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Pharmacology NURS 251 Final Exam 2025/2026 Portage Learning /ABC
nursing/Geneva College Complete All Questions And Correct Detailed Answers
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A patient taking warfarin presents with nosebleeds and gum bleeding. Which laboratory test should be closely monitored to ensure therapeutic anticoagulation levels and prevent risk of hemorrhage or clotting complications? Answer: C. INR A) Hemoglobin B) Platelet count C) INR D) White blood cell count A client newly prescribed lisinopril reports dizziness and a persistent dry cough. Which adverse effect associated with angiotensin-converting enzyme inhibitors should the nurse emphasize during medication teaching and follow-up monitoring? Answer: B. Dry cough A) Bradycardia B) Dry cough C) Weight gain D) Insomnia A nurse gives morphine for severe pain. Patient becomes drowsy, respiratory rate falls to 8/min, oxygen saturation decreases. Which emergency antidote must be administered to reverse respiratory depression quickly? Answer: A. Naloxone A) Naloxone B) Epinephrine
C) Atropine D) Flumazenil A patient receiving gentamicin therapy reports ringing in ears and hearing difficulty. Which nursing action is most appropriate to prevent further complications related to this ototoxic adverse drug effect? Answer: D. Notify provider A) Increase fluids B) Reassure patient C) Reduce noise exposure D) Notify provider A patient prescribed furosemide for heart failure complains of muscle weakness and irregular heartbeat. Which electrolyte imbalance should the nurse assess for as a priority to prevent cardiac complications? Answer: B. Hypokalemia A) Hypernatremia B) Hypokalemia C) Hypocalcemia D) Hyperkalemia A nurse prepares to administer digoxin. The patient’s apical heart rate is 52 beats per minute. Which nursing action is most appropriate before administering this cardiac glycoside medication? Answer: C. Hold medication A) Give medication B) Notify provider C) Hold medication D) Recheck in 4 hours A diabetic patient receives regular insulin at 0700. The nurse should monitor for hypoglycemia at what approximate time corresponding with peak effect of short-acting insulin administration?
C) Several weeks D) Several hours A nurse prepares to administer vancomycin IV. Which serious adverse effect should the nurse monitor closely to prevent complications associated with ototoxicity and nephrotoxicity during antibiotic therapy? Answer: B. Kidney function changes A) Hypotension B) Kidney function changes C) Constipation D) Insomnia A patient on nitroglycerin patch for angina reports headache. Which nursing response is most appropriate regarding this expected common side effect of nitrate therapy? Answer: D. Headache is common A) Stop medication B) Increase dose C) Notify provider immediately D) Headache is common A patient prescribed spironolactone asks about dietary restrictions. Which food should the nurse instruct the patient to limit to prevent risk of hyperkalemia with potassium-sparing diuretic therapy? Answer: B. Bananas A) Milk B) Bananas C) White bread D) Rice A nurse gives heparin to a patient with deep vein thrombosis. Which laboratory test is used to monitor therapeutic effect and ensure safety of anticoagulant therapy? Answer: A. aPTT
A) aPTT B) INR C) Hemoglobin D) Platelet count A nurse prepares to administer metformin. Which condition requires holding this antidiabetic medication to prevent risk of lactic acidosis and serious complications? Answer: C. Renal impairment A) Hypertension B) Hyperthyroidism C) Renal impairment D) Asthma A patient on statin therapy reports muscle pain and weakness. Which serious adverse effect must the nurse monitor for to prevent life-threatening complications from cholesterol-lowering medication? Answer: D. Rhabdomyolysis A) Constipation B) Headache C) Fatigue D) Rhabdomyolysis A nurse prepares to administer albuterol via inhaler for asthma exacerbation. What is the primary expected therapeutic effect of this short-acting beta-agonist medication? Answer: A. Bronchodilation A) Bronchodilation B) Increased heart rate C) Decreased secretions D) Antihistamine effect A patient with hypertension is started on hydrochlorothiazide. Which electrolyte imbalance is the nurse most concerned about when monitoring this thiazide diuretic’s side effects?
