NUR 210 | NUR210 Exam 1 V1 – Updated and Latest Questions and
Correct Answers with Rationale – Galen College of Nursing
1. A nurse is preparing to administer an oral medication to a patient with chronic liver failure.
Which pharmacokinetic process is most likely to be affected in this patient?
A. Absorption
B. Metabolism
C. Distribution
D. Excretion
Answer: B
Rationale: Metabolism is primarily the responsibility of the liver where drugs are
chemically altered for easier excretion. In chronic liver failure, the enzymatic pathways are
often compromised, leading to slower breakdown of drugs. This delay can cause
medication levels to rise to toxic levels within the patient’s system. While other processes
like distribution are affected by albumin levels, metabolism is the most direct hepatic
pharmacokinetic function. Nurses must monitor liver enzyme tests to ensure safe
medication administration in these patients.
2. When educating a patient about a new medication with a long half-life, which statement
by the nurse is most accurate?
A. The medication will leave the body very quickly.
B. It will take longer for the medication to reach a steady state.
C. The medication will need to be taken every 4 hours.
D. You will likely experience immediate side effects that disappear within an hour.
Answer: B
Rationale: Half-life refers to the time required for the concentration of a drug in the body
to decrease by 50%. A long half-life means the drug stays in the system for an extended
period, requiring less frequent dosing. Steady state is generally reached after
approximately four to five half-lives have passed. Therefore, drugs with longer half-lives
take significantly more time to achieve stable therapeutic levels in the blood. Nurses must
explain this to patients so they do not expect immediate therapeutic results from
medications like certain antidepressants.
3. A nurse is reviewing a medication order that reads: ‘Digoxin 0.125 mg PO daily.’ Which of
the six rights of medication administration is the nurse primarily verifying by checking the
dose against the drug guide?
A. Right Patient
,B. Right Route
C. Right Time
D. Right Dose
Answer: D
Rationale: Checking the specific milligram amount against evidence-based resources
ensures that the prescribed amount is within the safe therapeutic range. Digoxin has a
narrow therapeutic index, making the ‘Right Dose’ critical to prevent toxicity or
subtherapeutic effects. The nurse must verify that the ordered dose matches both the
prescriber’s intent and the manufacturer’s recommendations. Errors in dosage calculations
or transcription are leading causes of adverse drug events in clinical settings. This step is a
vital safety barrier before the medication reaches the patient.
4. A patient is prescribed a drug that acts as an antagonist. How should the nurse explain the
mechanism of action of this drug to the patient?
A. The drug will stimulate a specific receptor to produce a response.
B. The drug will increase the number of receptors available for hormones.
C. The drug will bind to a receptor and prevent other substances from activating it.
D. The drug will change the genetic structure of the cell permanently.
Answer: C
Rationale: Antagonists work by binding to receptors but not activating them, effectively
blocking other molecules like neurotransmitters from binding. This ‘blocking’ action
prevents the typical physiological response associated with that receptor site. Unlike
agonists, which trigger a biological effect, antagonists essentially produce their effect by
stopping something else from happening. A common example is a beta-blocker, which
prevents adrenaline from increasing the heart rate. Understanding this concept helps the
nurse anticipate how the drug will alter the patient’s physiological state.
5. Which factor should the nurse prioritize when assessing for potential drug toxicity in an 85-
year-old patient?
A. Decreased glomerular filtration rate (GFR)
B. Increased gastric motility
C. Increased total body water
D. Decreased body fat percentage
Answer: A
Rationale: Aging is associated with a natural decline in renal function, which significantly
reduces the body’s ability to excrete drugs. When the glomerular filtration rate decreases,
, drugs can accumulate in the bloodstream, leading to toxicity. Older adults typically have
less total body water and more body fat, altering the distribution of various medications.
Nurses must monitor creatinine clearance and serum creatinine levels rather than just BUN
to assess renal health in the elderly. Ensuring proper dosing based on renal function is a
hallmark of safe geriatric nursing practice.
6. The nurse is preparing to administer a sublingual medication. Which instruction should the
nurse provide to the patient?
A. Swallow the tablet with a full glass of water.
B. Chew the tablet thoroughly before swallowing.
C. Place the tablet under the tongue and let it dissolve completely.
D. Dissolve the tablet in 30 mL of juice before drinking.
Answer: C
Rationale: Sublingual administration involves placing a drug under the tongue where it is
absorbed directly into the systemic circulation through the mucous membranes. This route
bypasses the first-pass effect of the liver, allowing for rapid onset of action. The patient
must be instructed not to swallow or chew the medication, as this would direct it to the
stomach. Drinking fluids while the tablet is dissolving can also wash the medication down
the esophagus, reducing its effectiveness. The nurse should verify that the patient remains
still until the drug has fully disappeared from view.
7. A patient experiences a sudden onset of urticaria, wheezing, and hypotension after the
first dose of an IV antibiotic. What is the nurse’s priority action?
A. Slow the infusion rate and call the provider.
B. Elevate the patient’s head of the bed to 90 degrees.
C. Administer an antihistamine as ordered.
D. Stop the infusion immediately.
Answer: D
Rationale: The patient is demonstrating signs of anaphylaxis, which is a life-threatening
allergic reaction. The very first step in managing a suspected transfusion or infusion
reaction is to stop the offending agent immediately. Once the infusion is stopped, the nurse
should assess the patient’s airway and prepare for emergency interventions like
epinephrine. Hypotension and wheezing indicate systemic involvement that requires rapid
stabilization. Simply slowing the rate is insufficient and dangerous because exposure to the
allergen continues.
