RELIAS RN PHARMACOLOGY EXAM BANK:
REGISTERED NURSE PHARMACOLOGY
COMPETENCY ASSESSMENT, (LATEST
2026/2027 UPDATE), WITH
CORRECT/ACCURATE ANSWERS
RELIAS RN PHARMACOLOGY EXAM BANK:
REGISTERED NURSE PHARMACOLOGY
COMPETENCY ASSESSMENT
1. The nurse reviews the Six Rights of medication administration before giving a drug. Which option is
NOT considered one of the Six Rights?
A. Right patient
B. Right medication
C. Right documentation
D. Right pharmacy
Correct Answer: D. Right pharmacy
Rationale: The Six Rights include right patient, right medication, right dose, right route, right time, and right
documentation. These principles form the foundation of medication safety and error prevention in nursing
practice. While pharmacies play a critical role in medication safety, “right pharmacy” is not part of the Six
Rights framework. Adhering consistently to the Six Rights significantly reduces preventable medication
errors and promotes patient safety.
2. A patient is prescribed warfarin (Coumadin). Which laboratory value is most important for the
nurse to monitor routinely?
A. Serum creatinine
B. International Normalized Ratio (INR)
C. Hemoglobin A1c
D. Alanine aminotransferase (ALT)
Correct Answer: B. International Normalized Ratio (INR)
Rationale: Warfarin works by inhibiting vitamin K–dependent clotting factors, which prolongs blood
clotting time. The INR standardizes prothrombin time results and guides safe dosing. Maintaining the INR
,within the therapeutic range (commonly 2.0–3.0) balances the risk of thrombosis and bleeding. Frequent
monitoring is essential because warfarin has many food and drug interactions.
3. The nurse administers insulin aspart (NovoLog). Which statement accurately describes this
medication?
A. It is a long-acting insulin given once daily
B. It should be administered 30 minutes before meals
C. It is a rapid-acting insulin given immediately before meals
D. It has a duration of action lasting 24 hours
Correct Answer: C. It is a rapid-acting insulin given immediately before meals
Rationale: Insulin aspart is a rapid-acting insulin analog designed to control postprandial glucose levels. It
begins working within 10–20 minutes and peaks quickly. Administering it just before meals helps match
insulin action with carbohydrate absorption. Incorrect timing increases the risk of hypoglycemia or
hyperglycemia.
4. A patient receiving morphine sulfate has a respiratory rate of 8 breaths/min and reports dizziness.
What is the nurse’s priority action?
A. Encourage deep breathing exercises
B. Document findings in the medical record
C. Increase IV fluids
D. Administer naloxone per protocol
Correct Answer: D. Administer naloxone per protocol
Rationale: A respiratory rate below 10 breaths per minute indicates opioid-induced respiratory depression.
Naloxone rapidly reverses opioid effects and is a life-saving intervention. Delaying treatment could result in
hypoxia or cardiac arrest. Continuous monitoring is required after administration because naloxone’s
duration may be shorter than the opioid.
5. Which medication must be protected from light during IV administration?
A. Furosemide
B. Nitroprusside (Nitropress)
C. Metoprolol
D. Levothyroxine
Correct Answer: B. Nitroprusside (Nitropress)
Rationale: Nitroprusside is highly light-sensitive and degrades when exposed to light. Degradation can lead
to the formation of toxic byproducts such as cyanide. Using opaque coverings protects medication integrity
and patient safety. This drug is classified as high-alert and requires close monitoring.
, 6. When administering subcutaneous enoxaparin (Lovenox), which nursing action is appropriate?
A. Aspirate before injection
B. Massage the injection site afterward
C. Pinch the skin and inject at a 90-degree angle
D. Use a large-bore needle
Correct Answer: C. Pinch the skin and inject at a 90-degree angle
Rationale: Enoxaparin is injected into subcutaneous tissue, usually in the abdomen. Pinching the skin
ensures proper placement into fatty tissue. Aspirating or massaging increases the risk of bruising and
bleeding. Proper technique reduces complications and ensures accurate dosing.
7. A patient taking metformin (Glucophage) should discontinue the medication before which
procedure?
A. Colonoscopy
B. Dental cleaning
C. CT scan with IV contrast
D. Echocardiogram
Correct Answer: C. CT scan with IV contrast
Rationale: Iodinated contrast media can impair kidney function, increasing the risk of lactic acidosis in
patients taking metformin. Temporarily discontinuing metformin reduces this risk. Renal function should be
assessed before restarting the medication. Patient education is essential to prevent serious adverse outcomes.
8. Which medication is classified as a high-alert drug requiring independent double-checks before
administration?
A. Acetaminophen
B. Insulin
C. Amoxicillin
D. Diphenhydramine
Correct Answer: B. Insulin
Rationale: Insulin has a narrow therapeutic range and dosing errors can cause severe hypoglycemia or
hyperglycemia. Independent double-checks reduce the likelihood of calculation and administration errors.
High-alert medications require heightened safety measures. Proper labeling and patient monitoring are
critical components of safe insulin administration.
9. A nurse teaches a patient about nitroglycerin tablets. Which statement indicates correct
understanding?
