NURS 1150 Exam 1 Actual Exam V2 | NURS 1150 Nurse Pharmacology
I (NURS1150 Exam 1) | Northwest College (NWC)
1. A patient is taking a drug that has a very high first-pass effect. Which route of
administration would be most significantly affected by this process?
A. Intravenous (IV)
B. Sublingual
C. Oral (PO)
D. Transdermal
Answer: C
Rationale: The first-pass effect refers to the metabolism of a drug in the liver after it is
absorbed from the gastrointestinal tract but before it reaches systemic circulation. Drugs
given orally must pass through the portal vein to the liver, where a large portion may be
inactivated. In contrast, IV, sublingual, and transdermal routes bypass the initial trip
through the liver, ensuring higher bioavailability.
2. A physician orders 500 mg of an antibiotic. The medication is available as 250 mg tablets.
How many tablets should the nurse administer?
A. 2 tablets
B. 1 tablet
C. 0.5 tablets
D. 3 tablets
Answer: A
Rationale: To calculate the dosage, the nurse uses the formula ‘Desired over Have’. In this
case, 500 mg divided by 250 mg equals 2. Therefore, the nurse should administer exactly 2
tablets to meet the physician’s order.
3. Which pharmacokinetic process is primarily affected in a patient with chronic renal failure?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: C
,Rationale: The kidneys are the primary organs responsible for the excretion of drugs from
the body. Chronic renal failure impairs the ability of the kidneys to filter and remove drug
metabolites, leading to potential toxicity. Nurses must monitor creatinine levels and
potentially adjust dosages for patients with kidney dysfunction.
4. A drug is described as an ‘agonist.’ What does this term imply regarding the drug’s
interaction with receptors?
A. It blocks the receptor site to prevent a response.
B. It inhibits liver enzymes to increase drug levels.
C. It has no affinity for the receptor but changes cell pH.
D. It binds to the receptor and stimulates a physiological response.
Answer: D
Rationale: An agonist is a medication that binds to a specific receptor and activates it to
produce a biological effect. This mimics the action of endogenous substances like hormones
or neurotransmitters. Conversely, an antagonist would bind to the receptor but block the
response.
5. A nurse is preparing to administer a medication and checks the patient’s wristband against
the medication administration record (MAR). Which ‘Right’ of medication administration is
being practiced?
A. Right Dose
B. Right Patient
C. Right Route
D. Right Time
Answer: B
Rationale: Checking the patient’s identity using two identifiers like a name and birthdate
on a wristband ensures the ‘Right Patient.’ This is a critical safety step to prevent
medication errors involving the wrong individual. It must be performed immediately
before the medication is administered at the bedside.
6. Which lab value is most critical for a nurse to monitor when evaluating a drug that is highly
protein-bound in a malnourished patient?
A. Serum Albumin
B. Blood Urea Nitrogen (BUN)
C. White Blood Cell count
D. Platelet count
, Answer: A
Rationale: Albumin is the primary protein in the blood that drugs bind to during
distribution. If a patient is malnourished and has low albumin levels, there are fewer
binding sites, leading to more ‘free’ active drug in the system. This increases the risk of
drug toxicity because only unbound drug can produce a pharmacological effect.
7. If a drug has a half-life of 4 hours and a dose of 100 mg is given, how much of the drug
remains in the body after 8 hours?
A. 50 mg
B. 12.5 mg
C. 25 mg
D. 0 mg
Answer: C
Rationale: Half-life is the time required for the concentration of the drug in the body to
decrease by 50%. After one half-life (4 hours), 50 mg remains. After a second half-life (8
hours), 50% of that 50 mg remains, which is 25 mg.
8. The nurse notes an order for ‘Tylenol 650 mg PO PRN pain.’ What is missing from this
medication order?
A. The frequency/time interval
B. The dose
C. The route
D. The drug name
Answer: A
Rationale: A complete PRN (as needed) order must include a specific time interval, such as
‘every 4 to 6 hours.’ Without a frequency, the nurse does not know how often the
medication can be safely administered. All legal medication orders must include the drug
name, dose, route, frequency, and purpose.
9. Grapefruit juice is known to inhibit the cytochrome P450 enzyme system in the liver. How
does this affect drugs metabolized by these enzymes?
