NURSING PHARMACOLOGY
Practice Exam 2026/2027
50 NCLEX-Style Questions with Correct Answers
& Detailed Rationales | Graded A+
50 9 4 100%
Original questions Drug-class topics Item formats Rationales included
WHAT'S INSIDE
✓ Anticoagulants: heparin, warfarin, enoxaparin, DOACs, HIT, and reversal agents
✓ Insulin & diabetes: rapid, intermediate & long-acting insulins, mixing, hypoglycemia, metformin
✓ Cardiac: digoxin, beta blockers, ACE inhibitors, loop, thiazide & potassium-sparing diuretics
✓ Antibiotics: vancomycin, aminoglycosides, fluoroquinolones, metronidazole, anaphylaxis
✓ Opioids & naloxone: sedation assessment, respiratory depression, bowel regimen, intranasal naloxone
✓ Psychiatric: lithium, SSRIs, serotonin syndrome, MAOIs, tyramine & washout periods
✓ Respiratory & GI: SABA vs. LABA, inhaled steroids, theophylline, LAMA, PPIs, sucralfate, metoclopramide
✓ Dosage calculations: heparin drip, pediatric weight-based, gravity drip rate, tablets, dopamine mcg/kg/min
✓ Formats: multiple choice (A–D), select-all-that-apply, and NGN-style case items (drop-down cloze, matrix, bow-tie,
highlight)
Disclaimer: Original practice questions for study purposes; not affiliated with ATI, HESI, or NCSBN. Content reflects
current standard nursing pharmacology references at the time of writing; always follow your program's materials, facility
protocols, prescriber orders, and current drug labeling in clinical practice.
, Nursing Pharmacology Practice Exam 2026/2027 | 50 Original Questions with Rationales
Table of Contents
Topics, question numbers, and page locations
# Topic Questions Page
1 Anticoagulants Q1–Q6 (6) 3
2 Insulin & Diabetes Medications Q7–Q12 (6) 6
3 Cardiac Medications: Digoxin, Beta Blockers, ACE Inhibitors & Diuretics Q13–Q22 (10) 9
4 Antibiotics Q23–Q27 (5) 14
5 Opioids & Naloxone Q28–Q31 (4) 17
6 Psychiatric Medications: Lithium, SSRIs & MAOIs Q32–Q38 (7) 20
7 Respiratory Medications Q39–Q42 (4) 24
8 Gastrointestinal Medications Q43–Q45 (3) 26
9 Dosage Calculations Q46–Q50 (5) 28
Quick-Reference Answer Key Q1–Q50 30
How to Use This Exam
• Cover the answer box beneath each question and commit to an answer before reading the rationale.
• Read every rationale, including why the wrong options are wrong; this is where most of the learning happens.
• Select-all-that-apply (SATA) items may have any number of correct options; evaluate each option
independently as true or false.
• NGN-style case items mirror next-generation clinical judgment formats: recognize cues, analyze, prioritize, act,
and evaluate.
• For dosage calculations, show your work and round only at the final step unless instructed otherwise.
• Use the Quick-Reference Answer Key at the end to self-score a timed attempt (aim for about 1 minute per
item).
Disclaimer: Original practice questions for study purposes; not affiliated with ATI, HESI, or NCSBN. All questions were
written from scratch and are not reproduced from any exam, test bank, or publisher. This document is an educational
study aid and is not a substitute for clinical judgment, institutional protocols, or professional drug references.
Original practice questions for study purposes; not affiliated with ATI, HESI, or NCSBN. • Page 2
, Nursing Pharmacology Practice Exam 2026/2027 | 50 Original Questions with Rationales
SECTION 1
Anticoagulants
Questions 1–6
Question 1 Multiple Choice
A client is receiving a continuous IV infusion of unfractionated heparin for a deep vein thrombosis. The 0600
aPTT result is 118 seconds (facility therapeutic range: 60–85 seconds). Which action should the nurse take first?
