KAPLAN PHARMACOLOGY INTEGRATED PROCTORED EXAM (FORM D) – NGN STYLE QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
Pharmacokinetics and Pharmacodynamics
Cardiovascular and Hematologic Pharmacology
Neurological and Psychiatric Medications
Endocrine and Metabolic Agents
Anti-infective Therapies
Pain Management and Anesthesia
Gastrointestinal and Renal Medications
Patient Safety and Medication Administration
Introduction
The Kaplan Pharmacology Integrated Proctored Exam (Form D) is designed to assess the comprehensive
pharmacological knowledge and clinical judgment required for safe nursing practice. This examination
evaluates the candidate's understanding of drug classifications, mechanisms of action, adverse effects,
and legal and ethical considerations in medication administration. The test employs multiple-choice and
scenario-based questions that emphasize real-world application and decision-making. Candidates are
challenged to apply critical thinking skills to prioritize patient safety and optimize therapeutic outcomes
across diverse patient populations and healthcare settings.
SECTION ONE: QUESTIONS 1–70
1. A nurse is preparing to administer intravenous morphine sulfate to a postoperative patient.
Which assessment finding requires immediate action?
A. Respiratory rate of 18 breaths/min
B. Pain rating of 3 on a 0–10 scale
C. Blood pressure 110/70 mm Hg
🟢 D. Respiratory rate of 8 breaths/min
🔴 RATIONALE: A respiratory rate of 8 breaths/min indicates respiratory depression, a life-threatening
opioid adverse effect. Naloxone may be needed to reverse this effect. The other findings are within
acceptable ranges.
2. A patient with heart failure is prescribed furosemide 40 mg orally twice daily. Which laboratory
value should the nurse monitor most closely?
A. Serum sodium of 138 mEq/L
🟢 B. Serum potassium of 3.1 mEq/L
,C. Serum calcium of 9.2 mg/dL
D. Serum magnesium of 2.1 mg/dL
🔴 RATIONALE: Furosemide is a loop diuretic that causes hypokalemia (potassium loss). A potassium
of 3.1 mEq/L is below the normal range (3.5–5.0 mEq/L) and increases the risk for cardiac
dysrhythmias, especially in patients taking digoxin.
3. A nurse is teaching a patient about digoxin therapy. Which statement indicates understanding?
A. "I will take an extra dose if I miss one."
B. "I can stop taking digoxin if I feel better."
🟢 C. "I will check my pulse daily before taking the medication."
D. "I will take digoxin with antacids for stomach upset."
🔴 RATIONALE: Digoxin has a narrow therapeutic index. Bradycardia (pulse <60/min in adults) requires
holding the dose and notifying the provider. Antacids decrease digoxin absorption.
4. A patient with heart failure is prescribed digoxin. Which finding is most indicative of digoxin
toxicity?
🟢 A. Nausea and yellowish-green halos around lights
B. Heart rate of 68 bpm
C. Serum potassium of 4.0 mEq/L
D. Blood pressure of 130/80 mm Hg
🔴 RATIONALE: Nausea and visual disturbances (yellow-green halos) are classic signs of digoxin
toxicity. The therapeutic digoxin level is 0.8–2.0 ng/mL. Hypokalemia increases toxicity risk.
5. A nurse is teaching a client with atrial fibrillation about warfarin. Which statement indicates a
need for further teaching?
A. "I will eat the same amount of green leafy vegetables every week."
B. "I will use a soft toothbrush and electric razor."
🟢 C. "I can take ibuprofen for headaches because it is over-the-counter."
D. "I will have my INR checked regularly."
🔴 RATIONALE: Ibuprofen (NSAID) increases bleeding risk and should be avoided while taking
warfarin. Consistent vitamin K intake helps maintain stable INR.
6. A client is receiving a continuous heparin infusion. The nurse notes a sudden drop in platelet
count from 250,000/mm³ to 90,000/mm³. Which action should the nurse take first?
A. Administer protamine sulfate as ordered.
🟢 B. Stop the heparin infusion.
