Achieve confidence in NCLEX-style prep with this complete nursing
study pack. Elevate your nursing exam prep with this ultimate success
bundle of practice questions.
---
## 🏆 Pharmacology Revision Notes – Ultimate Student Guide |
2025/2026 NCLEX-Style Prep & Practice Questions
---
1. A client is prescribed digoxin. The nurse should hold the medication and notify the healthcare
provider if the client's apical pulse is less than:
A. 50 beats per minute.
B. 60 beats per minute.
C. 70 beats per minute.
D. 80 beats per minute.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The apical pulse should be checked for a full minute before administering digoxin. If
the pulse is below 60 beats per minute (or below 70 bpm in some institutions, but 60 is the standard for
adults), the medication should be held and the provider notified. This prevents bradycardia, a common
side effect of digoxin toxicity. This nursing exam prep question highlights the critical safety parameter
for cardiac glycosides and is a cornerstone of pharmacology study guides. The other options are
incorrect thresholds that could lead to unsafe medication administration.
2. A client with a history of seizures is prescribed phenytoin. The nurse notes that the client's serum
phenytoin level is 25 mcg/mL. What is the most appropriate nursing action?
A. Administer the medication as ordered.
B. Hold the medication and notify the healthcare provider.
C. Increase the client's fluid intake.
,D. Assess the client for signs of hypoglycemia.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The therapeutic range for phenytoin is 10-20 mcg/mL. A level of 25 mcg/mL is in the
toxic range and can cause nystagmus, ataxia, and confusion. The nurse should hold the dose and notify
the provider to adjust the dosage. This nursing study guide emphasizes the importance of therapeutic
drug monitoring. Increasing fluids or assessing for hypoglycemia are not appropriate actions for this
finding.
3. A client is prescribed warfarin. Which laboratory value is the most important to monitor to ensure the
medication is within the therapeutic range?
A. aPTT.
B. INR.
C. Platelet count.
D. Hemoglobin and hematocrit.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The International Normalized Ratio (INR) is the standardized test used to monitor
warfarin therapy. For most indications, the therapeutic INR is between 2.0 and 3.0. aPTT is used to
monitor heparin therapy. Monitoring platelet count and hemoglobin/hematocrit is important for
assessing bleeding risk but does not directly measure the anticoagulant effect of warfarin. This is a
fundamental concept for student success in pharmacology and NCLEX-style prep.
4. A client is prescribed enalapril. The nurse should instruct the client to report which side effect
immediately?
A. Dizziness.
B. Dry cough.
C. Constipation.
D. Rash.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: A persistent, dry cough is a common side effect of ACE inhibitors like enalapril. While
not immediately life-threatening, it can be bothersome and may require a change in medication.
However, a more serious side effect is angioedema (swelling of the face, lips, tongue, and throat), which
is an emergency. The question asks for a side effect to report, and a cough is significant. Dizziness is
common and usually resolves. This question is a key part of nursing exam prep and pharmacology
revision notes, focusing on client education regarding medication side effects.
,5. A client is prescribed metformin for type 2 diabetes. Which side effect should the nurse include in the
teaching plan?
A. Weight gain.
B. Hypoglycemia.
C. Lactic acidosis.
D. Constipation.
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Metformin can cause lactic acidosis, a rare but serious side effect, especially in clients
with renal impairment, liver disease, or cardiac failure. It is important to monitor for signs like muscle
pain, weakness, and difficulty breathing. Metformin is weight-neutral and less likely to cause
hypoglycemia compared to sulfonylureas or insulin. GI upset (diarrhea, nausea) is common but not the
most severe side effect. This nursing practice question emphasizes the critical safety monitoring
required for antidiabetic medications.
6. A client is prescribed a statin medication (atorvastatin) for hyperlipidemia. The nurse should monitor
which laboratory value?
