NUR 378 Final Exam V2 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Final Exam) |
Concordia
1. PHARMACOKINETICS AND PHARMACODYNAMICS - A patient is prescribed a medication
with a half-life of 8 hours. If the patient takes a 400 mg dose at 08:00, approximately how
much of the drug will remain in the system at 00:00 (midnight)?
A. 200 mg
B. 50 mg
C. 100 mg
D. 25 mg
Correct Answer: C
The time from 08:00 to 00:00 is 16 hours, which equals two half-lives (8 hours x 2). After
the first half-life, 200 mg remains; after the second, 100 mg remains. This question assesses
the nurse’s ability to apply pharmacokinetic principles to clinical timing. Understanding
half-life is critical for determining dosing intervals and predicting drug clearance. The
mathematical application ensures the nurse can anticipate drug levels for safety.
2. A patient with hypoalbuminemia is receiving a highly protein-bound medication. The nurse
should monitor for which clinical manifestation?
A. Reduced therapeutic effect
,B. Delayed onset of action
C. Increased risk of drug toxicity
D. Rapid renal excretion of the bound drug
Correct Answer: C
Albumin is the primary protein for drug binding; low levels result in more free (active)
drug in the bloodstream, increasing toxicity risk. Hypoalbuminemia is a frequent concern
in malnourished or chronically ill patients. Nurses must recognize that serum drug levels
may appear normal while the free fraction is dangerously high. This illustrates the
relationship between pathophysiology and pharmacodynamics.
3. Select All That Apply (SATA): Which of the following routes of administration are subject to
the first-pass effect? (Select all that apply)
A. Oral capsules
B. Sublingual tablets
C. Intravenous bolus
D. Nasogastric tube administration
E. Transdermal patches
F. Inhalation therapy
Correct Answer: AD
, Oral and nasogastric routes deliver drugs to the GI tract, where they are absorbed and
sent to the liver via the portal vein for metabolism. Sublingual, IV, transdermal, and
inhalation routes bypass the portal circulation. The first-pass effect significantly alters drug
bioavailability and determines dosing differences between routes. Recognizing which
routes bypass the liver helps the nurse understand why an IV dose is often much smaller
than an oral dose. This knowledge is essential for preventing medication errors during
route transitions.
4. The nurse is administering a drug that acts as an agonist. How should the nurse explain the
action of this drug to a student nurse?
A. It blocks the receptor site to prevent activation.
B. It decreases the affinity of other drugs for the receptor.
C. It prevents the breakdown of natural neurotransmitters.
D. It binds to the receptor and stimulates a physiological response.
Correct Answer: D
Agonists mimic the action of endogenous substances to activate receptors, whereas
antagonists block them. Distinguishing between agonists and antagonists is fundamental to
understanding drug classifications. This concept applies across all body systems, from
respiratory bronchodilators to cardiac beta-blockers. Clear communication of these
mechanisms supports safe clinical practice and patient education.
, 5. A patient is taking a drug that is a known inhibitor of the Cytochrome P450 enzyme system.
The nurse knows that if this patient is also taking Warfarin, the effect will be:
A. Decreased Warfarin levels due to rapid metabolism.
B. Increased risk of bleeding due to decreased metabolism.
C. No change, as P450 only affects water-soluble drugs.
D. Reduced effectiveness of the inhibitor drug.
Correct Answer: B
Inhibitors slow down the metabolism of other drugs processed by the same enzyme,
leading to higher serum levels and potential toxicity (bleeding for Warfarin). The CYP450
system is the source of many significant drug-drug interactions. Nurses must screen new
prescriptions for potential inhibition or induction of these enzymes. This proactive
assessment prevents adverse events in complex patients.
6. AUTONOMIC NERVOUS SYSTEM AND CARDIOVASCULAR PHARMACOLOGY - A patient with
a history of asthma is diagnosed with hypertension. Which medication should the nurse
question?
