NUR 100/NUR100 Final Exam V2 |
Pharmacology Q&A with Rationale | Fortis
College
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would the nurse expect to result in the lowest bioavailability for this drug?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Correct Answer: C
Expert Explanation: The oral route subjects the medication to metabolism by the liver
before it reaches systemic circulation, which defines the first-pass effect. Intravenous and
sublingual routes bypass this initial hepatic metabolism, leading to higher systemic
concentrations. Therefore, drugs with a high first-pass effect must be given in higher oral
doses or via an alternative route to achieve therapeutic levels.
2. Which laboratory value is most critical for a nurse to monitor in a patient receiving an
initial dose of an ACE inhibitor such as Lisinopril?
A. Serum Potassium
B. Serum Sodium
,C. Prothrombin Time (PT)
D. Blood Glucose
Correct Answer: A
Expert Explanation: ACE inhibitors block the secretion of aldosterone, which can lead to
the retention of potassium. Hyperkalemia is a significant and potentially dangerous
adverse effect of this medication class. The nurse must monitor these levels closely to
prevent cardiac arrhythmias associated with elevated potassium.
3. A nurse is preparing to administer Digoxin to a patient. Which assessment finding would
require the nurse to withhold the medication and notify the provider?
A. Blood pressure of 110/70 mmHg
B. Respiratory rate of 18 breaths per minute
C. Apical pulse of 52 beats per minute
D. Temperature of 99.1°F
Correct Answer: C
Expert Explanation: Digoxin has a negative chronotropic effect, meaning it slows the heart
rate. Standard nursing practice requires assessing the apical pulse for one full minute prior
to administration. If the heart rate is below 60 beats per minute in an adult, the dose is
typically withheld due to the risk of bradycardia and toxicity.
, 4. A patient is prescribed Warfarin (Coumadin). Which of the following educational points is
most important for the nurse to include regarding diet?
A. Avoid all foods containing Vitamin K.
B. Drink at least 3 liters of water daily.
C. Increase intake of citrus fruits to improve absorption.
D. Maintain a consistent intake of green leafy vegetables.
Correct Answer: D
Expert Explanation: Vitamin K is the antagonist to Warfarin and can decrease its
effectiveness. Patients do not need to avoid it entirely, but they must keep their intake
consistent to allow for stable dosing. Sudden changes in Vitamin K consumption can lead to
fluctuations in the International Normalized Ratio (INR), increasing the risk of clots or
bleeding.
5. What is the primary rationale for instructing a patient to rinse their mouth after using a
Beclomethasone inhaler?
A. To reduce the risk of systemic hypertension.
B. To improve the absorption of the medication in the lungs.
C. To prevent the development of oral candidiasis (thrush).
D. To prevent dental enamel erosion.
Correct Answer: C
Pharmacology Q&A with Rationale | Fortis
College
1. A patient is prescribed a medication that has a high first-pass effect. Which route of
administration would the nurse expect to result in the lowest bioavailability for this drug?
A. Intravenous
B. Sublingual
C. Oral
D. Transdermal
Correct Answer: C
Expert Explanation: The oral route subjects the medication to metabolism by the liver
before it reaches systemic circulation, which defines the first-pass effect. Intravenous and
sublingual routes bypass this initial hepatic metabolism, leading to higher systemic
concentrations. Therefore, drugs with a high first-pass effect must be given in higher oral
doses or via an alternative route to achieve therapeutic levels.
2. Which laboratory value is most critical for a nurse to monitor in a patient receiving an
initial dose of an ACE inhibitor such as Lisinopril?
A. Serum Potassium
B. Serum Sodium
,C. Prothrombin Time (PT)
D. Blood Glucose
Correct Answer: A
Expert Explanation: ACE inhibitors block the secretion of aldosterone, which can lead to
the retention of potassium. Hyperkalemia is a significant and potentially dangerous
adverse effect of this medication class. The nurse must monitor these levels closely to
prevent cardiac arrhythmias associated with elevated potassium.
3. A nurse is preparing to administer Digoxin to a patient. Which assessment finding would
require the nurse to withhold the medication and notify the provider?
A. Blood pressure of 110/70 mmHg
B. Respiratory rate of 18 breaths per minute
C. Apical pulse of 52 beats per minute
D. Temperature of 99.1°F
Correct Answer: C
Expert Explanation: Digoxin has a negative chronotropic effect, meaning it slows the heart
rate. Standard nursing practice requires assessing the apical pulse for one full minute prior
to administration. If the heart rate is below 60 beats per minute in an adult, the dose is
typically withheld due to the risk of bradycardia and toxicity.
, 4. A patient is prescribed Warfarin (Coumadin). Which of the following educational points is
most important for the nurse to include regarding diet?
A. Avoid all foods containing Vitamin K.
B. Drink at least 3 liters of water daily.
C. Increase intake of citrus fruits to improve absorption.
D. Maintain a consistent intake of green leafy vegetables.
Correct Answer: D
Expert Explanation: Vitamin K is the antagonist to Warfarin and can decrease its
effectiveness. Patients do not need to avoid it entirely, but they must keep their intake
consistent to allow for stable dosing. Sudden changes in Vitamin K consumption can lead to
fluctuations in the International Normalized Ratio (INR), increasing the risk of clots or
bleeding.
5. What is the primary rationale for instructing a patient to rinse their mouth after using a
Beclomethasone inhaler?
A. To reduce the risk of systemic hypertension.
B. To improve the absorption of the medication in the lungs.
C. To prevent the development of oral candidiasis (thrush).
D. To prevent dental enamel erosion.
Correct Answer: C
