KAPLAN PHARMACOLOGY
INTEGRATED EXAM (FORMS A, B,
C, D STYLE) NGN QUESTIONS
WITH CORRECT ANSWERS &
RATIONALES LATEST 2026
UPDATE | GRADED A+ | VERIFIED
CORE DOMAINS
General Pharmacological Principles
Cardiovascular Pharmacology
Endocrine Pharmacology
Neurologic and Psychiatric Pharmacology
Anti-Infective Pharmacology
Respiratory and Gastrointestinal Pharmacology
Pain Management and Anti-Inflammatory Agents
Chemotherapy and Critical Care Pharmacology
Antidotes and Reversal Agents
NGN Case Studies and Clinical Judgment
INTRODUCTION
,The Kaplan Pharmacology Integrated Exam evaluates nursing students'
mastery of pharmacological principles essential for safe, effective
clinical practice. This comprehensive assessment covers drug
classifications, mechanisms of action, therapeutic uses, adverse effects,
drug interactions, and patient education across all major body systems.
Questions are structured in multiple-choice and Next Generation
NCLEX (NGN) formats, including case studies and clinical judgment
items. Emphasis is placed on applying pharmacological knowledge to
real-world patient care scenarios requiring critical thinking and
decision-making. Candidates must demonstrate understanding of
medication safety, prioritization, and evidence-based rationales to
achieve a passing score and ensure NCLEX readiness.
SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is administering digoxin to a patient with heart failure. Which
finding requires immediate intervention?
A. Heart rate of 62 bpm
B. Serum potassium level of 3.2 mEq/L
C. Serum digoxin level of 1.0 ng/mL
D. Blood pressure of 120/80 mmHg
B. Serum potassium level of 3.2 mEq/L
RATIONALE: Hypokalemia (K+ <3.5 mEq/L) increases the risk of
digoxin toxicity, even with normal digoxin levels. The heart rate of 62
bpm is acceptable, the digoxin level 1.0 ng/mL is therapeutic (0.8-2.0
,ng/mL), and the blood pressure is normal. Hypokalemia potentiates
digoxin's effects on the heart, making toxicity more likely .
Question 2
A patient on digoxin reports nausea, yellow vision, and a heart rate of 52
bpm. What is the priority action?
A. Administer an antiemetic
B. Hold the next dose and check digoxin level
C. Give potassium chloride STAT
D. Reassess heart rate in 1 hour
B. Hold the next dose and check digoxin level
RATIONALE: Nausea and visual changes (yellow/green halos) are
classic signs of digoxin toxicity, especially with bradycardia. The
digoxin level should be obtained and the dose held until the provider is
notified. Digoxin has a narrow therapeutic index, and these symptoms
indicate potentially dangerous accumulation .
Question 3
A client is started on warfarin for atrial fibrillation. Which laboratory
value is most important to monitor?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
, B. INR
RATIONALE: Warfarin is monitored using the International
Normalized Ratio (INR) with a target of 2.0-3.0 for atrial fibrillation.
aPTT monitors heparin therapy. Platelet count monitors for heparin-
induced thrombocytopenia. Bleeding time is nonspecific and not used
for warfarin monitoring .
Question 4
A patient with atrial fibrillation is prescribed warfarin. Which INR range
indicates therapeutic anticoagulation for this indication?
A. 0.8-1.2
B. 1.5-2.0
C. 2.0-3.0
D. 3.0-4.0
C. 2.0-3.0
RATIONALE: For most indications (atrial fibrillation, DVT, PE),
the target INR is 2.0-3.0. Mechanical heart valves require a higher target
of 2.5-3.5. The INR must be monitored regularly due to warfarin's
narrow therapeutic index .
Question 5
A patient is prescribed a medication that is highly protein-bound. Which
pharmacokinetic parameter would be most affected by a decrease in
serum albumin?
