NR293 Exam 1 Actual Exam Style V3 | NR
293 Pharmacology for Nursing Practice |
Chamberlain
1. A nurse is reviewing the pharmacokinetics of a newly prescribed drug. Which factor would
the nurse identify as most significantly affecting the drug’s absorption from the
gastrointestinal tract?
A. The patient’s blood urea nitrogen (BUN) levels.
B. The presence of plasma protein binding sites.
C. The rate of drug metabolism in the liver.
D. The lipid solubility of the medication.
Correct Answer: D
Expert Explanation: Lipid solubility is a primary factor because the cell membranes of the
GI tract are composed of lipids, allowing lipid-soluble drugs to pass through easily. Drugs
that are highly lipid-soluble are absorbed more rapidly than those that are not. BUN levels
relate to excretion, while metabolism and protein binding occur after absorption.
2. When administering a drug with a high first-pass effect, the nurse understands that:
A. The drug must be given via the intravenous route to be effective.
B. The oral dose will likely be much higher than an intravenous dose.
C. The drug will bypass the liver before entering systemic circulation.
,D. The drug is primarily excreted through the biliary system.
Correct Answer: B
Expert Explanation: The first-pass effect occurs when a significant amount of an oral
medication is metabolized by the liver before reaching systemic circulation. To compensate
for this loss, clinicians must prescribe a higher oral dose compared to a parenteral dose.
This process ensures that a therapeutic concentration of the drug eventually reaches the
target tissues.
3. The nurse is caring for a patient with chronic renal failure. What adjustment in drug dosing
does the nurse anticipate?
A. Reduced dosage or increased dosing intervals.
B. Higher dosage amounts.
C. Increased frequency of dosing.
D. Switching to drugs with longer half-lives.
Correct Answer: A
Expert Explanation: Renal failure impairs the body’s ability to excrete drugs, leading to a
risk of accumulation and toxicity. Therefore, doses are typically reduced or the time
between doses is extended to allow the kidneys more time to process the medication.
Monitoring serum drug levels is often necessary in these patients to ensure safety.
, 4. A drug has a half-life of 4 hours. If a patient takes 200 mg of the drug at 12:00 PM, how
much of the drug will remain in the patient’s body at 8:00 PM?
A. 100 mg
B. 12.5 mg
C. 25 mg
D. 50 mg
Correct Answer: D
Expert Explanation: The half-life is the time required for the concentration of a drug to
decrease by half. After 4 hours (4:00 PM), 100 mg remains; after another 4 hours (8:00
PM), which is two half-lives total, 50 mg remains. Understanding half-life is critical for
determining dosing schedules and steady-state concentrations.
5. The nurse is administering an agonist medication. What is the expected mechanism of
action for this drug?
A. It binds to a receptor and prevents a biological response.
B. It blocks the action of endogenous chemicals in the body.
C. It destroys the receptor site to prevent further stimulation.
D. It binds to a receptor and stimulates a physiological response.
Correct Answer: D
293 Pharmacology for Nursing Practice |
Chamberlain
1. A nurse is reviewing the pharmacokinetics of a newly prescribed drug. Which factor would
the nurse identify as most significantly affecting the drug’s absorption from the
gastrointestinal tract?
A. The patient’s blood urea nitrogen (BUN) levels.
B. The presence of plasma protein binding sites.
C. The rate of drug metabolism in the liver.
D. The lipid solubility of the medication.
Correct Answer: D
Expert Explanation: Lipid solubility is a primary factor because the cell membranes of the
GI tract are composed of lipids, allowing lipid-soluble drugs to pass through easily. Drugs
that are highly lipid-soluble are absorbed more rapidly than those that are not. BUN levels
relate to excretion, while metabolism and protein binding occur after absorption.
2. When administering a drug with a high first-pass effect, the nurse understands that:
A. The drug must be given via the intravenous route to be effective.
B. The oral dose will likely be much higher than an intravenous dose.
C. The drug will bypass the liver before entering systemic circulation.
,D. The drug is primarily excreted through the biliary system.
Correct Answer: B
Expert Explanation: The first-pass effect occurs when a significant amount of an oral
medication is metabolized by the liver before reaching systemic circulation. To compensate
for this loss, clinicians must prescribe a higher oral dose compared to a parenteral dose.
This process ensures that a therapeutic concentration of the drug eventually reaches the
target tissues.
3. The nurse is caring for a patient with chronic renal failure. What adjustment in drug dosing
does the nurse anticipate?
A. Reduced dosage or increased dosing intervals.
B. Higher dosage amounts.
C. Increased frequency of dosing.
D. Switching to drugs with longer half-lives.
Correct Answer: A
Expert Explanation: Renal failure impairs the body’s ability to excrete drugs, leading to a
risk of accumulation and toxicity. Therefore, doses are typically reduced or the time
between doses is extended to allow the kidneys more time to process the medication.
Monitoring serum drug levels is often necessary in these patients to ensure safety.
, 4. A drug has a half-life of 4 hours. If a patient takes 200 mg of the drug at 12:00 PM, how
much of the drug will remain in the patient’s body at 8:00 PM?
A. 100 mg
B. 12.5 mg
C. 25 mg
D. 50 mg
Correct Answer: D
Expert Explanation: The half-life is the time required for the concentration of a drug to
decrease by half. After 4 hours (4:00 PM), 100 mg remains; after another 4 hours (8:00
PM), which is two half-lives total, 50 mg remains. Understanding half-life is critical for
determining dosing schedules and steady-state concentrations.
5. The nurse is administering an agonist medication. What is the expected mechanism of
action for this drug?
A. It binds to a receptor and prevents a biological response.
B. It blocks the action of endogenous chemicals in the body.
C. It destroys the receptor site to prevent further stimulation.
D. It binds to a receptor and stimulates a physiological response.
Correct Answer: D