8. Which statement best describes the ‘First-Pass Effect’?
A. The initial metabolism of an oral drug in the liver before it reaches systemic circulation.
B. The time it takes for a drug to reach its peak concentration.
Correct Answers with Rationale – Galen College of Nursing
1. A nurse is preparing to administer an oral medication to a patient with chronic liver failure.
Which pharmacokinetic process is most likely to be affected in this patient?
A. Absorption
B. Metabolism
C. Distribution
D. Excretion
Answer: B
Rationale: Metabolism is primarily the responsibility of the liver where drugs are
chemically altered for easier excretion. In chronic liver failure, the enzymatic pathways are
often compromised, leading to slower breakdown of drugs. This delay can cause
medication levels to rise to toxic levels within the patient’s system. While other processes
like distribution are affected by albumin levels, metabolism is the most direct hepatic
pharmacokinetic function. Nurses must monitor liver enzyme tests to ensure safe
medication administration in these patients.
2. When educating a patient about a new medication with a long half-life, which statement
by the nurse is most accurate?
A. The medication will leave the body very quickly.
B. It will take longer for the medication to reach a steady state.
C. The medication will need to be taken every 4 hours.
D. You will likely experience immediate side effects that disappear within an hour.
Answer: B
Rationale: Half-life refers to the time required for the concentration of a drug in the body
to decrease by 50%. A long half-life means the drug stays in the system for an extended
period, requiring less frequent dosing. Steady state is generally reached after
approximately four to five half-lives have passed. Therefore, drugs with longer half-lives
take significantly more time to achieve stable therapeutic levels in the blood. Nurses must
explain this to patients so they do not expect immediate therapeutic results from
medications like certain antidepressants.
3. A nurse is reviewing a medication order that reads: ‘Digoxin 0.125 mg PO daily.’ Which of
the six rights of medication administration is the nurse primarily verifying by checking the
dose against the drug guide?
A. Right Patient
,B. Right Route
C. Right Time
D. Right Dose
Answer: D
Rationale: Checking the specific milligram amount against evidence-based resources
ensures that the prescribed amount is within the safe therapeutic range. Digoxin has a
narrow therapeutic index, making the ‘Right Dose’ critical to prevent toxicity or
subtherapeutic effects. The nurse must verify that the ordered dose matches both the
prescriber’s intent and the manufacturer’s recommendations. Errors in dosage calculations
or transcription are leading causes of adverse drug events in clinical settings. This step is a
vital safety barrier before the medication reaches the patient.
4. A patient is prescribed a drug that acts as an antagonist. How should the nurse explain the
mechanism of action of this drug to the patient?
A. The drug will stimulate a specific receptor to produce a response.
B. The drug will increase the number of receptors available for hormones.
C. The drug will bind to a receptor and prevent other substances from activating it.
D. The drug will change the genetic structure of the cell permanently.
Answer: C
Rationale: Antagonists work by binding to receptors but not activating them, effectively
blocking other molecules like neurotransmitters from binding. This ‘blocking’ action
prevents the typical physiological response associated with that receptor site. Unlike
agonists, which trigger a biological effect, antagonists essentially produce their effect by
stopping something else from happening. A common example is a beta-blocker, which
prevents adrenaline from increasing the heart rate. Understanding this concept helps the
nurse anticipate how the drug will alter the patient’s physiological state.
5. Which factor should the nurse prioritize when assessing for potential drug toxicity in an 85-
year-old patient?
A. Decreased glomerular filtration rate (GFR)
B. Increased gastric motility
C. Increased total body water
D. Decreased body fat percentage
Answer: A
Rationale: Aging is associated with a natural decline in renal function, which significantly
reduces the body’s ability to excrete drugs. When the glomerular filtration rate decreases,
, drugs can accumulate in the bloodstream, leading to toxicity. Older adults typically have
less total body water and more body fat, altering the distribution of various medications.
Nurses must monitor creatinine clearance and serum creatinine levels rather than just BUN
to assess renal health in the elderly. Ensuring proper dosing based on renal function is a
hallmark of safe geriatric nursing practice.
6. The nurse is preparing to administer a sublingual medication. Which instruction should the
nurse provide to the patient?
A. Swallow the tablet with a full glass of water.
B. Chew the tablet thoroughly before swallowing.
C. Place the tablet under the tongue and let it dissolve completely.
D. Dissolve the tablet in 30 mL of juice before drinking.
Answer: C
Rationale: Sublingual administration involves placing a drug under the tongue where it is
absorbed directly into the systemic circulation through the mucous membranes. This route
bypasses the first-pass effect of the liver, allowing for rapid onset of action. The patient
must be instructed not to swallow or chew the medication, as this would direct it to the
stomach. Drinking fluids while the tablet is dissolving can also wash the medication down
the esophagus, reducing its effectiveness. The nurse should verify that the patient remains
still until the drug has fully disappeared from view.
7. A patient experiences a sudden onset of urticaria, wheezing, and hypotension after the
first dose of an IV antibiotic. What is the nurse’s priority action?
A. Slow the infusion rate and call the provider.
B. Elevate the patient’s head of the bed to 90 degrees.
C. Administer an antihistamine as ordered.
D. Stop the infusion immediately.
Answer: D
Rationale: The patient is demonstrating signs of anaphylaxis, which is a life-threatening
allergic reaction. The very first step in managing a suspected transfusion or infusion
reaction is to stop the offending agent immediately. Once the infusion is stopped, the nurse
should assess the patient’s airway and prepare for emergency interventions like
epinephrine. Hypotension and wheezing indicate systemic involvement that requires rapid
stabilization. Simply slowing the rate is insufficient and dangerous because exposure to the
allergen continues.
8. Which statement best describes the ‘First-Pass Effect’?
A. The initial metabolism of an oral drug in the liver before it reaches systemic circulation.
B. The time it takes for a drug to reach its peak concentration.
