NUR 210 | NUR210 Final Exam V1 – Updated and Latest Questions
and Correct Answers with Rationale – Galen College of Nursing
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would the nurse expect to be avoided to ensure maximum bioavailability?
A. Oral
B. Intravenous
C. Sublingual
D. Transdermal
Answer: A
Rationale: The first-pass effect occurs when a drug is metabolized in the liver before
reaching systemic circulation, which is characteristic of the oral route. Intravenous,
sublingual, and transdermal routes bypass the liver initially.
2. The nurse is monitoring a patient receiving a drug with a narrow therapeutic index. Which
nursing action is most important?
A. Encourage increased fluid intake
B. Administer the drug with food to prevent GI upset
C. Monitor serum drug levels frequently
D. Assess for a history of allergic reactions
Answer: C
Rationale: A narrow therapeutic index means the difference between a therapeutic dose
and a toxic dose is very small. Frequent monitoring of serum drug levels is required to
ensure the patient remains within the safe range. Failure to monitor can lead to severe
toxicity or subtherapeutic effects.
3. A patient is prescribed Rifampin for the treatment of tuberculosis. Which side effect should
the nurse educate the patient to expect?
A. Peripheral neuropathy
B. Ringing in the ears
C. Severe muscle weakness
D. Orange-red discoloration of body fluids
Answer: D
, Rationale: Rifampin commonly causes a harmless orange-red discoloration of urine, sweat,
tears, and saliva. Patients should be warned so they are not alarmed by the change.
Peripheral neuropathy is more common with Isoniazid (INH).
4. When administering a dose of Digoxin to a patient with heart failure, which vital sign must
the nurse assess first?
A. Blood pressure
B. Apical pulse for one full minute
C. Respiratory rate
D. Oxygen saturation
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. The nurse must assess
the apical pulse for 60 seconds and withhold the medication if the pulse is less than 60
beats per minute in an adult to avoid bradycardia.
5. A patient is receiving Warfarin for deep vein thrombosis. Which laboratory value will the
nurse monitor to evaluate the effectiveness of the therapy?
A. PT/INR
B. aPTT
C. Platelet count
D. Hemoglobin
Answer: A
Rationale: Prothrombin time (PT) and International Normalized Ratio (INR) are used to
monitor Warfarin therapy. Activated partial thromboplastin time (aPTT) is used to monitor
Heparin therapy.
6. The nurse identifies that a patient is experiencing an anaphylactic reaction to an IV
antibiotic. What is the priority nursing action?
A. Call the physician
B. Administer Benadryl
C. Elevate the patient’s head
D. Stop the infusion
Answer: D
Rationale: In any adverse reaction to an intravenous medication, the first and most critical
step is to stop the infusion immediately to prevent further exposure to the allergen.
and Correct Answers with Rationale – Galen College of Nursing
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would the nurse expect to be avoided to ensure maximum bioavailability?
A. Oral
B. Intravenous
C. Sublingual
D. Transdermal
Answer: A
Rationale: The first-pass effect occurs when a drug is metabolized in the liver before
reaching systemic circulation, which is characteristic of the oral route. Intravenous,
sublingual, and transdermal routes bypass the liver initially.
2. The nurse is monitoring a patient receiving a drug with a narrow therapeutic index. Which
nursing action is most important?
A. Encourage increased fluid intake
B. Administer the drug with food to prevent GI upset
C. Monitor serum drug levels frequently
D. Assess for a history of allergic reactions
Answer: C
Rationale: A narrow therapeutic index means the difference between a therapeutic dose
and a toxic dose is very small. Frequent monitoring of serum drug levels is required to
ensure the patient remains within the safe range. Failure to monitor can lead to severe
toxicity or subtherapeutic effects.
3. A patient is prescribed Rifampin for the treatment of tuberculosis. Which side effect should
the nurse educate the patient to expect?
A. Peripheral neuropathy
B. Ringing in the ears
C. Severe muscle weakness
D. Orange-red discoloration of body fluids
Answer: D
, Rationale: Rifampin commonly causes a harmless orange-red discoloration of urine, sweat,
tears, and saliva. Patients should be warned so they are not alarmed by the change.
Peripheral neuropathy is more common with Isoniazid (INH).
4. When administering a dose of Digoxin to a patient with heart failure, which vital sign must
the nurse assess first?
A. Blood pressure
B. Apical pulse for one full minute
C. Respiratory rate
D. Oxygen saturation
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. The nurse must assess
the apical pulse for 60 seconds and withhold the medication if the pulse is less than 60
beats per minute in an adult to avoid bradycardia.
5. A patient is receiving Warfarin for deep vein thrombosis. Which laboratory value will the
nurse monitor to evaluate the effectiveness of the therapy?
A. PT/INR
B. aPTT
C. Platelet count
D. Hemoglobin
Answer: A
Rationale: Prothrombin time (PT) and International Normalized Ratio (INR) are used to
monitor Warfarin therapy. Activated partial thromboplastin time (aPTT) is used to monitor
Heparin therapy.
6. The nurse identifies that a patient is experiencing an anaphylactic reaction to an IV
antibiotic. What is the priority nursing action?
A. Call the physician
B. Administer Benadryl
C. Elevate the patient’s head
D. Stop the infusion
Answer: D
Rationale: In any adverse reaction to an intravenous medication, the first and most critical
step is to stop the infusion immediately to prevent further exposure to the allergen.
