NUR 378 Final Exam V1 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Final Exam) |
Concordia
1. A patient with chronic renal failure is prescribed a medication that is primarily excreted by
the kidneys. Which pharmacokinetic process is most significantly impacted in this patient?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Correct Answer: C
Excretion is the process by which drugs are removed from the body, primarily via the
kidneys. In patients with renal failure, the glomerular filtration rate is decreased, leading to
prolonged drug half-life and potential toxicity. Nurses must monitor creatinine clearance
and adjust dosages accordingly to maintain therapeutic levels.
2. Which of the following factors influence the bioavailability of a drug administered via the
oral route? (Select all that apply)
A. Drug formulation and solubility
B. Gastric emptying time and intestinal motility
,C. First-pass hepatic metabolism
D. All of the above
E. Blood flow to the gastrointestinal tract
F. The presence of food in the stomach
Correct Answer: D
Bioavailability is the fraction of an administered dose of unchanged drug that reaches the
systemic circulation. Oral drugs must pass through the intestinal wall and the liver via the
portal vein, where the first-pass effect can significantly reduce concentrations. Various
physiological and chemical factors, including those listed, dictate the speed and extent of
this process.
3. A nurse is administering a highly protein-bound drug to a patient with severely low serum
albumin levels. What is the expected pharmacological effect?
A. Decreased therapeutic effect of the drug
B. Faster excretion of the drug
C. Increased risk of drug toxicity
D. Reduced distribution to target tissues
Correct Answer: C
Drugs that are highly protein-bound circulate in the blood attached to albumin, leaving
only the unbound ‘free’ drug to exert a pharmacological effect. If albumin levels are low,
, more free drug remains in the plasma, increasing the potency and the risk of adverse
reactions. This condition requires careful monitoring of the patient’s clinical response and
potentially lower doses.
4. A patient is prescribed a drug with a narrow therapeutic index. Which nursing action is
most critical for this patient?
A. Administering the drug with a full glass of water
B. Monitoring serum drug levels frequently
C. Assessing the patient’s ability to swallow
D. Ensuring the patient takes the drug at the same time every day
Correct Answer: B
A narrow therapeutic index indicates that the difference between a therapeutic dose and a
toxic dose is very small. Regular blood monitoring is necessary to ensure the drug remains
within the safe range. Nurses must be vigilant for early signs of toxicity to prevent serious
complications.
5. The nurse identifies that a drug is a ‘selective beta-1 antagonist.’ Which physiological
response should the nurse monitor for in the patient?
A. Increased heart rate
B. Decreased heart rate
C. Bronchodilation
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Final Exam) |
Concordia
1. A patient with chronic renal failure is prescribed a medication that is primarily excreted by
the kidneys. Which pharmacokinetic process is most significantly impacted in this patient?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
Correct Answer: C
Excretion is the process by which drugs are removed from the body, primarily via the
kidneys. In patients with renal failure, the glomerular filtration rate is decreased, leading to
prolonged drug half-life and potential toxicity. Nurses must monitor creatinine clearance
and adjust dosages accordingly to maintain therapeutic levels.
2. Which of the following factors influence the bioavailability of a drug administered via the
oral route? (Select all that apply)
A. Drug formulation and solubility
B. Gastric emptying time and intestinal motility
,C. First-pass hepatic metabolism
D. All of the above
E. Blood flow to the gastrointestinal tract
F. The presence of food in the stomach
Correct Answer: D
Bioavailability is the fraction of an administered dose of unchanged drug that reaches the
systemic circulation. Oral drugs must pass through the intestinal wall and the liver via the
portal vein, where the first-pass effect can significantly reduce concentrations. Various
physiological and chemical factors, including those listed, dictate the speed and extent of
this process.
3. A nurse is administering a highly protein-bound drug to a patient with severely low serum
albumin levels. What is the expected pharmacological effect?
A. Decreased therapeutic effect of the drug
B. Faster excretion of the drug
C. Increased risk of drug toxicity
D. Reduced distribution to target tissues
Correct Answer: C
Drugs that are highly protein-bound circulate in the blood attached to albumin, leaving
only the unbound ‘free’ drug to exert a pharmacological effect. If albumin levels are low,
, more free drug remains in the plasma, increasing the potency and the risk of adverse
reactions. This condition requires careful monitoring of the patient’s clinical response and
potentially lower doses.
4. A patient is prescribed a drug with a narrow therapeutic index. Which nursing action is
most critical for this patient?
A. Administering the drug with a full glass of water
B. Monitoring serum drug levels frequently
C. Assessing the patient’s ability to swallow
D. Ensuring the patient takes the drug at the same time every day
Correct Answer: B
A narrow therapeutic index indicates that the difference between a therapeutic dose and a
toxic dose is very small. Regular blood monitoring is necessary to ensure the drug remains
within the safe range. Nurses must be vigilant for early signs of toxicity to prevent serious
complications.
5. The nurse identifies that a drug is a ‘selective beta-1 antagonist.’ Which physiological
response should the nurse monitor for in the patient?
A. Increased heart rate
B. Decreased heart rate
C. Bronchodilation
