NLE Pharmacology and Medication Management — Questions and Answers

Question 1: What term describes the study of how drugs move through the body, including absorption, distribution, metabolism, and excretion?

Pharmacodynamics
Pharmacokinetics (Correct answer)
Pharmacogenomics
Pharmacotherapy

Correct answer: Pharmacokinetics

Pharmacokinetics describes the movement of drugs through the body via absorption, distribution, metabolism, and excretion (ADME).

Question 2: Which route of drug administration provides the fastest onset of action?

Oral
Subcutaneous
Intravenous (Correct answer)
Intramuscular

Correct answer: Intravenous

Intravenous (IV) administration delivers drugs directly into the bloodstream, bypassing absorption and providing the fastest onset.

Question 3: A medication has a 'narrow therapeutic index.' This means:

The drug has very few side effects
The drug treats a wide range of conditions
There is a small difference between therapeutic and toxic doses (Correct answer)
The drug is only available in one dosage form

Correct answer: There is a small difference between therapeutic and toxic doses

A narrow therapeutic index means the margin between the effective dose and the toxic dose is small, requiring careful monitoring.

Question 4: Naloxone is classified as an opioid antagonist because it:

Enhances the effects of opioids at receptor sites
Blocks opioid receptor sites and reverses opioid effects (Correct answer)
Stimulates the release of endogenous endorphins
Increases opioid metabolism in the liver

Correct answer: Blocks opioid receptor sites and reverses opioid effects

Naloxone competitively blocks opioid receptors, reversing respiratory depression and other opioid effects.

Question 5: The 'first-pass effect' refers to:

The first dose of a medication being the most potent
Hepatic metabolism of a drug before it reaches systemic circulation (Correct answer)
Initial side effects experienced when starting a new medication
Drug absorption through the skin on first application

Correct answer: Hepatic metabolism of a drug before it reaches systemic circulation

The first-pass effect occurs when orally administered drugs are metabolized by the liver before reaching systemic circulation, reducing bioavailability.

Question 6: A drug has a half-life of 6 hours. Approximately how long will it take for 97% of the drug to be eliminated from the body?

12 hours
18 hours
24 hours
30 hours (Correct answer)

Correct answer: 30 hours

Approximately 5 half-lives are needed to eliminate ~97% of a drug; with a 6-hour half-life, that equals 30 hours.

Question 7: Which medication class is most commonly associated with hypokalemia as a side effect?

Beta-blockers
Loop diuretics (Correct answer)
ACE inhibitors
Calcium channel blockers

Correct answer: Loop diuretics

Loop diuretics such as furosemide promote potassium excretion in the urine, commonly causing hypokalemia.

Question 8: A patient taking warfarin requires monitoring with which laboratory value?

Activated partial thromboplastin time (aPTT)
Prothrombin time/INR (Correct answer)
Complete blood count (CBC)
Platelet count

Correct answer: Prothrombin time/INR

Warfarin's anticoagulant effect is monitored using prothrombin time expressed as the International Normalized Ratio (INR).

Question 9: Which medication is a short-acting beta-2 adrenergic agonist used as a rescue inhaler for asthma?

Propranolol
Metoprolol
Albuterol (Correct answer)
Atenolol

Correct answer: Albuterol

Albuterol is a short-acting beta-2 agonist that causes rapid bronchodilation and is used for acute asthma relief.

Question 10: Which adverse effects should a nurse most closely monitor in a patient receiving an ACE inhibitor?

Bradycardia and hypoglycemia
Dry cough and hyperkalemia (Correct answer)
Tachycardia and hypokalemia
Constipation and hyponatremia

Correct answer: Dry cough and hyperkalemia

ACE inhibitors commonly cause a persistent dry cough (due to bradykinin accumulation) and hyperkalemia (due to reduced aldosterone activity).

Question 11: Which drug is the first-line treatment for acute anaphylaxis?

Diphenhydramine
Methylprednisolone
Epinephrine (Correct answer)
Loratadine

Correct answer: Epinephrine

Epinephrine is the first-line treatment for anaphylaxis, rapidly reversing bronchospasm, vasodilation, and other life-threatening effects.