A. Continue the infusion at the current rate and recheck the aPTT in 6 hours
B. Hold the infusion per protocol, assess the client for signs of bleeding, and notify the provider
C. Prepare to administer vitamin K (phytonadione) IV
D. Increase the infusion rate to maintain the therapeutic level
Correct Answer: B
Rationale: An aPTT well above the therapeutic range places the client at high risk for hemorrhage. Most
weight-based heparin protocols direct the nurse to hold the infusion (typically for about 1 hour), assess for
bleeding (gums, urine, stool, puncture sites, neuro changes), and notify the provider for a rate reduction. (A)
Continuing unchanged ignores a critical value. (C) Vitamin K reverses warfarin, not heparin; the heparin
antidote is protamine sulfate. (D) Increasing the rate would worsen the anticoagulation.
Question 2 Select All That Apply
A nurse is reinforcing discharge teaching for a client newly prescribed warfarin for atrial fibrillation. Which
statements by the client indicate understanding? Select all that apply.
☐ A. "I will keep the amount of leafy green vegetables I eat about the same each week."
☐ B. "I will switch to an electric razor."
☐ C. "If I miss a dose, I will take two tablets the next day."
☐ D. "I will report pink or red urine to my provider."
☐ E. "I will avoid taking ibuprofen for headaches unless my provider approves it."
☐ F. "Ginkgo biloba is a safe herbal supplement to take with warfarin."
Correct Answer: A, B, D, E
Rationale: (A) Correct: Warfarin antagonizes vitamin K; consistent—not eliminated—vitamin K intake keeps
the INR stable. (B) Correct: An electric razor reduces the risk of cuts and bleeding. (D) Correct: Hematuria is a
sign of bleeding and should be reported. (E) Correct: NSAIDs increase bleeding risk and GI bleeding;
acetaminophen in limited doses is usually preferred. (C) Incorrect: Doubling a dose can raise the INR
dangerously; the client should take a missed dose the same day only if remembered soon and otherwise
follow provider instructions—never double. (F) Incorrect: Ginkgo has antiplatelet effects and increases
bleeding risk with warfarin.
Original practice questions for study purposes; not affiliated with ATI, HESI, or NCSBN. • Page 3
Practice Exam 2026/2027
50 NCLEX-Style Questions with Correct Answers
& Detailed Rationales | Graded A+
50 9 4 100%
Original questions Drug-class topics Item formats Rationales included
WHAT'S INSIDE
✓ Anticoagulants: heparin, warfarin, enoxaparin, DOACs, HIT, and reversal agents
✓ Insulin & diabetes: rapid, intermediate & long-acting insulins, mixing, hypoglycemia, metformin
✓ Cardiac: digoxin, beta blockers, ACE inhibitors, loop, thiazide & potassium-sparing diuretics
✓ Antibiotics: vancomycin, aminoglycosides, fluoroquinolones, metronidazole, anaphylaxis
✓ Opioids & naloxone: sedation assessment, respiratory depression, bowel regimen, intranasal naloxone
✓ Psychiatric: lithium, SSRIs, serotonin syndrome, MAOIs, tyramine & washout periods
✓ Respiratory & GI: SABA vs. LABA, inhaled steroids, theophylline, LAMA, PPIs, sucralfate, metoclopramide
✓ Dosage calculations: heparin drip, pediatric weight-based, gravity drip rate, tablets, dopamine mcg/kg/min
✓ Formats: multiple choice (A–D), select-all-that-apply, and NGN-style case items (drop-down cloze, matrix, bow-tie,
highlight)
Disclaimer: Original practice questions for study purposes; not affiliated with ATI, HESI, or NCSBN. Content reflects
current standard nursing pharmacology references at the time of writing; always follow your program's materials, facility
protocols, prescriber orders, and current drug labeling in clinical practice.
