Saunders Comprehensive Review for the
NCLEX-RN Examination 9th Edition -
Ultimate Pharmacology Practice Questions
2026/2027
**1. A client with atrial fibrillation is taking digoxin. The nurse notes a
serum potassium of 3.0 mEq/L (normal 3.5–5.0). Which action is the
priority?**
**Answer:** Hold the digoxin and notify the provider. Hypokalemia
increases the risk of digoxin toxicity because low serum K⁺ enhances
digoxin binding to the Na⁺/K⁺-ATPase receptor in cardiac myocytes.
**2. A client taking lisinopril develops facial swelling. What is the
priority action?**
**Answer:** Stop medication and notify provider immediately. Facial
swelling indicates angioedema, a life-threatening adverse effect of
ACE inhibitors.
**3. A patient on warfarin has an INR of 4.5. What should the nurse
do?**
**Answer:** Hold the medication and notify the provider.
Therapeutic INR for most indications is 2.0–3.0.
,**4. A client taking digoxin has a pulse of 52 bpm. What is the nurse's
action?**
**Answer:** Hold the medication and notify the provider. Digoxin
should be held if the apical pulse is below 60 bpm.
**5. A patient on beta-blockers should avoid stopping abruptly due
to risk of what?**
**Answer:** Rebound hypertension and rebound tachycardia.
**6. A client taking statins reports muscle pain. What is the
concern?**
**Answer:** Rhabdomyolysis, a serious adverse effect that can lead
to kidney damage.
**7. A client taking nitroglycerin should be instructed to do what?**
**Answer:** Sit or lie down before taking the medication to prevent
hypotension.
**8. A patient with a history of asthma is prescribed propranolol for
migraine prophylaxis. What is the nurse's most appropriate action?**
, **Answer:** Hold propranolol and contact the prescriber. Non-
selective beta-blockers can precipitate bronchospasm in patients
with asthma.
**9. Which statement about ACE inhibitors and pregnancy is
correct?**
**Answer:** ACE inhibitors are contraindicated in pregnancy due to
risk of fetal injury, including oligohydramnios and renal anomalies.
Stop immediately if pregnancy occurs and notify the provider.
**10. A patient on spironolactone is at risk for what electrolyte
imbalance?**
**Answer:** Hyperkalemia, as spironolactone is a potassium-sparing
diuretic.
**11. What lab test is used to monitor unfractionated heparin
therapy?**
**Answer:** aPTT (activated partial thromboplastin time).
**12. A client on clopidogrel should be monitored for what?**
**Answer:** Bleeding, as it is an antiplatelet medication.
NCLEX-RN Examination 9th Edition -
Ultimate Pharmacology Practice Questions
2026/2027
**1. A client with atrial fibrillation is taking digoxin. The nurse notes a
serum potassium of 3.0 mEq/L (normal 3.5–5.0). Which action is the
priority?**
**Answer:** Hold the digoxin and notify the provider. Hypokalemia
increases the risk of digoxin toxicity because low serum K⁺ enhances
digoxin binding to the Na⁺/K⁺-ATPase receptor in cardiac myocytes.
**2. A client taking lisinopril develops facial swelling. What is the
priority action?**
**Answer:** Stop medication and notify provider immediately. Facial
swelling indicates angioedema, a life-threatening adverse effect of
ACE inhibitors.
**3. A patient on warfarin has an INR of 4.5. What should the nurse
do?**
**Answer:** Hold the medication and notify the provider.
Therapeutic INR for most indications is 2.0–3.0.
,**4. A client taking digoxin has a pulse of 52 bpm. What is the nurse's
action?**
**Answer:** Hold the medication and notify the provider. Digoxin
should be held if the apical pulse is below 60 bpm.
**5. A patient on beta-blockers should avoid stopping abruptly due
to risk of what?**
**Answer:** Rebound hypertension and rebound tachycardia.
**6. A client taking statins reports muscle pain. What is the
concern?**
**Answer:** Rhabdomyolysis, a serious adverse effect that can lead
to kidney damage.
**7. A client taking nitroglycerin should be instructed to do what?**
**Answer:** Sit or lie down before taking the medication to prevent
hypotension.
**8. A patient with a history of asthma is prescribed propranolol for
migraine prophylaxis. What is the nurse's most appropriate action?**
, **Answer:** Hold propranolol and contact the prescriber. Non-
selective beta-blockers can precipitate bronchospasm in patients
with asthma.
**9. Which statement about ACE inhibitors and pregnancy is
correct?**
**Answer:** ACE inhibitors are contraindicated in pregnancy due to
risk of fetal injury, including oligohydramnios and renal anomalies.
Stop immediately if pregnancy occurs and notify the provider.
**10. A patient on spironolactone is at risk for what electrolyte
imbalance?**
**Answer:** Hyperkalemia, as spironolactone is a potassium-sparing
diuretic.
**11. What lab test is used to monitor unfractionated heparin
therapy?**
**Answer:** aPTT (activated partial thromboplastin time).
**12. A client on clopidogrel should be monitored for what?**
**Answer:** Bleeding, as it is an antiplatelet medication.
