PHARMACOLOGY WEEK QUIZ (NURS
180) 2026 QUESTIONS AND ANSWERS
1. A patient is prescribed a medication that is highly protein-bound. If the patient has a low
serum albumin level, what is the most likely pharmacological outcome?
A. The drug will remain inactive in the bloodstream
B. The drug will be excreted more slowly by the kidneys
C. There will be a higher concentration of free, active drug, increasing risk of toxicity
D. The drug will require a higher dose to achieve therapeutic effects
Answer: C
Conceptual Explanation: Drugs that are protein-bound attach to albumin; only ‘free’
drugs are active. Low albumin results in fewer binding sites, leading to more free drug and
potential toxicity.
2. When administering a drug with a narrow therapeutic index, which nursing action is most
critical?
A. Checking the patient’s blood pressure before administration
B. Administering the drug with a full meal
C. Encouraging the patient to increase fluid intake
,D. Monitoring serum drug levels closely
Answer: D
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is very small, requiring precise monitoring of blood
levels.
3. The nurse is teaching a patient about a new prescription for an enteric-coated medication.
Which instruction is correct?
A. Crush the tablet if it is too difficult to swallow
B. Do not crush or chew the tablet, as it is designed to dissolve in the small intestine
C. Dissolve the tablet in orange juice to improve absorption
D. Take the medication with an antacid to prevent stomach upset
Answer: B
Conceptual Explanation: Enteric coatings protect the stomach from the drug or the drug
from stomach acid; crushing them destroys this mechanism and may cause gastric
irritation or premature drug release.
4. A patient experiences an idiosyncratic reaction to a medication. How should the nurse
define this to the patient’s family?
A. An expected side effect of the drug
B. An uncommon and unexpected response peculiar to the individual
, C. A predictable allergic reaction involving hives
D. A cumulative effect due to impaired metabolism
Answer: B
Conceptual Explanation: An idiosyncratic reaction is an unpredictable, individualized
response that is not related to the drug’s known pharmacological properties or an allergy.
5. During the ‘first-pass effect’, what primarily happens to a drug?
A. It is rapidly excreted by the lungs
B. It is absorbed through the gastric mucosa into the bloodstream
C. It binds to receptors in the central nervous system
D. It is metabolized by the liver before reaching systemic circulation
Answer: D
Conceptual Explanation: The first-pass effect occurs when orally administered drugs
travel through the portal vein to the liver, where they are partially metabolized before
reaching the rest of the body.
6. A patient is receiving Bethanechol (Urecholine) for urinary retention. Which assessment
finding would indicate a potential adverse effect of this cholinergic drug?
A. Dry mouth and constipation
B. Bronchoconstriction and increased secretions
C. Tachycardia and hypertension
180) 2026 QUESTIONS AND ANSWERS
1. A patient is prescribed a medication that is highly protein-bound. If the patient has a low
serum albumin level, what is the most likely pharmacological outcome?
A. The drug will remain inactive in the bloodstream
B. The drug will be excreted more slowly by the kidneys
C. There will be a higher concentration of free, active drug, increasing risk of toxicity
D. The drug will require a higher dose to achieve therapeutic effects
Answer: C
Conceptual Explanation: Drugs that are protein-bound attach to albumin; only ‘free’
drugs are active. Low albumin results in fewer binding sites, leading to more free drug and
potential toxicity.
2. When administering a drug with a narrow therapeutic index, which nursing action is most
critical?
A. Checking the patient’s blood pressure before administration
B. Administering the drug with a full meal
C. Encouraging the patient to increase fluid intake
,D. Monitoring serum drug levels closely
Answer: D
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is very small, requiring precise monitoring of blood
levels.
3. The nurse is teaching a patient about a new prescription for an enteric-coated medication.
Which instruction is correct?
A. Crush the tablet if it is too difficult to swallow
B. Do not crush or chew the tablet, as it is designed to dissolve in the small intestine
C. Dissolve the tablet in orange juice to improve absorption
D. Take the medication with an antacid to prevent stomach upset
Answer: B
Conceptual Explanation: Enteric coatings protect the stomach from the drug or the drug
from stomach acid; crushing them destroys this mechanism and may cause gastric
irritation or premature drug release.
4. A patient experiences an idiosyncratic reaction to a medication. How should the nurse
define this to the patient’s family?
A. An expected side effect of the drug
B. An uncommon and unexpected response peculiar to the individual
, C. A predictable allergic reaction involving hives
D. A cumulative effect due to impaired metabolism
Answer: B
Conceptual Explanation: An idiosyncratic reaction is an unpredictable, individualized
response that is not related to the drug’s known pharmacological properties or an allergy.
5. During the ‘first-pass effect’, what primarily happens to a drug?
A. It is rapidly excreted by the lungs
B. It is absorbed through the gastric mucosa into the bloodstream
C. It binds to receptors in the central nervous system
D. It is metabolized by the liver before reaching systemic circulation
Answer: D
Conceptual Explanation: The first-pass effect occurs when orally administered drugs
travel through the portal vein to the liver, where they are partially metabolized before
reaching the rest of the body.
6. A patient is receiving Bethanechol (Urecholine) for urinary retention. Which assessment
finding would indicate a potential adverse effect of this cholinergic drug?
A. Dry mouth and constipation
B. Bronchoconstriction and increased secretions
C. Tachycardia and hypertension
