NCLEX Pharmacology Practice Questions |
Introduction to Pharmacology
NGN Clinical Judgment Nursing Exam Prep
(20 MCQs + Rationales)
Below is a 20-item NCLEX-style pharmacology question set
focused on Introduction to Pharmacology, emphasizing clinical
judgment, medication safety, and nursing decision-making.
Question 1
Clinical Scenario
A nurse is preparing to administer a medication to a 72-year-old
client with decreased renal function (eGFR 35 mL/min). The
medication is primarily excreted by the kidneys.
Question Stem
Which action should the nurse take first?
A. Administer the medication as prescribed
B. Assess the client’s liver function tests
,C. Notify the provider about renal impairment
D. Increase the medication dose
Correct Answer
C. Notify the provider about renal impairment
Detailed Rationale
Medications eliminated via the kidneys can accumulate in
clients with reduced renal function, increasing toxicity risk. The
nurse must recognize that an eGFR of 35 mL/min indicates
moderate renal impairment, necessitating dosage adjustment
or alternative therapy. The priority action is to notify the
provider before administration to prevent adverse effects.
Option A is unsafe because administering without adjustment
risks toxicity.
Option B is less relevant since the drug is renally excreted.
Option D is incorrect and dangerous, as increasing the dose
worsens toxicity risk.
This reflects pharmacokinetic principles: impaired elimination
increases drug half-life. Nurses play a key role in preventing
medication errors through assessment and advocacy.
Learning Objective
After completing this question, the learner should be able to:
• Identify the impact of renal impairment on drug clearance
, • Prioritize nursing actions for safe medication administration
• Recognize when to hold medications and notify providers
Medication Safety Focus: Monitoring
Question 2
Clinical Scenario
A nurse is educating a client about a newly prescribed oral
medication with a narrow therapeutic index.
Question Stem
Which statement indicates understanding of medication safety?
A. “I can double the dose if I miss one.”
B. “I should take the medication exactly as prescribed.”
C. “Side effects are not important if the drug works.”
D. “I can stop the medication when I feel better.”
Correct Answer
B. “I should take the medication exactly as prescribed.”
Detailed Rationale
Drugs with a narrow therapeutic index (NTI) require precise
dosing because the difference between therapeutic and toxic
levels is small. The correct response reflects adherence to
dosing instructions, which is critical for safety.
Introduction to Pharmacology
NGN Clinical Judgment Nursing Exam Prep
(20 MCQs + Rationales)
Below is a 20-item NCLEX-style pharmacology question set
focused on Introduction to Pharmacology, emphasizing clinical
judgment, medication safety, and nursing decision-making.
Question 1
Clinical Scenario
A nurse is preparing to administer a medication to a 72-year-old
client with decreased renal function (eGFR 35 mL/min). The
medication is primarily excreted by the kidneys.
Question Stem
Which action should the nurse take first?
A. Administer the medication as prescribed
B. Assess the client’s liver function tests
,C. Notify the provider about renal impairment
D. Increase the medication dose
Correct Answer
C. Notify the provider about renal impairment
Detailed Rationale
Medications eliminated via the kidneys can accumulate in
clients with reduced renal function, increasing toxicity risk. The
nurse must recognize that an eGFR of 35 mL/min indicates
moderate renal impairment, necessitating dosage adjustment
or alternative therapy. The priority action is to notify the
provider before administration to prevent adverse effects.
Option A is unsafe because administering without adjustment
risks toxicity.
Option B is less relevant since the drug is renally excreted.
Option D is incorrect and dangerous, as increasing the dose
worsens toxicity risk.
This reflects pharmacokinetic principles: impaired elimination
increases drug half-life. Nurses play a key role in preventing
medication errors through assessment and advocacy.
Learning Objective
After completing this question, the learner should be able to:
• Identify the impact of renal impairment on drug clearance
, • Prioritize nursing actions for safe medication administration
• Recognize when to hold medications and notify providers
Medication Safety Focus: Monitoring
Question 2
Clinical Scenario
A nurse is educating a client about a newly prescribed oral
medication with a narrow therapeutic index.
Question Stem
Which statement indicates understanding of medication safety?
A. “I can double the dose if I miss one.”
B. “I should take the medication exactly as prescribed.”
C. “Side effects are not important if the drug works.”
D. “I can stop the medication when I feel better.”
Correct Answer
B. “I should take the medication exactly as prescribed.”
Detailed Rationale
Drugs with a narrow therapeutic index (NTI) require precise
dosing because the difference between therapeutic and toxic
levels is small. The correct response reflects adherence to
dosing instructions, which is critical for safety.
