NURS 1150 Final Exam Actual Exam V2 | NURS 1150 Nurse
Pharmacology I (NURS1150 Final Exam) | Northwest College (NWC)
1. A patient is prescribed an oral medication that undergoes a high first-pass effect. Which
statement by the nurse best explains this concept?
A. The drug is rapidly excreted by the kidneys before it can work.
B. The medication binds to plasma proteins and remains inactive.
C. The drug is absorbed through the stomach lining very slowly.
D. The medication is metabolized by the liver before reaching systemic circulation.
Answer: D
Rationale: The first-pass effect occurs when a drug is absorbed from the GI tract and
enters the portal circulation for transport to the liver. The liver metabolizes a significant
portion of the drug before it ever reaches the rest of the body. This process explains why
oral doses of certain medications are much higher than their intravenous counterparts.
2. When administering a medication with a narrow therapeutic index, which nursing action is
most important?
A. Teach the patient to take the drug twice a day regardless of timing.
B. Encourage the patient to increase fluid intake to prevent constipation.
C. Administer the drug only when the patient has an empty stomach.
D. Monitor the patient for signs of drug toxicity through blood levels.
Answer: D
Rationale: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. The nurse must monitor serum drug levels closely to
ensure safety and efficacy. Frequent clinical assessment for adverse effects is also required
to prevent harm to the patient.
3. A patient who is taking warfarin (Coumadin) has an International Normalized Ratio (INR) of
1.2. How should the nurse interpret this result?
A. The INR is too high, and the patient is at risk for bleeding.
B. The INR is within the expected therapeutic range for anticoagulation.
C. The INR indicates that the patient has developed liver failure.
D. The INR is subtherapeutic, and the patient is at risk for clots.
Answer: D
,Rationale: The typical therapeutic INR range for a patient on warfarin is between 2.0 and
3.0. An INR of 1.2 is low, indicating that the blood is clotting too quickly and the medication
dose may need to be increased. The nurse should report this value to the provider to
prevent potential thromboembolic events.
4. The nurse is preparing to administer digoxin to a patient. Which vital sign must be assessed
for one full minute prior to administration?
A. Apical pulse
B. Respiratory rate
C. Blood pressure
D. Oxygen saturation
Answer: A
Rationale: Digoxin is a cardiac glycoside that slows the heart rate and increases the force
of contraction. The nurse must assess the apical pulse for one full minute to ensure it is at
least 60 beats per minute. If the heart rate is below the specified threshold, the dose must
be withheld and the provider notified.
5. A patient is prescribed furosemide (Lasix) for heart failure. Which electrolyte imbalance is
the patient most at risk for developing?
A. Hypercalcemia
B. Hypomagnesemia
C. Hypernatremia
D. Hypokalemia
Answer: D
Rationale: Furosemide is a loop diuretic that causes the kidneys to excrete water, sodium,
and potassium. Potassium loss is a major concern that can lead to cardiac dysrhythmias
and muscle weakness. Patients are often encouraged to consume potassium-rich foods or
take a potassium supplement while on this therapy.
6. A patient is scheduled to receive a dose of insulin lispro (Humalog) at 0800. At what time
should the nurse ensure the patient’s breakfast is available?
A. Food is not required until lunch for this type of insulin.
B. By 0900, because lispro takes about an hour to start working.
C. By 1000, to match the peak action of the insulin.
D. By 0815, because lispro has a very rapid onset of action.
Answer: D
, Rationale: Insulin lispro is a rapid-acting insulin with an onset of 10 to 30 minutes. The
nurse must ensure that the patient has food ready to eat shortly after administration to
prevent hypoglycemia. Administering this insulin without food nearby is a significant
safety risk.
7. A nurse is caring for a patient receiving gentamicin, an aminoglycoside. Which two organs
are most commonly affected by toxic levels of this drug?
A. Liver and Pancreas
B. Lungs and Heart
C. Kidneys and Ears
D. Stomach and Brain
Answer: C
Rationale: Aminoglycosides like gentamicin are known for causing nephrotoxicity and
ototoxicity. The nurse should monitor serum creatinine and BUN levels to assess renal
function. Additionally, the patient should be assessed for hearing loss or tinnitus, which are
early signs of ear damage.
8. Which assessment finding is a hallmark adverse effect of ACE inhibitors, such as lisinopril?
A. Peripheral edema
B. Persistent dry cough
C. Tachycardia
D. Hypoglycemia
Answer: B
Rationale: A persistent, dry, nonproductive cough is a common side effect of ACE
inhibitors due to the accumulation of bradykinin in the lungs. This side effect is often the
primary reason patients switch to an Angiotensin II Receptor Blocker (ARB). The nurse
should educate the patient that the cough will likely not resolve until the medication is
stopped.
9. A patient with a history of asthma is diagnosed with hypertension. Which medication class
should the nurse question if prescribed?
