Nursing Pharmacology Exam Review | 120 Practice Questions with
Answers, Rationales & Dosage Calculations 2026/2027
Medication Safety and Administration
1. Before administering a medication, which action best prevents wrong-
patient errors?
A. Ask another client
B. Ask the room number
C. Use two approved patient identifiers
D. Recognize the client's face
Answer: C
Rationale: Two identifiers link the medication to the intended client. Room number
is not an approved patient identifier.
2. An order is unclear and the dose appears unusually high. What should the
nurse do?
A. Guess the intended dose
B. Ask family to choose
C. Administer half
D. Clarify before administration
Answer: D
Rationale: An ambiguous or potentially unsafe order must be clarified before
medication is given.
3. A client reports a penicillin allergy. What information is most useful?
A. Favorite food
B. The room number
C. Shoe size
D. The reaction and its severity
Answer: D
Rationale: The reaction history helps distinguish intolerance from potentially
serious hypersensitivity and guides safe selection.
4. Why is medication reconciliation important at transitions of care?
A. It eliminates all adverse reactions
B. It replaces assessment
C. It applies only to prescription drugs
,D. It identifies omissions, duplications, and interactions
Answer: D
Rationale: Compare prescription drugs, OTC products, and supplements to detect
discrepancies during admission, transfer, and discharge.
5. Which tablet should generally not be crushed?
A. Extended-release tablet
B. A crushable immediate-release tablet approved by pharmacy
C. A prescribed dispersible tablet
D. A scored tablet authorized for splitting
Answer: A
Rationale: Crushing modified-release formulations can release medication too
rapidly and cause toxicity.
6. Before medication through a feeding tube, what should the nurse do?
A. Mix all medications with formula
B. Verify formulation suitability and tube placement per policy
C. Skip flushing
D. Crush all drugs together
Answer: B
Rationale: Confirm access and appropriate formulations. Administer medications
separately with prescribed flushing to reduce obstruction and interactions.
7. A client refuses a medication. What is the appropriate response?
A. Force administration
B. Explore the reason, provide information, and document the refusal
C. Hide it in food
D. Record it as administered
Answer: B
Rationale: A capable client may refuse. Assess concerns, communicate clinically
important refusals, and document accurately.
8. A medication error occurs. What is the first priority?
A. Blame another staff member
B. Conceal the error
C. Assess the client and address potential harm
D. Complete the incident report before assessment
Answer: C
,Rationale: Immediate assessment and necessary treatment take priority, followed
by required notifications and reporting.
9. Which abbreviation is safest when documenting an insulin dose?
A. Units written in full
B. An unlabeled number
C. U
D. IU
Answer: A
Rationale: Writing units in full reduces misreading that can cause large dosing
errors.
10. A client has difficulty swallowing pills. What should the nurse do?
A. Consult pharmacy about appropriate alternative formulations
B. Crush every tablet automatically
C. Tell the client to swallow dry
D. Omit all medications without reporting
Answer: A
Rationale: Formulation changes must preserve safe delivery. Some tablets cannot
be crushed.
11. Which action improves safety for a high-alert medication?
A. Leave an unlabeled syringe
B. Skip verification when busy
C. Use required checks and monitoring
D. Rely on memory alone
Answer: C
Rationale: High-alert drugs can cause serious harm. Follow dose verification,
labeling, pump, and monitoring requirements.
12. Which action is appropriate for a transdermal medication patch?
A. Remove the old patch and apply as directed
B. Cut every patch in half
C. Apply a new patch over the old one
D. Apply a heating pad over it
Answer: A
Rationale: Removing the prior patch prevents duplicate dosing. Heat may increase
absorption, and cutting may alter delivery.
, Cardiovascular and Diuretic Medications
13. A client taking an ACE inhibitor develops tongue swelling. What is the
priority?
A. Offer water only
B. Activate emergency assistance and support the airway
C. Reassess next week
D. Give the next dose
Answer: B
Rationale: Angioedema can obstruct the airway and requires immediate
intervention.
14. Which laboratory value needs monitoring with lisinopril?
A. Potassium
B. Bilirubin alone
C. Hemoglobin A1c alone
D. Amylase alone
Answer: A
Rationale: ACE inhibitors can increase potassium and affect renal function,
especially with kidney disease or interacting drugs.
15. A persistent dry cough begins after lisinopril. What should the nurse do?
A. Automatically switch medication without an order
B. Recognize a possible adverse effect and notify the provider
C. Ignore all symptoms
D. Double the dose
Answer: B
Rationale: ACE inhibitors can cause a dry cough. The provider may consider an
alternative after evaluation.
16. Which assessment is important before metoprolol?
A. Foot size
B. Visual acuity only
C. Hair color
D. Heart rate and blood pressure
Answer: D
Rationale: Beta blockers can cause bradycardia and hypotension. Apply prescribed
hold parameters.
17. Why should a client not abruptly discontinue a beta blocker?
Answers, Rationales & Dosage Calculations 2026/2027
Medication Safety and Administration
1. Before administering a medication, which action best prevents wrong-
patient errors?
A. Ask another client
B. Ask the room number
C. Use two approved patient identifiers
D. Recognize the client's face
Answer: C
Rationale: Two identifiers link the medication to the intended client. Room number
is not an approved patient identifier.
2. An order is unclear and the dose appears unusually high. What should the
nurse do?
A. Guess the intended dose
B. Ask family to choose
C. Administer half
D. Clarify before administration
Answer: D
Rationale: An ambiguous or potentially unsafe order must be clarified before
medication is given.
3. A client reports a penicillin allergy. What information is most useful?
A. Favorite food
B. The room number
C. Shoe size
D. The reaction and its severity
Answer: D
Rationale: The reaction history helps distinguish intolerance from potentially
serious hypersensitivity and guides safe selection.
4. Why is medication reconciliation important at transitions of care?
A. It eliminates all adverse reactions
B. It replaces assessment
C. It applies only to prescription drugs
,D. It identifies omissions, duplications, and interactions
Answer: D
Rationale: Compare prescription drugs, OTC products, and supplements to detect
discrepancies during admission, transfer, and discharge.
5. Which tablet should generally not be crushed?
A. Extended-release tablet
B. A crushable immediate-release tablet approved by pharmacy
C. A prescribed dispersible tablet
D. A scored tablet authorized for splitting
Answer: A
Rationale: Crushing modified-release formulations can release medication too
rapidly and cause toxicity.
6. Before medication through a feeding tube, what should the nurse do?
A. Mix all medications with formula
B. Verify formulation suitability and tube placement per policy
C. Skip flushing
D. Crush all drugs together
Answer: B
Rationale: Confirm access and appropriate formulations. Administer medications
separately with prescribed flushing to reduce obstruction and interactions.
7. A client refuses a medication. What is the appropriate response?
A. Force administration
B. Explore the reason, provide information, and document the refusal
C. Hide it in food
D. Record it as administered
Answer: B
Rationale: A capable client may refuse. Assess concerns, communicate clinically
important refusals, and document accurately.
8. A medication error occurs. What is the first priority?
A. Blame another staff member
B. Conceal the error
C. Assess the client and address potential harm
D. Complete the incident report before assessment
Answer: C
,Rationale: Immediate assessment and necessary treatment take priority, followed
by required notifications and reporting.
9. Which abbreviation is safest when documenting an insulin dose?
A. Units written in full
B. An unlabeled number
C. U
D. IU
Answer: A
Rationale: Writing units in full reduces misreading that can cause large dosing
errors.
10. A client has difficulty swallowing pills. What should the nurse do?
A. Consult pharmacy about appropriate alternative formulations
B. Crush every tablet automatically
C. Tell the client to swallow dry
D. Omit all medications without reporting
Answer: A
Rationale: Formulation changes must preserve safe delivery. Some tablets cannot
be crushed.
11. Which action improves safety for a high-alert medication?
A. Leave an unlabeled syringe
B. Skip verification when busy
C. Use required checks and monitoring
D. Rely on memory alone
Answer: C
Rationale: High-alert drugs can cause serious harm. Follow dose verification,
labeling, pump, and monitoring requirements.
12. Which action is appropriate for a transdermal medication patch?
A. Remove the old patch and apply as directed
B. Cut every patch in half
C. Apply a new patch over the old one
D. Apply a heating pad over it
Answer: A
Rationale: Removing the prior patch prevents duplicate dosing. Heat may increase
absorption, and cutting may alter delivery.
, Cardiovascular and Diuretic Medications
13. A client taking an ACE inhibitor develops tongue swelling. What is the
priority?
A. Offer water only
B. Activate emergency assistance and support the airway
C. Reassess next week
D. Give the next dose
Answer: B
Rationale: Angioedema can obstruct the airway and requires immediate
intervention.
14. Which laboratory value needs monitoring with lisinopril?
A. Potassium
B. Bilirubin alone
C. Hemoglobin A1c alone
D. Amylase alone
Answer: A
Rationale: ACE inhibitors can increase potassium and affect renal function,
especially with kidney disease or interacting drugs.
15. A persistent dry cough begins after lisinopril. What should the nurse do?
A. Automatically switch medication without an order
B. Recognize a possible adverse effect and notify the provider
C. Ignore all symptoms
D. Double the dose
Answer: B
Rationale: ACE inhibitors can cause a dry cough. The provider may consider an
alternative after evaluation.
16. Which assessment is important before metoprolol?
A. Foot size
B. Visual acuity only
C. Hair color
D. Heart rate and blood pressure
Answer: D
Rationale: Beta blockers can cause bradycardia and hypotension. Apply prescribed
hold parameters.
17. Why should a client not abruptly discontinue a beta blocker?
