BIO 290 Final Exam Actual Exam V1 | BIO 290 Pharmacology (BIO290
Final Exam) | Joyce University
1. A patient is prescribed sublingual nitroglycerin for the management of angina. Which
instruction is most critical for the nurse to provide regarding storage?
A. Keep the medication in a clear plastic container for easy visibility.
B. Carry the tablets in a pocket-sized metal pillbox for convenience.
C. Place the bottle in the refrigerator to maintain potency.
D. Store the tablets in their original dark glass bottle to prevent light exposure.
Answer: D
Rationale: Nitroglycerin is highly sensitive to light, heat, and moisture, which can cause it
to decompose rapidly. Storing the tablets in their original dark glass container protects
them from environmental degradation. The nurse must emphasize that the bottle should be
tightly capped and not transferred to other containers to ensure therapeutic efficacy during
an acute episode.
2. Which pharmacokinetic process is most significantly affected by the first-pass effect when
a drug is administered orally?
A. Metabolism
B. Excretion
C. Distribution
D. Absorption
Answer: A
Rationale: The first-pass effect refers to the rapid hepatic metabolism of a drug absorbed
from the gastrointestinal tract before it reaches the systemic circulation. This process
significantly reduces the bioavailability of certain medications like propranolol or
morphine. Understanding this concept helps clinicians determine why oral doses are often
much higher than intravenous doses for the same medication.
3. A nurse is monitoring a patient receiving intravenous gentamicin. Which laboratory values
are most important to assess to prevent toxicity?
A. Serum sodium and potassium levels
B. Prothrombin time and INR
C. Blood urea nitrogen (BUN) and serum creatinine
D. Aspartate aminotransferase (AST) and ALT
,Answer: C
Rationale: Gentamicin is an aminoglycoside antibiotic known for its potential to cause
nephrotoxicity and ototoxicity. Monitoring BUN and serum creatinine is essential to
evaluate renal function, as the drug is primarily excreted by the kidneys. If these levels rise,
the dosage may need to be adjusted or the drug discontinued to avoid irreversible renal
damage.
4. A patient with a history of asthma is diagnosed with hypertension. Which class of
antihypertensive medications should the nurse question?
A. Calcium channel blockers
B. Non-selective beta-blockers
C. ACE inhibitors
D. Thiazide diuretics
Answer: B
Rationale: Non-selective beta-blockers, such as propranolol, block both beta-1 receptors in
the heart and beta-2 receptors in the lungs. Blocking beta-2 receptors can lead to
bronchoconstriction, which is dangerous for patients with asthma or COPD. Cardio-
selective beta-blockers or alternative antihypertensives are generally preferred in these
clinical scenarios.
5. A patient taking warfarin (Coumadin) for atrial fibrillation is advised to maintain a
consistent intake of which food group?
A. Dark green leafy vegetables
B. Citrus fruits like oranges and grapefruit
C. Red meats and organ meats
D. Dairy products like milk and cheese
Answer: A
Rationale: Warfarin acts by inhibiting the synthesis of Vitamin K-dependent clotting
factors. Dark green leafy vegetables are high in Vitamin K, and sudden changes in their
consumption can drastically alter the International Normalized Ratio (INR). Patients are
taught not to avoid these foods entirely but to keep their intake consistent to ensure stable
anticoagulation levels.
6. The nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding would require the nurse to hold the medication?
A. Blood pressure of 140/90 mmHg
B. Serum potassium level of 4.5 mEq/L
, C. Respiratory rate of 20 breaths per minute
D. Apical heart rate of 52 beats per minute
Answer: D
Rationale: Digoxin is a cardiac glycoside that has a negative chronotropic effect, meaning it
slows the heart rate. It is a standard nursing protocol to hold the dose if the apical heart
rate is less than 60 beats per minute in an adult. This prevents further bradycardia and
allows the nurse to assess for signs of digoxin toxicity.
7. A patient is prescribed alendronate (Fosamax) for osteoporosis. Which administration
instruction is vital for safety?
A. Take the medication first thing in the morning on an empty stomach and remain upright.
B. Lie down for 30 minutes after taking the pill to enhance absorption.
C. Take the medication with a full glass of milk.
D. Crush the tablet if it is too difficult to swallow.
Answer: A
Rationale: Alendronate is a bisphosphonate that can cause severe esophageal irritation
and ulceration if it remains in contact with the esophageal mucosa. Patients must take it
with a full glass of plain water and remain in an upright position (sitting or standing) for at
least 30 minutes. Taking it on an empty stomach is also necessary because food and other
beverages significantly impair its absorption.
8. Which of the following is the primary mechanism of action for Proton Pump Inhibitors
(PPIs) like omeprazole?
A. Neutralizing existing stomach acid
B. Blocking H2 receptors on parietal cells
C. Irreversibly inhibiting the H+/K+ ATPase enzyme system
D. Creating a protective coating over the gastric mucosa
Answer: C
Rationale: PPIs act by binding to the gastric proton pump, which is the final step in the
acid secretion process. By inhibiting the H+/K+ ATPase enzyme, these drugs provide more
potent and longer-lasting acid suppression than H2-receptor antagonists. This makes them
highly effective for treating GERD, peptic ulcers, and Zollinger-Ellison syndrome.
9. A patient has just been started on phenytoin (Dilantin) for seizure control. The nurse
should instruct the patient to perform which task regularly?