A. Serum creatinine.
B. Liver function tests (LFTs).
C. Complete blood count (CBC).
D. Serum sodium.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Statins can cause hepatotoxicity, so liver function tests (AST, ALT) should be
monitored before and periodically during therapy. Although rare, muscle damage (myopathy) is another
concern, but LFTs are the standard monitoring parameter. This is a crucial point in pharmacology study
guides and nursing exam prep. The other options are not the primary monitoring parameters for this
class of drugs.
7. A client is prescribed amoxicillin. The nurse should instruct the client to report which sign of a severe
allergic reaction?
A. Nausea.
B. Diarrhea.
C. Rash.
, D. Difficulty breathing.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Difficulty breathing, wheezing, or swelling of the face and throat are signs of
anaphylaxis, a life-threatening allergic reaction to penicillin-class antibiotics. Clients should be instructed
to seek emergency care immediately if these occur. While rash, nausea, and diarrhea can be side effects,
they are not as immediately life-threatening as respiratory distress. This nursing study guide prioritizes
the recognition of severe adverse reactions for student success.
8. A client is receiving a continuous heparin infusion. The nurse notes that the client's aPTT is 110
seconds. What is the most appropriate nursing action?
A. Continue the infusion as ordered.
B. Decrease the infusion rate by half.
C. Stop the infusion and notify the healthcare provider.
D. Administer protamine sulfate.
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: A therapeutic aPTT for heparin is typically 1.5 to 2.5 times the normal control (e.g.,
40-85 seconds). An aPTT of 110 seconds indicates a high risk of bleeding. The nurse should stop the
infusion immediately and notify the provider to obtain new orders. Protamine sulfate is the antidote and
may be ordered, but it is not the immediate action. This is a critical safety alert in this nursing exam
practice question.
9. A client is prescribed furosemide. The nurse should monitor the client for which electrolyte
imbalance?
A. Hyperkalemia.
B. Hypokalemia.
C. Hypernatremia.
D. Hypocalcemia.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the
ascending limb of the loop of Henle, leading to increased excretion of potassium. This results in
hypokalemia. The nurse should monitor serum potassium levels and assess for signs of hypokalemia
(e.g., muscle weakness, arrhythmias). This is a foundational pharmacology concept and a frequent
question in nursing study guides.
study pack. Elevate your nursing exam prep with this ultimate success
bundle of practice questions.
---
## 🏆 Pharmacology Revision Notes – Ultimate Student Guide |
2025/2026 NCLEX-Style Prep & Practice Questions
---
1. A client is prescribed digoxin. The nurse should hold the medication and notify the healthcare
provider if the client's apical pulse is less than:
A. 50 beats per minute.
B. 60 beats per minute.
C. 70 beats per minute.
D. 80 beats per minute.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The apical pulse should be checked for a full minute before administering digoxin. If
the pulse is below 60 beats per minute (or below 70 bpm in some institutions, but 60 is the standard for
adults), the medication should be held and the provider notified. This prevents bradycardia, a common
side effect of digoxin toxicity. This nursing exam prep question highlights the critical safety parameter
for cardiac glycosides and is a cornerstone of pharmacology study guides. The other options are
incorrect thresholds that could lead to unsafe medication administration.
2. A client with a history of seizures is prescribed phenytoin. The nurse notes that the client's serum
phenytoin level is 25 mcg/mL. What is the most appropriate nursing action?
A. Administer the medication as ordered.
B. Hold the medication and notify the healthcare provider.
C. Increase the client's fluid intake.
,D. Assess the client for signs of hypoglycemia.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The therapeutic range for phenytoin is 10-20 mcg/mL. A level of 25 mcg/mL is in the
toxic range and can cause nystagmus, ataxia, and confusion. The nurse should hold the dose and notify
the provider to adjust the dosage. This nursing study guide emphasizes the importance of therapeutic
drug monitoring. Increasing fluids or assessing for hypoglycemia are not appropriate actions for this
finding.
3. A client is prescribed warfarin. Which laboratory value is the most important to monitor to ensure the
medication is within the therapeutic range?
