NUR2474 | NUR2474 Pharmacology for
Professional Nursing Midterm v1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Rasmussen
1. A nurse is preparing to administer a drug that is known to have a high ‘first-pass
effect.’ Which route of administration should the nurse expect to result in the lowest
bioavailability?
A. Oral
B. Intravenous
C. Sublingual
D. Intramuscular
Correct Answer: A
Expert Explanation: The first-pass effect occurs when a drug is metabolized by the
liver before it reaches the systemic circulation. Oral medications pass through the
portal vein to the liver immediately after absorption in the gastrointestinal tract.
Consequently, much of the drug is inactivated, requiring higher oral doses compared
to parenteral routes.
2. When assessing a patient for toxicities related to Gentamicin, which laboratory
values are most important for the nurse to monitor?
A. ALT and AST
,B. BUN and Serum Creatinine
C. Amylase and Lipase
D. Hemoglobin and Hematocrit
Correct Answer: B
Expert Explanation: Gentamicin is an aminoglycoside known for its narrow
therapeutic index and risk of nephrotoxicity. Monitoring BUN and serum creatinine
is essential to identify early signs of renal impairment during therapy. The nurse
should also monitor for ototoxicity as these drugs can damage the eighth cranial
nerve.
3. A patient is prescribed Warfarin for atrial fibrillation. Which of the following
statements by the patient indicates a need for further teaching?
A. I will use a soft-bristled toothbrush to prevent gum bleeding.
B. I should report any dark, tarry stools to my provider immediately.
C. I will increase my intake of spinach and kale to stay healthy.
D. I need to have my blood checked regularly for my INR level.
Correct Answer: C
Expert Explanation: Spinach and kale are high in Vitamin K, which is the direct
antagonist to Warfarin’s anticoagulant effects. Sudden increases in Vitamin K intake
,can lower the INR and increase the risk of blood clots. Patients are taught to
maintain a consistent intake of Vitamin K rather than making drastic changes to
their diet.
4. The nurse is caring for a patient receiving Furosemide (Lasix). Which electrolyte
imbalance is the patient at the highest risk for developing?
A. Hyperkalemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: C
Expert Explanation: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the loop of Henle, leading to increased excretion of water
and potassium. This process frequently results in hypokalemia, which can cause
cardiac arrhythmias if not corrected. Nurses must monitor serum potassium levels
and encourage the consumption of potassium-rich foods or supplements as ordered.
5. A patient with a history of asthma is diagnosed with hypertension. Which class of
antihypertensive medications should the nurse clarify with the provider?
A. ACE Inhibitors
B. Calcium Channel Blockers
, C. Thiazide Diuretics
D. Non-selective Beta Blockers
Correct Answer: D
Expert Explanation: Non-selective beta blockers, such as Propranolol, block both
Beta-1 and Beta-2 receptors. Blocking Beta-2 receptors can cause
bronchoconstriction, which may trigger an asthma attack in susceptible patients.
Selective beta blockers are generally preferred if a beta blocker is absolutely
necessary for a patient with respiratory issues.
6. Which of the following is the primary reason why a patient should not abruptly stop
taking a prescribed systemic corticosteroid like Prednisone?
A. To prevent immediate rebound hypertension.
B. To avoid the development of Cushing’s syndrome.
C. To prevent gastrointestinal ulceration.
D. To allow the adrenal glands to resume natural hormone production.
Correct Answer: D
Expert Explanation: Exogenous corticosteroids suppress the hypothalamic-
pituitary-adrenal (HPA) axis, leading to adrenal atrophy. If the medication is
stopped suddenly, the body cannot produce enough endogenous cortisol, resulting
Professional Nursing Midterm v1 | Questions with
Correct Answers and Expert Explanation for Each
Question | Rasmussen
1. A nurse is preparing to administer a drug that is known to have a high ‘first-pass
effect.’ Which route of administration should the nurse expect to result in the lowest
bioavailability?
A. Oral
B. Intravenous
C. Sublingual
D. Intramuscular
Correct Answer: A
Expert Explanation: The first-pass effect occurs when a drug is metabolized by the
liver before it reaches the systemic circulation. Oral medications pass through the
portal vein to the liver immediately after absorption in the gastrointestinal tract.
Consequently, much of the drug is inactivated, requiring higher oral doses compared
to parenteral routes.
2. When assessing a patient for toxicities related to Gentamicin, which laboratory
values are most important for the nurse to monitor?
A. ALT and AST
,B. BUN and Serum Creatinine
C. Amylase and Lipase
D. Hemoglobin and Hematocrit
Correct Answer: B
Expert Explanation: Gentamicin is an aminoglycoside known for its narrow
therapeutic index and risk of nephrotoxicity. Monitoring BUN and serum creatinine
is essential to identify early signs of renal impairment during therapy. The nurse
should also monitor for ototoxicity as these drugs can damage the eighth cranial
nerve.
3. A patient is prescribed Warfarin for atrial fibrillation. Which of the following
statements by the patient indicates a need for further teaching?
A. I will use a soft-bristled toothbrush to prevent gum bleeding.
B. I should report any dark, tarry stools to my provider immediately.
C. I will increase my intake of spinach and kale to stay healthy.
D. I need to have my blood checked regularly for my INR level.
Correct Answer: C
Expert Explanation: Spinach and kale are high in Vitamin K, which is the direct
antagonist to Warfarin’s anticoagulant effects. Sudden increases in Vitamin K intake
,can lower the INR and increase the risk of blood clots. Patients are taught to
maintain a consistent intake of Vitamin K rather than making drastic changes to
their diet.
4. The nurse is caring for a patient receiving Furosemide (Lasix). Which electrolyte
imbalance is the patient at the highest risk for developing?
A. Hyperkalemia
B. Hypocalcemia
C. Hypokalemia
D. Hypernatremia
Correct Answer: C
Expert Explanation: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the loop of Henle, leading to increased excretion of water
and potassium. This process frequently results in hypokalemia, which can cause
cardiac arrhythmias if not corrected. Nurses must monitor serum potassium levels
and encourage the consumption of potassium-rich foods or supplements as ordered.
5. A patient with a history of asthma is diagnosed with hypertension. Which class of
antihypertensive medications should the nurse clarify with the provider?
A. ACE Inhibitors
B. Calcium Channel Blockers
, C. Thiazide Diuretics
D. Non-selective Beta Blockers
Correct Answer: D
Expert Explanation: Non-selective beta blockers, such as Propranolol, block both
Beta-1 and Beta-2 receptors. Blocking Beta-2 receptors can cause
bronchoconstriction, which may trigger an asthma attack in susceptible patients.
Selective beta blockers are generally preferred if a beta blocker is absolutely
necessary for a patient with respiratory issues.
6. Which of the following is the primary reason why a patient should not abruptly stop
taking a prescribed systemic corticosteroid like Prednisone?
A. To prevent immediate rebound hypertension.
B. To avoid the development of Cushing’s syndrome.
C. To prevent gastrointestinal ulceration.
D. To allow the adrenal glands to resume natural hormone production.
Correct Answer: D
Expert Explanation: Exogenous corticosteroids suppress the hypothalamic-
pituitary-adrenal (HPA) axis, leading to adrenal atrophy. If the medication is
stopped suddenly, the body cannot produce enough endogenous cortisol, resulting
