NURS 305 Exam 1 V2 | NURS 305 Pharmacology | Actual Q&A with
Rationale (NURS305 Exam 1) | Liberty University
1. A patient is prescribed a medication that undergoes a high first-pass effect. Which route of
administration would result in the lowest bioavailability for this drug?
A. Intravenous
B. Sublingual
C. Rectal
D. Oral
Answer: D
Explanation: Drugs administered orally travel from the gastrointestinal tract to the portal
vein and into the liver before reaching systemic circulation. A high first-pass effect means a
significant portion of the drug is metabolized by the liver, drastically reducing
bioavailability. Routes such as intravenous or sublingual bypass this initial hepatic
metabolism entirely.
2. When assessing an elderly patient, the nurse notes a decrease in total body water and
albumin levels. How will these physiological changes affect drug distribution?
A. Water-soluble drugs will have a larger volume of distribution.
B. Higher concentrations of highly protein-bound drugs will remain free in the
bloodstream.
C. Lipid-soluble drugs will be excreted more rapidly by the kidneys.
D. Drug toxicity is less likely because of decreased absorption.
Answer: B
Explanation: Geriatric patients often have reduced albumin levels, which leads to fewer
binding sites for highly protein-bound medications. Consequently, there is a higher
percentage of ‘free’ or active drug in the plasma, increasing the risk of toxicity. This
physiological shift necessitates careful monitoring and potential dosage adjustments by the
provider.
3. The nurse is reviewing the ‘Rights of Medication Administration’. Which of the following is
considered one of the primary safety checks before administering a drug?
A. Right Hospital
B. Right Documentation
C. Right Insurance
,D. Right Physician
Answer: B
Explanation: Right documentation is an essential component of the ‘Rights’ to ensure that
every dose given is recorded accurately to prevent double-dosing. It serves as a legal
record and a communication tool among the healthcare team. Other primary rights include
right patient, right drug, right dose, right route, and right time.
4. A drug has a half-life of 4 hours. If a patient receives a dose of 400 mg at 12:00 PM, how
much of the drug will remain in the body at 8:00 PM?
A. 200 mg
B. 50 mg
C. 100 mg
D. 0 mg
Answer: C
Explanation: The half-life of a drug is the time required for the concentration to decrease
by 50%. After 4 hours (4:00 PM), 200 mg remains; after another 4 hours (8:00 PM), half of
that 200 mg remains, which is 100 mg. Understanding half-life is critical for determining
dosing intervals and the time required to reach steady state.
5. Which schedule of controlled substances has the highest potential for abuse while still
having an accepted medical use in the United States?
A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule V
Answer: B
Explanation: Schedule II drugs, such as morphine and oxycodone, have a high potential for
abuse and severe psychological or physical dependence. Unlike Schedule I drugs, they do
have currently accepted medical uses but are subject to strict regulatory controls. Schedule
V drugs have the lowest potential for abuse among the controlled categories.
6. A patient is participating in a Phase I clinical trial. The nurse understands that the primary
goal of this phase is to:
A. Test the drug on a large number of patients with the target disease.
B. Compare the drug against existing standard treatments.
C. Obtain final FDA approval for marketing the drug.
, D. Determine the safe dosage range and identify side effects in healthy volunteers.
Answer: D
Explanation: Phase I clinical trials focus on safety and pharmacokinetics using a small
group of healthy volunteers. Researchers monitor for toxicities and establish the safe dose
range for human use. Phases II and III involve testing efficacy and safety in larger
populations of patients who actually have the condition.
7. A patient has a low serum albumin level. When the nurse administers a highly protein-
bound medication, what is the most significant risk?
A. The drug will be inactive.
B. The drug will be excreted too quickly.
C. Increased risk of drug toxicity.
D. Decreased absorption from the GI tract.
Answer: C
Explanation: Protein-bound drugs are pharmacologically inactive while attached to
albumin. With low albumin levels, more drug remains ‘free’ or unbound, which increases
the therapeutic effect and the risk of toxic side effects. Nurses must monitor patients with
malnutrition or liver disease closely when they take these medications.
8. The nurse is educating a pregnant patient about FDA pregnancy categories. Which category
indicates that the drug is contraindicated in pregnancy due to proven fetal risk?
A. Category A
B. Category B
C. Category X
D. Category C
Answer: C
Explanation: Category X signifies that studies in animals or humans have demonstrated
positive evidence of fetal abnormalities. The risks involved in using the drug in pregnant
women clearly outweigh any potential benefits. Healthcare providers must ensure patients
of childbearing age are aware of these risks.
