NCLEX RN Pharmacological and
Parenteral Therapies Practice Exam 1
100 Questions And Correct Answers
(Verified Answers) Plus Rationales
2026 Q&A Instant Download Pdf
Question 1
A nurse is preparing to administer digoxin to an adult client. Which assessment
finding requires the nurse to withhold the medication and notify the provider?
A. Apical pulse of 54/min
B. Blood pressure of 128/76 mm Hg
C. Respiratory rate of 18/min
D. Temperature of 37°C (98.6°F)
Answer: A. Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. The nurse should assess the apical
pulse for 1 full minute and generally withhold digoxin in an adult if the rate is
below 60/min, according to common medication parameters.
Question 2
A client taking warfarin asks which laboratory test is used to monitor the
medication's therapeutic effect. Which response is correct?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Platelet count
D. Serum creatinine
Answer: B. International normalized ratio (INR)
,Rationale: Warfarin therapy is monitored primarily with the PT/INR. The INR
helps determine whether anticoagulation is within the prescribed therapeutic
range.
Question 3
A client receiving IV potassium chloride reports burning at the infusion site.
What is the nurse's priority action?
A. Increase the infusion rate
B. Apply a warm compress and continue the infusion
C. Stop the infusion and assess the IV site
D. Administer the medication through the same site more rapidly
Answer: C. Stop the infusion and assess the IV site
Rationale: IV potassium can cause significant irritation and tissue injury if
infiltration or extravasation occurs. The infusion should be stopped and the IV
site assessed immediately.
Question 4
Which statement by a client taking lisinopril indicates a need for immediate
follow-up?
A. "I sometimes have a mild headache."
B. "I have developed swelling of my lips and tongue."
C. "I urinate more frequently than before."
D. "I occasionally feel tired."
Answer: B. "I have developed swelling of my lips and tongue."
Rationale: Facial, lip, tongue, or throat swelling may indicate angioedema, a
potentially life-threatening adverse effect of ACE inhibitors requiring
immediate intervention.
Question 5
A nurse is teaching a client about sublingual nitroglycerin. Which instruction is
appropriate?
A. Swallow the tablet with water
B. Store the tablets in the original container
,C. Take the medication only after chest pain lasts 30 minutes
D. Place the tablet under the tongue and allow it to dissolve
Answer: D. Place the tablet under the tongue and allow it to dissolve
Rationale: Sublingual nitroglycerin is placed under the tongue for rapid
absorption. It should not be swallowed, and clients should follow prescribed
emergency instructions for persistent chest pain.
Question 6
Which medication should the nurse question before administering to a client
with a documented severe allergy to penicillin?
A. Azithromycin
B. Amoxicillin
C. Doxycycline
D. Ciprofloxacin
Answer: B. Amoxicillin
Rationale: Amoxicillin is a penicillin-class antibiotic. A client with a severe
penicillin allergy may be at risk for a serious hypersensitivity reaction.
Question 7
A client receiving heparin develops bleeding from the gums and has an
unusually large bruise. What should the nurse do first?
A. Administer aspirin
B. Continue the infusion and reassess later
C. Assess the client and notify the provider promptly
D. Encourage increased fluid intake
Answer: C. Assess the client and notify the provider promptly
Rationale: Unusual bleeding and bruising can indicate excessive
anticoagulation or bleeding complications. The nurse should assess the client
and promptly communicate significant findings.
Question 8
A client taking furosemide is at greatest risk for which electrolyte imbalance?
, A. Hypercalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
Answer: C. Hypokalemia
Rationale: Loop diuretics such as furosemide increase urinary excretion of
potassium and can cause hypokalemia.
Question 9
Which assessment finding is most concerning in a client receiving morphine?
A. Respiratory rate of 8/min
B. Mild constipation
C. Drowsiness
D. Nausea
Answer: A. Respiratory rate of 8/min
Rationale: Opioids can cause life-threatening respiratory depression. A
respiratory rate of 8/min requires immediate assessment and intervention.
Question 10
Which medication is commonly used as an antidote for opioid-induced
respiratory depression?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: B. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced
respiratory and central nervous system depression.
Question 11
A client taking metformin is scheduled for a procedure involving iodinated
contrast. Which action is appropriate?
Parenteral Therapies Practice Exam 1
100 Questions And Correct Answers
(Verified Answers) Plus Rationales
2026 Q&A Instant Download Pdf
Question 1
A nurse is preparing to administer digoxin to an adult client. Which assessment
finding requires the nurse to withhold the medication and notify the provider?
A. Apical pulse of 54/min
B. Blood pressure of 128/76 mm Hg
C. Respiratory rate of 18/min
D. Temperature of 37°C (98.6°F)
Answer: A. Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. The nurse should assess the apical
pulse for 1 full minute and generally withhold digoxin in an adult if the rate is
below 60/min, according to common medication parameters.
Question 2
A client taking warfarin asks which laboratory test is used to monitor the
medication's therapeutic effect. Which response is correct?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Platelet count
D. Serum creatinine
Answer: B. International normalized ratio (INR)
,Rationale: Warfarin therapy is monitored primarily with the PT/INR. The INR
helps determine whether anticoagulation is within the prescribed therapeutic
range.
Question 3
A client receiving IV potassium chloride reports burning at the infusion site.
What is the nurse's priority action?
A. Increase the infusion rate
B. Apply a warm compress and continue the infusion
C. Stop the infusion and assess the IV site
D. Administer the medication through the same site more rapidly
Answer: C. Stop the infusion and assess the IV site
Rationale: IV potassium can cause significant irritation and tissue injury if
infiltration or extravasation occurs. The infusion should be stopped and the IV
site assessed immediately.
Question 4
Which statement by a client taking lisinopril indicates a need for immediate
follow-up?
A. "I sometimes have a mild headache."
B. "I have developed swelling of my lips and tongue."
C. "I urinate more frequently than before."
D. "I occasionally feel tired."
Answer: B. "I have developed swelling of my lips and tongue."
Rationale: Facial, lip, tongue, or throat swelling may indicate angioedema, a
potentially life-threatening adverse effect of ACE inhibitors requiring
immediate intervention.
Question 5
A nurse is teaching a client about sublingual nitroglycerin. Which instruction is
appropriate?
A. Swallow the tablet with water
B. Store the tablets in the original container
,C. Take the medication only after chest pain lasts 30 minutes
D. Place the tablet under the tongue and allow it to dissolve
Answer: D. Place the tablet under the tongue and allow it to dissolve
Rationale: Sublingual nitroglycerin is placed under the tongue for rapid
absorption. It should not be swallowed, and clients should follow prescribed
emergency instructions for persistent chest pain.
Question 6
Which medication should the nurse question before administering to a client
with a documented severe allergy to penicillin?
A. Azithromycin
B. Amoxicillin
C. Doxycycline
D. Ciprofloxacin
Answer: B. Amoxicillin
Rationale: Amoxicillin is a penicillin-class antibiotic. A client with a severe
penicillin allergy may be at risk for a serious hypersensitivity reaction.
Question 7
A client receiving heparin develops bleeding from the gums and has an
unusually large bruise. What should the nurse do first?
A. Administer aspirin
B. Continue the infusion and reassess later
C. Assess the client and notify the provider promptly
D. Encourage increased fluid intake
Answer: C. Assess the client and notify the provider promptly
Rationale: Unusual bleeding and bruising can indicate excessive
anticoagulation or bleeding complications. The nurse should assess the client
and promptly communicate significant findings.
Question 8
A client taking furosemide is at greatest risk for which electrolyte imbalance?
, A. Hypercalcemia
B. Hypermagnesemia
C. Hypokalemia
D. Hypernatremia
Answer: C. Hypokalemia
Rationale: Loop diuretics such as furosemide increase urinary excretion of
potassium and can cause hypokalemia.
Question 9
Which assessment finding is most concerning in a client receiving morphine?
A. Respiratory rate of 8/min
B. Mild constipation
C. Drowsiness
D. Nausea
Answer: A. Respiratory rate of 8/min
Rationale: Opioids can cause life-threatening respiratory depression. A
respiratory rate of 8/min requires immediate assessment and intervention.
Question 10
Which medication is commonly used as an antidote for opioid-induced
respiratory depression?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: B. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced
respiratory and central nervous system depression.
Question 11
A client taking metformin is scheduled for a procedure involving iodinated
contrast. Which action is appropriate?