A. Metoprolol
B. Amlodipine
C. Propranolol
D. Lisinopril
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Final Exam) |
Concordia
1. PHARMACOKINETICS AND PHARMACODYNAMICS - A patient is prescribed a medication
with a half-life of 8 hours. If the patient takes a 400 mg dose at 08:00, approximately how
much of the drug will remain in the system at 00:00 (midnight)?
A. 200 mg
B. 50 mg
C. 100 mg
D. 25 mg
Correct Answer: C
The time from 08:00 to 00:00 is 16 hours, which equals two half-lives (8 hours x 2). After
the first half-life, 200 mg remains; after the second, 100 mg remains. This question assesses
the nurse’s ability to apply pharmacokinetic principles to clinical timing. Understanding
half-life is critical for determining dosing intervals and predicting drug clearance. The
mathematical application ensures the nurse can anticipate drug levels for safety.
2. A patient with hypoalbuminemia is receiving a highly protein-bound medication. The nurse
should monitor for which clinical manifestation?
A. Reduced therapeutic effect
,B. Delayed onset of action
C. Increased risk of drug toxicity
D. Rapid renal excretion of the bound drug
Correct Answer: C
Albumin is the primary protein for drug binding; low levels result in more free (active)
drug in the bloodstream, increasing toxicity risk. Hypoalbuminemia is a frequent concern
in malnourished or chronically ill patients. Nurses must recognize that serum drug levels
may appear normal while the free fraction is dangerously high. This illustrates the
relationship between pathophysiology and pharmacodynamics.
3. Select All That Apply (SATA): Which of the following routes of administration are subject to
the first-pass effect? (Select all that apply)
A. Oral capsules
B. Sublingual tablets
C. Intravenous bolus
D. Nasogastric tube administration
E. Transdermal patches
F. Inhalation therapy
Correct Answer: AD
, Oral and nasogastric routes deliver drugs to the GI tract, where they are absorbed and
sent to the liver via the portal vein for metabolism. Sublingual, IV, transdermal, and
inhalation routes bypass the portal circulation. The first-pass effect significantly alters drug
bioavailability and determines dosing differences between routes. Recognizing which
routes bypass the liver helps the nurse understand why an IV dose is often much smaller
than an oral dose. This knowledge is essential for preventing medication errors during
route transitions.
4. The nurse is administering a drug that acts as an agonist. How should the nurse explain the
action of this drug to a student nurse?
A. It blocks the receptor site to prevent activation.
B. It decreases the affinity of other drugs for the receptor.
C. It prevents the breakdown of natural neurotransmitters.
D. It binds to the receptor and stimulates a physiological response.
Correct Answer: D
Agonists mimic the action of endogenous substances to activate receptors, whereas
antagonists block them. Distinguishing between agonists and antagonists is fundamental to
understanding drug classifications. This concept applies across all body systems, from
respiratory bronchodilators to cardiac beta-blockers. Clear communication of these
mechanisms supports safe clinical practice and patient education.
, 5. A patient is taking a drug that is a known inhibitor of the Cytochrome P450 enzyme system.
The nurse knows that if this patient is also taking Warfarin, the effect will be:
A. Decreased Warfarin levels due to rapid metabolism.
B. Increased risk of bleeding due to decreased metabolism.
C. No change, as P450 only affects water-soluble drugs.
D. Reduced effectiveness of the inhibitor drug.
Correct Answer: B
Inhibitors slow down the metabolism of other drugs processed by the same enzyme,
leading to higher serum levels and potential toxicity (bleeding for Warfarin). The CYP450
system is the source of many significant drug-drug interactions. Nurses must screen new
prescriptions for potential inhibition or induction of these enzymes. This proactive
assessment prevents adverse events in complex patients.
6. AUTONOMIC NERVOUS SYSTEM AND CARDIOVASCULAR PHARMACOLOGY - A patient with
a history of asthma is diagnosed with hypertension. Which medication should the nurse
question?
A. Metoprolol
B. Amlodipine
C. Propranolol
D. Lisinopril
