Drugs that have a significant first-pass effect:

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NCLEX PN Pharmacology Questions Questions

Question 1 of 9

Drugs that have a significant first-pass effect:

Correct Answer: C

Rationale: Choice C is correct because drugs with a significant first-pass effect undergo extensive liver metabolism after oral administration, reducing bioavailability and often leaving minimal active drug for systemic effects. Choice A is incorrect as these drugs can be given IV to avoid first-pass metabolism, not just orally. Choice B is wrong because they pass through hepatic circulation, not bypass it. Choice D is incorrect since first-pass typically inactivates drugs, not converts them to more active forms.

Question 2 of 9

Drugs that are known to cause fetal harm include:

Correct Answer: C

Rationale: Choice C is correct because thalidomide is a known teratogen, causing severe limb defects, historically proven to harm fetuses, unlike the others. Choice A is incorrect as fluoxetine (Category C) has risks but isn't definitively harmful like thalidomide. Choice B is wrong because acetaminophen (Category B) lacks evidence of fetal harm. Choice D is incorrect since only thalidomide is a clear example.

Question 3 of 9

Drugs that are receptor antagonists, such as beta blockers, demonstrate what property?

Correct Answer: C

Rationale: Choice C is correct because receptor antagonists, like beta blockers, block agonist effects, partially inhibiting their action without activating the receptor themselves. Choice A is incorrect as downregulation isn't typical; antagonists may cause upregulation. Choice B is wrong because abrupt discontinuation may cause rebound effects, but it's not their defining property. Choice D is incorrect since antagonists reduce, not exaggerate, responses to agonists.

Question 4 of 9

A patient who has HIV is being treated with Emtriva. The patient develops hepatitis B. The primary care NP should contact the patient's infectious disease specialist to discuss:

Correct Answer: B

Rationale: The correct answer is B because Truvada (Emtriva + tenofovir) treats both HIV and hepatitis B effectively. Choice A is incorrect (zidovudine not for hepatitis B). Choice C is wrong (tenofovir alone insufficient). Choice D is inaccurate (Combivir unnecessary).

Question 5 of 9

When prescribing TMP/SMX to children, the primary care NP should recall that:

Correct Answer: A

Rationale: The correct answer is A because TMP/SMX dosing in children uses the trimethoprim component. Choice B is incorrect (safe over 2 months). Choice C is wrong (folic acid not required). Choice D is inaccurate (twice daily sufficient).

Question 6 of 9

When prescribing TMP/SMX to children, the primary care NP should recall that:

Correct Answer: A

Rationale: The correct answer is A because TMP/SMX dosing in children uses the trimethoprim component. Choice B is incorrect (safe over 2 months). Choice C is wrong (folic acid not required). Choice D is inaccurate (twice daily sufficient).

Question 7 of 9

Drugs that may cause dependence include:

Correct Answer: D

Rationale: Choice D is correct because benzodiazepines (sedative dependence), opioids (physical addiction), and nicotine (psychological craving) all lead to dependence, per DSM-5 criteria. Choice A is incorrect alone as it's one class. Choice B is wrong by itself because opioids are just part. Choice C is incorrect solo since nicotine is only one substance.

Question 8 of 9

Which medication could potentially cause more errors due to its name?

Correct Answer: D

Rationale: Choice D is correct because Zyprexa (olanzapine) is often confused with similar-sounding drugs like Zyrtec or Zantac in busy settings, per error reports, increasing risk. Choice A is incorrect as Zyrtec (cetirizine) is distinct in allergy contexts. Choice B is wrong because Zantac (ranitidine) is less confused with Zyprexa. Choice C is incorrect since Zocor (simvastatin) aligns with lipids, reducing mix-up.

Question 9 of 9

A patient receives a hepatitis A vaccine and 4 weeks later develops symptoms of hepatitis. The patient has no history of exposure to blood or body fluids. The primary care NP should tell the patient that:

Correct Answer: C

Rationale: The correct answer is C because hepatitis A’s long incubation (15-50 days) means pre-vaccine exposure could cause symptoms. Choice A is incorrect (no exposure history). Choice B is wrong (vaccine side effects mild). Choice D is inaccurate (first dose effective).

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