C. Increase the heparin rate to prevent clotting.
D. Obtain aPTT and INR levels.
🔴 RATIONALE: This platelet drop suggests heparin-induced thrombocytopenia (HIT), a life-
threatening prothrombotic condition. Heparin must be stopped immediately.
, 7. A client with hypertension is prescribed lisinopril. Which adverse effect should the nurse instruct
the client to report immediately?
A. Dry, nonproductive cough
🟢 B. Swelling of the lips and tongue
C. Headache
D. Fatigue
🔴 RATIONALE: Angioedema (swelling of lips, tongue, throat) is a rare but life-threatening adverse
effect of ACE inhibitors. Dry cough is common but not emergent.
8. A nurse is administering alteplase (tPA) to a client with acute ischemic stroke. Which assessment
finding is the priority before administration?
A. Blood glucose level of 120 mg/dL
🟢 B. Blood pressure of 185/110 mm Hg
C. Heart rate of 88 bpm
D. Respiratory rate of 16 breaths/min
🔴 RATIONALE: Alteplase is contraindicated when blood pressure exceeds 185/110 mm Hg due to the
risk of intracranial hemorrhage. Blood pressure must be controlled before administration.
9. A client is prescribed spironolactone. Which laboratory value should the nurse monitor closely?
A. Serum sodium
🟢 B. Serum potassium
C. Serum calcium
D. Serum magnesium
🔴 RATIONALE: Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. Serum
potassium levels should be monitored closely, especially in patients with renal impairment.
10. A patient is prescribed metoprolol. The nurse should instruct the patient to avoid which of the
following?
A. Taking the medication with food
🟢 B. Stopping the medication abruptly
C. Taking the medication at the same time daily
D. Monitoring heart rate
🔴 RATIONALE: Abrupt discontinuation of metoprolol can cause rebound hypertension, tachycardia,
and angina. The medication should be tapered gradually under medical supervision.
11. A nurse is reviewing the medication list of a client taking warfarin. Which medication, if also
prescribed, would require the nurse to question the order?
A. Acetaminophen
🟢 B. Ibuprofen
AND CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
Core Domains
Pharmacokinetics and Pharmacodynamics
Cardiovascular and Hematologic Pharmacology
Neurological and Psychiatric Medications
Endocrine and Metabolic Agents
Anti-infective Therapies
Pain Management and Anesthesia
Gastrointestinal and Renal Medications
Patient Safety and Medication Administration
Introduction
The Kaplan Pharmacology Integrated Proctored Exam (Form D) is designed to assess the comprehensive
pharmacological knowledge and clinical judgment required for safe nursing practice. This examination
evaluates the candidate's understanding of drug classifications, mechanisms of action, adverse effects,
and legal and ethical considerations in medication administration. The test employs multiple-choice and
scenario-based questions that emphasize real-world application and decision-making. Candidates are
challenged to apply critical thinking skills to prioritize patient safety and optimize therapeutic outcomes
across diverse patient populations and healthcare settings.
SECTION ONE: QUESTIONS 1–70
1. A nurse is preparing to administer intravenous morphine sulfate to a postoperative patient.
Which assessment finding requires immediate action?
A. Respiratory rate of 18 breaths/min
B. Pain rating of 3 on a 0–10 scale
C. Blood pressure 110/70 mm Hg
🟢 D. Respiratory rate of 8 breaths/min
🔴 RATIONALE: A respiratory rate of 8 breaths/min indicates respiratory depression, a life-threatening
opioid adverse effect. Naloxone may be needed to reverse this effect. The other findings are within
acceptable ranges.
2. A patient with heart failure is prescribed furosemide 40 mg orally twice daily. Which laboratory
value should the nurse monitor most closely?
A. Serum sodium of 138 mEq/L
🟢 B. Serum potassium of 3.1 mEq/L
,C. Serum calcium of 9.2 mg/dL
D. Serum magnesium of 2.1 mg/dL
🔴 RATIONALE: Furosemide is a loop diuretic that causes hypokalemia (potassium loss). A potassium
of 3.1 mEq/L is below the normal range (3.5–5.0 mEq/L) and increases the risk for cardiac
dysrhythmias, especially in patients taking digoxin.
