NUR 378 EXAM 3 – PHARMACOLOGY STUDY GUIDE | TESTBANK | PRACTICE
QUESTIONS & ANSWERS | EXAM PREPARATION | ADVANCED REVIEW |
COMPREHENSIVE PRACTICE EXAM | LATEST UPDATE 2026/2027
Examiner:
School of Nursing / Course Faculty (NUR 378 – Pharmacology)
TABLE OF CONTENTS
1. Principles of Pharmacokinetics
2. Principles of Pharmacodynamics
3. Autonomic Nervous System Pharmacology
4. Cardiovascular Pharmacology
5. Respiratory Pharmacology
6. Endocrine Pharmacology
7. Antimicrobial Therapy
8. Neurologic and Psychiatric Pharmacology
9. Pain Management and Anesthetics
10. Gastrointestinal Pharmacology
11. Renal Pharmacology
12. Hematologic Pharmacology
13. Oncology Pharmacology
14. Medication Safety and Dosage Calculations
15. Adverse Drug Reactions and Toxicology
16. Patient Education and Clinical Decision-Making
PHARMACOKINETICS || PHARMACODYNAMICS || ABSORPTION || DISTRIBUTION ||
METABOLISM || ELIMINATION || ADVERSE DRUG REACTIONS || MEDICATION
SAFETY || HIGH-ALERT MEDICATIONS || DRUG INTERACTIONS || DOSAGE
CALCULATIONS || ANTIMICROBIALS || CARDIOVASCULAR DRUGS || ENDOCRINE
PHARMACOLOGY || AUTONOMIC PHARMACOLOGY || NURSING IMPLICATIONS ||
PATIENT EDUCATION || THERAPEUTIC DRUG MONITORING || EVIDENCE-BASED
PRACTICE || CLINICAL JUDGMENT
,QUESTION 1.
A patient with severe hypoalbuminemia is prescribed a medication that is normally
95% protein bound. Which outcome is the nurse most likely to anticipate during
initial therapy?
A. Reduced pharmacologic effect because less drug enters circulation
B. Increased free-drug concentration resulting in greater risk of toxicity
C. Accelerated renal elimination preventing therapeutic concentrations
D. Delayed absorption caused by decreased plasma protein availability
Correct Answer: B. Increased free-drug concentration resulting in greater risk
of toxicity
Explanation: Highly protein-bound medications rely on albumin for transport.
When albumin concentrations are significantly reduced, a larger fraction of the
drug remains unbound and pharmacologically active, increasing the likelihood of
adverse effects despite standard dosing. The other options incorrectly attribute
hypoalbuminemia to changes in absorption or predictable increases in elimination.
────────────────────────────────────────
QUESTION 2.
A patient receiving an ACE inhibitor develops facial swelling and difficulty swallowing
shortly after taking the medication. Which nursing action has the highest priority?
A. Administer the next scheduled dose with food
B. Immediately discontinue the medication and activate emergency management for
airway compromise
C. Document the finding and reassess in one hour
D. Encourage oral fluids to reduce medication concentration
Correct Answer: B. Immediately discontinue the medication and activate
emergency management for airway compromise
Explanation: Angioedema is a potentially life-threatening adverse reaction
associated with ACE inhibitors because airway obstruction may rapidly develop.
Immediate discontinuation and emergency intervention are essential. Observation
, alone or supportive measures without addressing the airway place the patient at
significant risk.
────────────────────────────────────────
QUESTION 3.
A patient receiving intravenous vancomycin reports generalized flushing and itching
during the infusion. Vital signs remain stable. Which intervention is most
appropriate?
A. Permanently discontinue vancomycin therapy
B. Administer naloxone immediately
C. Slow the infusion rate and notify the provider
D. Increase the infusion rate to complete therapy sooner
Correct Answer: C. Slow the infusion rate and notify the provider
Explanation: Rapid vancomycin administration may produce infusion-related
flushing commonly known as Red Man syndrome. Slowing the infusion and
notifying the provider generally resolves symptoms while allowing continued
therapy if appropriate. This differs from true anaphylaxis, which would require
immediate emergency treatment.
