ATI Pharmacology Made Easy Exam
Questions & Answers |
Introduction to Pharmacology NCLEX-RN
NGN Practice Test Bank |
20 Original Nursing MCQs with Rationales
Question 1
Clinical Scenario
A 72-year-old client is admitted to the medical unit with pneumonia.
The nurse reviews the medication reconciliation list and notes that the
client takes warfarin 5 mg daily for atrial fibrillation, lisinopril for
hypertension, and several over-the-counter supplements. The client
reports starting an herbal product containing ginkgo biloba 2 weeks ago
because a friend recommended it for memory improvement. The
admission laboratory results show an international normalized ratio
(INR) of 4.8.
Question Stem
Which action should the nurse take first?
,A. Administer the scheduled warfarin dose and reassess the INR
tomorrow.
B. Notify the provider about the elevated INR and the use of ginkgo
biloba.
C. Educate the client that herbal supplements do not affect prescription
medications.
D. Encourage the client to increase vitamin K intake immediately.
Correct Answer
Correct Answer: B. Notify the provider about the elevated INR and the
use of ginkgo biloba.
Detailed Rationale
The correct answer is B because the nurse should recognize a potential
medication interaction that increases the client’s risk for bleeding.
Warfarin has a narrow therapeutic index, meaning small changes in
drug effects can result in serious complications. The therapeutic INR
range for many clients receiving warfarin for atrial fibrillation is typically
approximately 2.0–3.0. An INR of 4.8 indicates excessive anticoagulation
and requires prompt evaluation. Ginkgo biloba may increase bleeding
risk because it can affect platelet aggregation and may enhance the
anticoagulant effects of warfarin.
Option A is incorrect because administering the scheduled warfarin
dose could further increase anticoagulation and place the client at risk
for hemorrhage. The nurse should not independently continue a
medication when assessment findings suggest potential harm.
Option C is incorrect because many herbal supplements have
pharmacologic effects and can interact with prescription medications.
,Medication reconciliation should include prescription drugs, over-the-
counter medications, and herbal products.
Option D is incorrect because increasing vitamin K intake can interfere
with warfarin therapy and should not be done without provider
guidance. Clients taking warfarin should maintain consistent vitamin K
intake rather than making sudden dietary changes.
The nurse’s priority is identifying a potentially dangerous drug
interaction, preventing bleeding complications, and communicating
findings promptly to the healthcare provider.
Learning Objective
After completing this question, the learner should be able to:
• Identify clinically significant drug interactions involving
anticoagulants.
• Recognize the importance of medication reconciliation.
• Interpret abnormal laboratory values related to medication
therapy.
• Apply nursing priorities when managing high-risk medications.
Medication Safety Focus
Drug interaction / High-alert medication
Question 2
Clinical Scenario
, A 45-year-old client with type 2 diabetes mellitus is prescribed
metformin 500 mg twice daily. The client is scheduled for a computed
tomography (CT) scan with intravenous contrast dye. The nurse reviews
the client’s laboratory results before administering the medication.
Laboratory results:
• Serum creatinine: 2.1 mg/dL
• Estimated glomerular filtration rate (eGFR): 32 mL/min/1.73 m²
The client states, “I took my morning dose of metformin because my
blood sugar was high.”
Question Stem
Which action should the nurse take?
A. Administer the medication because hyperglycemia should be treated
before diagnostic procedures.
B. Hold the medication and notify the provider regarding renal function
and contrast exposure.
C. Give the medication with food to reduce gastrointestinal adverse
effects.
D. Administer the medication and increase fluid intake after the CT scan.
Correct Answer
Correct Answer: B. Hold the medication and notify the provider
regarding renal function and contrast exposure.
Detailed Rationale
The correct answer is B because metformin requires careful evaluation
in clients with impaired renal function, especially when iodinated
Questions & Answers |
Introduction to Pharmacology NCLEX-RN
NGN Practice Test Bank |
20 Original Nursing MCQs with Rationales
Question 1
Clinical Scenario
A 72-year-old client is admitted to the medical unit with pneumonia.
The nurse reviews the medication reconciliation list and notes that the
client takes warfarin 5 mg daily for atrial fibrillation, lisinopril for
hypertension, and several over-the-counter supplements. The client
reports starting an herbal product containing ginkgo biloba 2 weeks ago
because a friend recommended it for memory improvement. The
admission laboratory results show an international normalized ratio
(INR) of 4.8.
Question Stem
Which action should the nurse take first?
,A. Administer the scheduled warfarin dose and reassess the INR
tomorrow.
B. Notify the provider about the elevated INR and the use of ginkgo
biloba.
C. Educate the client that herbal supplements do not affect prescription
medications.
D. Encourage the client to increase vitamin K intake immediately.
Correct Answer
Correct Answer: B. Notify the provider about the elevated INR and the
use of ginkgo biloba.
Detailed Rationale
The correct answer is B because the nurse should recognize a potential
medication interaction that increases the client’s risk for bleeding.
Warfarin has a narrow therapeutic index, meaning small changes in
drug effects can result in serious complications. The therapeutic INR
range for many clients receiving warfarin for atrial fibrillation is typically
approximately 2.0–3.0. An INR of 4.8 indicates excessive anticoagulation
and requires prompt evaluation. Ginkgo biloba may increase bleeding
risk because it can affect platelet aggregation and may enhance the
anticoagulant effects of warfarin.
Option A is incorrect because administering the scheduled warfarin
dose could further increase anticoagulation and place the client at risk
for hemorrhage. The nurse should not independently continue a
medication when assessment findings suggest potential harm.
Option C is incorrect because many herbal supplements have
pharmacologic effects and can interact with prescription medications.
,Medication reconciliation should include prescription drugs, over-the-
counter medications, and herbal products.
Option D is incorrect because increasing vitamin K intake can interfere
with warfarin therapy and should not be done without provider
guidance. Clients taking warfarin should maintain consistent vitamin K
intake rather than making sudden dietary changes.
The nurse’s priority is identifying a potentially dangerous drug
interaction, preventing bleeding complications, and communicating
findings promptly to the healthcare provider.
Learning Objective
After completing this question, the learner should be able to:
• Identify clinically significant drug interactions involving
anticoagulants.
• Recognize the importance of medication reconciliation.
• Interpret abnormal laboratory values related to medication
therapy.
• Apply nursing priorities when managing high-risk medications.
Medication Safety Focus
Drug interaction / High-alert medication
Question 2
Clinical Scenario
, A 45-year-old client with type 2 diabetes mellitus is prescribed
metformin 500 mg twice daily. The client is scheduled for a computed
tomography (CT) scan with intravenous contrast dye. The nurse reviews
the client’s laboratory results before administering the medication.
Laboratory results:
• Serum creatinine: 2.1 mg/dL
• Estimated glomerular filtration rate (eGFR): 32 mL/min/1.73 m²
The client states, “I took my morning dose of metformin because my
blood sugar was high.”
Question Stem
Which action should the nurse take?
A. Administer the medication because hyperglycemia should be treated
before diagnostic procedures.
B. Hold the medication and notify the provider regarding renal function
and contrast exposure.
C. Give the medication with food to reduce gastrointestinal adverse
effects.
D. Administer the medication and increase fluid intake after the CT scan.
Correct Answer
Correct Answer: B. Hold the medication and notify the provider
regarding renal function and contrast exposure.
Detailed Rationale
The correct answer is B because metformin requires careful evaluation
in clients with impaired renal function, especially when iodinated