3. A nurse is teaching a patient about digoxin therapy. Which statement indicates understanding?
A. "I will take an extra dose if I miss one."
B. "I can stop taking digoxin if I feel better."
🟢 C. "I will check my pulse daily before taking the medication."
D. "I will take digoxin with antacids for stomach upset."
🔴 RATIONALE: Digoxin has a narrow therapeutic index. Bradycardia (pulse <60/min in adults) requires
holding the dose and notifying the provider. Antacids decrease digoxin absorption.
4. A patient with heart failure is prescribed digoxin. Which finding is most indicative of digoxin
toxicity?
🟢 A. Nausea and yellowish-green halos around lights
B. Heart rate of 68 bpm
C. Serum potassium of 4.0 mEq/L
D. Blood pressure of 130/80 mm Hg
🔴 RATIONALE: Nausea and visual disturbances (yellow-green halos) are classic signs of digoxin
toxicity. The therapeutic digoxin level is 0.8–2.0 ng/mL. Hypokalemia increases toxicity risk.
5. A nurse is teaching a client with atrial fibrillation about warfarin. Which statement indicates a
need for further teaching?
A. "I will eat the same amount of green leafy vegetables every week."
B. "I will use a soft toothbrush and electric razor."
🟢 C. "I can take ibuprofen for headaches because it is over-the-counter."
D. "I will have my INR checked regularly."
🔴 RATIONALE: Ibuprofen (NSAID) increases bleeding risk and should be avoided while taking
warfarin. Consistent vitamin K intake helps maintain stable INR.
6. A client is receiving a continuous heparin infusion. The nurse notes a sudden drop in platelet
count from 250,000/mm³ to 90,000/mm³. Which action should the nurse take first?
A. Administer protamine sulfate as ordered.
🟢 B. Stop the heparin infusion.
C. Increase the heparin rate to prevent clotting.
D. Obtain aPTT and INR levels.
🔴 RATIONALE: This platelet drop suggests heparin-induced thrombocytopenia (HIT), a life-
threatening prothrombotic condition. Heparin must be stopped immediately.
, 7. A client with hypertension is prescribed lisinopril. Which adverse effect should the nurse instruct
the client to report immediately?
A. Dry, nonproductive cough
🟢 B. Swelling of the lips and tongue
C. Headache
D. Fatigue
🔴 RATIONALE: Angioedema (swelling of lips, tongue, throat) is a rare but life-threatening adverse
effect of ACE inhibitors. Dry cough is common but not emergent.
8. A nurse is administering alteplase (tPA) to a client with acute ischemic stroke. Which assessment
finding is the priority before administration?
A. Blood glucose level of 120 mg/dL
🟢 B. Blood pressure of 185/110 mm Hg
C. Heart rate of 88 bpm
D. Respiratory rate of 16 breaths/min
🔴 RATIONALE: Alteplase is contraindicated when blood pressure exceeds 185/110 mm Hg due to the
risk of intracranial hemorrhage. Blood pressure must be controlled before administration.
9. A client is prescribed spironolactone. Which laboratory value should the nurse monitor closely?
A. Serum sodium
🟢 B. Serum potassium
C. Serum calcium
D. Serum magnesium
🔴 RATIONALE: Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. Serum
potassium levels should be monitored closely, especially in patients with renal impairment.
10. A patient is prescribed metoprolol. The nurse should instruct the patient to avoid which of the
following?
A. Taking the medication with food
🟢 B. Stopping the medication abruptly
C. Taking the medication at the same time daily
D. Monitoring heart rate
🔴 RATIONALE: Abrupt discontinuation of metoprolol can cause rebound hypertension, tachycardia,
and angina. The medication should be tapered gradually under medical supervision.
11. A nurse is reviewing the medication list of a client taking warfarin. Which medication, if also
prescribed, would require the nurse to question the order?
A. Acetaminophen
🟢 B. Ibuprofen
