NUR 378 Exam 1 V3 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 1) |
Concordia
1. A patient is prescribed a medication that has a high protein-binding capacity. If the
patient’s serum albumin level is low, what should the nurse anticipate?
A. A decreased therapeutic effect because the drug cannot reach the target site.
B. An increased risk for drug toxicity due to more free drug in the plasma.
C. A rapid increase in the metabolism of the drug by the liver.
D. A need for a loading dose to saturate the available protein sites.
Correct Answer: B
Drugs that are highly protein-bound normally attach to albumin, leaving only a small
fraction of ‘free’ drug to exert an effect. When albumin is low, fewer binding sites are
available, leading to higher concentrations of active, free drug. This significantly increases
the risk of toxicity and adverse effects in the patient.
2. Which pharmacokinetic process is primarily affected in a patient with end-stage renal
disease (ESRD)?
A. Absorption
B. Metabolism
,C. Distribution
D. Excretion
Correct Answer: D
The kidneys are the primary organ responsible for the excretion of drugs and their
metabolites from the body. In ESRD, the glomerular filtration rate is severely reduced,
leading to drug accumulation. Nurses must monitor for signs of toxicity and expect
adjusted dosing intervals in these patients.
3. A drug is described as being an ‘agonist.’ How does the nurse interpret this characteristic?
A. The drug blocks a receptor to prevent a natural response.
B. The drug inhibits enzymes responsible for drug metabolism.
C. The drug acts as an antidote to a specific toxin.
D. The drug binds to a receptor and mimics the body’s natural response.
Correct Answer: D
An agonist is a molecule that binds to a specific receptor and activates it to produce a
biological response. This is in contrast to an antagonist, which binds to the receptor but
does not activate it, effectively blocking other substances. Understanding receptor
interaction is critical for predicting drug effects and side profile.
, 4. Which of the following factors can influence the rate of drug absorption from the
gastrointestinal tract? (Select all that apply)
A. Patient’s current heart rate
B. Gastric pH levels
C. Blood flow to the small intestine
D. Lipid solubility of the drug
E. Presence of food in the stomach
Correct Answer: E
Food can delay or enhance absorption depending on the specific medication’s chemical
properties. Gastric pH determines the ionization state of many drugs, which alters their
ability to cross lipid membranes. While heart rate reflects systemic perfusion, localized
blood flow to the GI tract and lipid solubility are more direct determinants of absorption
speed.
5. The nurse is monitoring a patient for the ‘first-pass effect.’ This phenomenon is most
relevant to which route of administration?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 1) |
Concordia
1. A patient is prescribed a medication that has a high protein-binding capacity. If the
patient’s serum albumin level is low, what should the nurse anticipate?
A. A decreased therapeutic effect because the drug cannot reach the target site.
B. An increased risk for drug toxicity due to more free drug in the plasma.
C. A rapid increase in the metabolism of the drug by the liver.
D. A need for a loading dose to saturate the available protein sites.
Correct Answer: B
Drugs that are highly protein-bound normally attach to albumin, leaving only a small
fraction of ‘free’ drug to exert an effect. When albumin is low, fewer binding sites are
available, leading to higher concentrations of active, free drug. This significantly increases
the risk of toxicity and adverse effects in the patient.
2. Which pharmacokinetic process is primarily affected in a patient with end-stage renal
disease (ESRD)?
A. Absorption
B. Metabolism
,C. Distribution
D. Excretion
Correct Answer: D
The kidneys are the primary organ responsible for the excretion of drugs and their
metabolites from the body. In ESRD, the glomerular filtration rate is severely reduced,
leading to drug accumulation. Nurses must monitor for signs of toxicity and expect
adjusted dosing intervals in these patients.
3. A drug is described as being an ‘agonist.’ How does the nurse interpret this characteristic?
A. The drug blocks a receptor to prevent a natural response.
B. The drug inhibits enzymes responsible for drug metabolism.
C. The drug acts as an antidote to a specific toxin.
D. The drug binds to a receptor and mimics the body’s natural response.
Correct Answer: D
An agonist is a molecule that binds to a specific receptor and activates it to produce a
biological response. This is in contrast to an antagonist, which binds to the receptor but
does not activate it, effectively blocking other substances. Understanding receptor
interaction is critical for predicting drug effects and side profile.
, 4. Which of the following factors can influence the rate of drug absorption from the
gastrointestinal tract? (Select all that apply)
A. Patient’s current heart rate
B. Gastric pH levels
C. Blood flow to the small intestine
D. Lipid solubility of the drug
E. Presence of food in the stomach
Correct Answer: E
Food can delay or enhance absorption depending on the specific medication’s chemical
properties. Gastric pH determines the ionization state of many drugs, which alters their
ability to cross lipid membranes. While heart rate reflects systemic perfusion, localized
blood flow to the GI tract and lipid solubility are more direct determinants of absorption
speed.
5. The nurse is monitoring a patient for the ‘first-pass effect.’ This phenomenon is most
relevant to which route of administration?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