A patient prescribed omeprazole asks about its purpose. Which explanation is correct regarding the mechanism of proton pump inhibitors in treating gastric reflux or ulcers? Answer: B. Reduce gastric acid secretion A) Neutralize acid B) Reduce gastric acid secretion C) Increase motility D) Coat stomach lining A nurse is preparing to administer epinephrine during an anaphylactic reaction. What is the primary therapeutic effect of this adrenergic medication in emergency management? Answer: A. Bronchodilation and vasoconstriction A) Bronchodilation and vasoconstriction B) Decreased heart rate C) Increased urination D) Lower blood glucose A patient prescribed sertraline reports feeling better after three days. Which nursing response is correct regarding onset of action for selective serotonin reuptake inhibitor antidepressants? Answer: C. Full effect takes weeks A) Immediate effect B) Few hours C) Full effect takes weeks D) Within 24 hours A patient on lithium for bipolar disorder reports tremors, nausea, and increased urination. Which laboratory value should the nurse prioritize monitoring to prevent lithium toxicity? Answer: B. Serum lithium level A) Sodium B) Serum lithium level C) Creatinine D) Potassium
A nurse gives atropine preoperatively. What therapeutic effect should the nurse expect from this anticholinergic medication before surgery? Answer: D. Decreased secretions A) Lower blood pressure B) Increased urine output C) Muscle relaxation D) Decreased secretions A patient taking iron supplements reports constipation. Which dietary instruction should the nurse give to help prevent this common side effect? Answer: A. Increase fiber intake A) Increase fiber intake B) Avoid fluids C) Reduce iron dose D) Take on empty stomach only A nurse prepares to administer metoprolol. Which vital sign should be checked before giving this beta-blocker to prevent adverse cardiovascular effects? Answer: B. Heart rate A) Temperature B) Heart rate C) Oxygen saturation D) Respiratory rate A patient on clopidogrel reports black, tarry stools. Which nursing action is most appropriate regarding this potential complication of antiplatelet therapy? Answer: C. Notify provider A) Reassure patient B) Increase fluids C) Notify provider D) Give antacids
A patient prescribed methotrexate for rheumatoid arthritis asks about adverse effects. Which complication should the nurse monitor due to immunosuppressant therapy? Answer: D. Increased risk of infection A) Weight gain B) Hypertension C) Constipation D) Increased risk of infection A nurse educates a patient on nitrofurantoin for urinary tract infection. Which important instruction prevents gastrointestinal irritation and ensures proper absorption? Answer: B. Take with food A) Take on empty stomach B) Take with food C) Take at bedtime only D) Take once weekly A patient receiving chemotherapy develops mouth sores. Which nursing intervention is appropriate to reduce mucositis discomfort associated with antineoplastic drugs? Answer: C. Encourage soft, bland foods A) Increase citrus intake B) Use alcohol-based rinses C) Encourage soft, bland foods D) Brush with hard bristles A nurse educates a patient prescribed hydrochlorothiazide. Which time of day should this diuretic be taken to reduce risk of nocturia? Answer: A. Morning A) Morning B) Afternoon C) Evening D) Night
A patient prescribed fluconazole asks about adverse effects. Which organ function should be closely monitored during antifungal therapy to prevent complications? Answer: B. Liver A) Kidneys B) Liver C) Heart D) Lungs A nurse administers metoclopramide for nausea. Which adverse effect should the nurse monitor due to its extrapyramidal risk? Answer: D. Involuntary movements A) Constipation B) Weight gain C) Rash D) Involuntary movements A patient taking hydralazine reports headaches and palpitations. Which vital sign should the nurse monitor closely to assess effectiveness and adverse effects of this antihypertensive? Answer: A. Blood pressure A) Blood pressure B) Temperature C) Oxygen saturation D) Pulse oximetry A nurse educates a patient on levothyroxine administration. Which instruction ensures maximum absorption and therapeutic effectiveness of thyroid hormone replacement therapy? Answer: C. Take on empty stomach in morning A) With evening meal B) At bedtime with snack C) Take on empty stomach in morning D) Take after lunch
Side effects - ANSWER=any effect other than the therapeutic effect that are usually undesirable but not harmful Adverse effect - ANSWER=general term for undesirable and potentially harmful drug effect Toxic effects - ANSWER=undesirable drug effect that implies drug poisoning; can be very harmful or life-threatening Mechanism of action - ANSWER=How a drug produces its effects targeted sit of action - ANSWER=the location within the body where a drug exerts its therapeutic effect, often a specific drug receptor Receptors - ANSWER=specific cellular structures that a drug binds to in order to produce a physiologic effect Agonist receptor - ANSWER=works to activate a physiologic response or drug effect Antagonist receptor - ANSWER=works to interfere with other drugs or substances from producing a drug-effect Dose-dependent relationship - ANSWER=basic principle of pharmacology which states that the response to any drug depends on the amount of drug given
