NURS 180 PHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient is prescribed a drug with a narrow therapeutic index. Which nursing action is
most critical during the administration of this medication?
A. Administer the drug with a full glass of water to improve absorption.
B. Assess the patient’s heart rate before each dose.
C. Educate the patient on the importance of taking the medication with food.
D. Monitor serum drug levels frequently to prevent toxicity.
Answer: D
Conceptual Explanation: Drugs with a narrow therapeutic index have a small margin
between a therapeutic dose and a toxic dose, necessitating close monitoring of serum
levels.
2. Which pharmacokinetic process is most affected in a patient with end-stage renal disease?
A. Excretion
B. Absorption
C. Metabolism
,D. Distribution
Answer: A
Conceptual Explanation: The kidneys are the primary organs for drug excretion. Impaired
renal function leads to decreased clearance and potential accumulation of drugs.
3. A patient is receiving intravenous vancomycin. The nurse notes the patient’s face and neck
are becoming flushed and red. What is the priority nursing action?
A. Stop the infusion immediately and notify the physician.
B. Slow the infusion rate and monitor for further symptoms.
C. Administer intramuscular epinephrine.
D. Apply cold compresses to the affected areas.
Answer: B
Conceptual Explanation: Red Man Syndrome is a rate-related infusion reaction, not a true
allergy. Slowing the infusion rate usually resolves the symptoms.
4. Which mechanism of action describes how Beta-1 selective blockers affect the
cardiovascular system?
A. Increase peripheral vascular resistance.
B. Promote bronchodilation in the lungs.
C. Decrease heart rate and myocardial contractility.
D. Stimulate the release of renin from the kidneys.
, Answer: C
Conceptual Explanation: Beta-1 receptors are located primarily in the heart. Blocking
them leads to a decrease in heart rate (negative chronotropic) and contractility (negative
inotropic).
5. A patient taking Warfarin (Coumadin) has an International Normalized Ratio (INR) of 5.5.
The nurse should anticipate an order for which antidote?
A. Protamine sulfate
B. Glucagon
C. Vitamin K
D. Naloxone
Answer: C
Conceptual Explanation: Vitamin K is the reversal agent for Warfarin. Protamine sulfate is
for Heparin, Glucagon is for Beta-blocker overdose, and Naloxone is for Opioids.
6. When administering Lisinopril, which electrolyte imbalance should the nurse monitor for?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient is prescribed a drug with a narrow therapeutic index. Which nursing action is
most critical during the administration of this medication?
A. Administer the drug with a full glass of water to improve absorption.
B. Assess the patient’s heart rate before each dose.
C. Educate the patient on the importance of taking the medication with food.
D. Monitor serum drug levels frequently to prevent toxicity.
Answer: D
Conceptual Explanation: Drugs with a narrow therapeutic index have a small margin
between a therapeutic dose and a toxic dose, necessitating close monitoring of serum
levels.
2. Which pharmacokinetic process is most affected in a patient with end-stage renal disease?
A. Excretion
B. Absorption
C. Metabolism
,D. Distribution
Answer: A
Conceptual Explanation: The kidneys are the primary organs for drug excretion. Impaired
renal function leads to decreased clearance and potential accumulation of drugs.
3. A patient is receiving intravenous vancomycin. The nurse notes the patient’s face and neck
are becoming flushed and red. What is the priority nursing action?
A. Stop the infusion immediately and notify the physician.
B. Slow the infusion rate and monitor for further symptoms.
C. Administer intramuscular epinephrine.
D. Apply cold compresses to the affected areas.
Answer: B
Conceptual Explanation: Red Man Syndrome is a rate-related infusion reaction, not a true
allergy. Slowing the infusion rate usually resolves the symptoms.
4. Which mechanism of action describes how Beta-1 selective blockers affect the
cardiovascular system?
A. Increase peripheral vascular resistance.
B. Promote bronchodilation in the lungs.
C. Decrease heart rate and myocardial contractility.
D. Stimulate the release of renin from the kidneys.
, Answer: C
Conceptual Explanation: Beta-1 receptors are located primarily in the heart. Blocking
them leads to a decrease in heart rate (negative chronotropic) and contractility (negative
inotropic).
5. A patient taking Warfarin (Coumadin) has an International Normalized Ratio (INR) of 5.5.
The nurse should anticipate an order for which antidote?
A. Protamine sulfate
B. Glucagon
C. Vitamin K
D. Naloxone
Answer: C
Conceptual Explanation: Vitamin K is the reversal agent for Warfarin. Protamine sulfate is
for Heparin, Glucagon is for Beta-blocker overdose, and Naloxone is for Opioids.
6. When administering Lisinopril, which electrolyte imbalance should the nurse monitor for?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypocalcemia
Answer: B