────────────────────────────────────────
QUESTION 4.
A patient taking warfarin begins therapy with trimethoprim-sulfamethoxazole. Which
laboratory value requires the closest monitoring?
A. Serum sodium
B. Hemoglobin A1c
C. White blood cell count
D. International Normalized Ratio (INR)
Correct Answer: D. International Normalized Ratio (INR)
, Explanation: Trimethoprim-sulfamethoxazole inhibits warfarin metabolism and
significantly increases anticoagulant effects, predisposing the patient to bleeding.
Frequent INR monitoring allows timely dose adjustments. The remaining
laboratory values do not directly assess warfarin efficacy or toxicity.
────────────────────────────────────────
QUESTION 5.
A patient with asthma is prescribed propranolol for hypertension. Which nursing
assessment should prompt immediate discussion with the prescriber?
A. Resting heart rate of 72 beats/minute
B. History of seasonal allergic rhinitis
C. Diagnosis of moderate persistent asthma requiring rescue bronchodilator use
D. Mild elevation in LDL cholesterol
Correct Answer: C. Diagnosis of moderate persistent asthma requiring rescue
bronchodilator use
Explanation: Nonselective beta-blockers such as propranolol may precipitate
bronchospasm by blocking beta2 receptors in the airways. Patients with active
asthma are at increased risk for respiratory compromise. The remaining findings do
not represent major contraindications.
────────────────────────────────────────
QUESTION 6.
A patient receiving insulin glargine asks why it cannot be mixed in the same syringe
with rapid-acting insulin. Which response by the nurse is most accurate?
A. Mixing alters the prolonged-release characteristics of insulin glargine.
B. Mixing causes immediate precipitation within the syringe, making injection
impossible.
C. Mixing increases insulin absorption and guarantees hypoglycemia.
D. Mixing destroys rapid-acting insulin molecules through oxidation.
QUESTIONS & ANSWERS | EXAM PREPARATION | ADVANCED REVIEW |
COMPREHENSIVE PRACTICE EXAM | LATEST UPDATE 2026/2027
Examiner:
School of Nursing / Course Faculty (NUR 378 – Pharmacology)
TABLE OF CONTENTS
1. Principles of Pharmacokinetics
2. Principles of Pharmacodynamics
3. Autonomic Nervous System Pharmacology
4. Cardiovascular Pharmacology
5. Respiratory Pharmacology
6. Endocrine Pharmacology
7. Antimicrobial Therapy
8. Neurologic and Psychiatric Pharmacology
9. Pain Management and Anesthetics
10. Gastrointestinal Pharmacology
11. Renal Pharmacology
12. Hematologic Pharmacology
13. Oncology Pharmacology
14. Medication Safety and Dosage Calculations
15. Adverse Drug Reactions and Toxicology
16. Patient Education and Clinical Decision-Making
PHARMACOKINETICS || PHARMACODYNAMICS || ABSORPTION || DISTRIBUTION ||
METABOLISM || ELIMINATION || ADVERSE DRUG REACTIONS || MEDICATION
SAFETY || HIGH-ALERT MEDICATIONS || DRUG INTERACTIONS || DOSAGE
CALCULATIONS || ANTIMICROBIALS || CARDIOVASCULAR DRUGS || ENDOCRINE
PHARMACOLOGY || AUTONOMIC PHARMACOLOGY || NURSING IMPLICATIONS ||
PATIENT EDUCATION || THERAPEUTIC DRUG MONITORING || EVIDENCE-BASED
PRACTICE || CLINICAL JUDGMENT
,QUESTION 1.
A patient with severe hypoalbuminemia is prescribed a medication that is normally
95% protein bound. Which outcome is the nurse most likely to anticipate during
initial therapy?
