NUR 210 Exam 1 V1 | NUR 210 Pharmacology |
Actual Q&A with Rationale (NUR 210 Exam 1) |
Galen
1. A nurse is administering an oral medication that undergoes a high first-pass effect. Which
statement best describes this process?
A. The drug is primarily excreted by the kidneys before it can act.
B. The drug is metabolized by the liver before reaching systemic circulation.
C. The drug is absorbed slowly through the gastric mucosa.
D. The drug binds strongly to albumin in the bloodstream.
Correct Answer: B
Explanation: The first-pass effect refers to the process where a drug is absorbed from the
gastrointestinal tract and carried to the liver via the portal vein. In the liver, a significant
portion of the drug is metabolized into inactive metabolites before it ever reaches the
systemic circulation. Because of this, drugs with a high first-pass effect often require much
higher oral doses compared to their intravenous counterparts to achieve the same
therapeutic effect.
2. When assessing a patient with low serum albumin levels, the nurse should be concerned
about the distribution of drugs that are:
A. Highly protein-bound
B. Lipid-soluble
,C. Highly water-soluble
D. Non-ionized
Correct Answer: A
Explanation: Albumin is the most common blood protein that carries drug molecules;
when a drug is highly protein-bound, only the ‘free’ or unbound portion is
pharmacologically active. A patient with low albumin levels has fewer binding sites, leading
to an increase in the amount of free, active drug in the bloodstream. This significantly
increases the risk of drug toxicity because the free drug is able to leave the capillaries and
interact with receptors.
3. A patient is prescribed a drug with a narrow therapeutic index. What is the most important
nursing intervention for this patient?
A. Instruct the patient to take the medication with a high-fat meal.
B. Monitor the patient for signs of drug toxicity and check blood levels.
C. Advise the patient to stop the medication if they feel better.
D. Administer the medication only on an as-needed basis.
Correct Answer: B
Explanation: The therapeutic index is a ratio that compares the blood concentration at
which a drug becomes toxic and the concentration at which the drug is effective. A narrow
therapeutic index means there is a very small margin of safety between a therapeutic dose
,and a toxic dose. Nurses must carefully monitor serum drug levels and clinical assessments
to ensure the patient stays within the safe range and avoids life-threatening toxicity.
4. The nurse is caring for a patient with end-stage renal disease. Which pharmacokinetic
phase is most likely to be impaired?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Correct Answer: C
Explanation: Excretion is the primary process by which drugs are removed from the body,
and the kidneys are the main organ responsible for this task. In patients with renal disease,
the ability to filter and eliminate drugs is compromised, leading to accumulation in the
body. This requires the nurse to monitor renal function tests like BUN and Creatinine and
expect dosage reductions to prevent accumulation and toxicity.
5. Which of the following is considered the primary site for drug metabolism in the human
body?
A. Kidneys
B. Small Intestine
C. Liver
, D. Lungs
Correct Answer: C
Explanation: The liver is the primary organ for drug metabolism, utilizing the cytochrome
P450 enzyme system to transform drugs into more water-soluble metabolites. This
transformation is necessary so that the drugs can eventually be excreted by the kidneys.
Damage to the liver, such as cirrhosis or hepatitis, can significantly slow this process and
increase the risk of drug accumulation.
6. A nurse is reviewing a new prescription and notes that it is an ‘agonist.’ How should the
nurse explain this to the patient?
A. The drug will block a receptor to prevent a response.
B. The drug will compete with natural hormones to slow down a process.
C. The drug will decrease the sensitivity of the cell membrane.
D. The drug will bind to a receptor and trigger a response.
Correct Answer: D
Explanation: An agonist is a drug that mimics the action of endogenous substances by
binding to a receptor and producing a biological response. It has both affinity for the
receptor and intrinsic activity to stimulate it. In contrast, an antagonist would bind to the
receptor but produce no response, effectively blocking other substances from binding.
Actual Q&A with Rationale (NUR 210 Exam 1) |
Galen
1. A nurse is administering an oral medication that undergoes a high first-pass effect. Which
statement best describes this process?
A. The drug is primarily excreted by the kidneys before it can act.
B. The drug is metabolized by the liver before reaching systemic circulation.
C. The drug is absorbed slowly through the gastric mucosa.
D. The drug binds strongly to albumin in the bloodstream.
Correct Answer: B
Explanation: The first-pass effect refers to the process where a drug is absorbed from the
gastrointestinal tract and carried to the liver via the portal vein. In the liver, a significant
portion of the drug is metabolized into inactive metabolites before it ever reaches the
systemic circulation. Because of this, drugs with a high first-pass effect often require much
higher oral doses compared to their intravenous counterparts to achieve the same
therapeutic effect.
2. When assessing a patient with low serum albumin levels, the nurse should be concerned
about the distribution of drugs that are:
A. Highly protein-bound
B. Lipid-soluble
,C. Highly water-soluble
D. Non-ionized
Correct Answer: A
Explanation: Albumin is the most common blood protein that carries drug molecules;
when a drug is highly protein-bound, only the ‘free’ or unbound portion is
pharmacologically active. A patient with low albumin levels has fewer binding sites, leading
to an increase in the amount of free, active drug in the bloodstream. This significantly
increases the risk of drug toxicity because the free drug is able to leave the capillaries and
interact with receptors.
3. A patient is prescribed a drug with a narrow therapeutic index. What is the most important
nursing intervention for this patient?
A. Instruct the patient to take the medication with a high-fat meal.
B. Monitor the patient for signs of drug toxicity and check blood levels.
C. Advise the patient to stop the medication if they feel better.
D. Administer the medication only on an as-needed basis.
Correct Answer: B
Explanation: The therapeutic index is a ratio that compares the blood concentration at
which a drug becomes toxic and the concentration at which the drug is effective. A narrow
therapeutic index means there is a very small margin of safety between a therapeutic dose
,and a toxic dose. Nurses must carefully monitor serum drug levels and clinical assessments
to ensure the patient stays within the safe range and avoids life-threatening toxicity.
4. The nurse is caring for a patient with end-stage renal disease. Which pharmacokinetic
phase is most likely to be impaired?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Correct Answer: C
Explanation: Excretion is the primary process by which drugs are removed from the body,
and the kidneys are the main organ responsible for this task. In patients with renal disease,
the ability to filter and eliminate drugs is compromised, leading to accumulation in the
body. This requires the nurse to monitor renal function tests like BUN and Creatinine and
expect dosage reductions to prevent accumulation and toxicity.
5. Which of the following is considered the primary site for drug metabolism in the human
body?
A. Kidneys
B. Small Intestine
C. Liver
, D. Lungs
Correct Answer: C
Explanation: The liver is the primary organ for drug metabolism, utilizing the cytochrome
P450 enzyme system to transform drugs into more water-soluble metabolites. This
transformation is necessary so that the drugs can eventually be excreted by the kidneys.
Damage to the liver, such as cirrhosis or hepatitis, can significantly slow this process and
increase the risk of drug accumulation.
6. A nurse is reviewing a new prescription and notes that it is an ‘agonist.’ How should the
nurse explain this to the patient?
A. The drug will block a receptor to prevent a response.
B. The drug will compete with natural hormones to slow down a process.
C. The drug will decrease the sensitivity of the cell membrane.
D. The drug will bind to a receptor and trigger a response.
Correct Answer: D
Explanation: An agonist is a drug that mimics the action of endogenous substances by
binding to a receptor and producing a biological response. It has both affinity for the
receptor and intrinsic activity to stimulate it. In contrast, an antagonist would bind to the
receptor but produce no response, effectively blocking other substances from binding.
