NURS 180 PHARMACOLOGY EXAM 2026
| WCU QUESTIONS AND ANSWERS
1. A patient is prescribed an oral medication that undergoes extensive first-pass metabolism.
What is the most likely clinical implication?
A. A higher oral dose is required compared to the parenteral dose.
B. The drug will have a faster onset of action.
C. The drug’s duration of action will be significantly prolonged.
D. The drug bypasses the liver and enters the systemic circulation directly.
Answer: A
Conceptual Explanation: First-pass metabolism occurs when the liver inactivates a
significant portion of a drug after oral absorption. To achieve therapeutic levels, the oral
dose must be higher than the IV dose, which bypasses the liver.
2. The nurse is monitoring a patient with a narrow therapeutic index medication. What is the
primary priority?
A. Assess for drug-drug interactions involving Vitamin K.
B. Educate the patient on the cost of the medication.
,C. Administer the drug only on an empty stomach.
D. Monitor serum drug levels frequently to prevent toxicity.
Answer: D
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small. Close monitoring of serum levels is essential for
safety.
3. A drug has a half-life of 4 hours. If 100 mg is administered at 08:00, how much remains in
the body at 16:00?
A. 50 mg
B. 25 mg
C. 0 mg
D. 12.5 mg
Answer: B
Conceptual Explanation: After 4 hours (12:00), 50 mg remains. After another 4 hours
(16:00), 25 mg remains (half of 50).
4. Which pharmacokinetic phase is most affected by a patient having hypoalbuminemia?
A. Absorption
B. Metabolism
C. Distribution
, D. Excretion
Answer: C
Conceptual Explanation: Distribution is affected because drugs bind to proteins like
albumin. Lower albumin levels lead to more free, active drug in the bloodstream, increasing
the risk of toxicity.
5. A patient is receiving an anticholinergic medication. Which side effect should the nurse
expect?
A. Excessive salivation
B. Diarrhea
C. Urinary retention
D. Bradycardia
Answer: C
Conceptual Explanation: Anticholinergics inhibit the parasympathetic nervous system,
leading to ‘drying’ effects: urinary retention, constipation, dry mouth, and blurred vision.
6. Following the administration of Epinephrine, the nurse expects stimulation of which
receptors to cause bronchodilation?
A. Beta-2
B. Beta-1
C. Alpha-1
| WCU QUESTIONS AND ANSWERS
1. A patient is prescribed an oral medication that undergoes extensive first-pass metabolism.
What is the most likely clinical implication?
A. A higher oral dose is required compared to the parenteral dose.
B. The drug will have a faster onset of action.
C. The drug’s duration of action will be significantly prolonged.
D. The drug bypasses the liver and enters the systemic circulation directly.
Answer: A
Conceptual Explanation: First-pass metabolism occurs when the liver inactivates a
significant portion of a drug after oral absorption. To achieve therapeutic levels, the oral
dose must be higher than the IV dose, which bypasses the liver.
2. The nurse is monitoring a patient with a narrow therapeutic index medication. What is the
primary priority?
A. Assess for drug-drug interactions involving Vitamin K.
B. Educate the patient on the cost of the medication.
,C. Administer the drug only on an empty stomach.
D. Monitor serum drug levels frequently to prevent toxicity.
Answer: D
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is small. Close monitoring of serum levels is essential for
safety.
3. A drug has a half-life of 4 hours. If 100 mg is administered at 08:00, how much remains in
the body at 16:00?
A. 50 mg
B. 25 mg
C. 0 mg
D. 12.5 mg
Answer: B
Conceptual Explanation: After 4 hours (12:00), 50 mg remains. After another 4 hours
(16:00), 25 mg remains (half of 50).
4. Which pharmacokinetic phase is most affected by a patient having hypoalbuminemia?
A. Absorption
B. Metabolism
C. Distribution
, D. Excretion
Answer: C
Conceptual Explanation: Distribution is affected because drugs bind to proteins like
albumin. Lower albumin levels lead to more free, active drug in the bloodstream, increasing
the risk of toxicity.
5. A patient is receiving an anticholinergic medication. Which side effect should the nurse
expect?
A. Excessive salivation
B. Diarrhea
C. Urinary retention
D. Bradycardia
Answer: C
Conceptual Explanation: Anticholinergics inhibit the parasympathetic nervous system,
leading to ‘drying’ effects: urinary retention, constipation, dry mouth, and blurred vision.
6. Following the administration of Epinephrine, the nurse expects stimulation of which
receptors to cause bronchodilation?
A. Beta-2
B. Beta-1
C. Alpha-1