A. Reduced pharmacologic effect because less drug enters circulation
B. Increased free-drug concentration resulting in greater risk of toxicity
C. Accelerated renal elimination preventing therapeutic concentrations
D. Delayed absorption caused by decreased plasma protein availability
Correct Answer: B. Increased free-drug concentration resulting in greater risk
of toxicity
Explanation: Highly protein-bound medications rely on albumin for transport.
When albumin concentrations are significantly reduced, a larger fraction of the
drug remains unbound and pharmacologically active, increasing the likelihood of
adverse effects despite standard dosing. The other options incorrectly attribute
hypoalbuminemia to changes in absorption or predictable increases in elimination.
────────────────────────────────────────
QUESTION 2.
A patient receiving an ACE inhibitor develops facial swelling and difficulty swallowing
shortly after taking the medication. Which nursing action has the highest priority?
A. Administer the next scheduled dose with food
B. Immediately discontinue the medication and activate emergency management for
airway compromise
C. Document the finding and reassess in one hour
D. Encourage oral fluids to reduce medication concentration
Correct Answer: B. Immediately discontinue the medication and activate
emergency management for airway compromise
Explanation: Angioedema is a potentially life-threatening adverse reaction
associated with ACE inhibitors because airway obstruction may rapidly develop.
Immediate discontinuation and emergency intervention are essential. Observation
, alone or supportive measures without addressing the airway place the patient at
significant risk.
────────────────────────────────────────
QUESTION 3.
A patient receiving intravenous vancomycin reports generalized flushing and itching
during the infusion. Vital signs remain stable. Which intervention is most
appropriate?
A. Permanently discontinue vancomycin therapy
B. Administer naloxone immediately
C. Slow the infusion rate and notify the provider
D. Increase the infusion rate to complete therapy sooner
Correct Answer: C. Slow the infusion rate and notify the provider
Explanation: Rapid vancomycin administration may produce infusion-related
flushing commonly known as Red Man syndrome. Slowing the infusion and
notifying the provider generally resolves symptoms while allowing continued
therapy if appropriate. This differs from true anaphylaxis, which would require
immediate emergency treatment.
────────────────────────────────────────
QUESTION 4.
A patient taking warfarin begins therapy with trimethoprim-sulfamethoxazole. Which
laboratory value requires the closest monitoring?
A. Serum sodium
B. Hemoglobin A1c
C. White blood cell count
D. International Normalized Ratio (INR)
Correct Answer: D. International Normalized Ratio (INR)
, Explanation: Trimethoprim-sulfamethoxazole inhibits warfarin metabolism and
significantly increases anticoagulant effects, predisposing the patient to bleeding.
Frequent INR monitoring allows timely dose adjustments. The remaining
laboratory values do not directly assess warfarin efficacy or toxicity.
────────────────────────────────────────
QUESTION 5.
A patient with asthma is prescribed propranolol for hypertension. Which nursing
assessment should prompt immediate discussion with the prescriber?
A. Resting heart rate of 72 beats/minute
B. History of seasonal allergic rhinitis
C. Diagnosis of moderate persistent asthma requiring rescue bronchodilator use
D. Mild elevation in LDL cholesterol
Correct Answer: C. Diagnosis of moderate persistent asthma requiring rescue
bronchodilator use
Explanation: Nonselective beta-blockers such as propranolol may precipitate
bronchospasm by blocking beta2 receptors in the airways. Patients with active
asthma are at increased risk for respiratory compromise. The remaining findings do
not represent major contraindications.
────────────────────────────────────────
QUESTION 6.
A patient receiving insulin glargine asks why it cannot be mixed in the same syringe
with rapid-acting insulin. Which response by the nurse is most accurate?
A. Mixing alters the prolonged-release characteristics of insulin glargine.
B. Mixing causes immediate precipitation within the syringe, making injection
impossible.
C. Mixing increases insulin absorption and guarantees hypoglycemia.
D. Mixing destroys rapid-acting insulin molecules through oxidation.
