NUR 334 EXAM 1 COMPREHENSIVE
REVIEW QUESTIONS AND DETAILED
ANSWERS 2026/2027
1. A patient with chronic renal failure is prescribed a medication that is primarily excreted by
the kidneys. Which pharmacokinetic process is most likely to be impaired?
A. Absorption
B. Distribution
C. Elimination
D. Metabolism
Answer: C
Conceptual Explanation: Elimination (or excretion) is the process by which drugs are
removed from the body, primarily through the kidneys. Renal failure directly hinders this
stage.
2. Which physiological mechanism explains why the ‘first-pass effect’ reduces the
bioavailability of oral medications?
A. Gastric acid degrades the drug before it reaches the small intestine.
B. The blood-brain barrier blocks the drug from entering the central nervous system.
C. Plasma proteins bind to the drug, preventing it from reaching the target tissue.
,D. The liver metabolizes a significant portion of the drug before it enters systemic
circulation.
Answer: D
Conceptual Explanation: The first-pass effect occurs when a drug is absorbed from the GI
tract and passes through the portal vein to the liver, where it is metabolized before
reaching the rest of the body.
3. A patient presents with a serum potassium level of 6.2 mEq/L. Which EKG change should
the nurse prioritize monitoring for?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves, widened
QRS complexes, and potentially cardiac arrest.
4. A nurse is caring for a patient with Respiratory Acidosis. Which ABG result is consistent
with this diagnosis?
A. pH 7.48, PaCO2 40, HCO3 30
B. pH 7.50, PaCO2 30, HCO3 22
, C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.30, PaCO2 52, HCO3 24
Answer: D
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and an
elevated PaCO2 (>45) due to hypoventilation.
5. During the assessment of a patient with Hypocalcemia, the nurse observes a carpal spasm
when the blood pressure cuff is inflated. This is known as:
A. Trousseau’s sign
B. Chvostek’s sign
C. Homans’ sign
D. Babinski reflex
Answer: A
Conceptual Explanation: Trousseau’s sign is a carpal spasm induced by inflating a BP cuff
above systolic pressure, indicating hypocalcemia.
6. Which characteristic of a drug allows it to cross the blood-brain barrier more easily?
A. Lipid solubility
B. High molecular weight
C. Water solubility
REVIEW QUESTIONS AND DETAILED
ANSWERS 2026/2027
1. A patient with chronic renal failure is prescribed a medication that is primarily excreted by
the kidneys. Which pharmacokinetic process is most likely to be impaired?
A. Absorption
B. Distribution
C. Elimination
D. Metabolism
Answer: C
Conceptual Explanation: Elimination (or excretion) is the process by which drugs are
removed from the body, primarily through the kidneys. Renal failure directly hinders this
stage.
2. Which physiological mechanism explains why the ‘first-pass effect’ reduces the
bioavailability of oral medications?
A. Gastric acid degrades the drug before it reaches the small intestine.
B. The blood-brain barrier blocks the drug from entering the central nervous system.
C. Plasma proteins bind to the drug, preventing it from reaching the target tissue.
,D. The liver metabolizes a significant portion of the drug before it enters systemic
circulation.
Answer: D
Conceptual Explanation: The first-pass effect occurs when a drug is absorbed from the GI
tract and passes through the portal vein to the liver, where it is metabolized before
reaching the rest of the body.
3. A patient presents with a serum potassium level of 6.2 mEq/L. Which EKG change should
the nurse prioritize monitoring for?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves, widened
QRS complexes, and potentially cardiac arrest.
4. A nurse is caring for a patient with Respiratory Acidosis. Which ABG result is consistent
with this diagnosis?
A. pH 7.48, PaCO2 40, HCO3 30
B. pH 7.50, PaCO2 30, HCO3 22
, C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.30, PaCO2 52, HCO3 24
Answer: D
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (<7.35) and an
elevated PaCO2 (>45) due to hypoventilation.
5. During the assessment of a patient with Hypocalcemia, the nurse observes a carpal spasm
when the blood pressure cuff is inflated. This is known as:
A. Trousseau’s sign
B. Chvostek’s sign
C. Homans’ sign
D. Babinski reflex
Answer: A
Conceptual Explanation: Trousseau’s sign is a carpal spasm induced by inflating a BP cuff
above systolic pressure, indicating hypocalcemia.
6. Which characteristic of a drug allows it to cross the blood-brain barrier more easily?
A. Lipid solubility
B. High molecular weight
C. Water solubility
