Pharmacology NURS 251 Final
Exam (2026–2027) Portage
Learning / ABC Nursing / Geneva
College | Complete Practice Test
Bank \ PDF
Q1. A patient is prescribed lisinopril. Which finding requires immediate action by the
nurse?
A. Mild headache
B. Persistent dry cough
C. Swelling of lips and tongue 👉 Answer: C
D. Fatigue
Rationale: Angioedema (swelling of lips/tongue) is a life-threatening reaction to ACE
inhibitors like lisinopril. It can block the airway and requires emergency intervention and
discontinuation of the drug.
Q2. A nurse is preparing to administer morphine. Which assessment finding is most
concerning?
A. Respiratory rate of 9 breaths/min 👉 Answer: A
B. Pain score of 8/10
C. Blood pressure 130/80
D. Heart rate 88 bpm
Rationale: Morphine suppresses respiratory drive. A respiratory rate below 10 is unsafe
and the medication must be withheld immediately.
,Q3. A patient is receiving warfarin therapy. Which diet instruction is correct?
A. Avoid all green vegetables
B. Increase protein intake only
C. Keep vitamin K intake consistent 👉 Answer: C
D. Eliminate carbohydrates
Rationale: Vitamin K affects clotting. Patients should not avoid it completely but must
maintain consistent intake to prevent INR fluctuations.
Q4. A nurse is administering furosemide. Which electrolyte imbalance should be
monitored closely?
A. Hyperkalemia
B. Hypokalemia 👉 Answer: B
C. Hypernatremia
D. Hypercalcemia
Rationale: Furosemide causes potassium loss in urine, leading to hypokalemia, which can
trigger dangerous dysrhythmias.
Q5. A patient receiving heparin therapy requires which laboratory monitoring?
A. INR
B. aPTT 👉 Answer: B
C. Blood glucose
D. Platelet antibodies only
Rationale: aPTT is used to monitor heparin effectiveness by assessing clotting time.
Q6. A patient taking digoxin reports nausea and visual changes. What is the priority
action?
A. Give next dose
B. Hold medication and notify provider 👉 Answer: B
,C. Encourage fluids
D. Administer antiemetic
Rationale: These are classic signs of digoxin toxicity. Continuing the drug may lead to fatal
arrhythmias.
Q7. A nurse is administering albuterol. Which side effect is expected?
A. Bradycardia
B. Tremors 👉 Answer: B
C. Constipation
D. Hypotension
Rationale: Albuterol stimulates beta receptors causing tremors, tachycardia, and
nervousness.
Q8. A patient is prescribed metformin. What instruction is most important?
A. Take with alcohol
B. Hold before contrast imaging 👉 Answer: B
C. Take only at bedtime
D. Double dose if glucose rises
Rationale: Metformin must be held before contrast dye due to risk of lactic acidosis,
especially with kidney impairment.
Q9. A nurse is administering vancomycin. Which finding indicates toxicity?
A. Increased appetite
B. Hearing loss 👉 Answer: B
C. Mild rash only
D. Constipation
Rationale: Vancomycin is ototoxic and nephrotoxic; hearing changes are an early sign of
toxicity.
, Q10. A patient on lithium reports diarrhea and vomiting. What does this indicate?
A. Normal adjustment
B. Lithium toxicity 👉 Answer: B
C. Mild dehydration only
D. Anxiety reaction
Rationale: GI symptoms are early signs of lithium toxicity and require immediate
intervention to prevent neurological damage.
Q11. A patient is prescribed nitroglycerin for angina. Which instruction is most
important?
A. Take with grapefruit juice
B. Store in a clear container for access
C. Replace medication after expiration date 👉 Answer: C
D. Chew tablet for faster effect
Rationale: Nitroglycerin loses potency quickly after expiration. It must be replaced regularly.
It should also be stored in its original dark container, not exposed to light or heat.
Q12. A nurse is administering insulin lispro. When should the nurse ensure food is
available?
A. 1 hour after administration
B. 30 minutes before administration
C. At the same time as administration 👉 Answer: C
D. 2 hours after administration
Rationale: Rapid-acting insulin (lispro) begins working immediately. Food must be available
at the same time to prevent hypoglycemia.
Q13. A patient is taking furosemide. Which symptom requires immediate reporting?
