NUR 210 Exam 1 V3 | NUR 210 Pharmacology | Actual Q&A with
Rationale (NUR 210 Exam 1) | Galen
1. A patient is prescribed an oral medication that undergoes significant first-pass metabolism.
Which statement correctly describes this process?
A. The drug is immediately excreted by the kidneys after absorption.
B. The drug is absorbed directly into the lymphatic system to bypass the heart.
C. The drug is metabolized by the liver before it reaches systemic circulation.
D. The drug bypasses the liver and goes directly to the target tissues.
Answer: C
Rationale: First-pass metabolism occurs when a drug is absorbed from the gastrointestinal
tract and enters the portal circulation to the liver. The liver then metabolizes a portion of
the drug before it can reach the rest of the body via the systemic circulation. This process
explains why the oral dose of a medication is often much higher than its intravenous
counterpart.
2. When administering a medication with a narrow therapeutic index, which nursing action is
most critical?
A. Administer the medication with food to slow down absorption.
B. Encourage the patient to increase fluid intake to prevent dehydration.
C. Monitor the patient for signs of toxicity and check blood levels frequently.
D. Teach the patient that side effects are expected and not harmful.
Answer: C
Rationale: A narrow therapeutic index means there is a very small difference between a
therapeutic dose and a toxic dose. Because of this small margin of safety, the nurse must
closely monitor serum drug levels to ensure they stay within the therapeutic range. Failure
to monitor can result in severe adverse reactions or treatment failure.
3. A nurse is preparing to administer a medication that is highly protein-bound. The patient’s
albumin level is significantly low. What is the expected result?
A. The drug will be ineffective because it cannot bind to protein.
B. There will be an increased risk of drug toxicity.
C. The drug will be excreted faster than normal.
D. The patient will require a higher dose of the medication.
,Answer: B
Rationale: Drugs that are highly protein-bound compete for binding sites on albumin;
however, only the ‘free’ or unbound drug is pharmacologically active. When albumin levels
are low, such as in malnutrition or liver disease, more free drug is available in the
bloodstream. This increase in active drug concentration significantly raises the risk of
adverse effects and toxicity.
4. The nurse is educating an older adult patient about why they are more sensitive to
medications. Which physiological change should the nurse include?
A. Increased total body water.
B. Increased gastric acidity.
C. Decreased renal blood flow and glomerular filtration rate.
D. Enhanced liver enzyme activity.
Answer: C
Rationale: Aging is associated with a natural decline in renal function, including reduced
blood flow and a lower glomerular filtration rate. This leads to slower excretion of
medications, causing them to remain in the body longer and potentially build up to toxic
levels. Understanding these changes is essential for nurses to advocate for lower dosages in
the geriatric population.
5. A patient is receiving an infusion of a drug that is an agonist. How does an agonist drug
work?
A. It binds to a receptor and prevents a response from occurring.
B. It blocks the action of endogenous chemicals in the body.
C. It binds to a receptor and produces a biological response.
D. It destroys the receptor site so no further binding can occur.
Answer: C
Rationale: An agonist is a medication that mimics the action of the body’s natural
substances by binding to specific receptors and activating them. This binding triggers a
physiological response similar to that produced by endogenous ligands. In contrast, an
antagonist would bind to the receptor to block or inhibit a response.
6. Which ‘right’ of medication administration is being practiced when the nurse checks the
patient’s wristband and asks for their date of birth?
A. Right Route
B. Right Documentation
C. Right Patient
, D. Right Time
Answer: C
Rationale: Identifying the patient using two unique identifiers, such as name and date of
birth, is the standard procedure for verifying the ‘Right Patient.’ This safety step must be
performed before every medication administration to prevent errors. Comparing the
patient’s stated information with the medication administration record and wristband
ensures the highest level of safety.
7. What is the primary site for drug metabolism in the human body?
A. Kidneys
B. Liver
C. Small Intestine
D. Lungs
Answer: B
Rationale: The liver is the primary organ responsible for the metabolism
(biotransformation) of drugs, primarily through the cytochrome P450 enzyme system.
Metabolism converts lipid-soluble drugs into water-soluble metabolites that can be more
easily excreted. If a patient has liver dysfunction, their ability to metabolize drugs is
impaired, necessitating dose adjustments.
8. A drug has a half-life of 4 hours. If a patient receives a 100 mg dose at 12:00 PM, how much
of the drug will remain in the body at 8:00 PM?
A. 50 mg
B. 25 mg
C. 75 mg
D. 12.5 mg
Answer: B
Rationale: Half-life is the time required for the concentration of a drug in the body to
decrease by 50%. From 12:00 PM to 8:00 PM is 8 hours, which equals two half-lives. After 4
hours (one half-life), 50 mg remains; after another 4 hours (two half-lives), half of 50 mg
remains, which is 25 mg.
9. The nurse is caring for a patient who is a ‘slow acetylator.’ How does this genetic variation
affect drug therapy?
