NUR 100/NUR100 Exam 2 V1 |
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is reviewing a medication order that indicates a drug is to be administered via the
‘sublingual’ route. Which instruction should the nurse provide to the patient?
A. Place the medication under the tongue until it dissolves.
B. Swallow the tablet whole with a full glass of water.
C. Dissolve the medication in the cheek area.
D. Chew the tablet thoroughly before swallowing.
Correct Answer: A
Expert Explanation: Sublingual administration requires the medication to be placed under
the tongue where it is absorbed through the highly vascular oral mucosa. This route
bypasses the first-pass metabolism of the liver, allowing for faster systemic absorption. The
patient must be instructed not to swallow or chew the medication, as this would decrease
its effectiveness by subjecting it to gastric juices.
2. The nurse understands that ‘pharmacokinetics’ includes the study of what happens to a
drug from the time it enters the body until it leaves. Which process is primarily responsible
for the chemical alteration of a drug into an inactive metabolite?
A. Absorption
,B. Metabolism
C. Distribution
D. Excretion
Correct Answer: B
Expert Explanation: Metabolism, also known as biotransformation, is the biochemical
alteration of a drug into an inactive metabolite, a more soluble compound, or a more potent
active metabolite. This process most commonly occurs in the liver via cytochrome P450
enzymes. Understanding metabolism is crucial for nurses to monitor for potential drug
toxicities, especially in patients with impaired hepatic function.
3. A patient is prescribed a medication with a narrow therapeutic index. What is the nurse’s
priority action when managing this therapy?
A. Administer the medication only once per day.
B. Teach the patient to take the drug on an empty stomach.
C. Increase the dose if the patient does not feel better immediately.
D. Monitor blood levels frequently to ensure safety and efficacy.
Correct Answer: D
Expert Explanation: A narrow therapeutic index means that the difference between a
therapeutic dose and a toxic dose is very small. Consequently, the nurse must monitor
serum drug levels, such as peak and trough levels, to prevent toxicity or subtherapeutic
,dosing. Close observation for adverse effects is also required to ensure patient safety
throughout the treatment course.
4. Which of the following is considered one of the ‘Six Rights’ of medication administration
used to prevent medication errors?
A. Right Physician
B. Right Room Number
C. Right Insurance Provider
D. Right Documentation
Correct Answer: D
Expert Explanation: Right Documentation is a critical component of the ‘Six Rights,’
ensuring that the medication administration is recorded accurately and timely in the MAR.
The other standard rights include right patient, right drug, right dose, right route, and right
time. Failure to document correctly can lead to duplicate dosing or omission of necessary
treatments.
5. When administering an intradermal injection for a tuberculosis (TB) skin test, at what angle
should the nurse insert the needle?
A. 90 degrees
B. 45 degrees
C. 15 degrees
, D. 30 degrees
Correct Answer: C
Expert Explanation: Intradermal injections should be administered at a 5- to 15-degree
angle to ensure the medication is deposited just below the epidermis. Proper technique
should result in a small wheal or ‘bleb’ appearing on the skin surface. If no bleb forms, the
medication was likely injected too deeply into the subcutaneous tissue, rendering the test
results invalid.
6. A nurse is caring for an elderly patient who is taking multiple medications. The nurse
recognizes that this patient is at high risk for which phenomenon?
A. Tachyphylaxis
B. Hyper-metabolism
C. Polypharmacy
D. First-pass enhancement
Correct Answer: C
Expert Explanation: Polypharmacy refers to the use of many different drugs concurrently
in one patient, which is common among the geriatric population. This increase in the
number of medications significantly raises the risk of drug-drug interactions and adverse
drug events. Nurses must perform thorough medication reconciliations to simplify
regimens and ensure patient safety.
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is reviewing a medication order that indicates a drug is to be administered via the
‘sublingual’ route. Which instruction should the nurse provide to the patient?
A. Place the medication under the tongue until it dissolves.
B. Swallow the tablet whole with a full glass of water.
C. Dissolve the medication in the cheek area.
D. Chew the tablet thoroughly before swallowing.
Correct Answer: A
Expert Explanation: Sublingual administration requires the medication to be placed under
the tongue where it is absorbed through the highly vascular oral mucosa. This route
bypasses the first-pass metabolism of the liver, allowing for faster systemic absorption. The
patient must be instructed not to swallow or chew the medication, as this would decrease
its effectiveness by subjecting it to gastric juices.
2. The nurse understands that ‘pharmacokinetics’ includes the study of what happens to a
drug from the time it enters the body until it leaves. Which process is primarily responsible
for the chemical alteration of a drug into an inactive metabolite?
A. Absorption
,B. Metabolism
C. Distribution
D. Excretion
Correct Answer: B
Expert Explanation: Metabolism, also known as biotransformation, is the biochemical
alteration of a drug into an inactive metabolite, a more soluble compound, or a more potent
active metabolite. This process most commonly occurs in the liver via cytochrome P450
enzymes. Understanding metabolism is crucial for nurses to monitor for potential drug
toxicities, especially in patients with impaired hepatic function.
3. A patient is prescribed a medication with a narrow therapeutic index. What is the nurse’s
priority action when managing this therapy?
A. Administer the medication only once per day.
B. Teach the patient to take the drug on an empty stomach.
C. Increase the dose if the patient does not feel better immediately.
D. Monitor blood levels frequently to ensure safety and efficacy.
Correct Answer: D
Expert Explanation: A narrow therapeutic index means that the difference between a
therapeutic dose and a toxic dose is very small. Consequently, the nurse must monitor
serum drug levels, such as peak and trough levels, to prevent toxicity or subtherapeutic
,dosing. Close observation for adverse effects is also required to ensure patient safety
throughout the treatment course.
4. Which of the following is considered one of the ‘Six Rights’ of medication administration
used to prevent medication errors?
A. Right Physician
B. Right Room Number
C. Right Insurance Provider
D. Right Documentation
Correct Answer: D
Expert Explanation: Right Documentation is a critical component of the ‘Six Rights,’
ensuring that the medication administration is recorded accurately and timely in the MAR.
The other standard rights include right patient, right drug, right dose, right route, and right
time. Failure to document correctly can lead to duplicate dosing or omission of necessary
treatments.
5. When administering an intradermal injection for a tuberculosis (TB) skin test, at what angle
should the nurse insert the needle?
A. 90 degrees
B. 45 degrees
C. 15 degrees
, D. 30 degrees
Correct Answer: C
Expert Explanation: Intradermal injections should be administered at a 5- to 15-degree
angle to ensure the medication is deposited just below the epidermis. Proper technique
should result in a small wheal or ‘bleb’ appearing on the skin surface. If no bleb forms, the
medication was likely injected too deeply into the subcutaneous tissue, rendering the test
results invalid.
6. A nurse is caring for an elderly patient who is taking multiple medications. The nurse
recognizes that this patient is at high risk for which phenomenon?
A. Tachyphylaxis
B. Hyper-metabolism
C. Polypharmacy
D. First-pass enhancement
Correct Answer: C
Expert Explanation: Polypharmacy refers to the use of many different drugs concurrently
in one patient, which is common among the geriatric population. This increase in the
number of medications significantly raises the risk of drug-drug interactions and adverse
drug events. Nurses must perform thorough medication reconciliations to simplify
regimens and ensure patient safety.
