NUR 110 – Pharmacology for Nurses |
Comprehensive Examination 110 Practice
Questions with Answers & Rationales
Question 1
A nurse is teaching a client about a newly prescribed medication. The client asks,
"What does 'half-life' mean?" The nurse's best response is:
A) "The time it takes for half of the medication to be absorbed into the
bloodstream"
B) "The time it takes for half of the medication to be eliminated from the body"
C) "The time it takes for the medication to reach its peak effect"
D) "The time it takes for the medication to start working"
Answer: B
Rationale: Half-life is the time required for the concentration of a drug in the body
to decrease by 50%. It is an important pharmacokinetic parameter that determines
dosing intervals. Drugs with a short half-life require more frequent dosing, while
drugs with a long half-life require less frequent dosing.
Question 2
A client is prescribed a medication that has high first-pass metabolism. The nurse
understands that this medication will:
A) Be rapidly absorbed from the gastrointestinal tract
B) Be extensively metabolized by the liver before reaching systemic circulation
C) Have a longer half-life than expected
D) Require a higher dose when administered intravenously
Answer: B
Rationale: First-pass metabolism refers to the metabolism of a drug in the liver
before it reaches systemic circulation. Drugs with high first-pass metabolism have
reduced bioavailability when administered orally. These drugs often require higher
oral doses or alternative routes of administration (IV, sublingual).
,Question 3
A client is receiving a medication that is highly protein-bound. Which assessment
finding indicates a risk for increased drug effects?
A) Low serum albumin level
B) High serum albumin level
C) Decreased liver function
D) Increased kidney function
Answer: A
Rationale: Drugs that are highly protein-bound rely on albumin for transport in the
blood. If a client has low serum albumin (e.g., malnutrition, liver disease), there is
less protein available for binding, resulting in more free (unbound) drug available.
This increases the risk of drug toxicity and adverse effects.
Question 4
The nurse is reviewing a medication order that includes the route "IV push." The
nurse understands that a medication administered by this route:
A) Has a slower onset of action than oral administration
B) Has the fastest onset of action
C) Is absorbed through the gastrointestinal tract
D) Requires first-pass metabolism
Answer: B
Rationale: IV push (intravenous administration) delivers medication directly into
the bloodstream, resulting in the fastest onset of action. There is no absorption
phase or first-pass metabolism. This route is used for emergency situations and
medications that require immediate effect.
Question 5
A nurse is evaluating a client's response to a medication. Which assessment finding
indicates the medication is at its peak effect?
A) The client reports the onset of action
B) The client's symptoms are maximally relieved
C) The client is experiencing a side effect
D) The client requests the next dose
,Answer: B
Rationale: Peak effect is the time when the medication reaches its maximum
therapeutic effect. The client's symptoms should be most improved at peak
concentration. The onset of action is the first sign of drug effect, which occurs
before peak.
Question 6
A nurse is caring for a client who is prescribed a medication that is a weak acid.
The nurse understands that this medication will be:
A) Better absorbed in an alkaline environment
B) Better absorbed in an acidic environment
C) Only absorbed intravenously
D) Excreted unchanged in the urine
Answer: B
Rationale: Weak acids are better absorbed in acidic environments (e.g., the
stomach) because they are more lipophilic (non-ionized) in acidic pH. Weak bases
are better absorbed in alkaline environments (e.g., the small intestine).
Question 7
The nurse administers a medication that is metabolized by the cytochrome P450
system. Which of the following may increase the risk of drug toxicity?
A) Concurrent use of a drug that induces CYP450 enzymes
B) Concurrent use of a drug that inhibits CYP450 enzymes
C) Increased blood flow to the liver
D) Decreased gastric motility
Answer: B
Rationale: CYP450 inhibitors decrease the metabolism of other drugs, leading to
increased drug levels and toxicity. Inducers have the opposite effect, decreasing
drug levels. Common CYP450 inhibitors include grapefruit juice, ketoconazole,
erythromycin, and cimetidine.
, Question 8
A nurse is assessing a client for adverse drug reactions. Which of the following is
an example of a type A (augmented) adverse drug reaction?
A) Anaphylaxis to penicillin
B) Hypotension from an antihypertensive medication
C) Stevens-Johnson syndrome
D) Drug-induced liver injury
Answer: B
Rationale: Type A adverse drug reactions are predictable, dose-dependent, and
related to the drug's pharmacological action. Hypotension from an antihypertensive
is a type A reaction. Type B reactions are unpredictable, idiosyncratic, and not
dose-dependent (e.g., anaphylaxis, Stevens-Johnson syndrome).
Question 9
A client is prescribed a medication that is 90% protein-bound. The nurse
understands that this medication:
A) Is rapidly excreted by the kidneys
B) Has a large volume of distribution
C) Is primarily inactive due to protein binding
D) May interact with other highly protein-bound drugs
Answer: D
Rationale: Highly protein-bound drugs compete for binding sites on albumin.
When two highly protein-bound drugs are taken concurrently, they may displace
each other, leading to increased free (active) drug levels and increased risk of
toxicity.
Question 10
A nurse is preparing to administer a medication that is eliminated by the kidneys.
Which laboratory value should the nurse monitor?
