NURS 180 Pharmacology Week 3 Quiz 2026 Update WCU
1. A patient with liver cirrhosis has low albumin levels. When administering a
highly protein-bound medication, the nurse should expect which physiological
effect?
A. Decreased drug metabolism in the kidneys
B. Reduced bioavailability of the medication
C. Increased risk of drug toxicity due to more free drug
D. Need for a higher loading dose
Answer: C
Rationale: Low albumin means fewer binding sites are available. This results in more free
(active) drug in the bloodstream, increasing the risk of toxicity.
2. Which pharmacokinetic process is most significantly affected by the first-pass
effect when a drug is administered orally?
A. Metabolism
B. Distribution
C. Excretion
D. Absorption
Answer: A
Rationale: The first-pass effect refers to the metabolism of a drug by the liver after
absorption from the GI tract but before reaching systemic circulation.
,3. A drug has a half-life of 4 hours. If a dose of 400 mg is given at 08:00, how
much drug remains in the body at 20:00?
A. 50 mg
B. 25 mg
C. 100 mg
D. 12.5 mg
Answer: A
Rationale: From 08:00 to 20:00 is 12 hours (3 half-lives). 400mg to 200mg (1), 200mg to
100mg (2), 100mg to 50mg (3).
4. The nurse is monitoring a patient for ‘Peak and Trough’ levels. When should
the nurse draw the trough level?
A. Immediately before the next dose is administered
B. 30 minutes after the infusion is complete
C. Midway between doses
D. 60 minutes after administration
Answer: A
Rationale: The trough level is the lowest concentration of the drug in the blood, measured
just before the next dose.
5. A patient is prescribed a drug with a narrow therapeutic index. What is the
nurse’s priority action?
A. Administer the drug only as needed (PRN)
B. Monitor blood levels closely for toxicity
C. Ensure the drug is given with food to prevent GI upset
D. Teach the patient to double the dose if a dose is missed
Answer: B
Rationale: A narrow therapeutic index means the difference between a therapeutic dose
and a toxic dose is very small.
, 6. Which factor in geriatric patients is the most common cause of adverse drug
reactions?
A. Reduced renal excretion
B. Enhanced liver metabolism
C. Increased gastric acidity
D. Increased body water percentage
Answer: A
Rationale: Decreased renal function is the most important cause of adverse drug reactions
in the elderly due to drug accumulation.
7. When administering a medication to a pregnant woman, the nurse notes it is
classified as ‘Category X’. What does this signify?
A. Fetal risks outweigh any possible benefits
B. The drug is safe for use in all trimesters
C. There are no adequate studies in humans
D. The drug can be used if clearly needed
Answer: A
Rationale: Category X medications have proven fetal risks that clearly outweigh any
possible benefit to the mother.
8. Which route of administration provides 100% bioavailability?
A. Intramuscular
B. Intravenous
C. Oral
D. Subcutaneous
Answer: B
Rationale: IV administration enters the systemic circulation directly, bypassing all
absorption barriers and the first-pass effect.
1. A patient with liver cirrhosis has low albumin levels. When administering a
highly protein-bound medication, the nurse should expect which physiological
effect?
A. Decreased drug metabolism in the kidneys
B. Reduced bioavailability of the medication
C. Increased risk of drug toxicity due to more free drug
D. Need for a higher loading dose
Answer: C
Rationale: Low albumin means fewer binding sites are available. This results in more free
(active) drug in the bloodstream, increasing the risk of toxicity.
2. Which pharmacokinetic process is most significantly affected by the first-pass
effect when a drug is administered orally?
A. Metabolism
B. Distribution
C. Excretion
D. Absorption
Answer: A
Rationale: The first-pass effect refers to the metabolism of a drug by the liver after
absorption from the GI tract but before reaching systemic circulation.
,3. A drug has a half-life of 4 hours. If a dose of 400 mg is given at 08:00, how
much drug remains in the body at 20:00?
A. 50 mg
B. 25 mg
C. 100 mg
D. 12.5 mg
Answer: A
Rationale: From 08:00 to 20:00 is 12 hours (3 half-lives). 400mg to 200mg (1), 200mg to
100mg (2), 100mg to 50mg (3).
4. The nurse is monitoring a patient for ‘Peak and Trough’ levels. When should
the nurse draw the trough level?
A. Immediately before the next dose is administered
B. 30 minutes after the infusion is complete
C. Midway between doses
D. 60 minutes after administration
Answer: A
Rationale: The trough level is the lowest concentration of the drug in the blood, measured
just before the next dose.
5. A patient is prescribed a drug with a narrow therapeutic index. What is the
nurse’s priority action?
A. Administer the drug only as needed (PRN)
B. Monitor blood levels closely for toxicity
C. Ensure the drug is given with food to prevent GI upset
D. Teach the patient to double the dose if a dose is missed
Answer: B
Rationale: A narrow therapeutic index means the difference between a therapeutic dose
and a toxic dose is very small.
, 6. Which factor in geriatric patients is the most common cause of adverse drug
reactions?
A. Reduced renal excretion
B. Enhanced liver metabolism
C. Increased gastric acidity
D. Increased body water percentage
Answer: A
Rationale: Decreased renal function is the most important cause of adverse drug reactions
in the elderly due to drug accumulation.
7. When administering a medication to a pregnant woman, the nurse notes it is
classified as ‘Category X’. What does this signify?
A. Fetal risks outweigh any possible benefits
B. The drug is safe for use in all trimesters
C. There are no adequate studies in humans
D. The drug can be used if clearly needed
Answer: A
Rationale: Category X medications have proven fetal risks that clearly outweigh any
possible benefit to the mother.
8. Which route of administration provides 100% bioavailability?
A. Intramuscular
B. Intravenous
C. Oral
D. Subcutaneous
Answer: B
Rationale: IV administration enters the systemic circulation directly, bypassing all
absorption barriers and the first-pass effect.
