NURS 180 PHARMACOLOGY EXAM 1
2026 | WCU QUESTIONS AND ANSWERS
1. A patient with cirrhosis of the liver is prescribed a highly protein-bound drug. Which
laboratory result is the most critical for the nurse to monitor to prevent drug toxicity?
A. Serum Albumin levels
B. Blood Urea Nitrogen (BUN)
C. Platelet count
D. Hemoglobin A1c
Answer: A
Conceptual Explanation: Albumin is the primary protein to which drugs bind. In patients
with liver failure, albumin production decreases, leading to more free (active) drug in the
circulation, which increases the risk of toxicity.
2. Which pharmacokinetic process is primarily affected when a patient is administered an
enteric-coated tablet along with a large amount of food?
A. Excretion
B. Distribution
,C. Metabolism
D. Absorption
Answer: D
Conceptual Explanation: Absorption is the movement of a drug from its site of
administration into the bloodstream. Food and enteric coatings specifically alter the rate
and extent of this process.
3. The nurse is preparing to administer a drug with a narrow therapeutic index. What is the
nurse’s priority action?
A. Monitor serum drug levels closely.
B. Administer the drug at a faster rate than usual.
C. Encourage the patient to increase fluid intake.
D. Wait until the patient is symptomatic to give the next dose.
Answer: A
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small. Monitoring serum levels (peaks and troughs) is
essential for safety.
4. A drug that binds to a receptor and prevents a biological response is known as a(n):
A. Agonist
B. Antagonist
, C. Synergist
D. Potentiator
Answer: B
Conceptual Explanation: Antagonists bind to receptors but do not activate them; they
function by blocking agonists from binding and producing a response.
5. Which factor most significantly increases the risk of adverse drug reactions in geriatric
patients?
A. Increased total body water
B. Increased hepatic blood flow
C. Decreased glomerular filtration rate (GFR)
D. Enhanced gastric acidity
Answer: C
Conceptual Explanation: Decreased GFR in older adults reduces drug excretion, leading to
drug accumulation and a higher incidence of adverse effects.
6. A patient is prescribed a drug that undergoes significant first-pass effect. Which route of
administration would result in the highest bioavailability?
A. Oral (PO)
B. Rectal (PR)
C. Nasogastric (NG) tube
2026 | WCU QUESTIONS AND ANSWERS
1. A patient with cirrhosis of the liver is prescribed a highly protein-bound drug. Which
laboratory result is the most critical for the nurse to monitor to prevent drug toxicity?
A. Serum Albumin levels
B. Blood Urea Nitrogen (BUN)
C. Platelet count
D. Hemoglobin A1c
Answer: A
Conceptual Explanation: Albumin is the primary protein to which drugs bind. In patients
with liver failure, albumin production decreases, leading to more free (active) drug in the
circulation, which increases the risk of toxicity.
2. Which pharmacokinetic process is primarily affected when a patient is administered an
enteric-coated tablet along with a large amount of food?
A. Excretion
B. Distribution
,C. Metabolism
D. Absorption
Answer: D
Conceptual Explanation: Absorption is the movement of a drug from its site of
administration into the bloodstream. Food and enteric coatings specifically alter the rate
and extent of this process.
3. The nurse is preparing to administer a drug with a narrow therapeutic index. What is the
nurse’s priority action?
A. Monitor serum drug levels closely.
B. Administer the drug at a faster rate than usual.
C. Encourage the patient to increase fluid intake.
D. Wait until the patient is symptomatic to give the next dose.
Answer: A
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small. Monitoring serum levels (peaks and troughs) is
essential for safety.
4. A drug that binds to a receptor and prevents a biological response is known as a(n):
A. Agonist
B. Antagonist
, C. Synergist
D. Potentiator
Answer: B
Conceptual Explanation: Antagonists bind to receptors but do not activate them; they
function by blocking agonists from binding and producing a response.
5. Which factor most significantly increases the risk of adverse drug reactions in geriatric
patients?
A. Increased total body water
B. Increased hepatic blood flow
C. Decreased glomerular filtration rate (GFR)
D. Enhanced gastric acidity
Answer: C
Conceptual Explanation: Decreased GFR in older adults reduces drug excretion, leading to
drug accumulation and a higher incidence of adverse effects.
6. A patient is prescribed a drug that undergoes significant first-pass effect. Which route of
administration would result in the highest bioavailability?
A. Oral (PO)
B. Rectal (PR)
C. Nasogastric (NG) tube