A. aPTT.
B. INR.
C. Platelet count.
D. Hemoglobin and hematocrit.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: The International Normalized Ratio (INR) is the standardized test used to monitor
warfarin therapy. For most indications, the therapeutic INR is between 2.0 and 3.0. aPTT is used to
monitor heparin therapy. Monitoring platelet count and hemoglobin/hematocrit is important for
assessing bleeding risk but does not directly measure the anticoagulant effect of warfarin. This is a
fundamental concept for student success in pharmacology and NCLEX-style prep.
4. A client is prescribed enalapril. The nurse should instruct the client to report which side effect
immediately?
A. Dizziness.
B. Dry cough.
C. Constipation.
D. Rash.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: A persistent, dry cough is a common side effect of ACE inhibitors like enalapril. While
not immediately life-threatening, it can be bothersome and may require a change in medication.
However, a more serious side effect is angioedema (swelling of the face, lips, tongue, and throat), which
is an emergency. The question asks for a side effect to report, and a cough is significant. Dizziness is
common and usually resolves. This question is a key part of nursing exam prep and pharmacology
revision notes, focusing on client education regarding medication side effects.
,5. A client is prescribed metformin for type 2 diabetes. Which side effect should the nurse include in the
teaching plan?
A. Weight gain.
B. Hypoglycemia.
C. Lactic acidosis.
D. Constipation.
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: Metformin can cause lactic acidosis, a rare but serious side effect, especially in clients
with renal impairment, liver disease, or cardiac failure. It is important to monitor for signs like muscle
pain, weakness, and difficulty breathing. Metformin is weight-neutral and less likely to cause
hypoglycemia compared to sulfonylureas or insulin. GI upset (diarrhea, nausea) is common but not the
most severe side effect. This nursing practice question emphasizes the critical safety monitoring
required for antidiabetic medications.
6. A client is prescribed a statin medication (atorvastatin) for hyperlipidemia. The nurse should monitor
which laboratory value?
A. Serum creatinine.
B. Liver function tests (LFTs).
C. Complete blood count (CBC).
D. Serum sodium.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Statins can cause hepatotoxicity, so liver function tests (AST, ALT) should be
monitored before and periodically during therapy. Although rare, muscle damage (myopathy) is another
concern, but LFTs are the standard monitoring parameter. This is a crucial point in pharmacology study
guides and nursing exam prep. The other options are not the primary monitoring parameters for this
class of drugs.
7. A client is prescribed amoxicillin. The nurse should instruct the client to report which sign of a severe
allergic reaction?
A. Nausea.
B. Diarrhea.
C. Rash.
, D. Difficulty breathing.
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Difficulty breathing, wheezing, or swelling of the face and throat are signs of
anaphylaxis, a life-threatening allergic reaction to penicillin-class antibiotics. Clients should be instructed
to seek emergency care immediately if these occur. While rash, nausea, and diarrhea can be side effects,
they are not as immediately life-threatening as respiratory distress. This nursing study guide prioritizes
the recognition of severe adverse reactions for student success.
8. A client is receiving a continuous heparin infusion. The nurse notes that the client's aPTT is 110
seconds. What is the most appropriate nursing action?
A. Continue the infusion as ordered.
B. Decrease the infusion rate by half.
C. Stop the infusion and notify the healthcare provider.
D. Administer protamine sulfate.
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: A therapeutic aPTT for heparin is typically 1.5 to 2.5 times the normal control (e.g.,
40-85 seconds). An aPTT of 110 seconds indicates a high risk of bleeding. The nurse should stop the
infusion immediately and notify the provider to obtain new orders. Protamine sulfate is the antidote and
may be ordered, but it is not the immediate action. This is a critical safety alert in this nursing exam
practice question.
9. A client is prescribed furosemide. The nurse should monitor the client for which electrolyte
imbalance?
A. Hyperkalemia.
B. Hypokalemia.
C. Hypernatremia.
D. Hypocalcemia.
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the
ascending limb of the loop of Henle, leading to increased excretion of potassium. This results in
hypokalemia. The nurse should monitor serum potassium levels and assess for signs of hypokalemia
(e.g., muscle weakness, arrhythmias). This is a foundational pharmacology concept and a frequent
question in nursing study guides.
