NUR 2474 PHARMACOLOGY MIDTERM
EXAM (LATEST 2026/ 2027 UPDATE)
QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS| GRADE A+
1. A patient with advanced liver cirrhosis is receiving a medication that is primarily
metabolized by the liver. Which pharmacokinetic process should the nurse most closely
monitor for impairment?
A. Absorption
B. Metabolism
C. Distribution
D. Excretion
Answer: B
Conceptual Explanation: Metabolism occurs primarily in the liver. In patients with liver
disease, the liver’s ability to break down drugs is decreased, leading to potential toxicity.
2. Which statement regarding a drug with a narrow therapeutic index is most accurate?
A. The drug is safe to administer without blood level monitoring.
,B. The drug has a very high safety profile.
C. There is a small margin between the effective dose and the toxic dose.
D. The drug requires a loading dose to reach a steady state quickly.
Answer: C
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is very small, requiring frequent blood level monitoring.
3. A patient is prescribed an oral medication that undergoes significant first-pass effect. The
nurse understands that this means:
A. A large portion of the drug is inactivated by the liver before reaching systemic
circulation.
B. The drug is absorbed rapidly through the gastric mucosa.
C. The drug must be administered via the intravenous route to be effective.
D. The drug’s bioavailability is increased by gastric acidity.
Answer: A
Conceptual Explanation: The first-pass effect occurs when a drug is metabolized by the
liver immediately after absorption from the GI tract, reducing the amount of active drug
available.
, 4. When administering a drug that acts as an antagonist, the nurse understands that the drug
will:
A. Mimic the action of endogenous substances.
B. Bind to receptors and block the action of endogenous chemicals.
C. Produce a maximal response by activating receptors.
D. Enhance the receptor’s sensitivity to other drugs.
Answer: B
Conceptual Explanation: Antagonists bind to receptors but do not activate them; instead,
they prevent other substances (agonists) from binding and producing a response.
5. A nurse is preparing to administer Bethanechol to a patient with urinary retention. Which
assessment finding is a contraindication for this medication?
A. Asthma
B. Tachycardia
C. Constipation
D. Hypertension
Answer: A
Conceptual Explanation: Bethanechol is a cholinergic agonist. It can cause
bronchoconstriction, making it contraindicated in patients with asthma or COPD.
EXAM (LATEST 2026/ 2027 UPDATE)
QUESTIONS AND 100% CORRECT
VERIFIED ANSWERS| GRADE A+
1. A patient with advanced liver cirrhosis is receiving a medication that is primarily
metabolized by the liver. Which pharmacokinetic process should the nurse most closely
monitor for impairment?
A. Absorption
B. Metabolism
C. Distribution
D. Excretion
Answer: B
Conceptual Explanation: Metabolism occurs primarily in the liver. In patients with liver
disease, the liver’s ability to break down drugs is decreased, leading to potential toxicity.
2. Which statement regarding a drug with a narrow therapeutic index is most accurate?
A. The drug is safe to administer without blood level monitoring.
,B. The drug has a very high safety profile.
C. There is a small margin between the effective dose and the toxic dose.
D. The drug requires a loading dose to reach a steady state quickly.
Answer: C
Conceptual Explanation: A narrow therapeutic index means the difference between a
therapeutic dose and a toxic dose is very small, requiring frequent blood level monitoring.
3. A patient is prescribed an oral medication that undergoes significant first-pass effect. The
nurse understands that this means:
A. A large portion of the drug is inactivated by the liver before reaching systemic
circulation.
B. The drug is absorbed rapidly through the gastric mucosa.
C. The drug must be administered via the intravenous route to be effective.
D. The drug’s bioavailability is increased by gastric acidity.
Answer: A
Conceptual Explanation: The first-pass effect occurs when a drug is metabolized by the
liver immediately after absorption from the GI tract, reducing the amount of active drug
available.
, 4. When administering a drug that acts as an antagonist, the nurse understands that the drug
will:
A. Mimic the action of endogenous substances.
B. Bind to receptors and block the action of endogenous chemicals.
C. Produce a maximal response by activating receptors.
D. Enhance the receptor’s sensitivity to other drugs.
Answer: B
Conceptual Explanation: Antagonists bind to receptors but do not activate them; instead,
they prevent other substances (agonists) from binding and producing a response.
5. A nurse is preparing to administer Bethanechol to a patient with urinary retention. Which
assessment finding is a contraindication for this medication?
A. Asthma
B. Tachycardia
C. Constipation
D. Hypertension
Answer: A
Conceptual Explanation: Bethanechol is a cholinergic agonist. It can cause
bronchoconstriction, making it contraindicated in patients with asthma or COPD.
