NURS 180 COMPREHENSIVE
PHARMACOLOGY FINAL EXAM 1 2026 |
WCU
1. A patient with chronic renal failure is prescribed a drug that is primarily excreted by the
kidneys. The nurse should anticipate which modification to the drug regimen?
A. Increase the frequency of administration
B. Switch to an oral route to delay absorption
C. Decrease the dose or increase the dosing interval
D. Administer a loading dose followed by standard maintenance doses
Answer: C
Conceptual Explanation: In patients with renal impairment, the clearance of drugs
excreted by the kidneys is reduced, leading to potential toxicity. To maintain therapeutic
levels without accumulation, the dose should be decreased or the interval between doses
increased.
2. A patient is receiving Vancomycin intravenously for a MRSA infection. Which laboratory
value is most critical for the nurse to monitor to prevent nephrotoxicity?
A. White blood cell count
,B. Serum peak levels
C. Serum trough levels
D. Hemoglobin and Hematocrit
Answer: C
Conceptual Explanation: Trough levels are the most reliable indicator for monitoring
Vancomycin to ensure therapeutic efficacy while minimizing the risk of nephrotoxicity and
ototoxicity.
3. Which statement by a patient prescribed Warfarin indicates a need for further teaching?
A. ‘I will use a soft-bristled toothbrush to prevent gum bleeding.’
B. ‘I will need regular blood tests to check my INR levels.’
C. ‘I should increase my intake of spinach and kale to improve my health.’
D. ‘I should avoid taking aspirin or ibuprofen while on this medication.’
Answer: C
Conceptual Explanation: Spinach and kale are high in Vitamin K, which is the antidote to
Warfarin. A sudden increase in Vitamin K intake can decrease the effectiveness of Warfarin,
increasing the risk of clotting.
4. A nurse is preparing to administer Digoxin to a patient with heart failure. Which clinical
finding would require the nurse to withhold the medication?
A. Blood pressure of 140/90 mmHg
, B. Respiratory rate of 22 breaths/min
C. Serum potassium level of 4.8 mEq/L
D. Apical pulse of 52 beats/min
Answer: D
Conceptual Explanation: Digoxin is a negative chronotrope that slows the heart rate. It
should be withheld if the apical pulse is less than 60 beats/min in an adult to avoid severe
bradycardia.
5. What is the mechanism of action of Spironolactone?
A. Inhibits the sodium-potassium-chloride symporter in the loop of Henle
B. Inhibits the enzyme carbonic anhydrase
C. Blocks the action of aldosterone in the distal nephron
D. Promotes the excretion of potassium in the collecting duct
Answer: C
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic that acts as an
aldosterone antagonist, leading to sodium excretion and potassium retention.
6. A patient is prescribed Lisinopril for hypertension. Which side effect is most uniquely
associated with ACE inhibitors due to the accumulation of bradykinin?
A. Peripheral edema
B. Dry, nonproductive cough
PHARMACOLOGY FINAL EXAM 1 2026 |
WCU
1. A patient with chronic renal failure is prescribed a drug that is primarily excreted by the
kidneys. The nurse should anticipate which modification to the drug regimen?
A. Increase the frequency of administration
B. Switch to an oral route to delay absorption
C. Decrease the dose or increase the dosing interval
D. Administer a loading dose followed by standard maintenance doses
Answer: C
Conceptual Explanation: In patients with renal impairment, the clearance of drugs
excreted by the kidneys is reduced, leading to potential toxicity. To maintain therapeutic
levels without accumulation, the dose should be decreased or the interval between doses
increased.
2. A patient is receiving Vancomycin intravenously for a MRSA infection. Which laboratory
value is most critical for the nurse to monitor to prevent nephrotoxicity?
A. White blood cell count
,B. Serum peak levels
C. Serum trough levels
D. Hemoglobin and Hematocrit
Answer: C
Conceptual Explanation: Trough levels are the most reliable indicator for monitoring
Vancomycin to ensure therapeutic efficacy while minimizing the risk of nephrotoxicity and
ototoxicity.
3. Which statement by a patient prescribed Warfarin indicates a need for further teaching?
A. ‘I will use a soft-bristled toothbrush to prevent gum bleeding.’
B. ‘I will need regular blood tests to check my INR levels.’
C. ‘I should increase my intake of spinach and kale to improve my health.’
D. ‘I should avoid taking aspirin or ibuprofen while on this medication.’
Answer: C
Conceptual Explanation: Spinach and kale are high in Vitamin K, which is the antidote to
Warfarin. A sudden increase in Vitamin K intake can decrease the effectiveness of Warfarin,
increasing the risk of clotting.
4. A nurse is preparing to administer Digoxin to a patient with heart failure. Which clinical
finding would require the nurse to withhold the medication?
A. Blood pressure of 140/90 mmHg
, B. Respiratory rate of 22 breaths/min
C. Serum potassium level of 4.8 mEq/L
D. Apical pulse of 52 beats/min
Answer: D
Conceptual Explanation: Digoxin is a negative chronotrope that slows the heart rate. It
should be withheld if the apical pulse is less than 60 beats/min in an adult to avoid severe
bradycardia.
5. What is the mechanism of action of Spironolactone?
A. Inhibits the sodium-potassium-chloride symporter in the loop of Henle
B. Inhibits the enzyme carbonic anhydrase
C. Blocks the action of aldosterone in the distal nephron
D. Promotes the excretion of potassium in the collecting duct
Answer: C
Conceptual Explanation: Spironolactone is a potassium-sparing diuretic that acts as an
aldosterone antagonist, leading to sodium excretion and potassium retention.
6. A patient is prescribed Lisinopril for hypertension. Which side effect is most uniquely
associated with ACE inhibitors due to the accumulation of bradykinin?
A. Peripheral edema
B. Dry, nonproductive cough