A) Liver function tests
B) Serum creatinine and BUN
C) Complete blood count
D) Serum albumin
Comprehensive Examination 110 Practice
Questions with Answers & Rationales
Question 1
A nurse is teaching a client about a newly prescribed medication. The client asks,
"What does 'half-life' mean?" The nurse's best response is:
A) "The time it takes for half of the medication to be absorbed into the
bloodstream"
B) "The time it takes for half of the medication to be eliminated from the body"
C) "The time it takes for the medication to reach its peak effect"
D) "The time it takes for the medication to start working"
Answer: B
Rationale: Half-life is the time required for the concentration of a drug in the body
to decrease by 50%. It is an important pharmacokinetic parameter that determines
dosing intervals. Drugs with a short half-life require more frequent dosing, while
drugs with a long half-life require less frequent dosing.
Question 2
A client is prescribed a medication that has high first-pass metabolism. The nurse
understands that this medication will:
A) Be rapidly absorbed from the gastrointestinal tract
B) Be extensively metabolized by the liver before reaching systemic circulation
C) Have a longer half-life than expected
D) Require a higher dose when administered intravenously
Answer: B
Rationale: First-pass metabolism refers to the metabolism of a drug in the liver
before it reaches systemic circulation. Drugs with high first-pass metabolism have
reduced bioavailability when administered orally. These drugs often require higher
oral doses or alternative routes of administration (IV, sublingual).
,Question 3
A client is receiving a medication that is highly protein-bound. Which assessment
finding indicates a risk for increased drug effects?
A) Low serum albumin level
B) High serum albumin level
C) Decreased liver function
D) Increased kidney function
Answer: A
Rationale: Drugs that are highly protein-bound rely on albumin for transport in the
blood. If a client has low serum albumin (e.g., malnutrition, liver disease), there is
less protein available for binding, resulting in more free (unbound) drug available.
This increases the risk of drug toxicity and adverse effects.
Question 4
The nurse is reviewing a medication order that includes the route "IV push." The
nurse understands that a medication administered by this route:
A) Has a slower onset of action than oral administration
B) Has the fastest onset of action
C) Is absorbed through the gastrointestinal tract
D) Requires first-pass metabolism
Answer: B
Rationale: IV push (intravenous administration) delivers medication directly into
the bloodstream, resulting in the fastest onset of action. There is no absorption
phase or first-pass metabolism. This route is used for emergency situations and
medications that require immediate effect.
Question 5
A nurse is evaluating a client's response to a medication. Which assessment finding
indicates the medication is at its peak effect?
A) The client reports the onset of action
B) The client's symptoms are maximally relieved
C) The client is experiencing a side effect
D) The client requests the next dose
,Answer: B
Rationale: Peak effect is the time when the medication reaches its maximum
therapeutic effect. The client's symptoms should be most improved at peak
concentration. The onset of action is the first sign of drug effect, which occurs
before peak.
Question 6
A nurse is caring for a client who is prescribed a medication that is a weak acid.
The nurse understands that this medication will be:
A) Better absorbed in an alkaline environment
B) Better absorbed in an acidic environment
C) Only absorbed intravenously
D) Excreted unchanged in the urine
Answer: B
Rationale: Weak acids are better absorbed in acidic environments (e.g., the
stomach) because they are more lipophilic (non-ionized) in acidic pH. Weak bases
are better absorbed in alkaline environments (e.g., the small intestine).
Question 7
The nurse administers a medication that is metabolized by the cytochrome P450
system. Which of the following may increase the risk of drug toxicity?
A) Concurrent use of a drug that induces CYP450 enzymes
B) Concurrent use of a drug that inhibits CYP450 enzymes
C) Increased blood flow to the liver
D) Decreased gastric motility
Answer: B
Rationale: CYP450 inhibitors decrease the metabolism of other drugs, leading to
increased drug levels and toxicity. Inducers have the opposite effect, decreasing
drug levels. Common CYP450 inhibitors include grapefruit juice, ketoconazole,
erythromycin, and cimetidine.
, Question 8
A nurse is assessing a client for adverse drug reactions. Which of the following is
an example of a type A (augmented) adverse drug reaction?
A) Anaphylaxis to penicillin
B) Hypotension from an antihypertensive medication
C) Stevens-Johnson syndrome
D) Drug-induced liver injury
Answer: B
Rationale: Type A adverse drug reactions are predictable, dose-dependent, and
related to the drug's pharmacological action. Hypotension from an antihypertensive
is a type A reaction. Type B reactions are unpredictable, idiosyncratic, and not
dose-dependent (e.g., anaphylaxis, Stevens-Johnson syndrome).
Question 9
A client is prescribed a medication that is 90% protein-bound. The nurse
understands that this medication:
A) Is rapidly excreted by the kidneys
B) Has a large volume of distribution
C) Is primarily inactive due to protein binding
D) May interact with other highly protein-bound drugs
Answer: D
Rationale: Highly protein-bound drugs compete for binding sites on albumin.
When two highly protein-bound drugs are taken concurrently, they may displace
each other, leading to increased free (active) drug levels and increased risk of
toxicity.
Question 10
A nurse is preparing to administer a medication that is eliminated by the kidneys.
Which laboratory value should the nurse monitor?
A) Liver function tests
B) Serum creatinine and BUN
C) Complete blood count
D) Serum albumin
