NUR 210 | NUR210 Exam 1 V3 – Updated and Latest Questions and
Correct Answers with Rationale – Galen College of Nursing
1. A nurse is performing medication reconciliation for a newly admitted patient. Which action
best describes this process?
A. Checking the pharmacy’s stock for availability of prescribed medications.
B. Verifying that the patient’s insurance covers the cost of the drugs.
C. Comparing the patient’s current list of home medications with new prescriptions.
D. Ensuring the patient has no history of drug allergies or sensitivities.
Answer: C
Rationale: Medication reconciliation is the process of creating the most accurate list
possible of all medications a patient is taking. The nurse compares this list against the
physician’s admission, transfer, and discharge orders. This practice is critical for
preventing medication errors such as omissions, duplications, or dosing errors. It should be
conducted at every transition of care to ensure continuity. The ultimate goal is to provide a
safe and effective transition for the patient across the healthcare continuum.
2. A patient is prescribed a drug that has a very high first-pass effect. Which route of
administration would most likely be avoided to ensure therapeutic blood levels?
A. Intravenous
B. Subcutaneous
C. Sublingual
D. Oral
Answer: D
Rationale: The first-pass effect refers to the rapid hepatic inactivation of certain oral drugs
before they reach systemic circulation. Drugs taken orally are absorbed from the GI tract
and carried directly to the liver via the hepatic portal vein. If the liver’s capacity to
metabolize the drug is high, the drug can be entirely inactivated on its first pass. To
circumvent this, these drugs are often administered via routes that bypass the liver, such as
parenteral or sublingual routes. Nurses must understand this concept to rationalize why
specific routes are chosen for certain medications.
3. Which pharmacokinetic process is most significantly affected by a patient’s
hypoalbuminemia?
A. Absorption
B. Distribution
,C. Metabolism
D. Excretion
Answer: B
Rationale: Distribution involves the transport of a drug by the bloodstream to its site of
action. Many drugs bind to proteins, primarily albumin, while traveling in the blood. If a
patient has low albumin levels (hypoalbuminemia), there are fewer binding sites available
for the drug. This leads to an increase in the concentration of ‘free’ or active drug, which
can potentially cause toxicity. Nurses must monitor patients with malnutrition or liver
disease closely when they are prescribed protein-bound medications.
4. An 80-year-old patient is being prescribed a new medication. Which physiological change in
the elderly should the nurse consider regarding drug excretion?
A. Increased gastric pH
B. Increased hepatic blood flow
C. Decreased glomerular filtration rate (GFR)
D. Increased body fat percentage
Answer: C
Rationale: Renal function typically declines with age, leading to a decreased glomerular
filtration rate (GFR). This reduction means the kidneys are less efficient at clearing drugs
from the body during the excretion phase. Consequently, drugs can accumulate to toxic
levels if dosages are not adjusted for the elderly. Monitoring serum creatinine and
creatinine clearance is essential to assess renal capability in geriatric patients. This
physiological shift is the most common cause of adverse drug reactions in this population.
5. A nurse is administering a medication that acts as an agonist. What is the expected effect
of this drug?
A. It blocks the receptor site to prevent activation.
B. It binds to a receptor and mimics the body’s own regulatory molecules.
C. It causes a permanent change in the structure of the cell membrane.
D. It neutralizes toxic substances already present in the bloodstream.
Answer: B
Rationale: Agonists are molecules that activate receptors by binding to them and
mimicking the effect of endogenous ligands. By binding to these receptors, agonists
produce a physiological response similar to the body’s natural chemicals. In contrast,
antagonists prevent receptor activation by blocking the binding sites. Understanding the
agonist-receptor interaction is fundamental to predicting drug therapeutic outcomes.
, Nurses must distinguish between these mechanisms to explain how a drug achieves its
intended clinical effect.
6. The nurse is preparing to administer a drug with a narrow therapeutic index. Which nursing
action is most appropriate?
A. Administer the drug at the patient’s request for pain.
B. Double the dose if the patient misses a scheduled time.
C. Monitor serum drug levels closely as ordered.
D. Encourage the patient to drink more fluids to dilute the drug.
Answer: C
Rationale: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Medications in this category require precise dosing and
frequent monitoring of blood levels to ensure safety. If levels are too low, the drug will be
ineffective; if too high, toxicity will occur. Examples include digoxin, lithium, and phenytoin.
The nurse plays a vital role in coordinating laboratory draws for peak and trough levels to
guide therapy.
7. A patient is prescribed a medication that is known to be teratogenic. What is the priority
nursing assessment?
A. The patient’s current blood pressure.
B. The patient’s history of alcohol consumption.
C. The patient’s dietary intake of potassium.
D. The patient’s last menstrual period and pregnancy status.
Answer: D
Rationale: A teratogen is a substance that can cause developmental abnormalities or death
to a fetus. Therefore, before administering any teratogenic drug, the nurse must ensure the
patient is not pregnant. This involves assessment of the last menstrual period and often a
pregnancy test. Educating the patient on effective contraception is also a critical nursing
responsibility. Safety for the unborn child is a primary ethical and legal consideration in
pharmacology.
