NUR 2407 PHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would most likely result in the lowest bioavailability?
A. Intravenous
B. Oral
C. Sublingual
D. Intramuscular
Answer: B
Conceptual Explanation: The first-pass effect refers to the metabolism of a drug by the
liver before it reaches systemic circulation. Oral medications are absorbed from the GI tract
and carried directly to the liver via the portal vein, significantly reducing bioavailability
compared to parenteral routes.
,2. Which clinical manifestation should the nurse prioritize when assessing a patient for
digoxin toxicity?
A. Increased appetite and constipation
B. Visual disturbances such as yellow-green halos
C. Peripheral edema and weight gain
D. Dry cough and shortness of breath
Answer: B
Conceptual Explanation: Digoxin toxicity commonly presents with visual changes (yellow
or green halos), nausea, vomiting, and cardiac arrhythmias. Early detection is critical for
patient safety.
3. A patient with asthma is prescribed albuterol and beclomethasone inhalers. What
instruction should the nurse provide regarding administration?
A. Use the beclomethasone first to reduce inflammation.
B. Use the albuterol first to open the airways.
C. Wait at least 15 minutes between the two inhalers.
D. Rinse the mouth only after using the albuterol inhaler.
Answer: B
Conceptual Explanation: Albuterol is a bronchodilator and should be used first to dilate
the airways, allowing the corticosteroid (beclomethasone) to reach deeper into the lungs.
, The patient should wait 5 minutes between different inhalers and rinse their mouth after
the steroid.
4. A patient is brought to the emergency department with suspected opioid overdose. Which
medication should the nurse anticipate administering?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Acetylcysteine
Answer: B
Conceptual Explanation: Naloxone is an opioid antagonist used to reverse respiratory
depression and other effects of opioid toxicity. Flumazenil is for benzodiazepines,
acetylcysteine for acetaminophen, and protamine sulfate for heparin.
5. A patient taking metformin is scheduled for a CT scan with intravenous contrast dye. Which
action should the nurse take?
A. Double the dose of metformin to prevent hyperglycemia.
B. Hold the metformin 48 hours before and after the procedure.
C. Administer the metformin with a full glass of water.
D. Change the metformin to a sulfonylurea for the day.
Answer: B
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would most likely result in the lowest bioavailability?
A. Intravenous
B. Oral
C. Sublingual
D. Intramuscular
Answer: B
Conceptual Explanation: The first-pass effect refers to the metabolism of a drug by the
liver before it reaches systemic circulation. Oral medications are absorbed from the GI tract
and carried directly to the liver via the portal vein, significantly reducing bioavailability
compared to parenteral routes.
,2. Which clinical manifestation should the nurse prioritize when assessing a patient for
digoxin toxicity?
A. Increased appetite and constipation
B. Visual disturbances such as yellow-green halos
C. Peripheral edema and weight gain
D. Dry cough and shortness of breath
Answer: B
Conceptual Explanation: Digoxin toxicity commonly presents with visual changes (yellow
or green halos), nausea, vomiting, and cardiac arrhythmias. Early detection is critical for
patient safety.
3. A patient with asthma is prescribed albuterol and beclomethasone inhalers. What
instruction should the nurse provide regarding administration?
A. Use the beclomethasone first to reduce inflammation.
B. Use the albuterol first to open the airways.
C. Wait at least 15 minutes between the two inhalers.
D. Rinse the mouth only after using the albuterol inhaler.
Answer: B
Conceptual Explanation: Albuterol is a bronchodilator and should be used first to dilate
the airways, allowing the corticosteroid (beclomethasone) to reach deeper into the lungs.
, The patient should wait 5 minutes between different inhalers and rinse their mouth after
the steroid.
4. A patient is brought to the emergency department with suspected opioid overdose. Which
medication should the nurse anticipate administering?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Acetylcysteine
Answer: B
Conceptual Explanation: Naloxone is an opioid antagonist used to reverse respiratory
depression and other effects of opioid toxicity. Flumazenil is for benzodiazepines,
acetylcysteine for acetaminophen, and protamine sulfate for heparin.
5. A patient taking metformin is scheduled for a CT scan with intravenous contrast dye. Which
action should the nurse take?
A. Double the dose of metformin to prevent hyperglycemia.
B. Hold the metformin 48 hours before and after the procedure.
C. Administer the metformin with a full glass of water.
D. Change the metformin to a sulfonylurea for the day.
Answer: B
