PRN 1381/PRN1381 Final Exam V1 |
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would most likely require the highest dose to achieve a therapeutic effect?
A. Intravenous
B. Oral
C. Sublingual
D. Intramuscular
Correct Answer: B
Expert Explanation: The first-pass effect occurs when a drug is extensively metabolized
by the liver after being absorbed from the gastrointestinal tract. This process significantly
reduces the amount of active drug that reaches the systemic circulation. Consequently, oral
doses must be higher than parenteral doses to compensate for this initial metabolic loss.
2. When administering medication to a pediatric patient, which factor is most important for
the nurse to consider regarding drug metabolism?
A. Pediatric patients have faster gastric emptying.
B. Children have higher body fat percentages.
C. Immature liver function can lead to toxicity.
,D. Kidneys excrete drugs faster in infants.
Correct Answer: C
Expert Explanation: Infants and young children often have immature hepatic enzyme
systems that cannot process drugs as efficiently as adults. This reduced metabolic capacity
increases the risk of drug accumulation and potential toxicity. Nurses must monitor
pediatric patients closely and ensure dosages are calculated based on weight or body
surface area.
3. A nurse is preparing to administer digoxin to a patient. Which assessment finding would
require the nurse to withhold the medication?
A. Blood pressure of 140/90 mmHg
B. Respiratory rate of 18 breaths per minute
C. Temperature of 99.1 degrees F
D. Apical pulse of 52 beats per minute
Correct Answer: D
Expert Explanation: Digoxin is a cardiac glycoside that slows the heart rate while
increasing the force of contraction. It is standard practice to withhold the drug if the apical
pulse is below 60 beats per minute in an adult. Administering the drug during bradycardia
could further decrease the heart rate to dangerous levels.
, 4. Which of the following is a common side effect of ACE inhibitors, such as lisinopril, that
patients should be educated about?
A. Tachycardia
B. Increased hair growth
C. Hypokalemia
D. Persistent dry cough
Correct Answer: D
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, which can lead
to a persistent, non-productive dry cough in some patients. This side effect is a common
reason for patients to discontinue the medication. If the cough becomes intolerable, the
healthcare provider may switch the patient to an Angiotensin II Receptor Blocker (ARB).
5. A patient is receiving heparin therapy. Which laboratory value is most critical for the nurse
to monitor to ensure safe dosing?
A. Prothrombin Time (PT)
B. Activated Partial Thromboplastin Time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet Count only
Correct Answer: B
Principles of Pharmacology Q&A with
Rationale | Rasmussen University
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would most likely require the highest dose to achieve a therapeutic effect?
A. Intravenous
B. Oral
C. Sublingual
D. Intramuscular
Correct Answer: B
Expert Explanation: The first-pass effect occurs when a drug is extensively metabolized
by the liver after being absorbed from the gastrointestinal tract. This process significantly
reduces the amount of active drug that reaches the systemic circulation. Consequently, oral
doses must be higher than parenteral doses to compensate for this initial metabolic loss.
2. When administering medication to a pediatric patient, which factor is most important for
the nurse to consider regarding drug metabolism?
A. Pediatric patients have faster gastric emptying.
B. Children have higher body fat percentages.
C. Immature liver function can lead to toxicity.
,D. Kidneys excrete drugs faster in infants.
Correct Answer: C
Expert Explanation: Infants and young children often have immature hepatic enzyme
systems that cannot process drugs as efficiently as adults. This reduced metabolic capacity
increases the risk of drug accumulation and potential toxicity. Nurses must monitor
pediatric patients closely and ensure dosages are calculated based on weight or body
surface area.
3. A nurse is preparing to administer digoxin to a patient. Which assessment finding would
require the nurse to withhold the medication?
A. Blood pressure of 140/90 mmHg
B. Respiratory rate of 18 breaths per minute
C. Temperature of 99.1 degrees F
D. Apical pulse of 52 beats per minute
Correct Answer: D
Expert Explanation: Digoxin is a cardiac glycoside that slows the heart rate while
increasing the force of contraction. It is standard practice to withhold the drug if the apical
pulse is below 60 beats per minute in an adult. Administering the drug during bradycardia
could further decrease the heart rate to dangerous levels.
, 4. Which of the following is a common side effect of ACE inhibitors, such as lisinopril, that
patients should be educated about?
A. Tachycardia
B. Increased hair growth
C. Hypokalemia
D. Persistent dry cough
Correct Answer: D
Expert Explanation: ACE inhibitors prevent the breakdown of bradykinin, which can lead
to a persistent, non-productive dry cough in some patients. This side effect is a common
reason for patients to discontinue the medication. If the cough becomes intolerable, the
healthcare provider may switch the patient to an Angiotensin II Receptor Blocker (ARB).
5. A patient is receiving heparin therapy. Which laboratory value is most critical for the nurse
to monitor to ensure safe dosing?
A. Prothrombin Time (PT)
B. Activated Partial Thromboplastin Time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet Count only
Correct Answer: B
