VALUE PACK:NCLEX RN/NCLEX PHARMACOLOGY
EXAMS 2025/2026| A GRADE PASS GUARANTEE
SECTION I: MEDICATION ADMINISTRATION & SAFETY (Questions 1–20)
Question 1
A nurse is preparing to administer digoxin (Lanoxin) to an adult client. The apical pulse is 52
beats per minute. Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the healthcare provider
C. Administer the medication and recheck the pulse in 30 minutes
D. Give half the prescribed dose
Correct Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. The therapeutic threshold
for withholding digoxin is typically an apical pulse below 60 beats per minute in adults.
Administering digoxin at a pulse of 52 could precipitate bradycardia or heart block. The nurse
must hold the dose and notify the provider. Option A is incorrect because it risks harm. Option C
delays appropriate intervention. Option D is never appropriate—nurses do not independently
alter prescribed doses.
Question 2
A nurse is teaching a client about the "rights" of medication administration. Which of the
following are considered the rights of medication administration? Select all that apply.
A. Right client
B. Right dose
C. Right route
D. Right time
E. Right diagnosis
F. Right documentation
Correct Answer: A, B, C, D, F
Rationale: The classic rights of medication administration include the right client, right drug,
right dose, right route, right time, and right documentation. Additional rights include the right
,reason and right to refuse. "Right diagnosis" is not a standard right of medication
administration; the nurse administers medications based on prescribed indications, but the
diagnosis itself is not one of the traditional rights. Documentation is essential and is considered
a right.
Question 3
A nurse is preparing to administer heparin subcutaneously. Which site is most appropriate for
the injection?
A. Deltoid muscle
B. Anterolateral abdominal wall
C. Ventrogluteal site
D. Dorsogluteal site
Correct Answer: B
Rationale: Heparin is administered subcutaneously into the anterolateral abdominal wall, at
least 2 inches away from the umbilicus. This area has consistent subcutaneous tissue and
absorption. The deltoid is used for IM or SC injections but is not preferred for heparin.
Ventrogluteal and dorsogluteal sites are IM sites, not SC sites, and are inappropriate for heparin
administration due to the risk of hematoma.
Question 4
A nurse is calculating a pediatric dose. The child weighs 22 pounds. The ordered dose is 10
mg/kg/day divided every 12 hours. How many milligrams will the nurse administer per dose?
A. 50 mg
B. 100 mg
C. 25 mg
D. 200 mg
Correct Answer: A
Rationale: First convert pounds to kilograms: 22 lb ÷ 2.2 = 10 kg. The total daily dose is 10
mg/kg/day × 10 kg = 100 mg/day. Divided every 12 hours (2 doses per day), each dose is 100 mg
÷ 2 = 50 mg. Option B is the total daily dose, not per dose. Option C and D are calculation errors.
,Question 5
A nurse is administering a medication via a nasogastric (NG) tube. Which action is correct?
A. Administer the medication with the client in a supine position
B. Flush the tube with 30 mL of water before and after medication administration
C. Mix all medications together and administer as one bolus
D. Administer the medication rapidly to prevent clogging
Correct Answer: B
Rationale: The NG tube should be flushed with 15–30 mL of water before and after
administering medications to prevent clogging and ensure delivery. The client should be in a
semi-Fowler's or high-Fowler's position to prevent aspiration, not supine. Medications should
be administered separately, not mixed together, as mixing can cause interactions or precipitate
formation. Medications should be administered at a moderate rate, not rapidly.
Question 6
A nurse is reviewing a medication order that reads "MS 4 mg IV push q4h prn." Which action
should the nurse take first?
A. Administer the medication as ordered
B. Clarify the order with the prescribing healthcare provider
C. Ask another nurse to interpret the order
D. Hold the medication until the next scheduled dose
Correct Answer: B
Rationale: "MS" is an error-prone abbreviation that can mean morphine sulfate or
magnesium sulfate. The nurse must clarify the order with the prescriber before administration
to prevent a medication error. Administering the medication without clarification could cause
serious harm. Asking another nurse is not sufficient—the prescriber must clarify. Holding the
medication without clarification delays necessary treatment and does not address the
ambiguity.
Question 7
A nurse is preparing to administer an intramuscular (IM) injection to an adult client. Which
needle length is most appropriate for a deltoid injection?
, A. ½ inch
B. 5/8 inch
C. 1 inch
D. 1½ inches
Correct Answer: B
Rationale: For an adult deltoid IM injection, a 5/8-inch needle is typically appropriate for
clients with adequate muscle mass. A ½-inch needle may be too short to reach muscle tissue in
most adults. A 1-inch needle is generally used for the vastus lateralis in adults or for deltoid in
larger clients. A 1½-inch needle is used for ventrogluteal or dorsogluteal sites in adults.
Question 8
A nurse is administering a medication that is classified as a Pregnancy Category X. What does
this classification indicate?
A. The medication is safe during pregnancy
B. The medication is contraindicated during pregnancy
C. The medication has not been studied in pregnancy
D. The medication is safe during the first trimester only
Correct Answer: B
Rationale: Pregnancy Category X indicates that studies in animals or humans have
demonstrated fetal abnormalities, and the risk of use clearly outweighs any possible benefit.
The medication is contraindicated in women who are or may become pregnant. Category A is
the safest, Category B and C have varying levels of safety, and Category D has evidence of
human fetal risk but may be used in life-threatening situations.
Question 9
A nurse is preparing to administer a controlled substance. Which of the following actions are
required? Select all that apply.
