NURS 180 COMPREHENSIVE
PHARMACOLOGY EXAM 1 2026
QUESTIONS AND ANSWERS
1. Which pharmacokinetic process is primarily affected in a patient with severe liver cirrhosis?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: C
Conceptual Explanation: The liver is the primary site of drug metabolism. Cirrhosis
impairs the liver’s ability to chemically alter drugs, often leading to toxicity.
2. A drug with a low therapeutic index (TI) requires which of the following nursing
interventions?
A. Monitoring of serum peak and trough levels
B. Administration only via the intravenous route
C. Checking blood pressure every 15 minutes
D. Double-locking the medication in a narcotics drawer
,Answer: A
Conceptual Explanation: A low therapeutic index means the difference between a
therapeutic dose and a toxic dose is narrow, requiring close blood level monitoring.
3. Which physiological change in older adults most significantly impacts drug distribution?
A. Increased total body water
B. Decreased body fat percentage
C. Increased glomerular filtration rate
D. Decreased serum albumin levels
Answer: D
Conceptual Explanation: Decreased albumin leads to fewer protein-binding sites, which
increases the amount of free (active) drug in the bloodstream.
4. The ‘first-pass effect’ refers to which phenomenon?
A. The rapid excretion of drugs through the kidneys
B. Metabolism of a drug by the liver before reaching systemic circulation
C. The initial distribution of drug to the brain
D. Absorption of a drug across the gastric mucosa
Answer: B
, Conceptual Explanation: Oral drugs are absorbed in the GI tract and pass through the
liver via the portal vein, where they may be significantly metabolized before reaching the
heart.
5. A patient is prescribed a drug that is a known ‘enzyme inducer.’ What is the expected
effect on a concurrent drug metabolized by the same pathway?
A. Increased therapeutic effect of the second drug
B. Decreased metabolism and potential toxicity
C. No effect on the second drug
D. Increased metabolism and decreased drug levels
Answer: D
Conceptual Explanation: Enzyme inducers speed up the liver’s metabolic activity, causing
other drugs to be broken down faster, resulting in lower blood levels.
6. What is the primary legal responsibility of the nurse when handling Schedule II controlled
substances?
A. To prescribe them in emergency situations
B. To witness the administration with a family member
C. To dispose of unused portions in the regular trash
D. To ensure they are kept in a double-locked cabinet
Answer: D
PHARMACOLOGY EXAM 1 2026
QUESTIONS AND ANSWERS
1. Which pharmacokinetic process is primarily affected in a patient with severe liver cirrhosis?
A. Absorption
B. Distribution
C. Metabolism
D. Excretion
Answer: C
Conceptual Explanation: The liver is the primary site of drug metabolism. Cirrhosis
impairs the liver’s ability to chemically alter drugs, often leading to toxicity.
2. A drug with a low therapeutic index (TI) requires which of the following nursing
interventions?
A. Monitoring of serum peak and trough levels
B. Administration only via the intravenous route
C. Checking blood pressure every 15 minutes
D. Double-locking the medication in a narcotics drawer
,Answer: A
Conceptual Explanation: A low therapeutic index means the difference between a
therapeutic dose and a toxic dose is narrow, requiring close blood level monitoring.
3. Which physiological change in older adults most significantly impacts drug distribution?
A. Increased total body water
B. Decreased body fat percentage
C. Increased glomerular filtration rate
D. Decreased serum albumin levels
Answer: D
Conceptual Explanation: Decreased albumin leads to fewer protein-binding sites, which
increases the amount of free (active) drug in the bloodstream.
4. The ‘first-pass effect’ refers to which phenomenon?
A. The rapid excretion of drugs through the kidneys
B. Metabolism of a drug by the liver before reaching systemic circulation
C. The initial distribution of drug to the brain
D. Absorption of a drug across the gastric mucosa
Answer: B
, Conceptual Explanation: Oral drugs are absorbed in the GI tract and pass through the
liver via the portal vein, where they may be significantly metabolized before reaching the
heart.
5. A patient is prescribed a drug that is a known ‘enzyme inducer.’ What is the expected
effect on a concurrent drug metabolized by the same pathway?
A. Increased therapeutic effect of the second drug
B. Decreased metabolism and potential toxicity
C. No effect on the second drug
D. Increased metabolism and decreased drug levels
Answer: D
Conceptual Explanation: Enzyme inducers speed up the liver’s metabolic activity, causing
other drugs to be broken down faster, resulting in lower blood levels.
6. What is the primary legal responsibility of the nurse when handling Schedule II controlled
substances?
A. To prescribe them in emergency situations
B. To witness the administration with a family member
C. To dispose of unused portions in the regular trash
D. To ensure they are kept in a double-locked cabinet
Answer: D