A. Check blood glucose three times a day.
Final Exam) | Joyce University
1. A patient is prescribed sublingual nitroglycerin for the management of angina. Which
instruction is most critical for the nurse to provide regarding storage?
A. Keep the medication in a clear plastic container for easy visibility.
B. Carry the tablets in a pocket-sized metal pillbox for convenience.
C. Place the bottle in the refrigerator to maintain potency.
D. Store the tablets in their original dark glass bottle to prevent light exposure.
Answer: D
Rationale: Nitroglycerin is highly sensitive to light, heat, and moisture, which can cause it
to decompose rapidly. Storing the tablets in their original dark glass container protects
them from environmental degradation. The nurse must emphasize that the bottle should be
tightly capped and not transferred to other containers to ensure therapeutic efficacy during
an acute episode.
2. Which pharmacokinetic process is most significantly affected by the first-pass effect when
a drug is administered orally?
A. Metabolism
B. Excretion
C. Distribution
D. Absorption
Answer: A
Rationale: The first-pass effect refers to the rapid hepatic metabolism of a drug absorbed
from the gastrointestinal tract before it reaches the systemic circulation. This process
significantly reduces the bioavailability of certain medications like propranolol or
morphine. Understanding this concept helps clinicians determine why oral doses are often
much higher than intravenous doses for the same medication.
3. A nurse is monitoring a patient receiving intravenous gentamicin. Which laboratory values
are most important to assess to prevent toxicity?
A. Serum sodium and potassium levels
B. Prothrombin time and INR
C. Blood urea nitrogen (BUN) and serum creatinine
D. Aspartate aminotransferase (AST) and ALT
,Answer: C
Rationale: Gentamicin is an aminoglycoside antibiotic known for its potential to cause
nephrotoxicity and ototoxicity. Monitoring BUN and serum creatinine is essential to
evaluate renal function, as the drug is primarily excreted by the kidneys. If these levels rise,
the dosage may need to be adjusted or the drug discontinued to avoid irreversible renal
damage.
4. A patient with a history of asthma is diagnosed with hypertension. Which class of
antihypertensive medications should the nurse question?
A. Calcium channel blockers
B. Non-selective beta-blockers
C. ACE inhibitors
D. Thiazide diuretics
Answer: B
Rationale: Non-selective beta-blockers, such as propranolol, block both beta-1 receptors in
the heart and beta-2 receptors in the lungs. Blocking beta-2 receptors can lead to
bronchoconstriction, which is dangerous for patients with asthma or COPD. Cardio-
selective beta-blockers or alternative antihypertensives are generally preferred in these
clinical scenarios.
5. A patient taking warfarin (Coumadin) for atrial fibrillation is advised to maintain a
consistent intake of which food group?
A. Dark green leafy vegetables
B. Citrus fruits like oranges and grapefruit
C. Red meats and organ meats
D. Dairy products like milk and cheese
Answer: A
Rationale: Warfarin acts by inhibiting the synthesis of Vitamin K-dependent clotting
factors. Dark green leafy vegetables are high in Vitamin K, and sudden changes in their
consumption can drastically alter the International Normalized Ratio (INR). Patients are
taught not to avoid these foods entirely but to keep their intake consistent to ensure stable
anticoagulation levels.
6. The nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding would require the nurse to hold the medication?
A. Blood pressure of 140/90 mmHg
B. Serum potassium level of 4.5 mEq/L
, C. Respiratory rate of 20 breaths per minute
D. Apical heart rate of 52 beats per minute
Answer: D
Rationale: Digoxin is a cardiac glycoside that has a negative chronotropic effect, meaning it
slows the heart rate. It is a standard nursing protocol to hold the dose if the apical heart
rate is less than 60 beats per minute in an adult. This prevents further bradycardia and
allows the nurse to assess for signs of digoxin toxicity.
7. A patient is prescribed alendronate (Fosamax) for osteoporosis. Which administration
instruction is vital for safety?
A. Take the medication first thing in the morning on an empty stomach and remain upright.
B. Lie down for 30 minutes after taking the pill to enhance absorption.
C. Take the medication with a full glass of milk.
D. Crush the tablet if it is too difficult to swallow.
Answer: A
Rationale: Alendronate is a bisphosphonate that can cause severe esophageal irritation
and ulceration if it remains in contact with the esophageal mucosa. Patients must take it
with a full glass of plain water and remain in an upright position (sitting or standing) for at
least 30 minutes. Taking it on an empty stomach is also necessary because food and other
beverages significantly impair its absorption.
8. Which of the following is the primary mechanism of action for Proton Pump Inhibitors
(PPIs) like omeprazole?
A. Neutralizing existing stomach acid
B. Blocking H2 receptors on parietal cells
C. Irreversibly inhibiting the H+/K+ ATPase enzyme system
D. Creating a protective coating over the gastric mucosa
Answer: C
Rationale: PPIs act by binding to the gastric proton pump, which is the final step in the
acid secretion process. By inhibiting the H+/K+ ATPase enzyme, these drugs provide more
potent and longer-lasting acid suppression than H2-receptor antagonists. This makes them
highly effective for treating GERD, peptic ulcers, and Zollinger-Ellison syndrome.
9. A patient has just been started on phenytoin (Dilantin) for seizure control. The nurse
should instruct the patient to perform which task regularly?
A. Check blood glucose three times a day.
