NURS 180 Pharmacology Module Exam 1 (Week 3) 2026 |WCU
1. A patient with liver cirrhosis has low albumin levels. When administering a
drug that is highly protein-bound, what should the nurse monitor for?
A. Decreased drug effectiveness
B. Increased risk of drug toxicity
C. Rapid drug excretion
D. Delayed absorption in the gut
Answer: B
Rationale: When albumin levels are low, there are fewer binding sites for highly protein-
bound drugs, leading to an increase in the ‘free’ or active fraction of the drug, which
increases the risk of toxicity.
2. Which pharmacokinetic process is primarily affected by the ‘first-pass effect’?
A. Excretion
B. Metabolism
C. Distribution
D. Absorption
Answer: B
Rationale: The first-pass effect occurs when a drug is metabolized by the liver immediately
after absorption from the GI tract and before reaching the systemic circulation.
,3. A nurse is administering a medication with a narrow therapeutic index. Which
action is most important?
A. Administer the drug with food to prevent GI upset
B. Monitor serum drug levels frequently
C. Instruct the patient to double the dose if a dose is missed
D. Wait 2 hours after administration to check vital signs
Answer: B
Rationale: Drugs with a narrow therapeutic index have a small margin between a
therapeutic dose and a toxic dose, requiring close monitoring of blood levels.
4. What is the primary site for drug metabolism in the human body?
A. Kidneys
B. Small intestine
C. Lungs
D. Liver
Answer: D
Rationale: The liver is the primary organ responsible for the metabolic breakdown of
drugs, primarily through the cytochrome P450 enzyme system.
5. An 80-year-old patient is prescribed a new medication. Which physiological
change associated with aging most affects drug distribution?
A. Increased total body water
B. Increased liver enzyme activity
C. Decreased gastric pH
D. Increased percentage of body fat
Answer: D
Rationale: In older adults, the percentage of body fat increases while lean body mass and
total body water decrease, which affects the distribution of lipid-soluble and water-soluble
drugs.
, 6. A drug that binds to a receptor and produces a maximal response is known as
a(n):
A. Agonist
B. Antagonist
C. Partial agonist
D. Inhibitor
Answer: A
Rationale: An agonist is a drug that binds to a receptor and activates it to produce a
biological response.
7. The time required for the plasma concentration of a drug to decrease by 50%
is called:
A. Steady state
B. Peak level
C. Duration of action
D. Half-life
Answer: D
Rationale: Half-life is the time it takes for the amount of drug in the body to be reduced by
half.
8. A patient is receiving an intravenous (IV) medication. What is the
bioavailability of this drug?
A. 100%
B. 50%
C. 75%
D. 0%
Answer: A
Rationale: Bioavailability is 100% for drugs administered intravenously because they are
injected directly into the systemic circulation, bypassing absorption.
1. A patient with liver cirrhosis has low albumin levels. When administering a
drug that is highly protein-bound, what should the nurse monitor for?
A. Decreased drug effectiveness
B. Increased risk of drug toxicity
C. Rapid drug excretion
D. Delayed absorption in the gut
Answer: B
Rationale: When albumin levels are low, there are fewer binding sites for highly protein-
bound drugs, leading to an increase in the ‘free’ or active fraction of the drug, which
increases the risk of toxicity.
2. Which pharmacokinetic process is primarily affected by the ‘first-pass effect’?
A. Excretion
B. Metabolism
C. Distribution
D. Absorption
Answer: B
Rationale: The first-pass effect occurs when a drug is metabolized by the liver immediately
after absorption from the GI tract and before reaching the systemic circulation.
,3. A nurse is administering a medication with a narrow therapeutic index. Which
action is most important?
A. Administer the drug with food to prevent GI upset
B. Monitor serum drug levels frequently
C. Instruct the patient to double the dose if a dose is missed
D. Wait 2 hours after administration to check vital signs
Answer: B
Rationale: Drugs with a narrow therapeutic index have a small margin between a
therapeutic dose and a toxic dose, requiring close monitoring of blood levels.
4. What is the primary site for drug metabolism in the human body?
A. Kidneys
B. Small intestine
C. Lungs
D. Liver
Answer: D
Rationale: The liver is the primary organ responsible for the metabolic breakdown of
drugs, primarily through the cytochrome P450 enzyme system.
5. An 80-year-old patient is prescribed a new medication. Which physiological
change associated with aging most affects drug distribution?
A. Increased total body water
B. Increased liver enzyme activity
C. Decreased gastric pH
D. Increased percentage of body fat
Answer: D
Rationale: In older adults, the percentage of body fat increases while lean body mass and
total body water decrease, which affects the distribution of lipid-soluble and water-soluble
drugs.
, 6. A drug that binds to a receptor and produces a maximal response is known as
a(n):
A. Agonist
B. Antagonist
C. Partial agonist
D. Inhibitor
Answer: A
Rationale: An agonist is a drug that binds to a receptor and activates it to produce a
biological response.
7. The time required for the plasma concentration of a drug to decrease by 50%
is called:
A. Steady state
B. Peak level
C. Duration of action
D. Half-life
Answer: D
Rationale: Half-life is the time it takes for the amount of drug in the body to be reduced by
half.
8. A patient is receiving an intravenous (IV) medication. What is the
bioavailability of this drug?
A. 100%
B. 50%
C. 75%
D. 0%
Answer: A
Rationale: Bioavailability is 100% for drugs administered intravenously because they are
injected directly into the systemic circulation, bypassing absorption.
