BSN Advanced Pharmacology | Final Exam Questions With
Answers and detailed Rationales
Question 1.
A patient is prescribed a drug with a high first-pass effect. How should the nurse expect
this drug to be administered?
A. Oral
B. Sublingual
C. Intravenous
D. Transdermal
Correct Answer: C. Intravenous
Explanation: Drugs with a high first-pass effect are extensively metabolized by the liver
when taken orally; therefore, parenteral routes like IV bypass the liver initially.
Question 2.
Which pharmacokinetic process is primarily affected by a patient’s serum albumin levels?
A. Distribution
B. Absorption
C. Metabolism
D. Excretion
Correct Answer: A. Distribution
Explanation: Distribution is affected by protein binding. Many drugs bind to albumin; low
albumin levels can lead to increased free drug levels.
Question 3.
A patient is receiving Digoxin. Which electrolyte imbalance most increases the risk of
Digoxin toxicity?
A. Hyperkalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypokalemia
Correct Answer: D. Hypokalemia
Explanation: Hypokalemia enhances the action of Digoxin at its binding site, significantly
increasing the risk of toxicity.
, Question 4.
What is the primary mechanism of action for ACE inhibitors like Lisinopril?
A. Blocks Beta-1 receptors
B. Inhibits Calcium influx into smooth muscle
C. Antagonizes Aldosterone receptors
D. Blocks the conversion of Angiotensin I to Angiotensin II
Correct Answer: D. Blocks the conversion of Angiotensin I to Angiotensin II
Explanation: ACE inhibitors prevent the conversion of Angiotensin I to the potent
vasoconstrictor Angiotensin II.
Question 5.
A patient taking Warfarin has an INR of 1.2. How should the nurse interpret this result?
A. The dose is too low; risk of clotting.
B. The dose is too high; risk of bleeding.
C. The dose is therapeutic.
D. The patient is experiencing toxicity.
Correct Answer: A. The dose is too low; risk of clotting.
Explanation: A therapeutic INR for most conditions on Warfarin is 2.0-3.0. An INR of 1.2 is
subtherapeutic.
Question 6.
Which medication is considered a ‘rescue’ inhaler for acute bronchospasm?
A. Salmeterol
B. Tiotropium
C. Fluticasone
D. Albuterol
Correct Answer: D. Albuterol
Explanation: Albuterol is a Short-Acting Beta Agonist (SABA) used for rapid relief of acute
asthma symptoms.
Question 7.
Which adverse effect is unique to ACE inhibitors and often leads to discontinuation?
A. Dry, nonproductive cough
B. Hypokalemia
C. Peripheral edema
D. Tachycardia
Correct Answer: A. Dry, nonproductive cough
Explanation: The accumulation of bradykinin caused by ACE inhibition leads to a
persistent dry cough in some patients.
Answers and detailed Rationales
Question 1.
A patient is prescribed a drug with a high first-pass effect. How should the nurse expect
this drug to be administered?
A. Oral
B. Sublingual
C. Intravenous
D. Transdermal
Correct Answer: C. Intravenous
Explanation: Drugs with a high first-pass effect are extensively metabolized by the liver
when taken orally; therefore, parenteral routes like IV bypass the liver initially.
Question 2.
Which pharmacokinetic process is primarily affected by a patient’s serum albumin levels?
A. Distribution
B. Absorption
C. Metabolism
D. Excretion
Correct Answer: A. Distribution
Explanation: Distribution is affected by protein binding. Many drugs bind to albumin; low
albumin levels can lead to increased free drug levels.
Question 3.
A patient is receiving Digoxin. Which electrolyte imbalance most increases the risk of
Digoxin toxicity?
A. Hyperkalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypokalemia
Correct Answer: D. Hypokalemia
Explanation: Hypokalemia enhances the action of Digoxin at its binding site, significantly
increasing the risk of toxicity.
, Question 4.
What is the primary mechanism of action for ACE inhibitors like Lisinopril?
A. Blocks Beta-1 receptors
B. Inhibits Calcium influx into smooth muscle
C. Antagonizes Aldosterone receptors
D. Blocks the conversion of Angiotensin I to Angiotensin II
Correct Answer: D. Blocks the conversion of Angiotensin I to Angiotensin II
Explanation: ACE inhibitors prevent the conversion of Angiotensin I to the potent
vasoconstrictor Angiotensin II.
Question 5.
A patient taking Warfarin has an INR of 1.2. How should the nurse interpret this result?
A. The dose is too low; risk of clotting.
B. The dose is too high; risk of bleeding.
C. The dose is therapeutic.
D. The patient is experiencing toxicity.
Correct Answer: A. The dose is too low; risk of clotting.
Explanation: A therapeutic INR for most conditions on Warfarin is 2.0-3.0. An INR of 1.2 is
subtherapeutic.
Question 6.
Which medication is considered a ‘rescue’ inhaler for acute bronchospasm?
A. Salmeterol
B. Tiotropium
C. Fluticasone
D. Albuterol
Correct Answer: D. Albuterol
Explanation: Albuterol is a Short-Acting Beta Agonist (SABA) used for rapid relief of acute
asthma symptoms.
Question 7.
Which adverse effect is unique to ACE inhibitors and often leads to discontinuation?
A. Dry, nonproductive cough
B. Hypokalemia
C. Peripheral edema
D. Tachycardia
Correct Answer: A. Dry, nonproductive cough
Explanation: The accumulation of bradykinin caused by ACE inhibition leads to a
persistent dry cough in some patients.