9. Which pharmacological term describes the process by which a drug moves from its site of
administration into the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
Rationale (NURS305 Exam 1) | Liberty University
1. A patient is prescribed a medication that undergoes a high first-pass effect. Which route of
administration would result in the lowest bioavailability for this drug?
A. Intravenous
B. Sublingual
C. Rectal
D. Oral
Answer: D
Explanation: Drugs administered orally travel from the gastrointestinal tract to the portal
vein and into the liver before reaching systemic circulation. A high first-pass effect means a
significant portion of the drug is metabolized by the liver, drastically reducing
bioavailability. Routes such as intravenous or sublingual bypass this initial hepatic
metabolism entirely.
2. When assessing an elderly patient, the nurse notes a decrease in total body water and
albumin levels. How will these physiological changes affect drug distribution?
A. Water-soluble drugs will have a larger volume of distribution.
B. Higher concentrations of highly protein-bound drugs will remain free in the
bloodstream.
C. Lipid-soluble drugs will be excreted more rapidly by the kidneys.
D. Drug toxicity is less likely because of decreased absorption.
Answer: B
Explanation: Geriatric patients often have reduced albumin levels, which leads to fewer
binding sites for highly protein-bound medications. Consequently, there is a higher
percentage of ‘free’ or active drug in the plasma, increasing the risk of toxicity. This
physiological shift necessitates careful monitoring and potential dosage adjustments by the
provider.
3. The nurse is reviewing the ‘Rights of Medication Administration’. Which of the following is
considered one of the primary safety checks before administering a drug?
A. Right Hospital
B. Right Documentation
C. Right Insurance
,D. Right Physician
Answer: B
Explanation: Right documentation is an essential component of the ‘Rights’ to ensure that
every dose given is recorded accurately to prevent double-dosing. It serves as a legal
record and a communication tool among the healthcare team. Other primary rights include
right patient, right drug, right dose, right route, and right time.
4. A drug has a half-life of 4 hours. If a patient receives a dose of 400 mg at 12:00 PM, how
much of the drug will remain in the body at 8:00 PM?
A. 200 mg
B. 50 mg
C. 100 mg
D. 0 mg
Answer: C
Explanation: The half-life of a drug is the time required for the concentration to decrease
by 50%. After 4 hours (4:00 PM), 200 mg remains; after another 4 hours (8:00 PM), half of
that 200 mg remains, which is 100 mg. Understanding half-life is critical for determining
dosing intervals and the time required to reach steady state.
5. Which schedule of controlled substances has the highest potential for abuse while still
having an accepted medical use in the United States?
A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule V
Answer: B
Explanation: Schedule II drugs, such as morphine and oxycodone, have a high potential for
abuse and severe psychological or physical dependence. Unlike Schedule I drugs, they do
have currently accepted medical uses but are subject to strict regulatory controls. Schedule
V drugs have the lowest potential for abuse among the controlled categories.
6. A patient is participating in a Phase I clinical trial. The nurse understands that the primary
goal of this phase is to:
A. Test the drug on a large number of patients with the target disease.
B. Compare the drug against existing standard treatments.
C. Obtain final FDA approval for marketing the drug.
, D. Determine the safe dosage range and identify side effects in healthy volunteers.
Answer: D
Explanation: Phase I clinical trials focus on safety and pharmacokinetics using a small
group of healthy volunteers. Researchers monitor for toxicities and establish the safe dose
range for human use. Phases II and III involve testing efficacy and safety in larger
populations of patients who actually have the condition.
7. A patient has a low serum albumin level. When the nurse administers a highly protein-
bound medication, what is the most significant risk?
A. The drug will be inactive.
B. The drug will be excreted too quickly.
C. Increased risk of drug toxicity.
D. Decreased absorption from the GI tract.
Answer: C
Explanation: Protein-bound drugs are pharmacologically inactive while attached to
albumin. With low albumin levels, more drug remains ‘free’ or unbound, which increases
the therapeutic effect and the risk of toxic side effects. Nurses must monitor patients with
malnutrition or liver disease closely when they take these medications.
8. The nurse is educating a pregnant patient about FDA pregnancy categories. Which category
indicates that the drug is contraindicated in pregnancy due to proven fetal risk?
A. Category A
B. Category B
C. Category X
D. Category C
Answer: C
Explanation: Category X signifies that studies in animals or humans have demonstrated
positive evidence of fetal abnormalities. The risks involved in using the drug in pregnant
women clearly outweigh any potential benefits. Healthcare providers must ensure patients
of childbearing age are aware of these risks.
9. Which pharmacological term describes the process by which a drug moves from its site of
administration into the bloodstream?
A. Distribution
B. Metabolism
C. Absorption
