NURS 6521 WEEK 7 MIDTERM EXAM 2026 WALDEN | 80 QUESTIONS +
CORRECT ANSWERS LATEST VERSION
1. A patient with liver cirrhosis is prescribed lorazepam. The nurse
expects the prescriber to order a reduced dose because lorazepam
undergoes:
• A. Renal excretion unchanged
• B. Hepatic metabolism via glucuronidation
• C. First-pass effect in the intestine
• D. Hepatic metabolism; impaired liver function prolongs drug
half-life ANSWER
2. A drug with a half-life of 6 hours is administered every 6 hours. Steady-
state plasma concentration will be reached in approximately:
• A. 6 hours
• B. 12 hours
• C. 24–30 hours (4–5 half-lives) ANSWER
• D. 48 hours
3. The nurse understands that a drug with high therapeutic index is:
• A. Relatively safe with a wide margin between effective and
toxic doses ANSWER
• B. Dangerous even at low doses
• C. Always administered IV
• D. Requires frequent therapeutic drug monitoring
4. A patient taking warfarin also starts taking ciprofloxacin. The nurse
monitors for increased warfarin effect because ciprofloxacin exhibits:
• A. Additive effect
• B. Inhibition of warfarin metabolism (CYP1A2/3A4) ANSWER
, • C. Synergistic antibacterial effect
• D. Antagonism
5. The term "bioavailability" refers to:
• A. The amount of drug metabolized by the liver
• B. The fraction of administered drug that reaches systemic
circulation ANSWER
• C. The rate of renal excretion
• D. The drug's ability to bind plasma proteins
6. A patient has low albumin levels. The nurse is concerned about toxicity
with highly protein-bound drugs because:
• A. The drug will be excreted faster
• B. More free (unbound) drug is available to exert
pharmacologic effects ANSWER
• C. The drug will not reach target tissues
• D. Protein binding increases drug metabolism
7. First-pass metabolism primarily occurs in the:
• A. Kidneys
• B. Liver ANSWER
• C. Lungs
• D. Spleen
8. A drug that acts as an agonist at a receptor:
• A. Blocks the receptor without activating it
• B. Binds to and activates the receptor, producing a biologic
response ANSWER
• C. Decreases receptor sensitivity
• D. Accelerates receptor degradation
SECTION B: Autonomic Nervous System (Questions 9–14)
, 9. A patient receives atropine preoperatively. The nurse monitors for
which expected anticholinergic effect?
• A. Bradycardia
• B. Dry mouth and reduced secretions ANSWER
• C. Diarrhea
• D. Miosis
10. A patient with asthma uses albuterol, a beta-2 agonist. The nurse
knows this drug works by:
• A. Bronchodilation through smooth muscle relaxation ANSWER
• B. Bronchoconstriction via alpha-1 stimulation
• C. Reducing mucus production via anticholinergic action
• D. Blocking histamine release
11. A patient on a nonselective beta-blocker (propranolol) develops
bronchospasm. This occurs because propranolol:
• A. Stimulates beta-2 receptors in the lungs
• B. Blocks beta-2 receptors, preventing bronchodilation
ANSWER
• C. Increases histamine release
• D. Causes alpha-1 mediated vasoconstriction
12. The nurse administers pilocarpine to a patient with glaucoma. The
mechanism of action is:
• A. Cholinergic agonist causing miosis and increased aqueous
humor outflow ANSWER
• B. Anticholinergic causing mydriasis
• C. Beta-blocker reducing aqueous production
• D. Alpha-agonist increasing uveoscleral outflow
13. A patient receives epinephrine during anaphylaxis. The nurse
understands that epinephrine reverses hypotension primarily through:
• A. Beta-2 agonism causing bronchodilation
CORRECT ANSWERS LATEST VERSION
1. A patient with liver cirrhosis is prescribed lorazepam. The nurse
expects the prescriber to order a reduced dose because lorazepam
undergoes:
• A. Renal excretion unchanged
• B. Hepatic metabolism via glucuronidation
• C. First-pass effect in the intestine
• D. Hepatic metabolism; impaired liver function prolongs drug
half-life ANSWER
2. A drug with a half-life of 6 hours is administered every 6 hours. Steady-
state plasma concentration will be reached in approximately:
• A. 6 hours
• B. 12 hours
• C. 24–30 hours (4–5 half-lives) ANSWER
• D. 48 hours
3. The nurse understands that a drug with high therapeutic index is:
• A. Relatively safe with a wide margin between effective and
toxic doses ANSWER
• B. Dangerous even at low doses
• C. Always administered IV
• D. Requires frequent therapeutic drug monitoring
4. A patient taking warfarin also starts taking ciprofloxacin. The nurse
monitors for increased warfarin effect because ciprofloxacin exhibits:
• A. Additive effect
• B. Inhibition of warfarin metabolism (CYP1A2/3A4) ANSWER
, • C. Synergistic antibacterial effect
• D. Antagonism
5. The term "bioavailability" refers to:
• A. The amount of drug metabolized by the liver
• B. The fraction of administered drug that reaches systemic
circulation ANSWER
• C. The rate of renal excretion
• D. The drug's ability to bind plasma proteins
6. A patient has low albumin levels. The nurse is concerned about toxicity
with highly protein-bound drugs because:
• A. The drug will be excreted faster
• B. More free (unbound) drug is available to exert
pharmacologic effects ANSWER
• C. The drug will not reach target tissues
• D. Protein binding increases drug metabolism
7. First-pass metabolism primarily occurs in the:
• A. Kidneys
• B. Liver ANSWER
• C. Lungs
• D. Spleen
8. A drug that acts as an agonist at a receptor:
• A. Blocks the receptor without activating it
• B. Binds to and activates the receptor, producing a biologic
response ANSWER
• C. Decreases receptor sensitivity
• D. Accelerates receptor degradation
SECTION B: Autonomic Nervous System (Questions 9–14)
, 9. A patient receives atropine preoperatively. The nurse monitors for
which expected anticholinergic effect?
• A. Bradycardia
• B. Dry mouth and reduced secretions ANSWER
• C. Diarrhea
• D. Miosis
10. A patient with asthma uses albuterol, a beta-2 agonist. The nurse
knows this drug works by:
• A. Bronchodilation through smooth muscle relaxation ANSWER
• B. Bronchoconstriction via alpha-1 stimulation
• C. Reducing mucus production via anticholinergic action
• D. Blocking histamine release
11. A patient on a nonselective beta-blocker (propranolol) develops
bronchospasm. This occurs because propranolol:
• A. Stimulates beta-2 receptors in the lungs
• B. Blocks beta-2 receptors, preventing bronchodilation
ANSWER
• C. Increases histamine release
• D. Causes alpha-1 mediated vasoconstriction
12. The nurse administers pilocarpine to a patient with glaucoma. The
mechanism of action is:
• A. Cholinergic agonist causing miosis and increased aqueous
humor outflow ANSWER
• B. Anticholinergic causing mydriasis
• C. Beta-blocker reducing aqueous production
• D. Alpha-agonist increasing uveoscleral outflow
13. A patient receives epinephrine during anaphylaxis. The nurse
understands that epinephrine reverses hypotension primarily through:
• A. Beta-2 agonism causing bronchodilation