8. Which of the following is a symptom of a cholinergic crisis?
A. Dry mouth and constipation
B. Tachycardia and hypertension
C. Excessive salivation and muscle fasciculations
D. Urinary retention and dilated pupils
Correct Answers with Rationale – Galen College of Nursing
1. A nurse is performing medication reconciliation for a newly admitted patient. Which action
best describes this process?
A. Checking the pharmacy’s stock for availability of prescribed medications.
B. Verifying that the patient’s insurance covers the cost of the drugs.
C. Comparing the patient’s current list of home medications with new prescriptions.
D. Ensuring the patient has no history of drug allergies or sensitivities.
Answer: C
Rationale: Medication reconciliation is the process of creating the most accurate list
possible of all medications a patient is taking. The nurse compares this list against the
physician’s admission, transfer, and discharge orders. This practice is critical for
preventing medication errors such as omissions, duplications, or dosing errors. It should be
conducted at every transition of care to ensure continuity. The ultimate goal is to provide a
safe and effective transition for the patient across the healthcare continuum.
2. A patient is prescribed a drug that has a very high first-pass effect. Which route of
administration would most likely be avoided to ensure therapeutic blood levels?
A. Intravenous
B. Subcutaneous
C. Sublingual
D. Oral
Answer: D
Rationale: The first-pass effect refers to the rapid hepatic inactivation of certain oral drugs
before they reach systemic circulation. Drugs taken orally are absorbed from the GI tract
and carried directly to the liver via the hepatic portal vein. If the liver’s capacity to
metabolize the drug is high, the drug can be entirely inactivated on its first pass. To
circumvent this, these drugs are often administered via routes that bypass the liver, such as
parenteral or sublingual routes. Nurses must understand this concept to rationalize why
specific routes are chosen for certain medications.
3. Which pharmacokinetic process is most significantly affected by a patient’s
hypoalbuminemia?
A. Absorption
B. Distribution
,C. Metabolism
D. Excretion
Answer: B
Rationale: Distribution involves the transport of a drug by the bloodstream to its site of
action. Many drugs bind to proteins, primarily albumin, while traveling in the blood. If a
patient has low albumin levels (hypoalbuminemia), there are fewer binding sites available
for the drug. This leads to an increase in the concentration of ‘free’ or active drug, which
can potentially cause toxicity. Nurses must monitor patients with malnutrition or liver
disease closely when they are prescribed protein-bound medications.
4. An 80-year-old patient is being prescribed a new medication. Which physiological change in
the elderly should the nurse consider regarding drug excretion?
A. Increased gastric pH
B. Increased hepatic blood flow
C. Decreased glomerular filtration rate (GFR)
D. Increased body fat percentage
Answer: C
Rationale: Renal function typically declines with age, leading to a decreased glomerular
filtration rate (GFR). This reduction means the kidneys are less efficient at clearing drugs
from the body during the excretion phase. Consequently, drugs can accumulate to toxic
levels if dosages are not adjusted for the elderly. Monitoring serum creatinine and
creatinine clearance is essential to assess renal capability in geriatric patients. This
physiological shift is the most common cause of adverse drug reactions in this population.
5. A nurse is administering a medication that acts as an agonist. What is the expected effect
of this drug?
A. It blocks the receptor site to prevent activation.
B. It binds to a receptor and mimics the body’s own regulatory molecules.
C. It causes a permanent change in the structure of the cell membrane.
D. It neutralizes toxic substances already present in the bloodstream.
Answer: B
Rationale: Agonists are molecules that activate receptors by binding to them and
mimicking the effect of endogenous ligands. By binding to these receptors, agonists
produce a physiological response similar to the body’s natural chemicals. In contrast,
antagonists prevent receptor activation by blocking the binding sites. Understanding the
agonist-receptor interaction is fundamental to predicting drug therapeutic outcomes.
, Nurses must distinguish between these mechanisms to explain how a drug achieves its
intended clinical effect.
6. The nurse is preparing to administer a drug with a narrow therapeutic index. Which nursing
action is most appropriate?
A. Administer the drug at the patient’s request for pain.
B. Double the dose if the patient misses a scheduled time.
C. Monitor serum drug levels closely as ordered.
D. Encourage the patient to drink more fluids to dilute the drug.
Answer: C
Rationale: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Medications in this category require precise dosing and
frequent monitoring of blood levels to ensure safety. If levels are too low, the drug will be
ineffective; if too high, toxicity will occur. Examples include digoxin, lithium, and phenytoin.
The nurse plays a vital role in coordinating laboratory draws for peak and trough levels to
guide therapy.
7. A patient is prescribed a medication that is known to be teratogenic. What is the priority
nursing assessment?
A. The patient’s current blood pressure.
B. The patient’s history of alcohol consumption.
C. The patient’s dietary intake of potassium.
D. The patient’s last menstrual period and pregnancy status.
Answer: D
Rationale: A teratogen is a substance that can cause developmental abnormalities or death
to a fetus. Therefore, before administering any teratogenic drug, the nurse must ensure the
patient is not pregnant. This involves assessment of the last menstrual period and often a
pregnancy test. Educating the patient on effective contraception is also a critical nursing
responsibility. Safety for the unborn child is a primary ethical and legal consideration in
pharmacology.
8. Which of the following is a symptom of a cholinergic crisis?
A. Dry mouth and constipation
B. Tachycardia and hypertension
C. Excessive salivation and muscle fasciculations
D. Urinary retention and dilated pupils
