NUR 252 Nursing Pharmacology Exam Actual Exam
2026/2027 | Clinical Application | Questions with Verified
Answers | 100% Correct | Pass Guaranteed
SECTION 1: Pharmacology Foundations & Safety
Competency Focus: Medication administration, pharmacokinetics, rights, high-alert
safety
Q1 A nurse is preparing a high-alert medication (insulin IV). The first safety action is:
A. Check the drug in the Pyxis
B. Perform an independent double-check with another nurse
C. Verify the MAR
D. Ask the patient’s allergy history
Correct Answer: B
Rationale: Nursing Process – Implementation: High-alert medications require
independent double-check per Joint Commission and hospital policy to prevent
life-threatening errors.
Safety Steps: Two licensed nurses verify dose, concentration, route, patient, pump
settings.
Common Error: Skipping double-check due to time pressure.
,Q2 A patient asks why a sublingual tablet works faster than a swallowed tablet. The
nurse replies:
A. “It dissolves better in saliva.”
B. “It bypasses the liver’s first-pass metabolism and enters the bloodstream directly.”
C. “The stomach absorbs it faster.”
D. “It is metabolized quicker.”
Correct Answer: B
Rationale: Pharmacokinetics – Absorption: Sublingual route allows direct venous
drainage into superior vena cava, avoiding hepatic first-pass metabolism → rapid onset.
Patient Education: Do not swallow tablet; keep under tongue until dissolved.
Q3 The provider writes a sliding-scale insulin order. The nurse understands this is based
on:
A. Patient’s weight
B. Current blood glucose level
C. Carbohydrate intake
D. HbA1c value
Correct Answer: B
Rationale: Medication Administration: Sliding scale adjusts short/rapid-acting insulin
dose according to pre-meal finger-stick glucose.
, Nursing Action: Check blood sugar before each dose; document result and dose given.
Q4 A nurse notes “Do not crush” on an extended-release tablet. The reason is:
A. It tastes bitter
B. Crushing destroys the extended-release matrix, causing dose dumping and toxicity
C. It will dissolve too slowly
D. It becomes less effective
Correct Answer: B
Rationale: Drug Formulation: Extended-release (ER) tablets use matrix or coating to
dissolve slowly; crushing releases entire dose immediately → toxicity, hypotension, or
respiratory depression depending on drug.
Safe Practice: Use liquid formulation or immediate-release equivalent if swallowing
impaired; obtain pharmacy approval.
Q5 A patient on warfarin has an INR of 5.8 (target 2–3). The nurse anticipates:
A. Increase warfarin dose
B. Hold warfarin and notify provider; consider vitamin K per protocol
C. Give aspirin
D. Switch to heparin
Correct Answer: B
2026/2027 | Clinical Application | Questions with Verified
Answers | 100% Correct | Pass Guaranteed
SECTION 1: Pharmacology Foundations & Safety
Competency Focus: Medication administration, pharmacokinetics, rights, high-alert
safety
Q1 A nurse is preparing a high-alert medication (insulin IV). The first safety action is:
A. Check the drug in the Pyxis
B. Perform an independent double-check with another nurse
C. Verify the MAR
D. Ask the patient’s allergy history
Correct Answer: B
Rationale: Nursing Process – Implementation: High-alert medications require
independent double-check per Joint Commission and hospital policy to prevent
life-threatening errors.
Safety Steps: Two licensed nurses verify dose, concentration, route, patient, pump
settings.
Common Error: Skipping double-check due to time pressure.
,Q2 A patient asks why a sublingual tablet works faster than a swallowed tablet. The
nurse replies:
A. “It dissolves better in saliva.”
B. “It bypasses the liver’s first-pass metabolism and enters the bloodstream directly.”
C. “The stomach absorbs it faster.”
D. “It is metabolized quicker.”
Correct Answer: B
Rationale: Pharmacokinetics – Absorption: Sublingual route allows direct venous
drainage into superior vena cava, avoiding hepatic first-pass metabolism → rapid onset.
Patient Education: Do not swallow tablet; keep under tongue until dissolved.
Q3 The provider writes a sliding-scale insulin order. The nurse understands this is based
on:
A. Patient’s weight
B. Current blood glucose level
C. Carbohydrate intake
D. HbA1c value
Correct Answer: B
Rationale: Medication Administration: Sliding scale adjusts short/rapid-acting insulin
dose according to pre-meal finger-stick glucose.
, Nursing Action: Check blood sugar before each dose; document result and dose given.
Q4 A nurse notes “Do not crush” on an extended-release tablet. The reason is:
A. It tastes bitter
B. Crushing destroys the extended-release matrix, causing dose dumping and toxicity
C. It will dissolve too slowly
D. It becomes less effective
Correct Answer: B
Rationale: Drug Formulation: Extended-release (ER) tablets use matrix or coating to
dissolve slowly; crushing releases entire dose immediately → toxicity, hypotension, or
respiratory depression depending on drug.
Safe Practice: Use liquid formulation or immediate-release equivalent if swallowing
impaired; obtain pharmacy approval.
Q5 A patient on warfarin has an INR of 5.8 (target 2–3). The nurse anticipates:
A. Increase warfarin dose
B. Hold warfarin and notify provider; consider vitamin K per protocol
C. Give aspirin
D. Switch to heparin
Correct Answer: B
