Saunders NCLEX-RN Pharmacology Exam Questions and
Correct Answers
Question 1
) A client who was started on anticonvulsant therapy with clonazepam (Klonopin) tells the nurse of increasing clumsiness
and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what
to do. The nurse's response is based on the understanding that these symptoms:
1. Usually occur if the client takes the medication with food
2. Are probably the result of an interaction with another medication
3. Indicate that the client is experiencing a severe untoward reaction to the medication
4. Are worse during initial therapy and decrease or disappear with long-term use
Correct Answer
4. Are worse during initial therapy and decrease or disappear with long-term use
Rationale:
Drowsiness, unsteadiness, and clumsiness are expected effects of the medication during early therapy. They are dose
related and usually diminish or disappear altogether with continued use of the medication. It does not indicate that a
severe side effect is occurring. It is also unrelated to interaction with another medication. The client is encouraged to take
this medication with food to minimize gastrointestinal upset.
*Eliminate options 2 and 3 first because they are comparable or alike and because of the word "severe" in option
3*
Page 1 of 228
,Question 2
) A client is being treated for acute congestive heart failure with intravenously administered bumetanide. The vital signs are
as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24 breaths/min. After the initial dose,
which of the following is the priority assessment?
1. Monitoring weight loss
2. Monitoring temperature
3. Monitoring blood pressure
4. Monitoring potassium level
Correct Answer
3. Monitoring blood pressure
Rationale:
Bumetanide is a loop diuretic. Hypotension is a common side effect associated with the use of this medication. The other
options also require assessment but are not the priority.
*priority ABCs—airway, breathing, and circulation*
Page 2 of 228
,Question 3
) Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible
toxic effect related to this medication?
1. Pallor
2. Drowsiness
3. Bradycardia
4. Restlessness
Correct Answer
4. Restlessness
Rationale:
Toxicity (overdosage) of this medication produces central nervous system excitation, such as nervousness, restlessness,
hallucinations, and irritability. Other signs of toxicity include hypotension or hypertension, confusion, tachycardia, flushed
or red face, and signs of respiratory depression. Drowsiness is a frequent side effect of the medication but does not
indicate overdosage.
Page 3 of 228
, Question 4
) A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The
client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding
that:
1. Both are weak potassium-losing diuretics.
2. The combination of these medications prevents renal toxicity.
3. Hydrochlorothiazide is an expensive medication, so using a combination of diuretics is cost-effective.
4. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.
Correct Answer
4. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.
Rationale:
Potassium-sparing diuretics include amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium). They
are weak diuretics that are used in combination with potassium-losing diuretics. This combination is useful when
medication and dietary supplement of potassium is not appropriate. The use of two different diuretics does not prevent
renal toxicity. Hydrochlorothiazide is an effective and inexpensive generic form of the thiazide classification of diuretics.
*It is especially helpful to remember that hydrochlorothiazide is a potassium-losing diuretic and triamterene is a
potassium-sparing diuretic*
Page 4 of 228
Correct Answers
Question 1
) A client who was started on anticonvulsant therapy with clonazepam (Klonopin) tells the nurse of increasing clumsiness
and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what
to do. The nurse's response is based on the understanding that these symptoms:
1. Usually occur if the client takes the medication with food
2. Are probably the result of an interaction with another medication
3. Indicate that the client is experiencing a severe untoward reaction to the medication
4. Are worse during initial therapy and decrease or disappear with long-term use
Correct Answer
4. Are worse during initial therapy and decrease or disappear with long-term use
Rationale:
Drowsiness, unsteadiness, and clumsiness are expected effects of the medication during early therapy. They are dose
related and usually diminish or disappear altogether with continued use of the medication. It does not indicate that a
severe side effect is occurring. It is also unrelated to interaction with another medication. The client is encouraged to take
this medication with food to minimize gastrointestinal upset.
*Eliminate options 2 and 3 first because they are comparable or alike and because of the word "severe" in option
3*
Page 1 of 228
,Question 2
) A client is being treated for acute congestive heart failure with intravenously administered bumetanide. The vital signs are
as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats/min; and respirations, 24 breaths/min. After the initial dose,
which of the following is the priority assessment?
1. Monitoring weight loss
2. Monitoring temperature
3. Monitoring blood pressure
4. Monitoring potassium level
Correct Answer
3. Monitoring blood pressure
Rationale:
Bumetanide is a loop diuretic. Hypotension is a common side effect associated with the use of this medication. The other
options also require assessment but are not the priority.
*priority ABCs—airway, breathing, and circulation*
Page 2 of 228
,Question 3
) Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible
toxic effect related to this medication?
1. Pallor
2. Drowsiness
3. Bradycardia
4. Restlessness
Correct Answer
4. Restlessness
Rationale:
Toxicity (overdosage) of this medication produces central nervous system excitation, such as nervousness, restlessness,
hallucinations, and irritability. Other signs of toxicity include hypotension or hypertension, confusion, tachycardia, flushed
or red face, and signs of respiratory depression. Drowsiness is a frequent side effect of the medication but does not
indicate overdosage.
Page 3 of 228
, Question 4
) A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The
client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding
that:
1. Both are weak potassium-losing diuretics.
2. The combination of these medications prevents renal toxicity.
3. Hydrochlorothiazide is an expensive medication, so using a combination of diuretics is cost-effective.
4. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.
Correct Answer
4. Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.
Rationale:
Potassium-sparing diuretics include amiloride (Midamor), spironolactone (Aldactone), and triamterene (Dyrenium). They
are weak diuretics that are used in combination with potassium-losing diuretics. This combination is useful when
medication and dietary supplement of potassium is not appropriate. The use of two different diuretics does not prevent
renal toxicity. Hydrochlorothiazide is an effective and inexpensive generic form of the thiazide classification of diuretics.
*It is especially helpful to remember that hydrochlorothiazide is a potassium-losing diuretic and triamterene is a
potassium-sparing diuretic*
Page 4 of 228
