NUR 210 Exam 1 V3 | NUR 210 Pharmacology |
Actual Q&A with Rationale (NUR 210 Exam 1) |
Galen
1. A patient is prescribed a medication that undergoes significant first-pass metabolism.
Which route of administration would the nurse expect the provider to avoid to ensure
maximum bioavailability?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Correct Answer: C
Explanation: Oral medications are absorbed in the gastrointestinal tract and enter the
portal circulation, where the liver may metabolize a large portion of the drug before it
reaches systemic circulation. This process is known as the first-pass effect and significantly
reduces the bioavailability of the medication. Routes such as intravenous, sublingual, and
transdermal bypass the liver initially, allowing more of the active drug to reach the
bloodstream.
,2. The nurse is reviewing a patient’s laboratory results and notes a significantly low serum
albumin level. What is the primary pharmacokinetic concern for a patient receiving a highly
protein-bound medication?
A. The drug will be excreted more rapidly by the kidneys.
B. The onset of action for the medication will be significantly delayed.
C. The drug will be unable to cross the blood-brain barrier.
D. There will be an increased concentration of free drug, increasing the risk of toxicity.
Correct Answer: D
Explanation: Highly protein-bound drugs require albumin to act as a carrier; only the ‘free’
or unbound portion of the drug is pharmacologically active. When albumin levels are low,
fewer binding sites are available, leading to higher levels of active drug in the circulation.
The nurse must monitor the patient closely for adverse effects and toxicity because the
effective dose is essentially higher than intended.
3. A drug has a half-life of 4 hours. If a patient receives a dose of 400 mg at 08:00, how much
of the drug will remain in the patient’s system at 20:00?
A. 200 mg
B. 50 mg
C. 100 mg
D. 25 mg
,Correct Answer: B
Explanation: The time from 08:00 to 20:00 is 12 hours, which equates to three half-lives
(12 divided by 4). After the first half-life, 200 mg remains; after the second, 100 mg
remains; and after the third, 50 mg remains. Understanding half-life is critical for nurses to
predict drug clearance and steady-state concentrations.
4. The nurse is administering an adrenergic agonist that stimulates Beta-1 receptors. Which
physiological response should the nurse monitor for in the patient?
A. Bronchodilation
B. Uterine relaxation
C. Increased heart rate
D. Decreased blood pressure
Correct Answer: C
Explanation: Beta-1 receptors are primarily located in the heart and stimulation leads to
positive inotropic and chronotropic effects. This results in an increased heart rate and
increased force of myocardial contraction. Beta-2 receptors, by contrast, are located in the
lungs and lead to bronchodilation when stimulated.
5. A patient is receiving a medication with a narrow therapeutic index. Which nursing action
is most important for ensuring patient safety?
A. Administer the drug with food to prevent GI upset.
B. Assess the patient’s apical pulse for a full minute.
, C. Monitor serum drug levels frequently as ordered.
D. Encourage increased fluid intake to promote excretion.
Correct Answer: C
Explanation: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Small changes in serum concentration can lead to either
subtherapeutic levels or severe toxicity. Monitoring blood levels is essential to ensure the
drug remains within the safe and effective range.
6. Which schedule of controlled substances includes drugs that have a high potential for
abuse but have currently accepted medical uses in the United States?
A. Schedule I
B. Schedule V
C. Schedule III
D. Schedule II
Correct Answer: D
Explanation: Schedule II drugs, such as morphine, fentanyl, and methylphenidate, have a
high potential for abuse and severe dependence but are medically necessary. Schedule I
drugs are defined as having no currently accepted medical use and a high potential for
abuse. Nurses must strictly adhere to legal protocols when handling Schedule II substances
due to their high risk.
Actual Q&A with Rationale (NUR 210 Exam 1) |
Galen
1. A patient is prescribed a medication that undergoes significant first-pass metabolism.
Which route of administration would the nurse expect the provider to avoid to ensure
maximum bioavailability?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Correct Answer: C
Explanation: Oral medications are absorbed in the gastrointestinal tract and enter the
portal circulation, where the liver may metabolize a large portion of the drug before it
reaches systemic circulation. This process is known as the first-pass effect and significantly
reduces the bioavailability of the medication. Routes such as intravenous, sublingual, and
transdermal bypass the liver initially, allowing more of the active drug to reach the
bloodstream.
,2. The nurse is reviewing a patient’s laboratory results and notes a significantly low serum
albumin level. What is the primary pharmacokinetic concern for a patient receiving a highly
protein-bound medication?
A. The drug will be excreted more rapidly by the kidneys.
B. The onset of action for the medication will be significantly delayed.
C. The drug will be unable to cross the blood-brain barrier.
D. There will be an increased concentration of free drug, increasing the risk of toxicity.
Correct Answer: D
Explanation: Highly protein-bound drugs require albumin to act as a carrier; only the ‘free’
or unbound portion of the drug is pharmacologically active. When albumin levels are low,
fewer binding sites are available, leading to higher levels of active drug in the circulation.
The nurse must monitor the patient closely for adverse effects and toxicity because the
effective dose is essentially higher than intended.
3. A drug has a half-life of 4 hours. If a patient receives a dose of 400 mg at 08:00, how much
of the drug will remain in the patient’s system at 20:00?
A. 200 mg
B. 50 mg
C. 100 mg
D. 25 mg
,Correct Answer: B
Explanation: The time from 08:00 to 20:00 is 12 hours, which equates to three half-lives
(12 divided by 4). After the first half-life, 200 mg remains; after the second, 100 mg
remains; and after the third, 50 mg remains. Understanding half-life is critical for nurses to
predict drug clearance and steady-state concentrations.
4. The nurse is administering an adrenergic agonist that stimulates Beta-1 receptors. Which
physiological response should the nurse monitor for in the patient?
A. Bronchodilation
B. Uterine relaxation
C. Increased heart rate
D. Decreased blood pressure
Correct Answer: C
Explanation: Beta-1 receptors are primarily located in the heart and stimulation leads to
positive inotropic and chronotropic effects. This results in an increased heart rate and
increased force of myocardial contraction. Beta-2 receptors, by contrast, are located in the
lungs and lead to bronchodilation when stimulated.
5. A patient is receiving a medication with a narrow therapeutic index. Which nursing action
is most important for ensuring patient safety?
A. Administer the drug with food to prevent GI upset.
B. Assess the patient’s apical pulse for a full minute.
, C. Monitor serum drug levels frequently as ordered.
D. Encourage increased fluid intake to promote excretion.
Correct Answer: C
Explanation: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Small changes in serum concentration can lead to either
subtherapeutic levels or severe toxicity. Monitoring blood levels is essential to ensure the
drug remains within the safe and effective range.
6. Which schedule of controlled substances includes drugs that have a high potential for
abuse but have currently accepted medical uses in the United States?
A. Schedule I
B. Schedule V
C. Schedule III
D. Schedule II
Correct Answer: D
Explanation: Schedule II drugs, such as morphine, fentanyl, and methylphenidate, have a
high potential for abuse and severe dependence but are medically necessary. Schedule I
drugs are defined as having no currently accepted medical use and a high potential for
abuse. Nurses must strictly adhere to legal protocols when handling Schedule II substances
due to their high risk.
