NCLEX Pharmacology, 70 Essential Practice Questions & Rationales NCLEX GUIDES with 100% CORRECT ANSWERS

NCLEX Pharmacology, 70 Essential Practice Questions &
Rationales NCLEX GUIDES with 100% CORRECT
ANSWERS


1. A nurse is preparing to administer Digoxin to a patient. Which clinical finding
would require the nurse to withhold the medication and notify the provider?

 A. Blood pressure of 110/70 mmHg
 B. Respiratory rate of 18 breaths/min
 C. Apical pulse of 52 beats/min
 D. Potassium level of 4.5 mEq/L
 Correct Answer: C
 Rationale: Digoxin is a cardiac glycoside that decreases the heart rate. It is standard
practice to withhold the dose if the apical pulse is less than 60 bpm in adults to prevent
bradycardia.

2. Which medication is considered the gold standard for the immediate reversal of
benzodiazepine-induced sedation?

 A. Naloxone
 B. Flumazenil
 C. Acetyl cysteine
 D. Protamine sulfate
 Correct Answer: B
 Rationale: Flumazenil is a competitive benzodiazepine receptor antagonist. Naloxone is
for opioids; Acetyl cysteine is for acetaminophen; Protamine sulfate is for heparin.

3. A patient with a history of heart failure is prescribed Spironolactone. Which dietary
choice indicates the patient needs further teaching?

 A. Using a salt substitute to season meals
 B. Eating apples instead of oranges
 C. Limiting intake of leafy greens
 D. Increasing fluid intake to 3L per day
 Correct Answer: A
 Rationale: Spironolactone is a potassium-sparing diuretic. Salt substitutes often contain
potassium chloride instead of sodium chloride, which puts the patient at risk for life-
threatening hyperkalemia.

4. A patient receiving a Vancomycin infusion reports feeling flushed and has a visible
red rash on the face and neck. What is the nurse's priority action?

 A. Administer IM epinephrine immediately

, B. Stop the infusion and notify the rapid response team
 C. Slow the rate of the infusion
 D. Apply cold compresses to the affected area
 Correct Answer: C
 Rationale: This describes "Red Man Syndrome," which is a rate-related reaction, not a
true allergy. Slowing the infusion rate typically resolves the symptoms.

5. A patient is prescribed Rifampin for the treatment of Tuberculosis. Which
statement by the patient indicates an understanding of the medication?

 A. "I will stop taking the medicine when my cough goes away."
 B. "I should expect my sweat and urine to turn an orange-red color."
 C. "I will take this medicine with a high-fat meal to increase absorption."
 D. "This medication will help prevent the spread of the virus to my family."
 Correct Answer: B
 Rationale: Rifampin causes a harmless reddish-orange discoloration of body fluids.
Tuberculosis is bacterial, not viral, and therapy must be long-term (6–9 months).

6. Which laboratory value must be monitored most closely for a patient taking
Enoxaparin?

 A. aPTT
 B. Prothrombin Time (PT)
 C. Platelet count
 D. International Normalized Ratio (INR)
 Correct Answer: C
 Rationale: Enoxaparin is a low-molecular-weight heparin. The primary concern is
Heparin-Induced Thrombocytopenia (HIT); therefore, platelets are monitored. Unlike
unfractionated heparin, it does not require routine aPTT monitoring.

7. A nurse is teaching a patient about a new prescription for Alendronate. Which
instruction is essential for safety?

 A. Take the medication right before going to bed
 B. Take the medication with a full glass of milk
 C. Sit upright for 30 minutes after administration
 D. Chew the tablet thoroughly before swallowing
 Correct Answer: C
 Rationale: Alendronate (a bisphosphonate) can cause severe esophageal erosion. Staying
upright and taking it with water on an empty stomach ensures the pill reaches the
stomach quickly.

8. A patient with Type 2 Diabetes is prescribed Metformin. Which diagnostic test
would require the nurse to hold this medication for 48 hours?

 A. Chest X-ray

,  B. CT scan with intravenous contrast
 C. Electrocardiogram (ECG)
 D. Ultrasound of the abdomen
 Correct Answer: B
 Rationale: The combination of Metformin and iodine-based contrast dye can cause acute
renal failure and lactic acidosis.

9. What is the primary therapeutic effect of Filgrastim?

 A. Increased Red Blood Cell (RBC) production
 B. Increased White Blood Cell (WBC) production
 C. Decreased blood viscosity
 D. Prevention of platelet aggregation
 Correct Answer: B
 Rationale: Filgrastim is a colony-stimulating factor that stimulates the bone marrow to
produce neutrophils, reducing the risk of infection in immunocompromised patients.

10. A patient is taking Lithium for Bipolar Disorder. Which behavior increases the risk
of Lithium toxicity?

 A. Drinking 2 liters of water daily
 B. Increasing sodium intake
 C. Participating in a hot yoga class and sweating profusely
 D. Taking the medication with food
 Correct Answer: C
 Rationale: Lithium is a salt. Dehydration and sodium depletion (through sweat or
diuretics) cause the kidneys to reabsorb lithium, leading to toxic levels.

11. A patient is receiving an infusion of Magnesium Sulfate for preeclampsia. Which
assessment finding is an early sign of toxicity?

 A. Hyperreflexia
 B. Increased urine output
 C. Diminished deep tendon reflexes
 D. Rapid respiratory rate
 Correct Answer: C
 Rationale: Loss of deep tendon reflexes (DTRs) is a classic early sign of magnesium
toxicity, followed by respiratory depression and cardiac arrest.

12. Which medication is the drug of choice for a patient experiencing Status
Epilepticus?

 A. Phenytoin
 B. Valproic Acid
 C. Lorazepam
 D. Ethosuximide