NUR2474 PHARMACOLOGY MIDTERM
EXAM COMPREHENSIVE REVIEW
(LATEST 2026/ 2027 UPDATE)
QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS| GRADE A+
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would be least effective for achieving a therapeutic systemic drug level?
A. Intravenous
B. Oral
C. Sublingual
D. Transdermal
Answer: B
Conceptual Explanation: The first-pass effect occurs when a drug is metabolized by the
liver before reaching systemic circulation. Oral drugs pass through the portal vein to the
liver first, significantly reducing bioavailability compared to parenteral or sublingual
routes.
,2. A nurse is monitoring a patient receiving Gentamicin. The nurse knows that this drug has a
narrow therapeutic index. What does this indicate?
A. The drug is only effective against a few types of bacteria.
B. The drug has a very long half-life.
C. The drug must be taken on an empty stomach to be absorbed.
D. The difference between a therapeutic dose and a toxic dose is small.
Answer: D
Conceptual Explanation: A narrow therapeutic index means there is a very small margin
of safety between the dose that is effective and the dose that is toxic, requiring close
monitoring of serum drug levels.
3. Which of the following is a primary characteristic of a drug that acts as an agonist?
A. It binds to a receptor and triggers a physiological response.
B. It blocks the receptor site to prevent activation.
C. It decreases the affinity of other drugs for the receptor.
D. It accelerates the excretion of other chemicals.
Answer: A
Conceptual Explanation: Agonists are drugs that bind to receptors and mimic the body’s
own regulatory molecules, thereby activating the receptor to produce a biological response.
, 4. A patient with a history of asthma is prescribed Propranolol for hypertension. Why is this
medication contraindicated for this patient?
A. It causes excessive tachycardia.
B. It masks the symptoms of hypoglycemia.
C. It increases the risk of metabolic acidosis.
D. It is a non-selective beta-blocker that can cause bronchoconstriction.
Answer: D
Conceptual Explanation: Propranolol is a non-selective beta-adrenergic antagonist. By
blocking Beta-2 receptors in the lungs, it can cause bronchospasm, which is dangerous for
patients with asthma or COPD.
5. A patient is receiving Bethanechol for urinary retention. The nurse should monitor for
which side effect related to cholinergic activation?
A. Dry mouth
B. Tachycardia
C. Excessive salivation
D. Constipation
Answer: C
EXAM COMPREHENSIVE REVIEW
(LATEST 2026/ 2027 UPDATE)
QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS| GRADE A+
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would be least effective for achieving a therapeutic systemic drug level?
A. Intravenous
B. Oral
C. Sublingual
D. Transdermal
Answer: B
Conceptual Explanation: The first-pass effect occurs when a drug is metabolized by the
liver before reaching systemic circulation. Oral drugs pass through the portal vein to the
liver first, significantly reducing bioavailability compared to parenteral or sublingual
routes.
,2. A nurse is monitoring a patient receiving Gentamicin. The nurse knows that this drug has a
narrow therapeutic index. What does this indicate?
A. The drug is only effective against a few types of bacteria.
B. The drug has a very long half-life.
C. The drug must be taken on an empty stomach to be absorbed.
D. The difference between a therapeutic dose and a toxic dose is small.
Answer: D
Conceptual Explanation: A narrow therapeutic index means there is a very small margin
of safety between the dose that is effective and the dose that is toxic, requiring close
monitoring of serum drug levels.
3. Which of the following is a primary characteristic of a drug that acts as an agonist?
A. It binds to a receptor and triggers a physiological response.
B. It blocks the receptor site to prevent activation.
C. It decreases the affinity of other drugs for the receptor.
D. It accelerates the excretion of other chemicals.
Answer: A
Conceptual Explanation: Agonists are drugs that bind to receptors and mimic the body’s
own regulatory molecules, thereby activating the receptor to produce a biological response.
, 4. A patient with a history of asthma is prescribed Propranolol for hypertension. Why is this
medication contraindicated for this patient?
A. It causes excessive tachycardia.
B. It masks the symptoms of hypoglycemia.
C. It increases the risk of metabolic acidosis.
D. It is a non-selective beta-blocker that can cause bronchoconstriction.
Answer: D
Conceptual Explanation: Propranolol is a non-selective beta-adrenergic antagonist. By
blocking Beta-2 receptors in the lungs, it can cause bronchospasm, which is dangerous for
patients with asthma or COPD.
5. A patient is receiving Bethanechol for urinary retention. The nurse should monitor for
which side effect related to cholinergic activation?
A. Dry mouth
B. Tachycardia
C. Excessive salivation
D. Constipation
Answer: C
