NUR 100/NUR100 Exam 1 V2 | Pharmacology Q&A
with Rationale | Fortis College
1. A nurse is administering a medication that has a high first-pass effect. Which route of
administration would be most affected by this process?
A. Oral
B. Sublingual
C. Intravenous
D. Subcutaneous
Correct Answer: A
Explanation: The first-pass effect refers to the metabolism of a drug by the liver before it
reaches the systemic circulation. This phenomenon primarily occurs with drugs
administered via the oral route as they are absorbed from the GI tract into the portal vein.
Routes such as IV or sublingual bypass the liver initially, ensuring higher bioavailability.
2. Which pharmacokinetic process is primarily affected in a patient with end-stage renal
disease?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
,Correct Answer: C
Explanation: Excretion is the process by which drugs are removed from the body, and the
kidneys are the primary organs responsible for this. In patients with renal failure, the
inability to filter waste leads to drug accumulation and potential toxicity. Nurses must
monitor creatinine clearance and BUN levels to adjust dosages accordingly.
3. The nurse notes that a drug has a narrow therapeutic index. What is the clinical
significance of this finding?
A. The drug is very safe and requires little monitoring.
B. The difference between a therapeutic dose and a toxic dose is small.
C. The drug will reach a steady state very quickly.
D. The drug is only effective if given intravenously.
Correct Answer: B
Explanation: A narrow therapeutic index indicates that there is a slim margin between the
dose that produces a beneficial effect and the dose that causes toxicity. This requires the
nurse to perform frequent blood level monitoring to ensure patient safety. Medications like
digoxin and lithium are common examples that require this level of vigilance.
4. When assessing an elderly patient’s risk for drug toxicity, which physiological change is
most relevant?
A. Increased gastric motility
B. Increased total body water
, C. Decreased albumin levels
D. Enhanced liver enzyme activity
Correct Answer: C
Explanation: Elderly patients often have decreased serum albumin levels, which leads to
fewer binding sites for protein-bound drugs. This results in an increase in the amount of
free, active drug in the bloodstream, raising the risk of toxicity. The nurse must be aware
that ‘normal’ doses for younger adults may be excessive for geriatric patients.
5. A patient is prescribed a drug that acts as an agonist. How does this drug exert its effect?
A. By blocking a receptor site to prevent a response
B. By neutralizing stomach acid through a chemical reaction
C. By increasing the rate of drug excretion
D. By binding to a receptor and triggering a biological response
Correct Answer: D
Explanation: An agonist is a molecule that mimics the action of a naturally occurring
substance by binding to and activating a receptor. This binding results in a physiological
response that enhances or stimulates cellular activity. In contrast, an antagonist would
bind to the receptor to inhibit or block such a response.
with Rationale | Fortis College
1. A nurse is administering a medication that has a high first-pass effect. Which route of
administration would be most affected by this process?
A. Oral
B. Sublingual
C. Intravenous
D. Subcutaneous
Correct Answer: A
Explanation: The first-pass effect refers to the metabolism of a drug by the liver before it
reaches the systemic circulation. This phenomenon primarily occurs with drugs
administered via the oral route as they are absorbed from the GI tract into the portal vein.
Routes such as IV or sublingual bypass the liver initially, ensuring higher bioavailability.
2. Which pharmacokinetic process is primarily affected in a patient with end-stage renal
disease?
A. Absorption
B. Distribution
C. Excretion
D. Metabolism
,Correct Answer: C
Explanation: Excretion is the process by which drugs are removed from the body, and the
kidneys are the primary organs responsible for this. In patients with renal failure, the
inability to filter waste leads to drug accumulation and potential toxicity. Nurses must
monitor creatinine clearance and BUN levels to adjust dosages accordingly.
3. The nurse notes that a drug has a narrow therapeutic index. What is the clinical
significance of this finding?
A. The drug is very safe and requires little monitoring.
B. The difference between a therapeutic dose and a toxic dose is small.
C. The drug will reach a steady state very quickly.
D. The drug is only effective if given intravenously.
Correct Answer: B
Explanation: A narrow therapeutic index indicates that there is a slim margin between the
dose that produces a beneficial effect and the dose that causes toxicity. This requires the
nurse to perform frequent blood level monitoring to ensure patient safety. Medications like
digoxin and lithium are common examples that require this level of vigilance.
4. When assessing an elderly patient’s risk for drug toxicity, which physiological change is
most relevant?
A. Increased gastric motility
B. Increased total body water
, C. Decreased albumin levels
D. Enhanced liver enzyme activity
Correct Answer: C
Explanation: Elderly patients often have decreased serum albumin levels, which leads to
fewer binding sites for protein-bound drugs. This results in an increase in the amount of
free, active drug in the bloodstream, raising the risk of toxicity. The nurse must be aware
that ‘normal’ doses for younger adults may be excessive for geriatric patients.
5. A patient is prescribed a drug that acts as an agonist. How does this drug exert its effect?
A. By blocking a receptor site to prevent a response
B. By neutralizing stomach acid through a chemical reaction
C. By increasing the rate of drug excretion
D. By binding to a receptor and triggering a biological response
Correct Answer: D
Explanation: An agonist is a molecule that mimics the action of a naturally occurring
substance by binding to and activating a receptor. This binding results in a physiological
response that enhances or stimulates cellular activity. In contrast, an antagonist would
bind to the receptor to inhibit or block such a response.
