NR293 Exam 1 Actual Exam Style V2
1. Which phase of pharmacokinetics is most affected by a patient with severe liver cirrhosis?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
Correct Answer: A
Expert Explanation: Metabolism occurs primarily in the liver through the cytochrome
P450 enzyme system. In patients with cirrhosis, hepatic function is impaired, leading to a
decreased ability to break down drugs. This can result in drug toxicity due to higher-than-
normal levels of the active medication in the bloodstream.
2. When administering an intravenous (IV) medication, the nurse understands that the
bioavailability is:
A. 0%
B. 100%
C. 75%
D. 50%
Correct Answer: B
,Expert Explanation: Bioavailability refers to the proportion of a drug that reaches the
systemic circulation in an unchanged form. Because IV medications are injected directly
into the bloodstream, they bypass the absorption phase and the first-pass effect. Therefore,
the bioavailability of an IV drug is always considered to be 100%.
3. The nurse is preparing to administer a Schedule II medication. Which statement regarding
Schedule II drugs is true?
A. They have no accepted medical use.
B. They have a high potential for abuse but have accepted medical uses.
C. They have a low potential for abuse and can be sold over-the-counter.
D. They are not regulated by the Drug Enforcement Administration (DEA).
Correct Answer: B
Expert Explanation: Schedule II drugs are substances that have a high potential for abuse
which may lead to severe psychological or physical dependence. Despite this risk, they have
currently accepted medical uses in treatment in the United States, such as morphine or
oxycodone. Nurses must follow strict protocols for handling and documenting these
controlled substances to prevent diversion.
4. Which pregnancy category indicates that there is positive evidence of human fetal risk, but
the benefits may outweigh the risk in certain situations?
A. Category A
B. Category D
, C. Category C
D. Category B
Correct Answer: B
Expert Explanation: Category D signifies that studies in pregnant women have
demonstrated a risk to the fetus. However, the drug may still be used if the potential benefit
to the mother outweighs the potential risk to the fetus, such as in life-threatening
situations. This differs from Category X, where the risks clearly outweigh any possible
benefit.
5. An elderly patient has reduced albumin levels. How does this affect the pharmacokinetics
of a highly protein-bound drug?
A. The drug concentration will decrease.
B. The drug will have a shorter half-life.
C. The drug will be excreted more rapidly.
D. The amount of free, active drug will increase.
Correct Answer: D
Expert Explanation: When a drug is highly protein-bound, it attaches to albumin and
remains inactive while bound. If albumin levels are low, there are fewer binding sites
available, leaving more of the drug in its ‘free’ or active state. This increase in free drug can
lead to an increased risk of toxicity and adverse effects in the patient.
1. Which phase of pharmacokinetics is most affected by a patient with severe liver cirrhosis?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
Correct Answer: A
Expert Explanation: Metabolism occurs primarily in the liver through the cytochrome
P450 enzyme system. In patients with cirrhosis, hepatic function is impaired, leading to a
decreased ability to break down drugs. This can result in drug toxicity due to higher-than-
normal levels of the active medication in the bloodstream.
2. When administering an intravenous (IV) medication, the nurse understands that the
bioavailability is:
A. 0%
B. 100%
C. 75%
D. 50%
Correct Answer: B
,Expert Explanation: Bioavailability refers to the proportion of a drug that reaches the
systemic circulation in an unchanged form. Because IV medications are injected directly
into the bloodstream, they bypass the absorption phase and the first-pass effect. Therefore,
the bioavailability of an IV drug is always considered to be 100%.
3. The nurse is preparing to administer a Schedule II medication. Which statement regarding
Schedule II drugs is true?
A. They have no accepted medical use.
B. They have a high potential for abuse but have accepted medical uses.
C. They have a low potential for abuse and can be sold over-the-counter.
D. They are not regulated by the Drug Enforcement Administration (DEA).
Correct Answer: B
Expert Explanation: Schedule II drugs are substances that have a high potential for abuse
which may lead to severe psychological or physical dependence. Despite this risk, they have
currently accepted medical uses in treatment in the United States, such as morphine or
oxycodone. Nurses must follow strict protocols for handling and documenting these
controlled substances to prevent diversion.
4. Which pregnancy category indicates that there is positive evidence of human fetal risk, but
the benefits may outweigh the risk in certain situations?
A. Category A
B. Category D
, C. Category C
D. Category B
Correct Answer: B
Expert Explanation: Category D signifies that studies in pregnant women have
demonstrated a risk to the fetus. However, the drug may still be used if the potential benefit
to the mother outweighs the potential risk to the fetus, such as in life-threatening
situations. This differs from Category X, where the risks clearly outweigh any possible
benefit.
5. An elderly patient has reduced albumin levels. How does this affect the pharmacokinetics
of a highly protein-bound drug?
A. The drug concentration will decrease.
B. The drug will have a shorter half-life.
C. The drug will be excreted more rapidly.
D. The amount of free, active drug will increase.
Correct Answer: D
Expert Explanation: When a drug is highly protein-bound, it attaches to albumin and
remains inactive while bound. If albumin levels are low, there are fewer binding sites
available, leaving more of the drug in its ‘free’ or active state. This increase in free drug can
lead to an increased risk of toxicity and adverse effects in the patient.