REGISTERED NURSE PHARMACOLOGY
COMPETENCY ASSESSMENT, (LATEST
2026/2027 UPDATE), WITH
CORRECT/ACCURATE ANSWERS
RELIAS RN PHARMACOLOGY EXAM BANK:
REGISTERED NURSE PHARMACOLOGY
COMPETENCY ASSESSMENT
1. The nurse reviews the Six Rights of medication administration before giving a drug. Which option is
NOT considered one of the Six Rights?
A. Right patient
B. Right medication
C. Right documentation
D. Right pharmacy
Correct Answer: D. Right pharmacy
Rationale: The Six Rights include right patient, right medication, right dose, right route, right time, and right
documentation. These principles form the foundation of medication safety and error prevention in nursing
practice. While pharmacies play a critical role in medication safety, “right pharmacy” is not part of the Six
Rights framework. Adhering consistently to the Six Rights significantly reduces preventable medication
errors and promotes patient safety.
2. A patient is prescribed warfarin (Coumadin). Which laboratory value is most important for the
nurse to monitor routinely?
A. Serum creatinine
B. International Normalized Ratio (INR)
C. Hemoglobin A1c
D. Alanine aminotransferase (ALT)
Correct Answer: B. International Normalized Ratio (INR)
Rationale: Warfarin works by inhibiting vitamin K–dependent clotting factors, which prolongs blood
clotting time. The INR standardizes prothrombin time results and guides safe dosing. Maintaining the INR
,within the therapeutic range (commonly 2.0–3.0) balances the risk of thrombosis and bleeding. Frequent
monitoring is essential because warfarin has many food and drug interactions.
3. The nurse administers insulin aspart (NovoLog). Which statement accurately describes this
medication?
A. It is a long-acting insulin given once daily
B. It should be administered 30 minutes before meals
C. It is a rapid-acting insulin given immediately before meals
D. It has a duration of action lasting 24 hours
Correct Answer: C. It is a rapid-acting insulin given immediately before meals
Rationale: Insulin aspart is a rapid-acting insulin analog designed to control postprandial glucose levels. It
begins working within 10–20 minutes and peaks quickly. Administering it just before meals helps match
insulin action with carbohydrate absorption. Incorrect timing increases the risk of hypoglycemia or
hyperglycemia.
4. A patient receiving morphine sulfate has a respiratory rate of 8 breaths/min and reports dizziness.
What is the nurse’s priority action?
A. Encourage deep breathing exercises
B. Document findings in the medical record
C. Increase IV fluids
D. Administer naloxone per protocol
Correct Answer: D. Administer naloxone per protocol
Rationale: A respiratory rate below 10 breaths per minute indicates opioid-induced respiratory depression.
Naloxone rapidly reverses opioid effects and is a life-saving intervention. Delaying treatment could result in
hypoxia or cardiac arrest. Continuous monitoring is required after administration because naloxone’s
duration may be shorter than the opioid.
5. Which medication must be protected from light during IV administration?
A. Furosemide
B. Nitroprusside (Nitropress)
C. Metoprolol
D. Levothyroxine
Correct Answer: B. Nitroprusside (Nitropress)
Rationale: Nitroprusside is highly light-sensitive and degrades when exposed to light. Degradation can lead
to the formation of toxic byproducts such as cyanide. Using opaque coverings protects medication integrity
and patient safety. This drug is classified as high-alert and requires close monitoring.
, 6. When administering subcutaneous enoxaparin (Lovenox), which nursing action is appropriate?
A. Aspirate before injection
B. Massage the injection site afterward
C. Pinch the skin and inject at a 90-degree angle
D. Use a large-bore needle
Correct Answer: C. Pinch the skin and inject at a 90-degree angle
Rationale: Enoxaparin is injected into subcutaneous tissue, usually in the abdomen. Pinching the skin
ensures proper placement into fatty tissue. Aspirating or massaging increases the risk of bruising and
bleeding. Proper technique reduces complications and ensures accurate dosing.
7. A patient taking metformin (Glucophage) should discontinue the medication before which
procedure?
A. Colonoscopy
B. Dental cleaning
C. CT scan with IV contrast
D. Echocardiogram
Correct Answer: C. CT scan with IV contrast
Rationale: Iodinated contrast media can impair kidney function, increasing the risk of lactic acidosis in
patients taking metformin. Temporarily discontinuing metformin reduces this risk. Renal function should be
assessed before restarting the medication. Patient education is essential to prevent serious adverse outcomes.
8. Which medication is classified as a high-alert drug requiring independent double-checks before
administration?
A. Acetaminophen
B. Insulin
C. Amoxicillin
D. Diphenhydramine
Correct Answer: B. Insulin
Rationale: Insulin has a narrow therapeutic range and dosing errors can cause severe hypoglycemia or
hyperglycemia. Independent double-checks reduce the likelihood of calculation and administration errors.
High-alert medications require heightened safety measures. Proper labeling and patient monitoring are
critical components of safe insulin administration.
9. A nurse teaches a patient about nitroglycerin tablets. Which statement indicates correct
understanding?
