PRN 1381/PRN1381 Final Exam V3 |
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. A patient is prescribed a drug that has a very high first-pass effect. Which route of
administration should the nurse expect to be avoided?
A. Intravenous
B. Transdermal
C. Sublingual
D. Oral
Answer: D
Rationale: The first-pass effect occurs when a drug is metabolized by the liver before
reaching systemic circulation, which happens primarily with oral medications. Drugs given
intravenously or sublingually bypass this initial liver metabolism, ensuring higher
bioavailability. Therefore, if a drug is significantly deactivated by the liver, the oral route is
generally not preferred.
2. What is the primary organ responsible for the excretion of most pharmacological agents?
A. Liver
B. Skin
C. Lungs
,D. Kidneys
Answer: D
Rationale: The kidneys are the main organs responsible for filtering and excreting drug
metabolites from the body. Adequate renal function is essential to prevent the
accumulation of drugs and potential toxicity. Nurses must monitor creatinine and BUN
levels to assess how well a patient can clear medications through their urine.
3. A nurse is preparing to administer Digoxin to a patient. Which assessment is the most
critical before giving this medication?
A. Check blood pressure
B. Assess respiratory rate
C. Monitor blood glucose levels
D. Measure apical pulse for 60 seconds
Answer: D
Rationale: Digoxin is a cardiac glycoside that slows the heart rate while increasing the
force of contraction. The nurse must assess the apical pulse for one full minute to ensure
the heart rate is at least 60 beats per minute before administration. If the pulse is too low,
the medication should be withheld and the physician notified to prevent bradycardia.
4. Which lab value is the most important to monitor for a patient receiving Warfarin
(Coumadin) therapy?
A. INR
, B. aPTT
C. Platelet count
D. Hemoglobin
Answer: A
Rationale: The International Normalized Ratio (INR) is the standard measurement used to
determine the effectiveness of Warfarin therapy. A therapeutic INR range is usually
between 2.0 and 3.0 for most conditions requiring anticoagulation. Monitoring this value
prevents both inadequate dosing, which leads to clots, and over-dosing, which leads to
bleeding.
5. What is the specific antidote for an overdose of Heparin?
A. Vitamin K
B. Naloxone
C. Acetylcysteine
D. Protamine Sulfate
Answer: D
Rationale: Protamine sulfate is the pharmacological antagonist used to reverse the effects
of heparin. It works by binding to heparin molecules and neutralizing their anticoagulant
activity. This is critical for managing life-threatening bleeds or preparing a patient for
emergency surgery while on heparin therapy.
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. A patient is prescribed a drug that has a very high first-pass effect. Which route of
administration should the nurse expect to be avoided?
A. Intravenous
B. Transdermal
C. Sublingual
D. Oral
Answer: D
Rationale: The first-pass effect occurs when a drug is metabolized by the liver before
reaching systemic circulation, which happens primarily with oral medications. Drugs given
intravenously or sublingually bypass this initial liver metabolism, ensuring higher
bioavailability. Therefore, if a drug is significantly deactivated by the liver, the oral route is
generally not preferred.
2. What is the primary organ responsible for the excretion of most pharmacological agents?
A. Liver
B. Skin
C. Lungs
,D. Kidneys
Answer: D
Rationale: The kidneys are the main organs responsible for filtering and excreting drug
metabolites from the body. Adequate renal function is essential to prevent the
accumulation of drugs and potential toxicity. Nurses must monitor creatinine and BUN
levels to assess how well a patient can clear medications through their urine.
3. A nurse is preparing to administer Digoxin to a patient. Which assessment is the most
critical before giving this medication?
A. Check blood pressure
B. Assess respiratory rate
C. Monitor blood glucose levels
D. Measure apical pulse for 60 seconds
Answer: D
Rationale: Digoxin is a cardiac glycoside that slows the heart rate while increasing the
force of contraction. The nurse must assess the apical pulse for one full minute to ensure
the heart rate is at least 60 beats per minute before administration. If the pulse is too low,
the medication should be withheld and the physician notified to prevent bradycardia.
4. Which lab value is the most important to monitor for a patient receiving Warfarin
(Coumadin) therapy?
A. INR
, B. aPTT
C. Platelet count
D. Hemoglobin
Answer: A
Rationale: The International Normalized Ratio (INR) is the standard measurement used to
determine the effectiveness of Warfarin therapy. A therapeutic INR range is usually
between 2.0 and 3.0 for most conditions requiring anticoagulation. Monitoring this value
prevents both inadequate dosing, which leads to clots, and over-dosing, which leads to
bleeding.
5. What is the specific antidote for an overdose of Heparin?
A. Vitamin K
B. Naloxone
C. Acetylcysteine
D. Protamine Sulfate
Answer: D
Rationale: Protamine sulfate is the pharmacological antagonist used to reverse the effects
of heparin. It works by binding to heparin molecules and neutralizing their anticoagulant
activity. This is critical for managing life-threatening bleeds or preparing a patient for
emergency surgery while on heparin therapy.
