UR 210 Final Exam V1 | NUR 210 Pharmacology |
Actual Q&A with Rationale (NUR 210 NFinal Exam)
| Galen
1. A nurse is preparing to administer an oral medication that undergoes extensive first-pass
metabolism. What is the primary implication for the route of administration?
A. The drug will have a higher bioavailability than the IV form.
B. The medication is more likely to cause systemic toxicity via the oral route.
C. The drug must be administered with food to prevent gastric irritation.
D. The oral dose will likely be significantly higher than an intravenous dose.
Correct Answer: D
Explanation: The first-pass effect involves the metabolism of a drug by the liver after
absorption from the gastrointestinal tract but before reaching systemic circulation. This
process results in a decreased amount of active drug available to the body tissues.
Consequently, oral doses are usually much larger than parenteral doses to compensate for
this initial loss.
2. A patient is receiving digoxin for heart failure. Which clinical finding should the nurse
prioritize as a potential sign of digoxin toxicity?
A. Visual disturbances such as yellow-green halos
B. Heart rate of 88 beats per minute
,C. Increased urinary output
D. Dry, hacking non-productive cough
Correct Answer: A
Explanation: Visual changes, such as yellow or green halos around lights, are classic signs
of digoxin toxicity. Other early signs include anorexia, nausea, and bradycardia. The nurse
must monitor serum levels and apical pulse before administration to ensure patient safety.
3. A nurse is educating a client about the administration of sublingual nitroglycerin tablets.
Which instruction is most important to include?
A. Swallow the tablet with a full glass of water.
B. Place the tablet under the tongue and allow it to dissolve completely.
C. Take the medication every 15 minutes for up to 5 doses.
D. Chew the tablet thoroughly to speed up absorption during an attack.
Correct Answer: B
Explanation: Sublingual nitroglycerin must be placed under the tongue to bypass the
digestive system and enter the bloodstream directly through the oral mucosa. Swallowing
or chewing the tablet would lead to extensive first-pass metabolism and render it
ineffective. Clients should also be taught to sit down when taking it due to the risk of
orthostatic hypotension.
, 4. A client is prescribed warfarin for the prevention of deep vein thrombosis. Which
laboratory value should the nurse monitor to assess the effectiveness of the therapy?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Correct Answer: C
Explanation: The INR is the standard laboratory test used to monitor the therapeutic
effect of warfarin. The target range for most conditions is between 2.0 and 3.0. A high INR
indicates a risk for bleeding, while a low INR suggests a risk for clot formation.
5. A nurse is reviewing the medication list for a client with a history of asthma who is now
prescribed propranolol. What is the nurse’s primary concern?
A. The medication may cause excessive tachycardia.
B. Propranolol can trigger bronchoconstriction.
C. The drug will likely lead to severe hypertension.
D. This medication is contraindicated in patients with a history of stroke.
Correct Answer: B
Explanation: Propranolol is a non-selective beta-blocker that affects both Beta-1 and Beta-
2 receptors. Blocking Beta-2 receptors in the lungs can cause bronchospasm and airway
Actual Q&A with Rationale (NUR 210 NFinal Exam)
| Galen
1. A nurse is preparing to administer an oral medication that undergoes extensive first-pass
metabolism. What is the primary implication for the route of administration?
A. The drug will have a higher bioavailability than the IV form.
B. The medication is more likely to cause systemic toxicity via the oral route.
C. The drug must be administered with food to prevent gastric irritation.
D. The oral dose will likely be significantly higher than an intravenous dose.
Correct Answer: D
Explanation: The first-pass effect involves the metabolism of a drug by the liver after
absorption from the gastrointestinal tract but before reaching systemic circulation. This
process results in a decreased amount of active drug available to the body tissues.
Consequently, oral doses are usually much larger than parenteral doses to compensate for
this initial loss.
2. A patient is receiving digoxin for heart failure. Which clinical finding should the nurse
prioritize as a potential sign of digoxin toxicity?
A. Visual disturbances such as yellow-green halos
B. Heart rate of 88 beats per minute
,C. Increased urinary output
D. Dry, hacking non-productive cough
Correct Answer: A
Explanation: Visual changes, such as yellow or green halos around lights, are classic signs
of digoxin toxicity. Other early signs include anorexia, nausea, and bradycardia. The nurse
must monitor serum levels and apical pulse before administration to ensure patient safety.
3. A nurse is educating a client about the administration of sublingual nitroglycerin tablets.
Which instruction is most important to include?
A. Swallow the tablet with a full glass of water.
B. Place the tablet under the tongue and allow it to dissolve completely.
C. Take the medication every 15 minutes for up to 5 doses.
D. Chew the tablet thoroughly to speed up absorption during an attack.
Correct Answer: B
Explanation: Sublingual nitroglycerin must be placed under the tongue to bypass the
digestive system and enter the bloodstream directly through the oral mucosa. Swallowing
or chewing the tablet would lead to extensive first-pass metabolism and render it
ineffective. Clients should also be taught to sit down when taking it due to the risk of
orthostatic hypotension.
, 4. A client is prescribed warfarin for the prevention of deep vein thrombosis. Which
laboratory value should the nurse monitor to assess the effectiveness of the therapy?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Correct Answer: C
Explanation: The INR is the standard laboratory test used to monitor the therapeutic
effect of warfarin. The target range for most conditions is between 2.0 and 3.0. A high INR
indicates a risk for bleeding, while a low INR suggests a risk for clot formation.
5. A nurse is reviewing the medication list for a client with a history of asthma who is now
prescribed propranolol. What is the nurse’s primary concern?
A. The medication may cause excessive tachycardia.
B. Propranolol can trigger bronchoconstriction.
C. The drug will likely lead to severe hypertension.
D. This medication is contraindicated in patients with a history of stroke.
Correct Answer: B
Explanation: Propranolol is a non-selective beta-blocker that affects both Beta-1 and Beta-
2 receptors. Blocking Beta-2 receptors in the lungs can cause bronchospasm and airway