A. Count the controlled substance with another nurse
B. Document the administration in the controlled substance record
C. Verify the client's identification using two identifiers
D. Leave the controlled substance in the client's room for later use
E. Report any discrepancy to the appropriate authority immediately
EXAMS 2025/2026| A GRADE PASS GUARANTEE
SECTION I: MEDICATION ADMINISTRATION & SAFETY (Questions 1–20)
Question 1
A nurse is preparing to administer digoxin (Lanoxin) to an adult client. The apical pulse is 52
beats per minute. Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the healthcare provider
C. Administer the medication and recheck the pulse in 30 minutes
D. Give half the prescribed dose
Correct Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. The therapeutic threshold
for withholding digoxin is typically an apical pulse below 60 beats per minute in adults.
Administering digoxin at a pulse of 52 could precipitate bradycardia or heart block. The nurse
must hold the dose and notify the provider. Option A is incorrect because it risks harm. Option C
delays appropriate intervention. Option D is never appropriate—nurses do not independently
alter prescribed doses.
Question 2
A nurse is teaching a client about the "rights" of medication administration. Which of the
following are considered the rights of medication administration? Select all that apply.
A. Right client
B. Right dose
C. Right route
D. Right time
E. Right diagnosis
F. Right documentation
Correct Answer: A, B, C, D, F
Rationale: The classic rights of medication administration include the right client, right drug,
right dose, right route, right time, and right documentation. Additional rights include the right
,reason and right to refuse. "Right diagnosis" is not a standard right of medication
administration; the nurse administers medications based on prescribed indications, but the
diagnosis itself is not one of the traditional rights. Documentation is essential and is considered
a right.
Question 3
A nurse is preparing to administer heparin subcutaneously. Which site is most appropriate for
the injection?
A. Deltoid muscle
B. Anterolateral abdominal wall
C. Ventrogluteal site
D. Dorsogluteal site
Correct Answer: B
Rationale: Heparin is administered subcutaneously into the anterolateral abdominal wall, at
least 2 inches away from the umbilicus. This area has consistent subcutaneous tissue and
absorption. The deltoid is used for IM or SC injections but is not preferred for heparin.
Ventrogluteal and dorsogluteal sites are IM sites, not SC sites, and are inappropriate for heparin
administration due to the risk of hematoma.
Question 4
A nurse is calculating a pediatric dose. The child weighs 22 pounds. The ordered dose is 10
mg/kg/day divided every 12 hours. How many milligrams will the nurse administer per dose?
A. 50 mg
B. 100 mg
C. 25 mg
D. 200 mg
Correct Answer: A
Rationale: First convert pounds to kilograms: 22 lb ÷ 2.2 = 10 kg. The total daily dose is 10
mg/kg/day × 10 kg = 100 mg/day. Divided every 12 hours (2 doses per day), each dose is 100 mg
÷ 2 = 50 mg. Option B is the total daily dose, not per dose. Option C and D are calculation errors.
,Question 5
A nurse is administering a medication via a nasogastric (NG) tube. Which action is correct?
A. Administer the medication with the client in a supine position
B. Flush the tube with 30 mL of water before and after medication administration
C. Mix all medications together and administer as one bolus
D. Administer the medication rapidly to prevent clogging
Correct Answer: B
Rationale: The NG tube should be flushed with 15–30 mL of water before and after
administering medications to prevent clogging and ensure delivery. The client should be in a
semi-Fowler's or high-Fowler's position to prevent aspiration, not supine. Medications should
be administered separately, not mixed together, as mixing can cause interactions or precipitate
formation. Medications should be administered at a moderate rate, not rapidly.
Question 6
A nurse is reviewing a medication order that reads "MS 4 mg IV push q4h prn." Which action
should the nurse take first?
A. Administer the medication as ordered
B. Clarify the order with the prescribing healthcare provider
C. Ask another nurse to interpret the order
D. Hold the medication until the next scheduled dose
Correct Answer: B
Rationale: "MS" is an error-prone abbreviation that can mean morphine sulfate or
magnesium sulfate. The nurse must clarify the order with the prescriber before administration
to prevent a medication error. Administering the medication without clarification could cause
serious harm. Asking another nurse is not sufficient—the prescriber must clarify. Holding the
medication without clarification delays necessary treatment and does not address the
ambiguity.
Question 7
A nurse is preparing to administer an intramuscular (IM) injection to an adult client. Which
needle length is most appropriate for a deltoid injection?
, A. ½ inch
B. 5/8 inch
C. 1 inch
D. 1½ inches
Correct Answer: B
Rationale: For an adult deltoid IM injection, a 5/8-inch needle is typically appropriate for
clients with adequate muscle mass. A ½-inch needle may be too short to reach muscle tissue in
most adults. A 1-inch needle is generally used for the vastus lateralis in adults or for deltoid in
larger clients. A 1½-inch needle is used for ventrogluteal or dorsogluteal sites in adults.
Question 8
A nurse is administering a medication that is classified as a Pregnancy Category X. What does
this classification indicate?
A. The medication is safe during pregnancy
B. The medication is contraindicated during pregnancy
C. The medication has not been studied in pregnancy
D. The medication is safe during the first trimester only
Correct Answer: B
Rationale: Pregnancy Category X indicates that studies in animals or humans have
demonstrated fetal abnormalities, and the risk of use clearly outweighs any possible benefit.
The medication is contraindicated in women who are or may become pregnant. Category A is
the safest, Category B and C have varying levels of safety, and Category D has evidence of
human fetal risk but may be used in life-threatening situations.
Question 9
A nurse is preparing to administer a controlled substance. Which of the following actions are
required? Select all that apply.
A. Count the controlled substance with another nurse
B. Document the administration in the controlled substance record
C. Verify the client's identification using two identifiers
D. Leave the controlled substance in the client's room for later use
E. Report any discrepancy to the appropriate authority immediately
