NURS 180 PHARMACOLOGY
COMPREHENSIVE FINAL EXAM
(WEEKS 1-14) QUESTIONS AND
ANSWERS
1. A patient with chronic renal failure is prescribed a drug that is primarily excreted via the
kidneys. How should the dosage be adjusted to prevent toxicity?
A. Decrease the dose or increase the dosing interval
B. Increase the dose frequency
C. Change the route of administration to intramuscular
D. Administer the drug with a high-protein meal
Answer: A
Conceptual Explanation: In renal failure, drug clearance is reduced, leading to
accumulation. Adjustments involve lowering the dose or spacing out doses to avoid toxic
serum levels.
2. Which pharmacokinetic process is most affected by the ‘first-pass effect’ in the liver?
A. Distribution
B. Metabolism
,C. Excretion
D. Absorption
Answer: B
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug absorbed from the GI tract before it reaches systemic circulation.
3. A nurse is monitoring a patient receiving Warfarin. Which lab value is most critical for
determining the therapeutic effectiveness and safety of this medication?
A. INR
B. Platelet count
C. aPTT
D. Serum potassium
Answer: A
Conceptual Explanation: International Normalized Ratio (INR) is the standard for
monitoring Warfarin therapy; aPTT is used for Heparin.
4. When administering Alendronate for osteoporosis, what instruction is vital to prevent
esophageal erosion?
A. Take the medication on an empty stomach with 8 oz of water and remain upright for 30
minutes
B. Lie down for 30 minutes after administration
, C. Take the medication with a full glass of milk
D. Take the medication immediately before sleep
Answer: A
Conceptual Explanation: Bisphosphonates like Alendronate can cause severe esophagitis;
upright positioning and water help ensure the pill reaches the stomach quickly.
5. A patient is diagnosed with Digoxin toxicity. Which electrolyte imbalance most significantly
increases the risk of this condition?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypokalemia
Answer: D
Conceptual Explanation: Low potassium levels increase the binding of Digoxin to the
Na+/K+ ATPase pump, significantly enhancing its effects and toxicity risk.
6. Which of the following is a classic adverse effect associated with the use of ACE inhibitors
such as Lisinopril?
A. Hypokalemia
B. Weight gain
C. Tachycardia
COMPREHENSIVE FINAL EXAM
(WEEKS 1-14) QUESTIONS AND
ANSWERS
1. A patient with chronic renal failure is prescribed a drug that is primarily excreted via the
kidneys. How should the dosage be adjusted to prevent toxicity?
A. Decrease the dose or increase the dosing interval
B. Increase the dose frequency
C. Change the route of administration to intramuscular
D. Administer the drug with a high-protein meal
Answer: A
Conceptual Explanation: In renal failure, drug clearance is reduced, leading to
accumulation. Adjustments involve lowering the dose or spacing out doses to avoid toxic
serum levels.
2. Which pharmacokinetic process is most affected by the ‘first-pass effect’ in the liver?
A. Distribution
B. Metabolism
,C. Excretion
D. Absorption
Answer: B
Conceptual Explanation: The first-pass effect refers to the rapid hepatic metabolism of a
drug absorbed from the GI tract before it reaches systemic circulation.
3. A nurse is monitoring a patient receiving Warfarin. Which lab value is most critical for
determining the therapeutic effectiveness and safety of this medication?
A. INR
B. Platelet count
C. aPTT
D. Serum potassium
Answer: A
Conceptual Explanation: International Normalized Ratio (INR) is the standard for
monitoring Warfarin therapy; aPTT is used for Heparin.
4. When administering Alendronate for osteoporosis, what instruction is vital to prevent
esophageal erosion?
A. Take the medication on an empty stomach with 8 oz of water and remain upright for 30
minutes
B. Lie down for 30 minutes after administration
, C. Take the medication with a full glass of milk
D. Take the medication immediately before sleep
Answer: A
Conceptual Explanation: Bisphosphonates like Alendronate can cause severe esophagitis;
upright positioning and water help ensure the pill reaches the stomach quickly.
5. A patient is diagnosed with Digoxin toxicity. Which electrolyte imbalance most significantly
increases the risk of this condition?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypokalemia
Answer: D
Conceptual Explanation: Low potassium levels increase the binding of Digoxin to the
Na+/K+ ATPase pump, significantly enhancing its effects and toxicity risk.
6. Which of the following is a classic adverse effect associated with the use of ACE inhibitors
such as Lisinopril?
A. Hypokalemia
B. Weight gain
C. Tachycardia