Onset of action - ANSWER=the time from the drug administration to the first observable effect Duration of action - ANSWER=the length of time that the drug continues to produce its effect Drug Names include - ANSWER=1. Chemical Name
- Describe the chemical composition and molecular structure
- Generic name - nonproprietary name
- Trade name - Owned by the producing company. Classification of drugs based on similarities of properties - ANSWER=1. Structure - e.g. beta blockers
- Use - e.g. antibiotics Aqueous Preparations - ANSWER=syrups - a solution of water and sugar to which a drug is added Tablets - ANSWER=drug powders that have been compressed into convenient form for swallowing. disintegrates in stomach more rapidly than most other solid preparations Troches and lozenges - ANSWER=flattened tablets that are allowed to dissolve in the mouth
Parenteral administration - ANSWER=route of drug administration that does not involve the gastrointestinal (GI) tract Routes of Drug Administration - ANSWER= Phases of drug activity - ANSWER=(1) Pharmaceutical Phase - administration of dosage form, dissolution of drug into body (2) Pharmacokinetic Phase - absorption, distribution, metabolism, excretion (3) Pharmacodynamic Phase - drug receptor interaction Pharmaceutics - ANSWER=Study of how various dosage forms influence how the drug effects the body. Dissolution - ANSWER=When taken, how does it appear in the digestive tract. Pharmakinetics - ANSWER=Study of what the body does to the drug.
- What happens to the drug when it is taken.
- Depends on how long drug is in the system. (absorption, distribution, metabolism, excretion) Absorption - ANSWER=the movement of a drug from its site of administration into the blood
Bioavailability - ANSWER=A measure of the extent of drug absorption for a given drug and route (from 0% to 100%). Distribution - ANSWER=transport of a drug by the bloodstream to its site of action Metabolism - ANSWER=the biochemical alteration of a drug into an inactive metabolite, a more potent metabolite, or a less active metabolite Substrates - ANSWER=a site where the enzyme acts Enzyme inducer - ANSWER=stimulates more drug metabolism Excretion - ANSWER=the elmination of drugs from the body Biliary excretion - ANSWER=when some drugs are excreted through the intestines Half-life of a drug - ANSWER=time it takes 50% of a given drug to be removed from the body Steady state - ANSWER=the physiologic state in which the amount of drug removed via elimination is equal to the amount absorbed with each dose
Factors affecting how someone responds to drug therapy - ANSWER=-Age, weight, sex, and genetic variation.
- Infants, children, and the elderly are generally more sensitive to drug actions than younger adults. Age related changes in pharmacokinetics - ANSWER=(1) Absorption - Drug absorption is delayed due to decreased intestinal blood flow, surface area and motility- this slows the onset of action (2) Distribution - Distribution is increased leading to increased drug effect due to decreased body water, lean body mass and increased fat content (3) Metabolism - Drug metabolism decreases increasing the duration of the drug due to decrease in blood flow to the liver and decrease in liver enzymes (4) Excretion - Excretion is decreased due to decreased blood flow to the kidneys and overall decreased renal function as one ages Most adult dosages are caculated for a _____ lbs adult - ANSWER=150 lbs Higher body fat percentage means that there is - ANSWER=less body water for the drug to dissolve in; therefore, they may have a greater response to the drug.
Drug interaction - ANSWER=the actions of one drug are affected by another drug. Common Drug Interactions - ANSWER=-Incompatibility: Physical changes that occur to a drug when it is mixed with another prior to administration
- Additive Effects: When the combined effect of two drugs is equal to the sum of each on their own
- Synergism: When the combined effect of two drugs is greater than the sum of their individual effects.
- Antagonism: When the combined effect of two drugs is less than the sum of their individual effects. The most common drug interactions happen when - ANSWER=there is competition between two drugs for metabolizing enzymes within the cytochrome P-450 enzyme Absorption + PPIs and Ircon - ANSWER=-Mechanism: The iron requires an acidic environment for absorption
- Result: Decreases the blood levels of iron leading to it being less effective