Exam (2026–2027) Portage
Learning / ABC Nursing / Geneva
College | Complete Practice Test
Bank \ PDF
Q1. A patient is prescribed lisinopril. Which finding requires immediate action by the
nurse?
A. Mild headache
B. Persistent dry cough
C. Swelling of lips and tongue 👉 Answer: C
D. Fatigue
Rationale: Angioedema (swelling of lips/tongue) is a life-threatening reaction to ACE
inhibitors like lisinopril. It can block the airway and requires emergency intervention and
discontinuation of the drug.
Q2. A nurse is preparing to administer morphine. Which assessment finding is most
concerning?
A. Respiratory rate of 9 breaths/min 👉 Answer: A
B. Pain score of 8/10
C. Blood pressure 130/80
D. Heart rate 88 bpm
Rationale: Morphine suppresses respiratory drive. A respiratory rate below 10 is unsafe
and the medication must be withheld immediately.
,Q3. A patient is receiving warfarin therapy. Which diet instruction is correct?
A. Avoid all green vegetables
B. Increase protein intake only
C. Keep vitamin K intake consistent 👉 Answer: C
D. Eliminate carbohydrates
Rationale: Vitamin K affects clotting. Patients should not avoid it completely but must
maintain consistent intake to prevent INR fluctuations.
Q4. A nurse is administering furosemide. Which electrolyte imbalance should be
monitored closely?
A. Hyperkalemia
B. Hypokalemia 👉 Answer: B
C. Hypernatremia
D. Hypercalcemia
Rationale: Furosemide causes potassium loss in urine, leading to hypokalemia, which can
trigger dangerous dysrhythmias.
Q5. A patient receiving heparin therapy requires which laboratory monitoring?
A. INR
B. aPTT 👉 Answer: B
C. Blood glucose
D. Platelet antibodies only
Rationale: aPTT is used to monitor heparin effectiveness by assessing clotting time.
Q6. A patient taking digoxin reports nausea and visual changes. What is the priority
action?
A. Give next dose
B. Hold medication and notify provider 👉 Answer: B
,C. Encourage fluids
D. Administer antiemetic
Rationale: These are classic signs of digoxin toxicity. Continuing the drug may lead to fatal
arrhythmias.
Q7. A nurse is administering albuterol. Which side effect is expected?
A. Bradycardia
B. Tremors 👉 Answer: B
C. Constipation
D. Hypotension
Rationale: Albuterol stimulates beta receptors causing tremors, tachycardia, and
nervousness.
Q8. A patient is prescribed metformin. What instruction is most important?
A. Take with alcohol
B. Hold before contrast imaging 👉 Answer: B
C. Take only at bedtime
D. Double dose if glucose rises
Rationale: Metformin must be held before contrast dye due to risk of lactic acidosis,
especially with kidney impairment.
Q9. A nurse is administering vancomycin. Which finding indicates toxicity?
A. Increased appetite
B. Hearing loss 👉 Answer: B
C. Mild rash only
D. Constipation
Rationale: Vancomycin is ototoxic and nephrotoxic; hearing changes are an early sign of
toxicity.
, Q10. A patient on lithium reports diarrhea and vomiting. What does this indicate?
A. Normal adjustment
B. Lithium toxicity 👉 Answer: B
C. Mild dehydration only
D. Anxiety reaction
Rationale: GI symptoms are early signs of lithium toxicity and require immediate
intervention to prevent neurological damage.
Q11. A patient is prescribed nitroglycerin for angina. Which instruction is most
important?
A. Take with grapefruit juice
B. Store in a clear container for access
C. Replace medication after expiration date 👉 Answer: C
D. Chew tablet for faster effect
Rationale: Nitroglycerin loses potency quickly after expiration. It must be replaced regularly.
It should also be stored in its original dark container, not exposed to light or heat.
Q12. A nurse is administering insulin lispro. When should the nurse ensure food is
available?
A. 1 hour after administration
B. 30 minutes before administration
C. At the same time as administration 👉 Answer: C
D. 2 hours after administration
Rationale: Rapid-acting insulin (lispro) begins working immediately. Food must be available
at the same time to prevent hypoglycemia.
Q13. A patient is taking furosemide. Which symptom requires immediate reporting?
