NUR 100/NUR100 Exam 3 V3 |
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is preparing to administer a medication that has a narrow therapeutic index.
Which action is most important for the nurse to take?
A. Encourage the client to increase fluid intake.
B. Administer the medication on an empty stomach.
C. Monitor serum drug levels frequently.
D. Instruct the client to take the medication PRN.
Correct Answer: C
Expert Explanation: Medications with a narrow therapeutic index have a very small
margin between a therapeutic dose and a toxic dose. Frequent monitoring of serum drug
levels is essential to ensure the patient stays within the safe range. The nurse must
prioritize laboratory results to prevent life-threatening toxicity or therapeutic failure.
2. The nurse is reviewing a client’s medication list and notes the client is taking a drug with a
high first-pass effect. Which route of administration would be least effective for this drug?
A. Intravenous
B. Oral
C. Sublingual
,D. Transdermal
Correct Answer: B
Expert Explanation: The first-pass effect refers to the metabolism of a drug in the liver
before it reaches systemic circulation. Drugs taken orally travel through the portal vein to
the liver, where a large portion may be inactivated. Routes such as sublingual, IV, or
transdermal bypass the liver initially, making them more effective for these types of drugs.
3. A client is prescribed a new medication that is highly protein-bound. The nurse notes the
client’s albumin level is 2.2 g/dL. What is the nurse’s primary concern?
A. The drug will be excreted too quickly by the kidneys.
B. The drug will be inactivated by the low protein levels.
C. There will be an increased risk of drug toxicity.
D. The drug will not reach the target tissues.
Correct Answer: C
Expert Explanation: Highly protein-bound drugs require albumin to transport them
through the bloodstream; however, only ‘free’ unbound drugs are pharmacologically active.
When albumin levels are low, as in this client, there are fewer binding sites, leading to more
free drug in the system. This increased concentration of active drug significantly raises the
risk of toxic effects.
,4. The nurse is educating a client about the use of an Albuterol inhaler. Which statement by
the client indicates a need for further teaching?
A. I should wait one minute between puffs.
B. I will use this inhaler when I feel short of breath.
C. I should shake the canister before each use.
D. I will rinse my mouth after using this inhaler to prevent thrush.
Correct Answer: D
Expert Explanation: Rinsing the mouth to prevent thrush is a teaching point specific to
inhaled corticosteroids, not bronchodilators like Albuterol. Albuterol is a rescue medication
used for acute shortness of breath and does not typically cause fungal infections. The client
needs to understand the specific care requirements for different types of inhalers to ensure
safety and efficacy.
5. A client is receiving Digoxin for heart failure. Which laboratory value should the nurse
monitor most closely to prevent Digoxin toxicity?
A. Sodium
B. Magnesium
C. Calcium
D. Potassium
Correct Answer: D
, Expert Explanation: Hypokalemia (low potassium) significantly increases the risk of
Digoxin toxicity because potassium competes with Digoxin for binding sites on the sodium-
potassium ATPase pump. If potassium levels are low, more Digoxin binds, leading to
increased drug effects and potential toxicity. Nurses must monitor potassium levels and
report any deviations from the normal range immediately.
6. The nurse is preparing to administer Warfarin. Which lab value is used to determine the
correct dosage of this medication?
A. aPTT
B. Platelet count
C. Hemoglobin
D. INR
Correct Answer: D
Expert Explanation: The International Normalized Ratio (INR) is the standardized
measurement used to monitor the effectiveness of Warfarin therapy. A therapeutic INR for
most conditions is typically between 2.0 and 3.0. Unlike Heparin, which is monitored via
aPTT, Warfarin requires consistent INR tracking to adjust dosages and prevent bleeding or
clotting.
7. A client is diagnosed with an opioid overdose. The nurse anticipates administering which
medication?
A. Naloxone
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is preparing to administer a medication that has a narrow therapeutic index.
Which action is most important for the nurse to take?
A. Encourage the client to increase fluid intake.
B. Administer the medication on an empty stomach.
C. Monitor serum drug levels frequently.
D. Instruct the client to take the medication PRN.
Correct Answer: C
Expert Explanation: Medications with a narrow therapeutic index have a very small
margin between a therapeutic dose and a toxic dose. Frequent monitoring of serum drug
levels is essential to ensure the patient stays within the safe range. The nurse must
prioritize laboratory results to prevent life-threatening toxicity or therapeutic failure.
2. The nurse is reviewing a client’s medication list and notes the client is taking a drug with a
high first-pass effect. Which route of administration would be least effective for this drug?
A. Intravenous
B. Oral
C. Sublingual
,D. Transdermal
Correct Answer: B
Expert Explanation: The first-pass effect refers to the metabolism of a drug in the liver
before it reaches systemic circulation. Drugs taken orally travel through the portal vein to
the liver, where a large portion may be inactivated. Routes such as sublingual, IV, or
transdermal bypass the liver initially, making them more effective for these types of drugs.
3. A client is prescribed a new medication that is highly protein-bound. The nurse notes the
client’s albumin level is 2.2 g/dL. What is the nurse’s primary concern?
A. The drug will be excreted too quickly by the kidneys.
B. The drug will be inactivated by the low protein levels.
C. There will be an increased risk of drug toxicity.
D. The drug will not reach the target tissues.
Correct Answer: C
Expert Explanation: Highly protein-bound drugs require albumin to transport them
through the bloodstream; however, only ‘free’ unbound drugs are pharmacologically active.
When albumin levels are low, as in this client, there are fewer binding sites, leading to more
free drug in the system. This increased concentration of active drug significantly raises the
risk of toxic effects.
,4. The nurse is educating a client about the use of an Albuterol inhaler. Which statement by
the client indicates a need for further teaching?
A. I should wait one minute between puffs.
B. I will use this inhaler when I feel short of breath.
C. I should shake the canister before each use.
D. I will rinse my mouth after using this inhaler to prevent thrush.
Correct Answer: D
Expert Explanation: Rinsing the mouth to prevent thrush is a teaching point specific to
inhaled corticosteroids, not bronchodilators like Albuterol. Albuterol is a rescue medication
used for acute shortness of breath and does not typically cause fungal infections. The client
needs to understand the specific care requirements for different types of inhalers to ensure
safety and efficacy.
5. A client is receiving Digoxin for heart failure. Which laboratory value should the nurse
monitor most closely to prevent Digoxin toxicity?
A. Sodium
B. Magnesium
C. Calcium
D. Potassium
Correct Answer: D
, Expert Explanation: Hypokalemia (low potassium) significantly increases the risk of
Digoxin toxicity because potassium competes with Digoxin for binding sites on the sodium-
potassium ATPase pump. If potassium levels are low, more Digoxin binds, leading to
increased drug effects and potential toxicity. Nurses must monitor potassium levels and
report any deviations from the normal range immediately.
6. The nurse is preparing to administer Warfarin. Which lab value is used to determine the
correct dosage of this medication?
A. aPTT
B. Platelet count
C. Hemoglobin
D. INR
Correct Answer: D
Expert Explanation: The International Normalized Ratio (INR) is the standardized
measurement used to monitor the effectiveness of Warfarin therapy. A therapeutic INR for
most conditions is typically between 2.0 and 3.0. Unlike Heparin, which is monitored via
aPTT, Warfarin requires consistent INR tracking to adjust dosages and prevent bleeding or
clotting.
7. A client is diagnosed with an opioid overdose. The nurse anticipates administering which
medication?
A. Naloxone
