NURSING PHARMACOLOGY
COMPREHENSIVE EXAM (NURS 180)
QUESTIONS AND ANSWERS
1. A patient with chronic kidney disease is prescribed a drug that is primarily excreted by the
kidneys. The nurse should anticipate which pharmacological adjustment?
A. Increased dosing frequency
B. Reduced dosage to prevent toxicity
C. Switching to an intravenous route
D. Addition of a loading dose
Answer: B
Conceptual Explanation: In patients with renal impairment, the excretion of drugs is
slowed, leading to accumulation and potential toxicity. Therefore, the dosage or frequency
must be reduced.
2. Which pharmacokinetic process is most significantly affected by the ‘first-pass effect’ in the
liver?
A. Metabolism
B. Excretion
,C. Absorption
D. Distribution
Answer: A
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug absorbed from the gastrointestinal tract before it reaches the systemic circulation.
3. A drug has a half-life of 4 hours. If a dose of 100 mg is administered, how much of the drug
will remain in the body after 12 hours?
A. 50 mg
B. 25 mg
C. 12.5 mg
D. 6.25 mg
Answer: C
Conceptual Explanation: After 12 hours (3 half-lives), the amount remains: 100 to 50 (1),
50 to 25 (2), 25 to 12.5 (3).
4. The nurse is monitoring a patient receiving a drug with a narrow therapeutic index. Which
action is most important?
A. Monitoring serum drug levels closely
B. Encouraging high fluid intake
C. Assessing for subjective side effects only
, D. Administering the drug with food
Answer: A
Conceptual Explanation: Drugs with a narrow therapeutic index have a small margin
between safety and toxicity, requiring precise blood level monitoring.
5. A patient is receiving bethanechol for urinary retention. Which finding would indicate a
potential adverse effect of this cholinergic agonist?
A. Tachycardia
B. Dry mouth
C. Bronchoconstriction
D. Constipation
Answer: C
Conceptual Explanation: Cholinergic agonists stimulate the parasympathetic nervous
system, which can cause bronchoconstriction, bradycardia, and increased secretions.
6. What is the primary mechanism of action of Atropine?
A. Alpha-adrenergic agonist
B. Beta-blocker
C. Muscarinic antagonist
D. Cholinesterase inhibitor
COMPREHENSIVE EXAM (NURS 180)
QUESTIONS AND ANSWERS
1. A patient with chronic kidney disease is prescribed a drug that is primarily excreted by the
kidneys. The nurse should anticipate which pharmacological adjustment?
A. Increased dosing frequency
B. Reduced dosage to prevent toxicity
C. Switching to an intravenous route
D. Addition of a loading dose
Answer: B
Conceptual Explanation: In patients with renal impairment, the excretion of drugs is
slowed, leading to accumulation and potential toxicity. Therefore, the dosage or frequency
must be reduced.
2. Which pharmacokinetic process is most significantly affected by the ‘first-pass effect’ in the
liver?
A. Metabolism
B. Excretion
,C. Absorption
D. Distribution
Answer: A
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug absorbed from the gastrointestinal tract before it reaches the systemic circulation.
3. A drug has a half-life of 4 hours. If a dose of 100 mg is administered, how much of the drug
will remain in the body after 12 hours?
A. 50 mg
B. 25 mg
C. 12.5 mg
D. 6.25 mg
Answer: C
Conceptual Explanation: After 12 hours (3 half-lives), the amount remains: 100 to 50 (1),
50 to 25 (2), 25 to 12.5 (3).
4. The nurse is monitoring a patient receiving a drug with a narrow therapeutic index. Which
action is most important?
A. Monitoring serum drug levels closely
B. Encouraging high fluid intake
C. Assessing for subjective side effects only
, D. Administering the drug with food
Answer: A
Conceptual Explanation: Drugs with a narrow therapeutic index have a small margin
between safety and toxicity, requiring precise blood level monitoring.
5. A patient is receiving bethanechol for urinary retention. Which finding would indicate a
potential adverse effect of this cholinergic agonist?
A. Tachycardia
B. Dry mouth
C. Bronchoconstriction
D. Constipation
Answer: C
Conceptual Explanation: Cholinergic agonists stimulate the parasympathetic nervous
system, which can cause bronchoconstriction, bradycardia, and increased secretions.
6. What is the primary mechanism of action of Atropine?
A. Alpha-adrenergic agonist
B. Beta-blocker
C. Muscarinic antagonist
D. Cholinesterase inhibitor
