NUR1140 Nursing Pharmacology
4.0 Credits
Complete Final Exam (Qns & Ans)
2025
Question 1:
A 55‑year‑old patient with moderate pain is prescribed codeine
for analgesia. Genetic testing later reveals that the patient is a
poor metabolizer via CYP2D6. Which outcome is most likely?
A. Increased risk of opioid toxicity due to high conversion to
morphine
B. An adequate analgesic response due to alternative metabolic
pathways
C. Diminished pain relief due to insufficient conversion of
codeine to morphine
©2025
,D. Increased incidence of adverse effects like respiratory
depression
Correct ANS: C
Rationale: Codeine is a prodrug that requires metabolism by
CYP2D6 to form its active metabolite, morphine. In poor
metabolizers, this conversion is reduced, leading to diminished
analgesic effect.
---
Question 2:
A patient on warfarin therapy is prescribed an antibiotic that is a
known inhibitor of CYP2C9. What is the most appropriate
nursing action regarding the patient’s anticoagulation therapy?
A. Advise the patient to double the warfarin dose
B. Monitor the patient’s International Normalized Ratio (INR)
more closely
C. Discontinue warfarin immediately
D. Inform the patient that no adjustments are necessary
Correct ANS: B
©2025
, Rationale: CYP2C9 inhibition reduces warfarin metabolism,
increasing its plasma concentration and the risk of bleeding. Close
monitoring of the INR allows for early detection of
supratherapeutic levels and dose adjustment if needed.
---
Question 3:
In administering an aminoglycoside to treat a severe Gram-
negative infection in an elderly patient, which parameter is most
critical for preventing nephrotoxicity?
A. Monitoring trough blood levels and serum creatinine
B. Checking the patient’s heart rate
C. Assessing the patient’s blood glucose regularly
D. Verbal inquires about the patient’s pain level at injection site
Correct ANS: A
Rationale: Aminoglycosides are nephrotoxic; therefore,
monitoring trough levels along with serum creatinine is essential
to adjust dosing and minimize the risk of renal impairment.
---
©2025
, Question 4:
A nurse is reviewing the pharmacokinetic profile of a lipophilic
drug that partitions extensively into tissues. Which parameter best
describes this characteristic?
A. High bioavailability
B. Small volume of distribution
C. Short half‑life
D. High volume of distribution
Correct ANS: D
Rationale: A high volume of distribution indicates that the drug
extensively penetrates into tissues rather than remaining in the
plasma, which is typical for lipophilic drugs.
---
Question 5:
A patient with a documented history of an anaphylactic reaction
to penicillin is scheduled for surgery. The prescriber considers a
cephalosporin prophylaxis. Which factor is most important in
assessing the risk of cross‑reactivity?
A. The generation of the cephalosporin and the severity of the
penicillin allergy
©2025
4.0 Credits
Complete Final Exam (Qns & Ans)
2025
Question 1:
A 55‑year‑old patient with moderate pain is prescribed codeine
for analgesia. Genetic testing later reveals that the patient is a
poor metabolizer via CYP2D6. Which outcome is most likely?
A. Increased risk of opioid toxicity due to high conversion to
morphine
B. An adequate analgesic response due to alternative metabolic
pathways
C. Diminished pain relief due to insufficient conversion of
codeine to morphine
©2025
,D. Increased incidence of adverse effects like respiratory
depression
Correct ANS: C
Rationale: Codeine is a prodrug that requires metabolism by
CYP2D6 to form its active metabolite, morphine. In poor
metabolizers, this conversion is reduced, leading to diminished
analgesic effect.
---
Question 2:
A patient on warfarin therapy is prescribed an antibiotic that is a
known inhibitor of CYP2C9. What is the most appropriate
nursing action regarding the patient’s anticoagulation therapy?
A. Advise the patient to double the warfarin dose
B. Monitor the patient’s International Normalized Ratio (INR)
more closely
C. Discontinue warfarin immediately
D. Inform the patient that no adjustments are necessary
Correct ANS: B
©2025
, Rationale: CYP2C9 inhibition reduces warfarin metabolism,
increasing its plasma concentration and the risk of bleeding. Close
monitoring of the INR allows for early detection of
supratherapeutic levels and dose adjustment if needed.
---
Question 3:
In administering an aminoglycoside to treat a severe Gram-
negative infection in an elderly patient, which parameter is most
critical for preventing nephrotoxicity?
A. Monitoring trough blood levels and serum creatinine
B. Checking the patient’s heart rate
C. Assessing the patient’s blood glucose regularly
D. Verbal inquires about the patient’s pain level at injection site
Correct ANS: A
Rationale: Aminoglycosides are nephrotoxic; therefore,
monitoring trough levels along with serum creatinine is essential
to adjust dosing and minimize the risk of renal impairment.
---
©2025
, Question 4:
A nurse is reviewing the pharmacokinetic profile of a lipophilic
drug that partitions extensively into tissues. Which parameter best
describes this characteristic?
A. High bioavailability
B. Small volume of distribution
C. Short half‑life
D. High volume of distribution
Correct ANS: D
Rationale: A high volume of distribution indicates that the drug
extensively penetrates into tissues rather than remaining in the
plasma, which is typical for lipophilic drugs.
---
Question 5:
A patient with a documented history of an anaphylactic reaction
to penicillin is scheduled for surgery. The prescriber considers a
cephalosporin prophylaxis. Which factor is most important in
assessing the risk of cross‑reactivity?
A. The generation of the cephalosporin and the severity of the
penicillin allergy
©2025