A. Calcium channel blockers
B. Non-selective beta blockers
C. Thiazide diuretics
D. ACE inhibitors
Answer: B
Pharmacology I (NURS1150 Final Exam) | Northwest College (NWC)
1. A patient is prescribed an oral medication that undergoes a high first-pass effect. Which
statement by the nurse best explains this concept?
A. The drug is rapidly excreted by the kidneys before it can work.
B. The medication binds to plasma proteins and remains inactive.
C. The drug is absorbed through the stomach lining very slowly.
D. The medication is metabolized by the liver before reaching systemic circulation.
Answer: D
Rationale: The first-pass effect occurs when a drug is absorbed from the GI tract and
enters the portal circulation for transport to the liver. The liver metabolizes a significant
portion of the drug before it ever reaches the rest of the body. This process explains why
oral doses of certain medications are much higher than their intravenous counterparts.
2. When administering a medication with a narrow therapeutic index, which nursing action is
most important?
A. Teach the patient to take the drug twice a day regardless of timing.
B. Encourage the patient to increase fluid intake to prevent constipation.
C. Administer the drug only when the patient has an empty stomach.
D. Monitor the patient for signs of drug toxicity through blood levels.
Answer: D
Rationale: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. The nurse must monitor serum drug levels closely to
ensure safety and efficacy. Frequent clinical assessment for adverse effects is also required
to prevent harm to the patient.
3. A patient who is taking warfarin (Coumadin) has an International Normalized Ratio (INR) of
1.2. How should the nurse interpret this result?
A. The INR is too high, and the patient is at risk for bleeding.
B. The INR is within the expected therapeutic range for anticoagulation.
C. The INR indicates that the patient has developed liver failure.
D. The INR is subtherapeutic, and the patient is at risk for clots.
Answer: D
,Rationale: The typical therapeutic INR range for a patient on warfarin is between 2.0 and
3.0. An INR of 1.2 is low, indicating that the blood is clotting too quickly and the medication
dose may need to be increased. The nurse should report this value to the provider to
prevent potential thromboembolic events.
4. The nurse is preparing to administer digoxin to a patient. Which vital sign must be assessed
for one full minute prior to administration?
A. Apical pulse
B. Respiratory rate
C. Blood pressure
D. Oxygen saturation
Answer: A
Rationale: Digoxin is a cardiac glycoside that slows the heart rate and increases the force
of contraction. The nurse must assess the apical pulse for one full minute to ensure it is at
least 60 beats per minute. If the heart rate is below the specified threshold, the dose must
be withheld and the provider notified.
5. A patient is prescribed furosemide (Lasix) for heart failure. Which electrolyte imbalance is
the patient most at risk for developing?
A. Hypercalcemia
B. Hypomagnesemia
C. Hypernatremia
D. Hypokalemia
Answer: D
Rationale: Furosemide is a loop diuretic that causes the kidneys to excrete water, sodium,
and potassium. Potassium loss is a major concern that can lead to cardiac dysrhythmias
and muscle weakness. Patients are often encouraged to consume potassium-rich foods or
take a potassium supplement while on this therapy.
6. A patient is scheduled to receive a dose of insulin lispro (Humalog) at 0800. At what time
should the nurse ensure the patient’s breakfast is available?
A. Food is not required until lunch for this type of insulin.
B. By 0900, because lispro takes about an hour to start working.
C. By 1000, to match the peak action of the insulin.
D. By 0815, because lispro has a very rapid onset of action.
Answer: D
, Rationale: Insulin lispro is a rapid-acting insulin with an onset of 10 to 30 minutes. The
nurse must ensure that the patient has food ready to eat shortly after administration to
prevent hypoglycemia. Administering this insulin without food nearby is a significant
safety risk.
7. A nurse is caring for a patient receiving gentamicin, an aminoglycoside. Which two organs
are most commonly affected by toxic levels of this drug?
A. Liver and Pancreas
B. Lungs and Heart
C. Kidneys and Ears
D. Stomach and Brain
Answer: C
Rationale: Aminoglycosides like gentamicin are known for causing nephrotoxicity and
ototoxicity. The nurse should monitor serum creatinine and BUN levels to assess renal
function. Additionally, the patient should be assessed for hearing loss or tinnitus, which are
early signs of ear damage.
8. Which assessment finding is a hallmark adverse effect of ACE inhibitors, such as lisinopril?
A. Peripheral edema
B. Persistent dry cough
C. Tachycardia
D. Hypoglycemia
Answer: B
Rationale: A persistent, dry, nonproductive cough is a common side effect of ACE
inhibitors due to the accumulation of bradykinin in the lungs. This side effect is often the
primary reason patients switch to an Angiotensin II Receptor Blocker (ARB). The nurse
should educate the patient that the cough will likely not resolve until the medication is
stopped.
9. A patient with a history of asthma is diagnosed with hypertension. Which medication class
should the nurse question if prescribed?
A. Calcium channel blockers
B. Non-selective beta blockers
C. Thiazide diuretics
D. ACE inhibitors
Answer: B