A. The patient will excrete drugs through the lungs faster.
B. The patient metabolizes certain drugs more slowly, increasing risk of toxicity.
Rationale (NUR 210 Exam 1) | Galen
1. A patient is prescribed an oral medication that undergoes significant first-pass metabolism.
Which statement correctly describes this process?
A. The drug is immediately excreted by the kidneys after absorption.
B. The drug is absorbed directly into the lymphatic system to bypass the heart.
C. The drug is metabolized by the liver before it reaches systemic circulation.
D. The drug bypasses the liver and goes directly to the target tissues.
Answer: C
Rationale: First-pass metabolism occurs when a drug is absorbed from the gastrointestinal
tract and enters the portal circulation to the liver. The liver then metabolizes a portion of
the drug before it can reach the rest of the body via the systemic circulation. This process
explains why the oral dose of a medication is often much higher than its intravenous
counterpart.
2. When administering a medication with a narrow therapeutic index, which nursing action is
most critical?
A. Administer the medication with food to slow down absorption.
B. Encourage the patient to increase fluid intake to prevent dehydration.
C. Monitor the patient for signs of toxicity and check blood levels frequently.
D. Teach the patient that side effects are expected and not harmful.
Answer: C
Rationale: A narrow therapeutic index means there is a very small difference between a
therapeutic dose and a toxic dose. Because of this small margin of safety, the nurse must
closely monitor serum drug levels to ensure they stay within the therapeutic range. Failure
to monitor can result in severe adverse reactions or treatment failure.
3. A nurse is preparing to administer a medication that is highly protein-bound. The patient’s
albumin level is significantly low. What is the expected result?
A. The drug will be ineffective because it cannot bind to protein.
B. There will be an increased risk of drug toxicity.
C. The drug will be excreted faster than normal.
D. The patient will require a higher dose of the medication.
,Answer: B
Rationale: Drugs that are highly protein-bound compete for binding sites on albumin;
however, only the ‘free’ or unbound drug is pharmacologically active. When albumin levels
are low, such as in malnutrition or liver disease, more free drug is available in the
bloodstream. This increase in active drug concentration significantly raises the risk of
adverse effects and toxicity.
4. The nurse is educating an older adult patient about why they are more sensitive to
medications. Which physiological change should the nurse include?
A. Increased total body water.
B. Increased gastric acidity.
C. Decreased renal blood flow and glomerular filtration rate.
D. Enhanced liver enzyme activity.
Answer: C
Rationale: Aging is associated with a natural decline in renal function, including reduced
blood flow and a lower glomerular filtration rate. This leads to slower excretion of
medications, causing them to remain in the body longer and potentially build up to toxic
levels. Understanding these changes is essential for nurses to advocate for lower dosages in
the geriatric population.
5. A patient is receiving an infusion of a drug that is an agonist. How does an agonist drug
work?
A. It binds to a receptor and prevents a response from occurring.
B. It blocks the action of endogenous chemicals in the body.
C. It binds to a receptor and produces a biological response.
D. It destroys the receptor site so no further binding can occur.
Answer: C
Rationale: An agonist is a medication that mimics the action of the body’s natural
substances by binding to specific receptors and activating them. This binding triggers a
physiological response similar to that produced by endogenous ligands. In contrast, an
antagonist would bind to the receptor to block or inhibit a response.
6. Which ‘right’ of medication administration is being practiced when the nurse checks the
patient’s wristband and asks for their date of birth?
A. Right Route
B. Right Documentation
C. Right Patient
, D. Right Time
Answer: C
Rationale: Identifying the patient using two unique identifiers, such as name and date of
birth, is the standard procedure for verifying the ‘Right Patient.’ This safety step must be
performed before every medication administration to prevent errors. Comparing the
patient’s stated information with the medication administration record and wristband
ensures the highest level of safety.
7. What is the primary site for drug metabolism in the human body?
A. Kidneys
B. Liver
C. Small Intestine
D. Lungs
Answer: B
Rationale: The liver is the primary organ responsible for the metabolism
(biotransformation) of drugs, primarily through the cytochrome P450 enzyme system.
Metabolism converts lipid-soluble drugs into water-soluble metabolites that can be more
easily excreted. If a patient has liver dysfunction, their ability to metabolize drugs is
impaired, necessitating dose adjustments.
8. A drug has a half-life of 4 hours. If a patient receives a 100 mg dose at 12:00 PM, how much
of the drug will remain in the body at 8:00 PM?
A. 50 mg
B. 25 mg
C. 75 mg
D. 12.5 mg
Answer: B
Rationale: Half-life is the time required for the concentration of a drug in the body to
decrease by 50%. From 12:00 PM to 8:00 PM is 8 hours, which equals two half-lives. After 4
hours (one half-life), 50 mg remains; after another 4 hours (two half-lives), half of 50 mg
remains, which is 25 mg.
9. The nurse is caring for a patient who is a ‘slow acetylator.’ How does this genetic variation
affect drug therapy?
A. The patient will excrete drugs through the lungs faster.
B. The patient metabolizes certain drugs more slowly, increasing risk of toxicity.
