PRN 1381/PRN1381 Final Exam V3 |
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. Which organ is primarily responsible for the metabolism of most pharmacological agents?
A. Liver
B. Kidneys
C. Small Intestine
D. Lungs
Correct Answer: A
Expert Explanation: The liver is the primary site for drug metabolism due to its high
concentration of microsomal enzymes. These enzymes, specifically the cytochrome P450
system, chemically alter drugs to make them more water-soluble for excretion. Impairment
in liver function can lead to drug accumulation and toxicity in the patient.
2. A patient is prescribed a medication with a narrow therapeutic index. What is the priority
nursing action?
A. Ensure the patient drinks at least 2 liters of water daily
B. Administer the drug with food to prevent GI upset
C. Monitor serum drug levels frequently
D. Assess the patient’s blood pressure every 4 hours
,Correct Answer: C
Expert Explanation: A narrow therapeutic index means there is a very small margin
between a safe dose and a toxic dose. Frequent monitoring of serum drug levels is essential
to ensure the medication remains within the effective range without reaching dangerous
concentrations. The nurse must report any levels outside the established therapeutic
window to the healthcare provider immediately.
3. What is the primary purpose of the ‘first-pass effect’ in pharmacology?
A. The metabolism of a drug by the liver before it reaches systemic circulation
B. To ensure the drug reaches the brain quickly
C. To increase the bioavailability of IV medications
D. The initial excretion of the drug by the kidneys
Correct Answer: A
Expert Explanation: The first-pass effect occurs when an oral medication is absorbed
from the GI tract and carried to the liver via the portal vein. The liver metabolizes a
significant portion of the drug, which reduces the amount of active medication that actually
enters the bloodstream. This phenomenon explains why oral doses are often much higher
than intravenous doses for the same medication.
4. A patient is taking Warfarin (Coumadin). Which lab value should the nurse monitor to
evaluate the drug’s effectiveness?
A. aPTT
, B. PT/INR
C. Platelet count
D. Hemoglobin and Hematocrit
Correct Answer: B
Expert Explanation: PT/INR is the standard laboratory test used to monitor the
effectiveness of Warfarin therapy. A therapeutic INR for most patients is typically between
2.0 and 3.0, depending on the indication. The nurse must assess these values to prevent
either clotting or excessive bleeding risks.
5. Which of the following is a common side effect of ACE inhibitors such as Lisinopril?
A. Constipation
B. Hypokalemia
C. Tachycardia
D. Dry, nonproductive cough
Correct Answer: D
Expert Explanation: ACE inhibitors often cause a persistent, dry cough due to the
accumulation of bradykinin in the lungs. This side effect is a common reason why patients
might be switched to an Angiotensin II Receptor Blocker (ARB). Nurses should educate
patients that this cough is not harmful but may require a change in therapy if it becomes
intolerable.
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. Which organ is primarily responsible for the metabolism of most pharmacological agents?
A. Liver
B. Kidneys
C. Small Intestine
D. Lungs
Correct Answer: A
Expert Explanation: The liver is the primary site for drug metabolism due to its high
concentration of microsomal enzymes. These enzymes, specifically the cytochrome P450
system, chemically alter drugs to make them more water-soluble for excretion. Impairment
in liver function can lead to drug accumulation and toxicity in the patient.
2. A patient is prescribed a medication with a narrow therapeutic index. What is the priority
nursing action?
A. Ensure the patient drinks at least 2 liters of water daily
B. Administer the drug with food to prevent GI upset
C. Monitor serum drug levels frequently
D. Assess the patient’s blood pressure every 4 hours
,Correct Answer: C
Expert Explanation: A narrow therapeutic index means there is a very small margin
between a safe dose and a toxic dose. Frequent monitoring of serum drug levels is essential
to ensure the medication remains within the effective range without reaching dangerous
concentrations. The nurse must report any levels outside the established therapeutic
window to the healthcare provider immediately.
3. What is the primary purpose of the ‘first-pass effect’ in pharmacology?
A. The metabolism of a drug by the liver before it reaches systemic circulation
B. To ensure the drug reaches the brain quickly
C. To increase the bioavailability of IV medications
D. The initial excretion of the drug by the kidneys
Correct Answer: A
Expert Explanation: The first-pass effect occurs when an oral medication is absorbed
from the GI tract and carried to the liver via the portal vein. The liver metabolizes a
significant portion of the drug, which reduces the amount of active medication that actually
enters the bloodstream. This phenomenon explains why oral doses are often much higher
than intravenous doses for the same medication.
4. A patient is taking Warfarin (Coumadin). Which lab value should the nurse monitor to
evaluate the drug’s effectiveness?
A. aPTT
, B. PT/INR
C. Platelet count
D. Hemoglobin and Hematocrit
Correct Answer: B
Expert Explanation: PT/INR is the standard laboratory test used to monitor the
effectiveness of Warfarin therapy. A therapeutic INR for most patients is typically between
2.0 and 3.0, depending on the indication. The nurse must assess these values to prevent
either clotting or excessive bleeding risks.
5. Which of the following is a common side effect of ACE inhibitors such as Lisinopril?
A. Constipation
B. Hypokalemia
C. Tachycardia
D. Dry, nonproductive cough
Correct Answer: D
Expert Explanation: ACE inhibitors often cause a persistent, dry cough due to the
accumulation of bradykinin in the lungs. This side effect is a common reason why patients
might be switched to an Angiotensin II Receptor Blocker (ARB). Nurses should educate
patients that this cough is not harmful but may require a change in therapy if it becomes
intolerable.
