Pharmacology Drug Classes, Adverse Effects, and Nursing Interventions
Practice Questions and Answers Updated 2026 | Complete Nursing
Pharmacology Study Guide with Verified Questions, Detailed Rationales,
Major Drug Classifications, Mechanisms of Action, Side Effects, Adverse
Reactions, Contraindications, Medication Safety, Dosage Calculations,
Patient Education & NGN NCLEX-RN/PN Exam Prep
Question 1: Which drug class is primarily used to treat hypertension by blocking
angiotensin II receptors?
A. ACE inhibitors
B. Beta-blockers
C. Calcium channel blockers
D. Angiotensin II receptor blockers (ARBs)
CORRECT ANSWER: D. Angiotensin II receptor blockers (ARBs)
Rationale: ARBs, such as losartan and valsartan, selectively block the binding of
angiotensin II to its type 1 (AT1) receptors, leading to vasodilation and reduced blood
pressure without affecting bradykinin metabolism, unlike ACE inhibitors.
Question 2: A patient taking warfarin should avoid excessive intake of which
vitamin due to its role in clotting factor synthesis?
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin K
CORRECT ANSWER: D. Vitamin K
Rationale: Vitamin K is essential for the hepatic synthesis of clotting factors II, VII, IX,
and X. High intake can counteract the anticoagulant effect of warfarin, increasing the
risk of thromboembolic events.
Question 3: Which adverse effect is most commonly associated with long-term use
of corticosteroids?
A. Hypoglycemia
B. Hyperkalemia
C. Osteoporosis
D. Bradycardia
CORRECT ANSWER: C. Osteoporosis
Rationale: Corticosteroids suppress osteoblast activity, increase calcium excretion,
and reduce intestinal calcium absorption, all contributing to decreased bone density
and increased fracture risk with prolonged use.
Question 4: What is the primary nursing intervention when administering
intravenous vancomycin to prevent “red man syndrome”?
,A. Administer with food
B. Infuse slowly over at least 60 minutes
C. Pre-medicate with acetaminophen
D. Monitor urine output hourly
CORRECT ANSWER: B. Infuse slowly over at least 60 minutes
Rationale: Rapid infusion of vancomycin can cause histamine-mediated flushing,
pruritus, and hypotension known as “red man syndrome.” Slowing the infusion rate
minimizes this reaction.
Question 5: Which medication class is contraindicated in patients with a history of
sulfa allergy?
A. Statins
B. Thiazide diuretics
C. Beta-blockers
D. Opioids
CORRECT ANSWER: B. Thiazide diuretics
Rationale: Many thiazide diuretics (e.g., hydrochlorothiazide) contain a sulfonamide
group and may trigger allergic reactions in individuals with sulfa allergies, including
rash, fever, or anaphylaxis.
Question 6: A patient on metformin develops lactic acidosis. Which condition most
likely contributed to this adverse effect?
A. Hyperthyroidism
B. Renal impairment
C. Hypertension
D. Asthma
CORRECT ANSWER: B. Renal impairment
Rationale: Metformin is excreted unchanged by the kidneys. Impaired renal function
leads to drug accumulation, increasing the risk of lactic acidosis—a rare but life-
threatening complication.
Question 7: Which drug requires regular monitoring of serum levels to ensure
therapeutic efficacy and prevent toxicity?
A. Lisinopril
B. Atorvastatin
C. Digoxin
D. Metoprolol
CORRECT ANSWER: C. Digoxin
, Rationale: Digoxin has a narrow therapeutic index. Serum levels must be monitored to
avoid toxicity, which can manifest as arrhythmias, nausea, visual disturbances, and
confusion.
Question 8: What is the antidote for benzodiazepine overdose?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
CORRECT ANSWER: B. Flumazenil
Rationale: Flumazenil is a competitive antagonist at benzodiazepine receptors and
reverses sedation and respiratory depression caused by benzodiazepine overdose,
though it is used cautiously in chronic users due to seizure risk.
Question 9: Which side effect is most characteristic of typical antipsychotics like
haloperidol?
A. Weight gain
B. Extrapyramidal symptoms (EPS)
C. Sedation
D. Orthostatic hypotension
CORRECT ANSWER: B. Extrapyramidal symptoms (EPS)
Rationale: Typical antipsychotics strongly block dopamine D2 receptors in the
nigrostriatal pathway, leading to EPS such as dystonia, akathisia, parkinsonism, and
tardive dyskinesia.
Question 10: A nurse should assess for which electrolyte imbalance in a patient
receiving furosemide?
A. Hypercalcemia
B. Hypernatremia
C. Hypokalemia
D. Hypomagnesemia
CORRECT ANSWER: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases potassium excretion in the distal
tubule, commonly causing hypokalemia, which can lead to muscle weakness,
arrhythmias, and ECG changes.
Question 11: Which medication is used to reverse opioid-induced respiratory
depression?
