NUR210 PHARMACOLOGY EXAM 1
(GALEN) COMPREHENSIVE REVIEW
1. A patient with liver cirrhosis has low albumin levels. When administering a highly protein-
bound medication, the nurse should monitor for which effect?
A. Decreased drug effectiveness due to rapid excretion
B. Increased risk of drug toxicity due to more free drug in the blood
C. Reduced absorption rate in the small intestine
D. Increased storage of the drug in adipose tissue
Answer: B
Conceptual Explanation: Highly protein-bound drugs require albumin to transport them.
With low albumin levels, there is less protein for the drug to bind to, leading to higher
levels of active ‘free’ drug, which increases the risk of toxicity.
2. Which pharmacokinetic phase is most affected by a patient’s glomerular filtration rate
(GFR)?
A. Absorption
B. Distribution
,C. Metabolism
D. Excretion
Answer: D
Conceptual Explanation: Excretion is the process by which drugs are removed from the
body, primarily through the kidneys. The GFR is a critical measure of renal function and
determines how efficiently drugs are excreted.
3. The nurse is administering a drug that has a narrow therapeutic index. What is the primary
clinical implication of this characteristic?
A. The drug is safe to administer without monitoring blood levels
B. The drug is highly effective at very low concentrations
C. The drug will take a long time to reach steady state
D. The difference between the effective dose and the toxic dose is small
Answer: D
Conceptual Explanation: A narrow therapeutic index means there is a small margin of
safety between the dose that produces a desired effect and the dose that produces toxic
effects, necessitating close monitoring of serum drug levels.
4. A drug is categorized by the FDA as Pregnancy Category X. What does this indicate?
A. Animal studies show no risk, but no human studies exist
B. The drug is safe to use if the benefits outweigh the risks
, C. The drug is known to cause fetal abnormalities and is contraindicated in pregnancy
D. There is no evidence of risk in humans during the first trimester
Answer: C
Conceptual Explanation: Category X drugs have demonstrated clear fetal risks in human
or animal studies that outweigh any possible benefit, making them strictly contraindicated
for pregnant women.
5. What is the ‘first-pass effect’ in pharmacology?
A. The initial increase in heart rate after a stimulant is given
B. The movement of a drug from the site of administration into the bloodstream
C. The first time a patient experiences a side effect from a new medication
D. The metabolism of a drug by the liver before it reaches systemic circulation
Answer: D
Conceptual Explanation: The first-pass effect occurs when an orally administered drug is
absorbed from the GI tract into the portal circulation and metabolized by the liver before
reaching the rest of the body, often reducing the bioavailability of the drug.
6. When administering medications to an elderly patient, the nurse recognizes that which
physiological change increases the risk for drug toxicity?
A. Increased gastrointestinal motility
B. Increased total body water
(GALEN) COMPREHENSIVE REVIEW
1. A patient with liver cirrhosis has low albumin levels. When administering a highly protein-
bound medication, the nurse should monitor for which effect?
A. Decreased drug effectiveness due to rapid excretion
B. Increased risk of drug toxicity due to more free drug in the blood
C. Reduced absorption rate in the small intestine
D. Increased storage of the drug in adipose tissue
Answer: B
Conceptual Explanation: Highly protein-bound drugs require albumin to transport them.
With low albumin levels, there is less protein for the drug to bind to, leading to higher
levels of active ‘free’ drug, which increases the risk of toxicity.
2. Which pharmacokinetic phase is most affected by a patient’s glomerular filtration rate
(GFR)?
A. Absorption
B. Distribution
,C. Metabolism
D. Excretion
Answer: D
Conceptual Explanation: Excretion is the process by which drugs are removed from the
body, primarily through the kidneys. The GFR is a critical measure of renal function and
determines how efficiently drugs are excreted.
3. The nurse is administering a drug that has a narrow therapeutic index. What is the primary
clinical implication of this characteristic?
A. The drug is safe to administer without monitoring blood levels
B. The drug is highly effective at very low concentrations
C. The drug will take a long time to reach steady state
D. The difference between the effective dose and the toxic dose is small
Answer: D
Conceptual Explanation: A narrow therapeutic index means there is a small margin of
safety between the dose that produces a desired effect and the dose that produces toxic
effects, necessitating close monitoring of serum drug levels.
4. A drug is categorized by the FDA as Pregnancy Category X. What does this indicate?
A. Animal studies show no risk, but no human studies exist
B. The drug is safe to use if the benefits outweigh the risks
, C. The drug is known to cause fetal abnormalities and is contraindicated in pregnancy
D. There is no evidence of risk in humans during the first trimester
Answer: C
Conceptual Explanation: Category X drugs have demonstrated clear fetal risks in human
or animal studies that outweigh any possible benefit, making them strictly contraindicated
for pregnant women.
5. What is the ‘first-pass effect’ in pharmacology?
A. The initial increase in heart rate after a stimulant is given
B. The movement of a drug from the site of administration into the bloodstream
C. The first time a patient experiences a side effect from a new medication
D. The metabolism of a drug by the liver before it reaches systemic circulation
Answer: D
Conceptual Explanation: The first-pass effect occurs when an orally administered drug is
absorbed from the GI tract into the portal circulation and metabolized by the liver before
reaching the rest of the body, often reducing the bioavailability of the drug.
6. When administering medications to an elderly patient, the nurse recognizes that which
physiological change increases the risk for drug toxicity?
A. Increased gastrointestinal motility
B. Increased total body water
