NURS 180 PHARMACOLOGY
COMPREHENSIVE REVIEW (WEEKS 1-
14) EXAM QUESTIONS AND ANSWERS
1. A patient with chronic renal failure is prescribed a drug that is primarily excreted by the
kidneys. Which pharmacokinetic adjustment should the nurse anticipate?
A. Reduced dosage or increased dosing interval
B. Increased initial loading dose
C. Switching to an intramuscular route for faster absorption
D. Decreased interval between doses to maintain steady state
Answer: A
Conceptual Explanation: In renal failure, drug clearance is reduced. To prevent toxicity,
the dosage must be lowered or the time between doses increased to allow for elimination.
2. Which statement best describes the ‘first-pass effect’ in pharmacology?
A. The rapid distribution of drug to the brain and heart
B. The binding of a drug to albumin in the bloodstream
C. The metabolism of an oral drug by the liver before it reaches systemic circulation
D. The excretion of a drug through the glomerular filtration system
,Answer: C
Conceptual Explanation: The first-pass effect occurs when drugs absorbed from the GI
tract are carried to the liver via the portal vein and metabolized before reaching the rest of
the body.
3. A patient is receiving a drug with a narrow therapeutic index. What is the nurse’s priority
action?
A. Administer the drug only on an empty stomach
B. Monitor serum drug levels frequently
C. Encourage the patient to increase fluid intake
D. Assess for signs of physical dependence
Answer: B
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small, necessitating close monitoring of blood levels.
4. When administering a beta-1 selective blocker like Metoprolol, which physiological effect
does the nurse expect?
A. Increased myocardial contractility
B. Bronchodilation in the lungs
C. Decreased heart rate and reduced cardiac output
D. Peripheral vasodilation and flushing
, Answer: C
Conceptual Explanation: Beta-1 receptors are primarily in the heart. Blocking them leads
to a decrease in heart rate (negative chronotropic) and contractility (negative inotropic).
5. A patient is experiencing an acute anaphylactic reaction. Why is Epinephrine the drug of
choice?
A. It acts as a selective beta-2 agonist to stop respiratory distress only
B. It stimulates alpha-1, beta-1, and beta-2 receptors to increase BP and cause
bronchodilation
C. It inhibits histamine release by blocking H1 and H2 receptors
D. It provides rapid sedation to calm the patient during the emergency
Answer: B
Conceptual Explanation: Epinephrine is a non-selective adrenergic agonist. Alpha-1
stimulation increases BP, while Beta-2 stimulation causes bronchodilation, treating both
cardiovascular collapse and airway constriction.
6. Which medication is the reversal agent for a patient who has received an overdose of
Lorazepam?
A. Flumazenil
B. Acetylcysteine
C. Naloxone
COMPREHENSIVE REVIEW (WEEKS 1-
14) EXAM QUESTIONS AND ANSWERS
1. A patient with chronic renal failure is prescribed a drug that is primarily excreted by the
kidneys. Which pharmacokinetic adjustment should the nurse anticipate?
A. Reduced dosage or increased dosing interval
B. Increased initial loading dose
C. Switching to an intramuscular route for faster absorption
D. Decreased interval between doses to maintain steady state
Answer: A
Conceptual Explanation: In renal failure, drug clearance is reduced. To prevent toxicity,
the dosage must be lowered or the time between doses increased to allow for elimination.
2. Which statement best describes the ‘first-pass effect’ in pharmacology?
A. The rapid distribution of drug to the brain and heart
B. The binding of a drug to albumin in the bloodstream
C. The metabolism of an oral drug by the liver before it reaches systemic circulation
D. The excretion of a drug through the glomerular filtration system
,Answer: C
Conceptual Explanation: The first-pass effect occurs when drugs absorbed from the GI
tract are carried to the liver via the portal vein and metabolized before reaching the rest of
the body.
3. A patient is receiving a drug with a narrow therapeutic index. What is the nurse’s priority
action?
A. Administer the drug only on an empty stomach
B. Monitor serum drug levels frequently
C. Encourage the patient to increase fluid intake
D. Assess for signs of physical dependence
Answer: B
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small, necessitating close monitoring of blood levels.
4. When administering a beta-1 selective blocker like Metoprolol, which physiological effect
does the nurse expect?
A. Increased myocardial contractility
B. Bronchodilation in the lungs
C. Decreased heart rate and reduced cardiac output
D. Peripheral vasodilation and flushing
, Answer: C
Conceptual Explanation: Beta-1 receptors are primarily in the heart. Blocking them leads
to a decrease in heart rate (negative chronotropic) and contractility (negative inotropic).
5. A patient is experiencing an acute anaphylactic reaction. Why is Epinephrine the drug of
choice?
A. It acts as a selective beta-2 agonist to stop respiratory distress only
B. It stimulates alpha-1, beta-1, and beta-2 receptors to increase BP and cause
bronchodilation
C. It inhibits histamine release by blocking H1 and H2 receptors
D. It provides rapid sedation to calm the patient during the emergency
Answer: B
Conceptual Explanation: Epinephrine is a non-selective adrenergic agonist. Alpha-1
stimulation increases BP, while Beta-2 stimulation causes bronchodilation, treating both
cardiovascular collapse and airway constriction.
6. Which medication is the reversal agent for a patient who has received an overdose of
Lorazepam?
A. Flumazenil
B. Acetylcysteine
C. Naloxone