INTEGRATED EXAM (FORMS A, B,
C, D STYLE) NGN QUESTIONS
WITH CORRECT ANSWERS &
RATIONALES LATEST 2026
UPDATE | GRADED A+ | VERIFIED
CORE DOMAINS
General Pharmacological Principles
Cardiovascular Pharmacology
Endocrine Pharmacology
Neurologic and Psychiatric Pharmacology
Anti-Infective Pharmacology
Respiratory and Gastrointestinal Pharmacology
Pain Management and Anti-Inflammatory Agents
Chemotherapy and Critical Care Pharmacology
Antidotes and Reversal Agents
NGN Case Studies and Clinical Judgment
INTRODUCTION
,The Kaplan Pharmacology Integrated Exam evaluates nursing students'
mastery of pharmacological principles essential for safe, effective
clinical practice. This comprehensive assessment covers drug
classifications, mechanisms of action, therapeutic uses, adverse effects,
drug interactions, and patient education across all major body systems.
Questions are structured in multiple-choice and Next Generation
NCLEX (NGN) formats, including case studies and clinical judgment
items. Emphasis is placed on applying pharmacological knowledge to
real-world patient care scenarios requiring critical thinking and
decision-making. Candidates must demonstrate understanding of
medication safety, prioritization, and evidence-based rationales to
achieve a passing score and ensure NCLEX readiness.
SECTION ONE: QUESTIONS 1–100
Question 1
A nurse is administering digoxin to a patient with heart failure. Which
finding requires immediate intervention?
A. Heart rate of 62 bpm
B. Serum potassium level of 3.2 mEq/L
C. Serum digoxin level of 1.0 ng/mL
D. Blood pressure of 120/80 mmHg
B. Serum potassium level of 3.2 mEq/L
RATIONALE: Hypokalemia (K+ <3.5 mEq/L) increases the risk of
digoxin toxicity, even with normal digoxin levels. The heart rate of 62
bpm is acceptable, the digoxin level 1.0 ng/mL is therapeutic (0.8-2.0
,ng/mL), and the blood pressure is normal. Hypokalemia potentiates
digoxin's effects on the heart, making toxicity more likely .
Question 2
A patient on digoxin reports nausea, yellow vision, and a heart rate of 52
bpm. What is the priority action?
A. Administer an antiemetic
B. Hold the next dose and check digoxin level
C. Give potassium chloride STAT
D. Reassess heart rate in 1 hour
B. Hold the next dose and check digoxin level
RATIONALE: Nausea and visual changes (yellow/green halos) are
classic signs of digoxin toxicity, especially with bradycardia. The
digoxin level should be obtained and the dose held until the provider is
notified. Digoxin has a narrow therapeutic index, and these symptoms
indicate potentially dangerous accumulation .
Question 3
A client is started on warfarin for atrial fibrillation. Which laboratory
value is most important to monitor?
A. aPTT
B. INR
C. Platelet count
D. Bleeding time
, B. INR
RATIONALE: Warfarin is monitored using the International
Normalized Ratio (INR) with a target of 2.0-3.0 for atrial fibrillation.
aPTT monitors heparin therapy. Platelet count monitors for heparin-
induced thrombocytopenia. Bleeding time is nonspecific and not used
for warfarin monitoring .
Question 4
A patient with atrial fibrillation is prescribed warfarin. Which INR range
indicates therapeutic anticoagulation for this indication?
A. 0.8-1.2
B. 1.5-2.0
C. 2.0-3.0
D. 3.0-4.0
C. 2.0-3.0
RATIONALE: For most indications (atrial fibrillation, DVT, PE),
the target INR is 2.0-3.0. Mechanical heart valves require a higher target
of 2.5-3.5. The INR must be monitored regularly due to warfarin's
narrow therapeutic index .
Question 5
A patient is prescribed a medication that is highly protein-bound. Which
pharmacokinetic parameter would be most affected by a decrease in
serum albumin?
