1
Saunders Pharmacology NCLEX-RN Practice
Exam – 260 Questions with Rationales |
Comprehensive Review 9th Edition | Updated for
2026
SAUNDERS ULTIMATE PHARMACOLOGY – NCLEX-RN
TABLE OF CONTENTS
Section 1: Medication Administration and Safety Questions 1 to 30
Section 2: Dosage Calculations Questions 31 to 50
Section 3: Cardiovascular Pharmacology Questions 51 to 85
Section 4: Respiratory Pharmacology Questions 86 to 105
Section 5: Endocrine Pharmacology Questions 106 to 130
Section 6: Neurologic and Psychiatric Pharmacology Questions 131 to 165
Section 7: Anti-Infective and Immunologic Pharmacology Questions 166 to
195
Section 8: Gastrointestinal and Renal Pharmacology Questions 196 to 220
Section 9: Chemotherapy and Special Populations Questions 221 to 240
Section 10: Mixed Review and NGN-Style Pharmacology Questions 241 to
260
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SECTION 1: MEDICATION ADMINISTRATION AND SAFETY
QUESTIONS 1 TO 30
Question 1
A nurse is preparing to administer morning medications. Which action best
satisfies the right patient principle of safe medication administration?
A. Ask the patient What is your name and match to the medication
administration record.
B. Check the patient's identification band and compare the name and birth
date to the medication administration record.
C. Verify the medication with the nurse who handed it to you earlier.
D. Ask the patient to state the name of their medication before giving it.
Correct Answer: B
Rationale: Checking the identification band against the medication
administration record using two patient identifiers such as name and birth
date is the standard method to confirm the right patient and reduce error.
Asking the patient name alone is insufficient because patients may be
confused or nonverbal. Verbal transfer between clinicians can propagate
errors. Patient self-report is a helpful adjunct but not a primary identifier
because patients may be disoriented or unable to respond.
Question 2
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A nurse prepares to give a new oral medication to a confused older adult
who is unable to swallow. The medication is available only as an
immediate-release tablet. Which action should the nurse take?
A. Crush the tablet and administer it with applesauce.
B. Request an alternative form such as liquid or hold the medication and
notify the prescriber.
C. Hold the medication indefinitely without documentation.
D. Administer the tablet via enteral tube without checking tube placement
because the patient is NPO.
Correct Answer: B
Rationale: The nurse should request an alternative form such as liquid,
consult pharmacy, or contact the prescriber to change formulation or route.
This follows the rights of medication administration and prevents an unsafe
practice. Crushing a medication may be inappropriate for enteric-coated or
extended-release formulations and can alter absorption and safety. Holding
without documentation and without notifying the prescriber is unsafe and
violates accountability. Administering without verifying tube placement
risks aspiration or pneumothorax.
Question 3
A nurse discovers a near-miss medication error where the wrong dose was
prepared but not administered. What is the best immediate action?
A. Discard the prepared medication and document the incident.
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B. Complete an incident report and notify the charge nurse.
C. Administer the correct dose and document that the error was caught.
D. Discuss the error with the patient and apologize for the mistake.
Correct Answer: A
Rationale: The nurse should discard the incorrectly prepared medication and
document the near-miss incident. Incident reports help identify system
issues and prevent future errors. Completing an incident report is
appropriate but the immediate action is to discard the wrong medication and
prepare the correct dose. Administering the correct dose is the goal but the
nurse must discard the wrong dose first. Discussing the error with the
patient is not necessary for a near-miss that was caught before
administration.
Question 4
Which strategy most effectively reduces medication errors when
administering high-alert medications such as heparin or insulin?
A. Rely on memory for dosage calculations.
B. Use independent double-check with another licensed nurse.
C. Administer the medication quickly to avoid interruptions.
D. Document the administration after the shift ends.
Correct Answer: B
Saunders Pharmacology NCLEX-RN Practice
Exam – 260 Questions with Rationales |
Comprehensive Review 9th Edition | Updated for
2026
SAUNDERS ULTIMATE PHARMACOLOGY – NCLEX-RN
TABLE OF CONTENTS
Section 1: Medication Administration and Safety Questions 1 to 30
Section 2: Dosage Calculations Questions 31 to 50
Section 3: Cardiovascular Pharmacology Questions 51 to 85
Section 4: Respiratory Pharmacology Questions 86 to 105
Section 5: Endocrine Pharmacology Questions 106 to 130
Section 6: Neurologic and Psychiatric Pharmacology Questions 131 to 165
Section 7: Anti-Infective and Immunologic Pharmacology Questions 166 to
195
Section 8: Gastrointestinal and Renal Pharmacology Questions 196 to 220
Section 9: Chemotherapy and Special Populations Questions 221 to 240
Section 10: Mixed Review and NGN-Style Pharmacology Questions 241 to
260
, 2
SECTION 1: MEDICATION ADMINISTRATION AND SAFETY
QUESTIONS 1 TO 30
Question 1
A nurse is preparing to administer morning medications. Which action best
satisfies the right patient principle of safe medication administration?
A. Ask the patient What is your name and match to the medication
administration record.
B. Check the patient's identification band and compare the name and birth
date to the medication administration record.
C. Verify the medication with the nurse who handed it to you earlier.
D. Ask the patient to state the name of their medication before giving it.
Correct Answer: B
Rationale: Checking the identification band against the medication
administration record using two patient identifiers such as name and birth
date is the standard method to confirm the right patient and reduce error.
Asking the patient name alone is insufficient because patients may be
confused or nonverbal. Verbal transfer between clinicians can propagate
errors. Patient self-report is a helpful adjunct but not a primary identifier
because patients may be disoriented or unable to respond.
Question 2
, 3
A nurse prepares to give a new oral medication to a confused older adult
who is unable to swallow. The medication is available only as an
immediate-release tablet. Which action should the nurse take?
A. Crush the tablet and administer it with applesauce.
B. Request an alternative form such as liquid or hold the medication and
notify the prescriber.
C. Hold the medication indefinitely without documentation.
D. Administer the tablet via enteral tube without checking tube placement
because the patient is NPO.
Correct Answer: B
Rationale: The nurse should request an alternative form such as liquid,
consult pharmacy, or contact the prescriber to change formulation or route.
This follows the rights of medication administration and prevents an unsafe
practice. Crushing a medication may be inappropriate for enteric-coated or
extended-release formulations and can alter absorption and safety. Holding
without documentation and without notifying the prescriber is unsafe and
violates accountability. Administering without verifying tube placement
risks aspiration or pneumothorax.
Question 3
A nurse discovers a near-miss medication error where the wrong dose was
prepared but not administered. What is the best immediate action?
A. Discard the prepared medication and document the incident.
, 4
B. Complete an incident report and notify the charge nurse.
C. Administer the correct dose and document that the error was caught.
D. Discuss the error with the patient and apologize for the mistake.
Correct Answer: A
Rationale: The nurse should discard the incorrectly prepared medication and
document the near-miss incident. Incident reports help identify system
issues and prevent future errors. Completing an incident report is
appropriate but the immediate action is to discard the wrong medication and
prepare the correct dose. Administering the correct dose is the goal but the
nurse must discard the wrong dose first. Discussing the error with the
patient is not necessary for a near-miss that was caught before
administration.
Question 4
Which strategy most effectively reduces medication errors when
administering high-alert medications such as heparin or insulin?
A. Rely on memory for dosage calculations.
B. Use independent double-check with another licensed nurse.
C. Administer the medication quickly to avoid interruptions.
D. Document the administration after the shift ends.
Correct Answer: B