A. Atropine
B. Naloxone
Practice Questions and Answers Updated 2026 | Complete Nursing
Pharmacology Study Guide with Verified Questions, Detailed Rationales,
Major Drug Classifications, Mechanisms of Action, Side Effects, Adverse
Reactions, Contraindications, Medication Safety, Dosage Calculations,
Patient Education & NGN NCLEX-RN/PN Exam Prep
Question 1: Which drug class is primarily used to treat hypertension by blocking
angiotensin II receptors?
A. ACE inhibitors
B. Beta-blockers
C. Calcium channel blockers
D. Angiotensin II receptor blockers (ARBs)
CORRECT ANSWER: D. Angiotensin II receptor blockers (ARBs)
Rationale: ARBs, such as losartan and valsartan, selectively block the binding of
angiotensin II to its type 1 (AT1) receptors, leading to vasodilation and reduced blood
pressure without affecting bradykinin metabolism, unlike ACE inhibitors.
Question 2: A patient taking warfarin should avoid excessive intake of which
vitamin due to its role in clotting factor synthesis?
A. Vitamin A
B. Vitamin B12
C. Vitamin C
D. Vitamin K
CORRECT ANSWER: D. Vitamin K
Rationale: Vitamin K is essential for the hepatic synthesis of clotting factors II, VII, IX,
and X. High intake can counteract the anticoagulant effect of warfarin, increasing the
risk of thromboembolic events.
Question 3: Which adverse effect is most commonly associated with long-term use
of corticosteroids?
A. Hypoglycemia
B. Hyperkalemia
C. Osteoporosis
D. Bradycardia
CORRECT ANSWER: C. Osteoporosis
Rationale: Corticosteroids suppress osteoblast activity, increase calcium excretion,
and reduce intestinal calcium absorption, all contributing to decreased bone density
and increased fracture risk with prolonged use.
Question 4: What is the primary nursing intervention when administering
intravenous vancomycin to prevent “red man syndrome”?
,A. Administer with food
B. Infuse slowly over at least 60 minutes
C. Pre-medicate with acetaminophen
D. Monitor urine output hourly
CORRECT ANSWER: B. Infuse slowly over at least 60 minutes
Rationale: Rapid infusion of vancomycin can cause histamine-mediated flushing,
pruritus, and hypotension known as “red man syndrome.” Slowing the infusion rate
minimizes this reaction.
Question 5: Which medication class is contraindicated in patients with a history of
sulfa allergy?
A. Statins
B. Thiazide diuretics
C. Beta-blockers
D. Opioids
CORRECT ANSWER: B. Thiazide diuretics
Rationale: Many thiazide diuretics (e.g., hydrochlorothiazide) contain a sulfonamide
group and may trigger allergic reactions in individuals with sulfa allergies, including
rash, fever, or anaphylaxis.
Question 6: A patient on metformin develops lactic acidosis. Which condition most
likely contributed to this adverse effect?
A. Hyperthyroidism
B. Renal impairment
C. Hypertension
D. Asthma
CORRECT ANSWER: B. Renal impairment
Rationale: Metformin is excreted unchanged by the kidneys. Impaired renal function
leads to drug accumulation, increasing the risk of lactic acidosis—a rare but life-
threatening complication.
Question 7: Which drug requires regular monitoring of serum levels to ensure
therapeutic efficacy and prevent toxicity?
A. Lisinopril
B. Atorvastatin
C. Digoxin
D. Metoprolol
CORRECT ANSWER: C. Digoxin
, Rationale: Digoxin has a narrow therapeutic index. Serum levels must be monitored to
avoid toxicity, which can manifest as arrhythmias, nausea, visual disturbances, and
confusion.
Question 8: What is the antidote for benzodiazepine overdose?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
CORRECT ANSWER: B. Flumazenil
Rationale: Flumazenil is a competitive antagonist at benzodiazepine receptors and
reverses sedation and respiratory depression caused by benzodiazepine overdose,
though it is used cautiously in chronic users due to seizure risk.
Question 9: Which side effect is most characteristic of typical antipsychotics like
haloperidol?
A. Weight gain
B. Extrapyramidal symptoms (EPS)
C. Sedation
D. Orthostatic hypotension
CORRECT ANSWER: B. Extrapyramidal symptoms (EPS)
Rationale: Typical antipsychotics strongly block dopamine D2 receptors in the
nigrostriatal pathway, leading to EPS such as dystonia, akathisia, parkinsonism, and
tardive dyskinesia.
Question 10: A nurse should assess for which electrolyte imbalance in a patient
receiving furosemide?
A. Hypercalcemia
B. Hypernatremia
C. Hypokalemia
D. Hypomagnesemia
CORRECT ANSWER: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases potassium excretion in the distal
tubule, commonly causing hypokalemia, which can lead to muscle weakness,
arrhythmias, and ECG changes.
Question 11: Which medication is used to reverse opioid-induced respiratory
depression?
A. Atropine
B. Naloxone
