,NUR210/NUR 210 Principles of Pharmacology
Exam 4 | Galen College | 2026 Edition (PDF)
1. Which organ is primarily responsible for the metabolism of drugs and is the main site for the first-pass
effect?
A) Kidneys
B) Liver
C) Lungs
D) Small intestine
Correct Answer: Liver
Rationale: The liver is the primary site of drug metabolism, utilizing enzymes such as the cytochrome
P450 system to chemically alter drugs. The kidneys are primarily responsible for excretion, while the
lungs have minor metabolic functions. The small intestine absorbs drugs but does not perform
significant metabolism.
2. A medication that binds to a receptor and produces a response that is less than maximal is known as
a:
A) Full agonist
B) Partial agonist
C) Antagonist
D) Inverse agonist
Correct Answer: Partial agonist
Rationale: A partial agonist binds to a receptor and activates it, but produces a submaximal response
even when all receptors are occupied. A full agonist produces a maximal response, while an antagonist
blocks the receptor without activating it.
,3. Which of the following adverse effects is associated with aminoglycoside therapy that requires
monitoring of peak and trough levels?
A) Hepatotoxicity
B) Nephrotoxicity and ototoxicity
C) Cardiotoxicity
D) Neurotoxicity
Correct Answer: Nephrotoxicity and ototoxicity
Rationale: Aminoglycosides such as gentamicin can cause nephrotoxicity (kidney damage) and
ototoxicity (damage to the vestibulocochlear nerve). Monitoring peak and trough levels is essential to
maintain therapeutic levels and prevent these toxicities.
4. A patient prescribed isoniazid (INH) for tuberculosis should be instructed to report which adverse
effect immediately?
A) Red-orange urine
B) Peripheral neuropathy
C) Hepatotoxicity
D) Photosensitivity
Correct Answer: Peripheral neuropathy
Rationale: Isoniazid can cause peripheral neuropathy due to pyridoxine (vitamin B6) deficiency. Patients
should be instructed to report tingling or numbness in the hands and feet. Red-orange urine is
associated with rifampin, not INH.
5. Which medication used for tuberculosis is known to cause red-orange discoloration of body fluids?
A) Isoniazid
B) Rifampin
C) Pyrazinamide
D) Ethambutol
, Correct Answer: Rifampin
Rationale: Rifampin causes harmless red-orange discoloration of urine, sweat, and tears. Patients should
be warned about this side effect to prevent unnecessary alarm. Isoniazid is associated with peripheral
neuropathy, pyrazinamide with hepatotoxicity, and ethambutol with optic neuritis.
6. When teaching a patient about the use of an inhaled corticosteroid such as Beclomethasone (QVAR),
which instruction is most important?
A) Use the medication as a rescue inhaler for acute attacks
B) Rinse the mouth with water after each use to prevent oral candidiasis
C) Limit fluid intake to 1 liter per day
D) Expect immediate relief of symptoms
Correct Answer: Rinse the mouth with water after each use to prevent oral candidiasis
Rationale: Inhaled corticosteroids like Beclomethasone can cause oral fungal infections (thrush). Rinsing
the mouth after each use is the primary prevention strategy. These medications are not rescue inhalers
and do not provide immediate relief.
7. A patient is prescribed Albuterol for exercise-induced bronchospasms. Which instruction regarding its
use should the nurse provide?
A) Expect a decrease in heart rate after administration
B) Take the medication only when feeling extremely short of breath
C) Use the medication 15 to 30 minutes before exercise
D) Rinse the mouth with water immediately before use
Correct Answer: Use the medication 15 to 30 minutes before exercise
Rationale: Albuterol is a short-acting beta2-agonist (SABA) used for the prevention of exercise-induced
bronchospasms and should be taken prior to activity. It can cause tachycardia, not bradycardia.
Exam 4 | Galen College | 2026 Edition (PDF)
1. Which organ is primarily responsible for the metabolism of drugs and is the main site for the first-pass
effect?
A) Kidneys
B) Liver
C) Lungs
D) Small intestine
Correct Answer: Liver
Rationale: The liver is the primary site of drug metabolism, utilizing enzymes such as the cytochrome
P450 system to chemically alter drugs. The kidneys are primarily responsible for excretion, while the
lungs have minor metabolic functions. The small intestine absorbs drugs but does not perform
significant metabolism.
2. A medication that binds to a receptor and produces a response that is less than maximal is known as
a:
A) Full agonist
B) Partial agonist
C) Antagonist
D) Inverse agonist
Correct Answer: Partial agonist
Rationale: A partial agonist binds to a receptor and activates it, but produces a submaximal response
even when all receptors are occupied. A full agonist produces a maximal response, while an antagonist
blocks the receptor without activating it.
,3. Which of the following adverse effects is associated with aminoglycoside therapy that requires
monitoring of peak and trough levels?
A) Hepatotoxicity
B) Nephrotoxicity and ototoxicity
C) Cardiotoxicity
D) Neurotoxicity
Correct Answer: Nephrotoxicity and ototoxicity
Rationale: Aminoglycosides such as gentamicin can cause nephrotoxicity (kidney damage) and
ototoxicity (damage to the vestibulocochlear nerve). Monitoring peak and trough levels is essential to
maintain therapeutic levels and prevent these toxicities.
4. A patient prescribed isoniazid (INH) for tuberculosis should be instructed to report which adverse
effect immediately?
A) Red-orange urine
B) Peripheral neuropathy
C) Hepatotoxicity
D) Photosensitivity
Correct Answer: Peripheral neuropathy
Rationale: Isoniazid can cause peripheral neuropathy due to pyridoxine (vitamin B6) deficiency. Patients
should be instructed to report tingling or numbness in the hands and feet. Red-orange urine is
associated with rifampin, not INH.
5. Which medication used for tuberculosis is known to cause red-orange discoloration of body fluids?
A) Isoniazid
B) Rifampin
C) Pyrazinamide
D) Ethambutol
, Correct Answer: Rifampin
Rationale: Rifampin causes harmless red-orange discoloration of urine, sweat, and tears. Patients should
be warned about this side effect to prevent unnecessary alarm. Isoniazid is associated with peripheral
neuropathy, pyrazinamide with hepatotoxicity, and ethambutol with optic neuritis.
6. When teaching a patient about the use of an inhaled corticosteroid such as Beclomethasone (QVAR),
which instruction is most important?
A) Use the medication as a rescue inhaler for acute attacks
B) Rinse the mouth with water after each use to prevent oral candidiasis
C) Limit fluid intake to 1 liter per day
D) Expect immediate relief of symptoms
Correct Answer: Rinse the mouth with water after each use to prevent oral candidiasis
Rationale: Inhaled corticosteroids like Beclomethasone can cause oral fungal infections (thrush). Rinsing
the mouth after each use is the primary prevention strategy. These medications are not rescue inhalers
and do not provide immediate relief.
7. A patient is prescribed Albuterol for exercise-induced bronchospasms. Which instruction regarding its
use should the nurse provide?
A) Expect a decrease in heart rate after administration
B) Take the medication only when feeling extremely short of breath
C) Use the medication 15 to 30 minutes before exercise
D) Rinse the mouth with water immediately before use
Correct Answer: Use the medication 15 to 30 minutes before exercise
Rationale: Albuterol is a short-acting beta2-agonist (SABA) used for the prevention of exercise-induced
bronchospasms and should be taken prior to activity. It can cause tachycardia, not bradycardia.