A. It has no effect on drug levels.
B. It causes the drug to be excreted faster.
C. It prevents the drug from being absorbed.
D. It increases the risk of drug toxicity.
Answer: D
I (NURS1150 Exam 1) | Northwest College (NWC)
1. A patient is taking a drug that has a very high first-pass effect. Which route of
administration would be most significantly affected by this process?
A. Intravenous (IV)
B. Sublingual
C. Oral (PO)
D. Transdermal
Answer: C
Rationale: The first-pass effect refers to the metabolism of a drug in the liver after it is
absorbed from the gastrointestinal tract but before it reaches systemic circulation. Drugs
given orally must pass through the portal vein to the liver, where a large portion may be
inactivated. In contrast, IV, sublingual, and transdermal routes bypass the initial trip
through the liver, ensuring higher bioavailability.
2. A physician orders 500 mg of an antibiotic. The medication is available as 250 mg tablets.
How many tablets should the nurse administer?
A. 2 tablets
B. 1 tablet
C. 0.5 tablets
D. 3 tablets
Answer: A
Rationale: To calculate the dosage, the nurse uses the formula ‘Desired over Have’. In this
case, 500 mg divided by 250 mg equals 2. Therefore, the nurse should administer exactly 2
tablets to meet the physician’s order.
3. Which pharmacokinetic process is primarily affected in a patient with chronic renal failure?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Answer: C
,Rationale: The kidneys are the primary organs responsible for the excretion of drugs from
the body. Chronic renal failure impairs the ability of the kidneys to filter and remove drug
metabolites, leading to potential toxicity. Nurses must monitor creatinine levels and
potentially adjust dosages for patients with kidney dysfunction.
4. A drug is described as an ‘agonist.’ What does this term imply regarding the drug’s
interaction with receptors?
A. It blocks the receptor site to prevent a response.
B. It inhibits liver enzymes to increase drug levels.
C. It has no affinity for the receptor but changes cell pH.
D. It binds to the receptor and stimulates a physiological response.
Answer: D
Rationale: An agonist is a medication that binds to a specific receptor and activates it to
produce a biological effect. This mimics the action of endogenous substances like hormones
or neurotransmitters. Conversely, an antagonist would bind to the receptor but block the
response.
5. A nurse is preparing to administer a medication and checks the patient’s wristband against
the medication administration record (MAR). Which ‘Right’ of medication administration is
being practiced?
A. Right Dose
B. Right Patient
C. Right Route
D. Right Time
Answer: B
Rationale: Checking the patient’s identity using two identifiers like a name and birthdate
on a wristband ensures the ‘Right Patient.’ This is a critical safety step to prevent
medication errors involving the wrong individual. It must be performed immediately
before the medication is administered at the bedside.
6. Which lab value is most critical for a nurse to monitor when evaluating a drug that is highly
protein-bound in a malnourished patient?
A. Serum Albumin
B. Blood Urea Nitrogen (BUN)
C. White Blood Cell count
D. Platelet count
, Answer: A
Rationale: Albumin is the primary protein in the blood that drugs bind to during
distribution. If a patient is malnourished and has low albumin levels, there are fewer
binding sites, leading to more ‘free’ active drug in the system. This increases the risk of
drug toxicity because only unbound drug can produce a pharmacological effect.
7. If a drug has a half-life of 4 hours and a dose of 100 mg is given, how much of the drug
remains in the body after 8 hours?
A. 50 mg
B. 12.5 mg
C. 25 mg
D. 0 mg
Answer: C
Rationale: Half-life is the time required for the concentration of the drug in the body to
decrease by 50%. After one half-life (4 hours), 50 mg remains. After a second half-life (8
hours), 50% of that 50 mg remains, which is 25 mg.
8. The nurse notes an order for ‘Tylenol 650 mg PO PRN pain.’ What is missing from this
medication order?
A. The frequency/time interval
B. The dose
C. The route
D. The drug name
Answer: A
Rationale: A complete PRN (as needed) order must include a specific time interval, such as
‘every 4 to 6 hours.’ Without a frequency, the nurse does not know how often the
medication can be safely administered. All legal medication orders must include the drug
name, dose, route, frequency, and purpose.
9. Grapefruit juice is known to inhibit the cytochrome P450 enzyme system in the liver. How
does this affect drugs metabolized by these enzymes?
A. It has no effect on drug levels.
B. It causes the drug to be excreted faster.
C. It prevents the drug from being absorbed.
D. It increases the risk of drug toxicity.
Answer: D
