comfort.
6. Which instruction should the nurse include when teaching a patient about taking Albuterol
and Beclomethasone inhalers?
A. Take the Beclomethasone first to open the airways.
B. Mix both medications in a nebulizer for faster delivery.
C. Take the Albuterol first, wait 5 minutes, then take the Beclomethasone.
D. Avoid rinsing the mouth after using the Beclomethasone inhaler.
Correct Answer: C
Explanation: Albuterol is a bronchodilator (beta-2 agonist) that acts quickly to open the
airways. Using the bronchodilator first allows the steroid, Beclomethasone, to penetrate
deeper into the lung tissue for better efficacy. Patients should always wait about 5 minutes
between different inhalers and rinse their mouths after steroid use to prevent oral
candidiasis.
7. A nurse is caring for a patient on Warfarin therapy. Which lab value indicates that the
medication is within the therapeutic range?
A. INR of 2.0 to 3.0
with Rationale | Fortis College
1. A nurse is administering an oral medication that has a high ‘first-pass effect.’ What is the
nurse’s primary understanding of this pharmacological concept?
A. The drug is rapidly excreted by the kidneys after the first dose.
B. The drug has a short half-life and must be administered frequently.
C. The drug is highly protein-bound and requires a loading dose.
D. The drug is extensively metabolized by the liver before reaching systemic circulation.
Correct Answer: D
Explanation: The first-pass effect occurs when an oral drug is absorbed from the GI tract
and passes through the liver via the portal vein. During this passage, the liver metabolizes a
large portion of the drug, which significantly reduces the amount of active drug that
reaches the systemic circulation. Consequently, drugs with a high first-pass effect often
require higher oral doses compared to parenteral routes to achieve the same therapeutic
effect.
2. When assessing a patient for the risk of drug toxicity, which laboratory value is most
critical for the nurse to monitor regarding drug excretion?
A. Alanine aminotransferase (ALT)
B. Glomerular Filtration Rate (GFR)
,C. Serum Albumin
D. Hemoglobin and Hematocrit
Correct Answer: B
Explanation: The kidneys are the primary organ responsible for the excretion of drugs
from the body. A decrease in the Glomerular Filtration Rate (GFR) indicates impaired renal
function, which can lead to the accumulation of drugs and increased toxicity risk. Nurses
must monitor renal function tests, such as GFR and Creatinine, to ensure patients are
clearing medications effectively.
3. A patient is prescribed a medication that is an ‘agonist.’ How should the nurse explain the
action of this drug to the patient?
A. The drug binds to a receptor and mimics a natural response.
B. The drug blocks receptors to prevent a response.
C. The drug chemically neutralizes toxins in the blood.
D. The drug prevents the liver from metabolizing other medications.
Correct Answer: A
Explanation: An agonist is a drug that binds to a specific receptor and produces a
functional response by mimicking the body’s own regulatory molecules. This action
activates the receptor to produce a desired physiological effect. In contrast, an antagonist
would bind to the receptor to block or inhibit a response.
,4. A nurse is preparing to administer Digoxin to a patient. Which assessment is the priority
before giving the medication?
A. Blood pressure in both arms
B. Apical pulse for one full minute
C. Respiratory rate for one full minute
D. Temperature and oxygen saturation
Correct Answer: B
Explanation: Digoxin is a cardiac glycoside that slows the heart rate and increases the
force of contraction. It is a standard nursing priority to assess the apical pulse for a full 60
seconds before administration. If the pulse is below 60 beats per minute in an adult, the
dose is typically withheld and the provider is notified to prevent bradycardia.
5. A patient is receiving Vancomycin intravenously. The nurse notes the patient’s face and
neck are becoming flushed and red. What is the nurse’s immediate action?
A. Stop the infusion and notify the provider immediately.
B. Apply cold compresses to the reddened areas.
C. Slow the rate of the infusion and monitor the patient.
D. Administer an immediate dose of epinephrine.
Correct Answer: C
, Explanation: The reddening of the face and neck, known as ‘Red Man Syndrome,’ is a
common infusion-related reaction to Vancomycin, not a true allergic reaction. It is typically
caused by administering the drug too rapidly, leading to histamine release. The standard
nursing intervention is to slow the infusion rate and continue to monitor the patient’s vitals
and comfort.
6. Which instruction should the nurse include when teaching a patient about taking Albuterol
and Beclomethasone inhalers?
A. Take the Beclomethasone first to open the airways.
B. Mix both medications in a nebulizer for faster delivery.
C. Take the Albuterol first, wait 5 minutes, then take the Beclomethasone.
D. Avoid rinsing the mouth after using the Beclomethasone inhaler.
Correct Answer: C
Explanation: Albuterol is a bronchodilator (beta-2 agonist) that acts quickly to open the
airways. Using the bronchodilator first allows the steroid, Beclomethasone, to penetrate
deeper into the lung tissue for better efficacy. Patients should always wait about 5 minutes
between different inhalers and rinse their mouths after steroid use to prevent oral
candidiasis.
7. A nurse is caring for a patient on Warfarin therapy. Which lab value indicates that the
medication is within the therapeutic range?
A. INR of 2.0 to 3.0