Question 12: Digoxin toxicity is most likely to develop when serum digoxin levels exceed:

0.5 ng/mL
1.0 ng/mL
2.0 ng/mL (Correct answer)
5.0 ng/mL

Correct answer: 2.0 ng/mL

Digoxin toxicity typically occurs at serum levels above 2.0 ng/mL, though hypokalemia can cause toxicity at lower levels.

Question 13: Which of the following is NOT a common side effect of opioid analgesics?

Constipation
Diarrhea (Correct answer)
Respiratory depression
Nausea

Correct answer: Diarrhea

Opioids cause constipation by slowing GI motility, not diarrhea; diarrhea is the opposite of the expected opioid GI effect.

Question 14: A patient on long-term corticosteroid therapy is at greatest risk for which complication?

Hypoglycemia and weight loss
Hyperglycemia and immunosuppression (Correct answer)
Bradycardia and hypotension
Hypokalemia and alkalosis only

Correct answer: Hyperglycemia and immunosuppression

Long-term corticosteroids cause hyperglycemia by increasing gluconeogenesis and immunosuppression by impairing immune cell function.

Question 15: Which action is most important before administering medications through a nasogastric (NG) tube?

Crushing all tablets to a fine powder
Verifying tube placement (Correct answer)
Flushing with 500 mL of water
Warming medications to body temperature

Correct answer: Verifying tube placement

Verifying NG tube placement before medication administration is critical to prevent aspiration or delivery to an unintended anatomical location.

Question 16: The 'five rights' of medication administration include all of the following EXCEPT:

Right patient
Right drug
Right manufacturer (Correct answer)
Right route

Correct answer: Right manufacturer

The five rights are right patient, right drug, right dose, right time, and right route; manufacturer is not a standard right of medication administration.

Question 17: Which type of insulin appears cloudy and should NEVER be administered intravenously?

Regular insulin
Insulin aspart
NPH insulin (Correct answer)
Insulin lispro

Correct answer: NPH insulin

NPH insulin is a suspension that appears cloudy and must never be given IV; only clear insulins such as regular insulin may be administered intravenously.

Question 18: A patient is receiving methotrexate therapy. Which laboratory values are most important to monitor?

Blood glucose and HbA1c
Serum potassium and sodium
Liver function tests and CBC (Correct answer)
Serum calcium and phosphorus

Correct answer: Liver function tests and CBC

Methotrexate is hepatotoxic and myelosuppressive, making liver function tests and complete blood count essential monitoring parameters.

Question 19: Which describes the correct Z-track injection technique?

Insert needle at 45 degrees and aspirate before injecting
Displace skin laterally, insert needle at 90 degrees, inject, then release skin (Correct answer)
Insert needle at 90 degrees without skin displacement and massage afterward
Insert needle at 15 degrees and inject slowly over 2 minutes

Correct answer: Displace skin laterally, insert needle at 90 degrees, inject, then release skin

The Z-track method requires displacing skin laterally before insertion and releasing it after injection to prevent medication from tracking back to the skin surface.

Question 20: A nurse needs to administer 10 mg of morphine IV. The available concentration is 5 mg/mL. How many mL should be administered?

0.5 mL
1 mL
2 mL (Correct answer)
5 mL

Correct answer: 2 mL

Using Dose ÷ Concentration = Volume: 10 mg ÷ 5 mg/mL = 2 mL.

Question 21: Which precaution is most critical when a nurse prepares to administer chemotherapy agents?

Administer only during morning hours when patient metabolism is highest
Wear personal protective equipment including gloves and a protective gown (Correct answer)
Mix agents in an open area to ensure adequate ventilation
Use only peripheral IV lines to avoid central line contamination

Correct answer: Wear personal protective equipment including gloves and a protective gown

Chemotherapy agents are classified as hazardous drugs, requiring PPE including gloves, gown, and eye protection to prevent nurse exposure.

NLE Pharmacology and Medication Management

What term describes the study of how drugs move through the body, including absorption, distribution, metabolism, and excretion?

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