NR293 Exam 1 Actual Exam Style V3 | NR
293 Pharmacology for Nursing Practice |
Chamberlain
1. A nurse is preparing to administer an oral medication that undergoes a high first-pass
effect. Which statement best describes this phenomenon?
A. The drug is metabolized by the liver before it reaches systemic circulation.
B. The drug is primarily excreted by the kidneys before reaching the site of action.
C. The drug is absorbed slowly across the gastrointestinal mucosa.
D. The drug binds strongly to plasma proteins, limiting its therapeutic effect.
Answer: A
Rationale: The first-pass effect refers to the metabolism of a drug in the liver after being
absorbed from the GI tract but before reaching the rest of the body. This process can
significantly reduce the bioavailability of oral medications compared to other routes.
Understanding this concept is crucial for nurses when comparing oral doses to parenteral
doses for the same medication.
2. When administering a medication to a geriatric patient, the nurse should be aware that
which physiological change most increases the risk of drug toxicity?
A. Increased total body water.
B. Increased glomerular filtration rate.
,C. Increased gastric acidity.
D. Decreased liver enzyme production and renal function.
Answer: D
Rationale: Aging is typically associated with a decline in organ function, particularly the
liver and kidneys which are responsible for metabolism and excretion. Reduced clearance
leads to a longer half-life and higher plasma concentrations of drugs in older adults. Nurses
must monitor for signs of toxicity and advocate for ‘start low and go slow’ dosing strategies.
3. A patient is prescribed a medication with a narrow therapeutic index. What is the priority
nursing action?
A. Teach the patient to double the dose if they miss one.
B. Administer the medication only on an empty stomach.
C. Assess for allergic reactions after the first dose only.
D. Monitor serum drug levels frequently to prevent toxicity.
Answer: D
Rationale: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Constant monitoring through peak and trough levels is
required to ensure the patient remains within the safe range. Failure to monitor these
drugs closely can result in severe adverse effects or therapeutic failure.
, 4. The nurse is reviewing the rights of medication administration. Which of the following is
considered one of the ‘Six Rights’?
A. Right Documentation
B. Right Room Number
C. Right Manufacturer
D. Right Pharmacy
Answer: A
Rationale: Right documentation is a critical safety step that involves recording the
administration immediately after the drug is given. The traditional six rights include the
right patient, right drug, right dose, right route, right time, and right documentation.
Ensuring these rights helps prevent medication errors and improves patient outcomes.
5. A patient is receiving an intravenous aminoglycoside. The nurse notes the patient is
complaining of ringing in the ears (tinnitus). Which action should the nurse take?
A. Increase the infusion rate to finish the dose faster.
B. Reassure the patient that this is a common and harmless side effect.
C. Recognize this as a sign of ototoxicity and notify the provider.
D. Administer an antihistamine to treat the allergic reaction.
Answer: C
293 Pharmacology for Nursing Practice |
Chamberlain
1. A nurse is preparing to administer an oral medication that undergoes a high first-pass
effect. Which statement best describes this phenomenon?
A. The drug is metabolized by the liver before it reaches systemic circulation.
B. The drug is primarily excreted by the kidneys before reaching the site of action.
C. The drug is absorbed slowly across the gastrointestinal mucosa.
D. The drug binds strongly to plasma proteins, limiting its therapeutic effect.
Answer: A
Rationale: The first-pass effect refers to the metabolism of a drug in the liver after being
absorbed from the GI tract but before reaching the rest of the body. This process can
significantly reduce the bioavailability of oral medications compared to other routes.
Understanding this concept is crucial for nurses when comparing oral doses to parenteral
doses for the same medication.
2. When administering a medication to a geriatric patient, the nurse should be aware that
which physiological change most increases the risk of drug toxicity?
A. Increased total body water.
B. Increased glomerular filtration rate.
,C. Increased gastric acidity.
D. Decreased liver enzyme production and renal function.
Answer: D
Rationale: Aging is typically associated with a decline in organ function, particularly the
liver and kidneys which are responsible for metabolism and excretion. Reduced clearance
leads to a longer half-life and higher plasma concentrations of drugs in older adults. Nurses
must monitor for signs of toxicity and advocate for ‘start low and go slow’ dosing strategies.
3. A patient is prescribed a medication with a narrow therapeutic index. What is the priority
nursing action?
A. Teach the patient to double the dose if they miss one.
B. Administer the medication only on an empty stomach.
C. Assess for allergic reactions after the first dose only.
D. Monitor serum drug levels frequently to prevent toxicity.
Answer: D
Rationale: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Constant monitoring through peak and trough levels is
required to ensure the patient remains within the safe range. Failure to monitor these
drugs closely can result in severe adverse effects or therapeutic failure.
, 4. The nurse is reviewing the rights of medication administration. Which of the following is
considered one of the ‘Six Rights’?
A. Right Documentation
B. Right Room Number
C. Right Manufacturer
D. Right Pharmacy
Answer: A
Rationale: Right documentation is a critical safety step that involves recording the
administration immediately after the drug is given. The traditional six rights include the
right patient, right drug, right dose, right route, right time, and right documentation.
Ensuring these rights helps prevent medication errors and improves patient outcomes.
5. A patient is receiving an intravenous aminoglycoside. The nurse notes the patient is
complaining of ringing in the ears (tinnitus). Which action should the nurse take?
A. Increase the infusion rate to finish the dose faster.
B. Reassure the patient that this is a common and harmless side effect.
C. Recognize this as a sign of ototoxicity and notify the provider.
D. Administer an antihistamine to treat the allergic reaction.
Answer: C
