NUR 252 Nursing Pharmacology Exam Actual Exam
2026/2027 | Clinical Application | Questions with Verified
Answers | 100% Correct | Pass Guaranteed
Q1: A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding requires immediate intervention before administration?
A. Heart rate 52 bpm
B. Heart rate 48 bpm
C. Blood pressure 140/90 mmHg
D. Respiratory rate 16/min
Correct Answer: B
Rationale: Nursing Process - Assessment: Digoxin has a narrow therapeutic index and
can cause bradycardia. Hold digoxin if HR <60 bpm or <50 bpm per facility policy. 48
bpm is dangerously low and increases toxicity risk.
Mechanism: Digoxin slows AV conduction - excessive bradycardia can lead to heart
block.
Nursing Action: Hold dose, notify provider, monitor ECG.
Q2: The nurse understands that a medication with a narrow therapeutic index means:
A. It has few side effects
B. Small differences in dose or blood level can lead to serious toxicity
C. It can be given without monitoring
D. It has a wide margin of safety
Correct Answer: B
Rationale: Pharmacology Principle: Narrow therapeutic index = small margin between
therapeutic and toxic doses. Requires frequent monitoring (serum levels, clinical
response).
,Examples: Digoxin, warfarin, lithium, phenytoin, aminoglycosides.
Nursing Implication: Double-check doses, monitor levels, assess for toxicity signs.
Q3: A patient asks why some medications must be taken on an empty stomach. The
nurse's best response is:
A. "Food makes medications work faster"
B. "Food can interfere with medication absorption and effectiveness"
C. "It prevents stomach upset"
D. "It's just a preference"
Correct Answer: B
Rationale: Pharmacokinetics: Food can bind to drugs, delay gastric emptying, or
compete for absorption → reduced bioavailability.
Patient Education: Take 1 hour before or 2 hours after meals with full glass of water
unless specified otherwise.
Examples: Levothyroxine, alendronate, tetracyclines.
Q4: A nurse discovers a medication error was made. The FIRST action should be:
A. Complete incident report
B. Assess patient for adverse effects
C. Notify pharmacy
D. Document in chart
Correct Answer: B
Rationale: Nursing Priority: Patient safety first - assess for harm from error. Then notify
provider, implement corrective measures, document, and complete incident report.
System Approach: Focus on preventing future errors, not blame.
Q5: The nurse recognizes that first-pass metabolism affects:
A. All medications equally
B. Oral medications more than IV medications
C. Topical medications most
, D. IM injections more than oral
Correct Answer: B
Rationale: Pharmacokinetics: Oral drugs absorbed from GI tract → portal circulation →
liver metabolism before systemic circulation.
Impact: May require higher oral doses or alternative routes (sublingual, transdermal, IV)
to bypass first-pass effect.
Examples: Nitroglycerin, propranolol, morphine.
Q6: A nurse is teaching about look-alike/sound-alike medications. Which pair requires
special precautions?
A. Metformin and metoprolol
B. Hydralazine and hydroxyzine
C. Lisinopril and levothyroxine
D. Amlodipine and atenolol
Correct Answer: B
Rationale: Medication Safety: Hydralazine (antihypertensive) and hydroxyzine
(antihistamine/anxiolytic) are classic LASA errors with different therapeutic classes.
Prevention: Use TALLman lettering (hydrALAZINE vs. hydrOXYzine), separate storage,
double-check high-alert list.
Q7: When administering medications through a nasogastric tube, the nurse should:
A. Mix all medications together
B. Check tube placement before administration
C. Crush all enteric-coated tablets
D. Administer with carbonated beverages
Correct Answer: B
Rationale: Enteral Administration Safety: Confirm NG tube placement (pH testing, x-ray
confirmation) before administration to prevent aspiration.
2026/2027 | Clinical Application | Questions with Verified
Answers | 100% Correct | Pass Guaranteed
Q1: A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding requires immediate intervention before administration?
A. Heart rate 52 bpm
B. Heart rate 48 bpm
C. Blood pressure 140/90 mmHg
D. Respiratory rate 16/min
Correct Answer: B
Rationale: Nursing Process - Assessment: Digoxin has a narrow therapeutic index and
can cause bradycardia. Hold digoxin if HR <60 bpm or <50 bpm per facility policy. 48
bpm is dangerously low and increases toxicity risk.
Mechanism: Digoxin slows AV conduction - excessive bradycardia can lead to heart
block.
Nursing Action: Hold dose, notify provider, monitor ECG.
Q2: The nurse understands that a medication with a narrow therapeutic index means:
A. It has few side effects
B. Small differences in dose or blood level can lead to serious toxicity
C. It can be given without monitoring
D. It has a wide margin of safety
Correct Answer: B
Rationale: Pharmacology Principle: Narrow therapeutic index = small margin between
therapeutic and toxic doses. Requires frequent monitoring (serum levels, clinical
response).
,Examples: Digoxin, warfarin, lithium, phenytoin, aminoglycosides.
Nursing Implication: Double-check doses, monitor levels, assess for toxicity signs.
Q3: A patient asks why some medications must be taken on an empty stomach. The
nurse's best response is:
A. "Food makes medications work faster"
B. "Food can interfere with medication absorption and effectiveness"
C. "It prevents stomach upset"
D. "It's just a preference"
Correct Answer: B
Rationale: Pharmacokinetics: Food can bind to drugs, delay gastric emptying, or
compete for absorption → reduced bioavailability.
Patient Education: Take 1 hour before or 2 hours after meals with full glass of water
unless specified otherwise.
Examples: Levothyroxine, alendronate, tetracyclines.
Q4: A nurse discovers a medication error was made. The FIRST action should be:
A. Complete incident report
B. Assess patient for adverse effects
C. Notify pharmacy
D. Document in chart
Correct Answer: B
Rationale: Nursing Priority: Patient safety first - assess for harm from error. Then notify
provider, implement corrective measures, document, and complete incident report.
System Approach: Focus on preventing future errors, not blame.
Q5: The nurse recognizes that first-pass metabolism affects:
A. All medications equally
B. Oral medications more than IV medications
C. Topical medications most
, D. IM injections more than oral
Correct Answer: B
Rationale: Pharmacokinetics: Oral drugs absorbed from GI tract → portal circulation →
liver metabolism before systemic circulation.
Impact: May require higher oral doses or alternative routes (sublingual, transdermal, IV)
to bypass first-pass effect.
Examples: Nitroglycerin, propranolol, morphine.
Q6: A nurse is teaching about look-alike/sound-alike medications. Which pair requires
special precautions?
A. Metformin and metoprolol
B. Hydralazine and hydroxyzine
C. Lisinopril and levothyroxine
D. Amlodipine and atenolol
Correct Answer: B
Rationale: Medication Safety: Hydralazine (antihypertensive) and hydroxyzine
(antihistamine/anxiolytic) are classic LASA errors with different therapeutic classes.
Prevention: Use TALLman lettering (hydrALAZINE vs. hydrOXYzine), separate storage,
double-check high-alert list.
Q7: When administering medications through a nasogastric tube, the nurse should:
A. Mix all medications together
B. Check tube placement before administration
C. Crush all enteric-coated tablets
D. Administer with carbonated beverages
Correct Answer: B
Rationale: Enteral Administration Safety: Confirm NG tube placement (pH testing, x-ray
confirmation) before administration to prevent aspiration.
