NUR 155 PHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient with liver cirrhosis is prescribed a medication that is primarily metabolized by the
liver. Which pharmacokinetic change should the nurse expect?
A. Increased risk of drug toxicity
B. Reduced drug half-life
C. Decreased duration of drug action
D. Increased rate of drug excretion
Answer: A
Conceptual Explanation: Liver cirrhosis impairs the organ’s ability to metabolize drugs,
leading to slower breakdown and potential accumulation, which increases the risk of
toxicity.
2. The nurse is administering a drug that has a narrow therapeutic index. Which action is
most important for patient safety?
A. Administering the drug with a full glass of water
,B. Ensuring the patient is not on any other medications
C. Checking the patient’s blood pressure every 4 hours
D. Monitoring serum drug levels closely
Answer: D
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small; therefore, blood levels must be monitored to
ensure safety.
3. Which statement by a patient indicates a correct understanding of the ‘first-pass effect’?
A. Sublingual medications are stronger because they are absorbed in the stomach.
B. Injectable medications work faster because they bypass the kidneys.
C. Oral medications are partially inactivated by the liver before reaching the systemic
circulation.
D. Topical patches provide a high concentration of drug to the liver immediately.
Answer: C
Conceptual Explanation: The first-pass effect occurs when oral drugs are absorbed from
the GI tract and carried to the liver via the portal vein, where they are metabolized before
reaching the rest of the body.
, 4. A nurse is preparing to administer Bethanechol to a patient with urinary retention. Which
condition is a contraindication for this drug?
A. Hypothyroidism
B. Gastrointestinal obstruction
C. Tachycardia
D. Hypertension
Answer: B
Conceptual Explanation: Bethanechol is a cholinergic agonist that stimulates GI and
urinary tract motility. If an obstruction is present, increased motility could cause
perforation.
5. Which assessment finding would be a priority for a nurse to report in a patient taking a
non-selective Beta-Blocker like Propranolol?
A. Heart rate of 70 beats per minute
B. Blood pressure of 120/80 mmHg
C. Increased appetite
D. Audible wheezing on expiration
Answer: D
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient with liver cirrhosis is prescribed a medication that is primarily metabolized by the
liver. Which pharmacokinetic change should the nurse expect?
A. Increased risk of drug toxicity
B. Reduced drug half-life
C. Decreased duration of drug action
D. Increased rate of drug excretion
Answer: A
Conceptual Explanation: Liver cirrhosis impairs the organ’s ability to metabolize drugs,
leading to slower breakdown and potential accumulation, which increases the risk of
toxicity.
2. The nurse is administering a drug that has a narrow therapeutic index. Which action is
most important for patient safety?
A. Administering the drug with a full glass of water
,B. Ensuring the patient is not on any other medications
C. Checking the patient’s blood pressure every 4 hours
D. Monitoring serum drug levels closely
Answer: D
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small; therefore, blood levels must be monitored to
ensure safety.
3. Which statement by a patient indicates a correct understanding of the ‘first-pass effect’?
A. Sublingual medications are stronger because they are absorbed in the stomach.
B. Injectable medications work faster because they bypass the kidneys.
C. Oral medications are partially inactivated by the liver before reaching the systemic
circulation.
D. Topical patches provide a high concentration of drug to the liver immediately.
Answer: C
Conceptual Explanation: The first-pass effect occurs when oral drugs are absorbed from
the GI tract and carried to the liver via the portal vein, where they are metabolized before
reaching the rest of the body.
, 4. A nurse is preparing to administer Bethanechol to a patient with urinary retention. Which
condition is a contraindication for this drug?
A. Hypothyroidism
B. Gastrointestinal obstruction
C. Tachycardia
D. Hypertension
Answer: B
Conceptual Explanation: Bethanechol is a cholinergic agonist that stimulates GI and
urinary tract motility. If an obstruction is present, increased motility could cause
perforation.
5. Which assessment finding would be a priority for a nurse to report in a patient taking a
non-selective Beta-Blocker like Propranolol?
A. Heart rate of 70 beats per minute
B. Blood pressure of 120/80 mmHg
C. Increased appetite
D. Audible wheezing on expiration
Answer: D
