NU 150 Exam 4 | Pharmacology
COMPREHENSIVE NURSING PRACTICE EXAM (2026/2027) - GALEN COLLEGE
(1) A nurse is preparing to administer digoxin to a client. Which action is the priority
before administration?
A. Check the client's blood pressure.
B. Monitor the client's respiratory rate.
C. Assess the apical pulse for one full minute.
D. Check the client's temperature.
CORRECT ANSWER: C
Clinical Rationale: Digoxin can cause bradycardia. The nurse must hold the dose and notify the
provider if the apical pulse is less than 60 bpm in adults.
(2) A client is prescribed sublingual nitroglycerin for chest pain. Which instruction should
the nurse include in the teaching?
A. Swallow the tablet with a full glass of water.
B. Take up to 3 tablets, 5 minutes apart, and call 911 if pain persists.
C. Store the medication in a clear plastic container for easy access.
D. Expect the medication to cause a decrease in heart rate.
CORRECT ANSWER: B
Clinical Rationale: The standard protocol for SL nitroglycerin is 1 tablet every 5 minutes for up
to 3 doses. If pain is not relieved after the first dose, the client should seek emergency services.
,(3) Which laboratory value should the nurse monitor for a client receiving warfarin
therapy?
A. PTT
B. INR/PT
C. Platelet count
D. Hemoglobin A1c
CORRECT ANSWER: B
Clinical Rationale: INR (International Normalized Ratio) and PT (Prothrombin Time) are used to
monitor the effectiveness and safety of warfarin therapy.
(4) The nurse is caring for a client receiving a continuous IV heparin infusion. Which
medication should be available as an antidote?
A. Vitamin K
B. Protamine sulfate
C. Flumazenil
D. Acetylcysteine
CORRECT ANSWER: B
Clinical Rationale: Protamine sulfate is the specific antidote for heparin overdose/toxicity.
(5) A client with Type 1 Diabetes is prescribed Lispro (Humalog) insulin. When should the
nurse administer this medication?
A. 30 to 60 minutes before a meal.
B. At bedtime.
C. 15 minutes before or immediately after eating.
D. Only when the blood glucose is above 200 mg/dL.
CORRECT ANSWER: C
Clinical Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes; it must be given
in close proximity to food to prevent hypoglycemia.
,(6) A client taking metformin is scheduled for a CT scan with IV contrast. Which nursing
action is essential?
A. Increase the metformin dose the morning of the procedure.
B. Hold the metformin 48 hours before and after the procedure.
C. Administer the metformin with a large glass of water.
D. Ensure the client remains NPO for 12 hours after the scan.
CORRECT ANSWER: B
Clinical Rationale: Metformin must be held before and after contrast dye procedures to
prevent acute renal failure and lactic acidosis.
(7) Which side effect is most common in a client using an Albuterol inhaler?
A. Bradycardia
B. Lethargy
C. Tachycardia and tremors
D. Hypoglycemia
CORRECT ANSWER: C
Clinical Rationale: Albuterol is a beta-2 agonist that can stimulate beta-1 receptors in the
heart, leading to tachycardia, palpitations, and tremors.
(8) A nurse is infusing IV Vancomycin and notes the client's face and neck have become
bright red and itchy. What is the nurse's priority action?
A. Stop the infusion immediately.
B. Slow the infusion rate.
C. Administer epinephrine.
D. Document the finding as a normal side effect.
CORRECT ANSWER: B
Clinical Rationale: This describes 'Red Man Syndrome,' which is usually related to a rapid
infusion rate. Slowing the rate typically resolves the issue, unlike a true anaphylactic reaction.
, (9) What are the two most serious adverse effects of aminoglycoside antibiotics like
Gentamicin?
A. Hepatotoxicity and cardiotoxicity.
B. Ototoxicity and nephrotoxicity.
C. Gastric ulcers and hypertension.
D. Visual changes and seizures.
CORRECT ANSWER: B
Clinical Rationale: Aminoglycosides are known for being toxic to the ears (hearing/balance)
and the kidneys.
(10) A nurse is assessing a client 30 minutes after administering IV morphine. Which
finding requires immediate intervention?
A. The client reports a pain level of 2/10.
B. The client appears sleepy but is easily aroused.
C. The client's respiratory rate is 8 breaths per minute.
D. The client reports mild nausea.
CORRECT ANSWER: C
Clinical Rationale: Respiratory depression (RR < 12) is a life-threatening adverse effect of
opioid analgesics like morphine.
(11) A nurse is preparing to administer digoxin to a client. Which action is the priority
before administration?
A. Check the client's blood pressure.
B. Monitor the client's respiratory rate.
C. Assess the apical pulse for one full minute.
D. Check the client's temperature.
CORRECT ANSWER: C
Clinical Rationale: Digoxin can cause bradycardia. The nurse must hold the dose and notify the
provider if the apical pulse is less than 60 bpm in adults.
COMPREHENSIVE NURSING PRACTICE EXAM (2026/2027) - GALEN COLLEGE
(1) A nurse is preparing to administer digoxin to a client. Which action is the priority
before administration?
A. Check the client's blood pressure.
B. Monitor the client's respiratory rate.
C. Assess the apical pulse for one full minute.
D. Check the client's temperature.
CORRECT ANSWER: C
Clinical Rationale: Digoxin can cause bradycardia. The nurse must hold the dose and notify the
provider if the apical pulse is less than 60 bpm in adults.
(2) A client is prescribed sublingual nitroglycerin for chest pain. Which instruction should
the nurse include in the teaching?
A. Swallow the tablet with a full glass of water.
B. Take up to 3 tablets, 5 minutes apart, and call 911 if pain persists.
C. Store the medication in a clear plastic container for easy access.
D. Expect the medication to cause a decrease in heart rate.
CORRECT ANSWER: B
Clinical Rationale: The standard protocol for SL nitroglycerin is 1 tablet every 5 minutes for up
to 3 doses. If pain is not relieved after the first dose, the client should seek emergency services.
,(3) Which laboratory value should the nurse monitor for a client receiving warfarin
therapy?
A. PTT
B. INR/PT
C. Platelet count
D. Hemoglobin A1c
CORRECT ANSWER: B
Clinical Rationale: INR (International Normalized Ratio) and PT (Prothrombin Time) are used to
monitor the effectiveness and safety of warfarin therapy.
(4) The nurse is caring for a client receiving a continuous IV heparin infusion. Which
medication should be available as an antidote?
A. Vitamin K
B. Protamine sulfate
C. Flumazenil
D. Acetylcysteine
CORRECT ANSWER: B
Clinical Rationale: Protamine sulfate is the specific antidote for heparin overdose/toxicity.
(5) A client with Type 1 Diabetes is prescribed Lispro (Humalog) insulin. When should the
nurse administer this medication?
A. 30 to 60 minutes before a meal.
B. At bedtime.
C. 15 minutes before or immediately after eating.
D. Only when the blood glucose is above 200 mg/dL.
CORRECT ANSWER: C
Clinical Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes; it must be given
in close proximity to food to prevent hypoglycemia.
,(6) A client taking metformin is scheduled for a CT scan with IV contrast. Which nursing
action is essential?
A. Increase the metformin dose the morning of the procedure.
B. Hold the metformin 48 hours before and after the procedure.
C. Administer the metformin with a large glass of water.
D. Ensure the client remains NPO for 12 hours after the scan.
CORRECT ANSWER: B
Clinical Rationale: Metformin must be held before and after contrast dye procedures to
prevent acute renal failure and lactic acidosis.
(7) Which side effect is most common in a client using an Albuterol inhaler?
A. Bradycardia
B. Lethargy
C. Tachycardia and tremors
D. Hypoglycemia
CORRECT ANSWER: C
Clinical Rationale: Albuterol is a beta-2 agonist that can stimulate beta-1 receptors in the
heart, leading to tachycardia, palpitations, and tremors.
(8) A nurse is infusing IV Vancomycin and notes the client's face and neck have become
bright red and itchy. What is the nurse's priority action?
A. Stop the infusion immediately.
B. Slow the infusion rate.
C. Administer epinephrine.
D. Document the finding as a normal side effect.
CORRECT ANSWER: B
Clinical Rationale: This describes 'Red Man Syndrome,' which is usually related to a rapid
infusion rate. Slowing the rate typically resolves the issue, unlike a true anaphylactic reaction.
, (9) What are the two most serious adverse effects of aminoglycoside antibiotics like
Gentamicin?
A. Hepatotoxicity and cardiotoxicity.
B. Ototoxicity and nephrotoxicity.
C. Gastric ulcers and hypertension.
D. Visual changes and seizures.
CORRECT ANSWER: B
Clinical Rationale: Aminoglycosides are known for being toxic to the ears (hearing/balance)
and the kidneys.
(10) A nurse is assessing a client 30 minutes after administering IV morphine. Which
finding requires immediate intervention?
A. The client reports a pain level of 2/10.
B. The client appears sleepy but is easily aroused.
C. The client's respiratory rate is 8 breaths per minute.
D. The client reports mild nausea.
CORRECT ANSWER: C
Clinical Rationale: Respiratory depression (RR < 12) is a life-threatening adverse effect of
opioid analgesics like morphine.
(11) A nurse is preparing to administer digoxin to a client. Which action is the priority
before administration?
A. Check the client's blood pressure.
B. Monitor the client's respiratory rate.
C. Assess the apical pulse for one full minute.
D. Check the client's temperature.
CORRECT ANSWER: C
Clinical Rationale: Digoxin can cause bradycardia. The nurse must hold the dose and notify the
provider if the apical pulse is less than 60 bpm in adults.