, Nursing Pharmacology Practice Exam 2026/2027 | 50 Original Questions with Rationales
Table of Contents
Topics, question numbers, and page locations
# Topic Questions Page
1 Anticoagulants Q1–Q6 (6) 3
2 Insulin & Diabetes Medications Q7–Q12 (6) 6
3 Cardiac Medications: Digoxin, Beta Blockers, ACE Inhibitors & Diuretics Q13–Q22 (10) 9
4 Antibiotics Q23–Q27 (5) 14
5 Opioids & Naloxone Q28–Q31 (4) 17
6 Psychiatric Medications: Lithium, SSRIs & MAOIs Q32–Q38 (7) 20
7 Respiratory Medications Q39–Q42 (4) 24
8 Gastrointestinal Medications Q43–Q45 (3) 26
9 Dosage Calculations Q46–Q50 (5) 28
Quick-Reference Answer Key Q1–Q50 30
How to Use This Exam
• Cover the answer box beneath each question and commit to an answer before reading the rationale.
• Read every rationale, including why the wrong options are wrong; this is where most of the learning happens.
• Select-all-that-apply (SATA) items may have any number of correct options; evaluate each option
independently as true or false.
• NGN-style case items mirror next-generation clinical judgment formats: recognize cues, analyze, prioritize, act,
and evaluate.
• For dosage calculations, show your work and round only at the final step unless instructed otherwise.
• Use the Quick-Reference Answer Key at the end to self-score a timed attempt (aim for about 1 minute per
item).
Disclaimer: Original practice questions for study purposes; not affiliated with ATI, HESI, or NCSBN. All questions were
written from scratch and are not reproduced from any exam, test bank, or publisher. This document is an educational
study aid and is not a substitute for clinical judgment, institutional protocols, or professional drug references.
Original practice questions for study purposes; not affiliated with ATI, HESI, or NCSBN. • Page 2
, Nursing Pharmacology Practice Exam 2026/2027 | 50 Original Questions with Rationales
SECTION 1
Anticoagulants
Questions 1–6
Question 1 Multiple Choice
A client is receiving a continuous IV infusion of unfractionated heparin for a deep vein thrombosis. The 0600
aPTT result is 118 seconds (facility therapeutic range: 60–85 seconds). Which action should the nurse take first?
A. Continue the infusion at the current rate and recheck the aPTT in 6 hours
B. Hold the infusion per protocol, assess the client for signs of bleeding, and notify the provider
C. Prepare to administer vitamin K (phytonadione) IV
D. Increase the infusion rate to maintain the therapeutic level
Correct Answer: B
Rationale: An aPTT well above the therapeutic range places the client at high risk for hemorrhage. Most
weight-based heparin protocols direct the nurse to hold the infusion (typically for about 1 hour), assess for
bleeding (gums, urine, stool, puncture sites, neuro changes), and notify the provider for a rate reduction. (A)
Continuing unchanged ignores a critical value. (C) Vitamin K reverses warfarin, not heparin; the heparin
antidote is protamine sulfate. (D) Increasing the rate would worsen the anticoagulation.
Question 2 Select All That Apply
A nurse is reinforcing discharge teaching for a client newly prescribed warfarin for atrial fibrillation. Which
statements by the client indicate understanding? Select all that apply.
☐ A. "I will keep the amount of leafy green vegetables I eat about the same each week."
☐ B. "I will switch to an electric razor."
☐ C. "If I miss a dose, I will take two tablets the next day."
☐ D. "I will report pink or red urine to my provider."
☐ E. "I will avoid taking ibuprofen for headaches unless my provider approves it."
☐ F. "Ginkgo biloba is a safe herbal supplement to take with warfarin."
Correct Answer: A, B, D, E
Rationale: (A) Correct: Warfarin antagonizes vitamin K; consistent—not eliminated—vitamin K intake keeps
the INR stable. (B) Correct: An electric razor reduces the risk of cuts and bleeding. (D) Correct: Hematuria is a
sign of bleeding and should be reported. (E) Correct: NSAIDs increase bleeding risk and GI bleeding;
acetaminophen in limited doses is usually preferred. (C) Incorrect: Doubling a dose can raise the INR
dangerously; the client should take a missed dose the same day only if remembered soon and otherwise
follow provider instructions—never double. (F) Incorrect: Ginkgo has antiplatelet effects and increases
bleeding risk with warfarin.
Original practice questions for study purposes; not affiliated with ATI, HESI, or NCSBN. • Page 3
