NUR 210 Final Exam V1 | NUR 210 Pharmacology |
Actual Q&A with Rationale (NUR 210 Final Exam) |
Galen
1. A nurse is providing care for a patient receiving an oral medication that undergoes
significant first-pass metabolism. Which statement best describes this pharmacokinetic
process?
A. The drug is rapidly excreted by the kidneys before it can provide a therapeutic effect.
B. The drug is absorbed through the gastric mucosa directly into the bloodstream.
C. The drug binds to plasma proteins, reducing its availability to the target tissues.
D. The drug is metabolized by the liver before it reaches the systemic circulation.
Correct Answer: D
Explanation: The first-pass effect is a phenomenon where the concentration of a drug is
greatly reduced before it reaches the systemic circulation. This occurs because the drug is
absorbed from the GI tract and passes through the portal vein to the liver, where it is
metabolized. Nurses must recognize that medications with high first-pass effects often
require higher oral doses compared to parenteral doses.
2. A patient is prescribed Lisinopril for hypertension. Which assessment finding should the
nurse prioritize as a potentially life-threatening adverse effect?
A. Swelling of the lips, tongue, and throat (angioedema).
B. A serum potassium level of 4.8 mEq/L.
,C. Development of a persistent, dry non-productive cough.
D. A reported metallic taste in the mouth.
Correct Answer: A
Explanation: Angioedema is a severe and life-threatening adverse effect associated with
ACE inhibitors like lisinopril. It can lead to airway obstruction and requires immediate
medical intervention to ensure patient safety. While a dry cough is a common side effect of
ACE inhibitors, it is not life-threatening like the potential for respiratory compromise seen
in angioedema.
3. Before administering Digoxin to a patient with heart failure, which action is most critical
for the nurse to perform?
A. Check the patient’s blood pressure in both arms.
B. Auscultate the patient’s lung sounds for rales.
C. Evaluate the patient’s intake and output for the last 24 hours.
D. Measure the apical pulse for one full minute.
Correct Answer: D
Explanation: Digoxin is a cardiac glycoside that slows the heart rate while increasing the
force of contraction. The nurse must assess the apical pulse for 60 seconds and withhold
the medication if the heart rate is below 60 beats per minute in an adult. This safety
measure prevents further bradycardia and ensures the patient is not experiencing signs of
digitalis toxicity.
, 4. A patient with Type 1 Diabetes is administered NPH insulin at 0800. At what time is the
patient at the highest risk for a hypoglycemic reaction?
A. 0900 to 1000
B. 1100 to 1200
C. 1400 to 2000
D. 2200 to 0200
Correct Answer: C
Explanation: NPH is an intermediate-acting insulin with a peak effect typically occurring 4
to 12 hours after administration. Since it was given at 0800, the peak risk for hypoglycemia
occurs between 1200 and 2000, roughly 4-12 hours later. Nurses must monitor for signs of
low blood sugar such as diaphoresis and shakiness during this specific window.
5. Which lab value is used to monitor the effectiveness and safety of a patient receiving
Warfarin therapy?
A. Activated partial thromboplastin time (aPTT)
B. Bleeding time
C. Platelet count
D. International Normalized Ratio (INR)
Correct Answer: D
Actual Q&A with Rationale (NUR 210 Final Exam) |
Galen
1. A nurse is providing care for a patient receiving an oral medication that undergoes
significant first-pass metabolism. Which statement best describes this pharmacokinetic
process?
A. The drug is rapidly excreted by the kidneys before it can provide a therapeutic effect.
B. The drug is absorbed through the gastric mucosa directly into the bloodstream.
C. The drug binds to plasma proteins, reducing its availability to the target tissues.
D. The drug is metabolized by the liver before it reaches the systemic circulation.
Correct Answer: D
Explanation: The first-pass effect is a phenomenon where the concentration of a drug is
greatly reduced before it reaches the systemic circulation. This occurs because the drug is
absorbed from the GI tract and passes through the portal vein to the liver, where it is
metabolized. Nurses must recognize that medications with high first-pass effects often
require higher oral doses compared to parenteral doses.
2. A patient is prescribed Lisinopril for hypertension. Which assessment finding should the
nurse prioritize as a potentially life-threatening adverse effect?
A. Swelling of the lips, tongue, and throat (angioedema).
B. A serum potassium level of 4.8 mEq/L.
,C. Development of a persistent, dry non-productive cough.
D. A reported metallic taste in the mouth.
Correct Answer: A
Explanation: Angioedema is a severe and life-threatening adverse effect associated with
ACE inhibitors like lisinopril. It can lead to airway obstruction and requires immediate
medical intervention to ensure patient safety. While a dry cough is a common side effect of
ACE inhibitors, it is not life-threatening like the potential for respiratory compromise seen
in angioedema.
3. Before administering Digoxin to a patient with heart failure, which action is most critical
for the nurse to perform?
A. Check the patient’s blood pressure in both arms.
B. Auscultate the patient’s lung sounds for rales.
C. Evaluate the patient’s intake and output for the last 24 hours.
D. Measure the apical pulse for one full minute.
Correct Answer: D
Explanation: Digoxin is a cardiac glycoside that slows the heart rate while increasing the
force of contraction. The nurse must assess the apical pulse for 60 seconds and withhold
the medication if the heart rate is below 60 beats per minute in an adult. This safety
measure prevents further bradycardia and ensures the patient is not experiencing signs of
digitalis toxicity.
, 4. A patient with Type 1 Diabetes is administered NPH insulin at 0800. At what time is the
patient at the highest risk for a hypoglycemic reaction?
A. 0900 to 1000
B. 1100 to 1200
C. 1400 to 2000
D. 2200 to 0200
Correct Answer: C
Explanation: NPH is an intermediate-acting insulin with a peak effect typically occurring 4
to 12 hours after administration. Since it was given at 0800, the peak risk for hypoglycemia
occurs between 1200 and 2000, roughly 4-12 hours later. Nurses must monitor for signs of
low blood sugar such as diaphoresis and shakiness during this specific window.
5. Which lab value is used to monitor the effectiveness and safety of a patient receiving
Warfarin therapy?
A. Activated partial thromboplastin time (aPTT)
B. Bleeding time
C. Platelet count
D. International Normalized Ratio (INR)
Correct Answer: D
