NUR 210 Exam 1 V2 | NUR 210 Pharmacology |
Actual Q&A with Rationale (NUR 210 Exam 1) |
Galen
1. A nurse is preparing to administer an oral medication that undergoes a high first-pass
effect. Which statement by the nurse best explains this concept?
A. The medication is highly bound to albumin in the bloodstream.
B. The medication must be administered with food to ensure proper absorption.
C. The medication is largely inactivated by the liver before reaching systemic circulation.
D. The medication is rapidly excreted by the kidneys within one hour.
Correct Answer: C
Explanation: The first-pass effect refers to the metabolism of a drug by the liver after it is
absorbed from the gastrointestinal tract but before it reaches the systemic circulation. This
process decreases the bioavailability of oral drugs compared to intravenous
administration. Nurses must understand that drugs with a high first-pass effect may
require significantly higher oral doses or alternative routes to achieve a therapeutic effect.
2. Which pharmacokinetic process is most likely to be affected in a patient with a serum
albumin level of 2.1 g/dL?
A. Distribution
B. Absorption
,C. Metabolism
D. Excretion
Correct Answer: A
Explanation: Distribution is heavily influenced by protein binding, particularly to albumin.
When a patient has low albumin levels (hypoalbuminemia), there are fewer binding sites
available, leading to an increase in the ‘free’ or active portion of highly protein-bound
drugs. This increase in free drug can lead to toxicity, requiring the nurse to monitor the
patient closely for adverse reactions.
3. A patient is prescribed a medication with a very narrow therapeutic index. Which nursing
action is a priority?
A. Administer the drug only when the patient is in a fasting state.
B. Teach the patient that side effects are unlikely to occur.
C. Ensure serum drug levels are monitored frequently as ordered.
D. Administer the medication via the intramuscular route only.
Correct Answer: C
Explanation: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Frequent monitoring of serum drug levels (peak and
trough) is essential to ensure the dose is safe and effective. The nurse must communicate
these levels to the healthcare provider to adjust dosing as needed to prevent toxicity.
, 4. The nurse is reviewing the medication list for an 80-year-old patient. Which physiological
change associated with aging increases the risk of drug toxicity?
A. Decreased glomerular filtration rate (GFR)
B. Increased total body water
C. Increased gastric acidity
D. Increased liver size and blood flow
Correct Answer: A
Explanation: Decreased glomerular filtration rate (GFR) is a common physiological change
in older adults that leads to slower excretion of medications. This results in the
accumulation of drugs in the body, which significantly increases the risk of adverse effects
and toxicity. Nurses must assess renal function (BUN and Creatinine) when administering
medications to geriatric patients.
5. A nurse administers an adrenergic agonist (sympathomimetic). Which clinical finding
should the nurse expect to observe in the patient?
A. Pupillary constriction (miosis)
B. Increased gastrointestinal motility
C. Increased heart rate and blood pressure
D. Decreased respiratory rate
Correct Answer: C
Actual Q&A with Rationale (NUR 210 Exam 1) |
Galen
1. A nurse is preparing to administer an oral medication that undergoes a high first-pass
effect. Which statement by the nurse best explains this concept?
A. The medication is highly bound to albumin in the bloodstream.
B. The medication must be administered with food to ensure proper absorption.
C. The medication is largely inactivated by the liver before reaching systemic circulation.
D. The medication is rapidly excreted by the kidneys within one hour.
Correct Answer: C
Explanation: The first-pass effect refers to the metabolism of a drug by the liver after it is
absorbed from the gastrointestinal tract but before it reaches the systemic circulation. This
process decreases the bioavailability of oral drugs compared to intravenous
administration. Nurses must understand that drugs with a high first-pass effect may
require significantly higher oral doses or alternative routes to achieve a therapeutic effect.
2. Which pharmacokinetic process is most likely to be affected in a patient with a serum
albumin level of 2.1 g/dL?
A. Distribution
B. Absorption
,C. Metabolism
D. Excretion
Correct Answer: A
Explanation: Distribution is heavily influenced by protein binding, particularly to albumin.
When a patient has low albumin levels (hypoalbuminemia), there are fewer binding sites
available, leading to an increase in the ‘free’ or active portion of highly protein-bound
drugs. This increase in free drug can lead to toxicity, requiring the nurse to monitor the
patient closely for adverse reactions.
3. A patient is prescribed a medication with a very narrow therapeutic index. Which nursing
action is a priority?
A. Administer the drug only when the patient is in a fasting state.
B. Teach the patient that side effects are unlikely to occur.
C. Ensure serum drug levels are monitored frequently as ordered.
D. Administer the medication via the intramuscular route only.
Correct Answer: C
Explanation: A narrow therapeutic index means that the difference between a therapeutic
dose and a toxic dose is very small. Frequent monitoring of serum drug levels (peak and
trough) is essential to ensure the dose is safe and effective. The nurse must communicate
these levels to the healthcare provider to adjust dosing as needed to prevent toxicity.
, 4. The nurse is reviewing the medication list for an 80-year-old patient. Which physiological
change associated with aging increases the risk of drug toxicity?
A. Decreased glomerular filtration rate (GFR)
B. Increased total body water
C. Increased gastric acidity
D. Increased liver size and blood flow
Correct Answer: A
Explanation: Decreased glomerular filtration rate (GFR) is a common physiological change
in older adults that leads to slower excretion of medications. This results in the
accumulation of drugs in the body, which significantly increases the risk of adverse effects
and toxicity. Nurses must assess renal function (BUN and Creatinine) when administering
medications to geriatric patients.
5. A nurse administers an adrenergic agonist (sympathomimetic). Which clinical finding
should the nurse expect to observe in the patient?
A. Pupillary constriction (miosis)
B. Increased gastrointestinal motility
C. Increased heart rate and blood pressure
D. Decreased respiratory rate
Correct Answer: C
