NCLEX-Style Test Bank
Chapter 3: Toxic Effects of Drugs
Based on: Focus on Nursing Pharmacology – 8th Edition
by Amy M. Karch
✔ 50 NCLEX-Style Questions + Cheat Sheet
✔ Detailed Rationales for Every Answer
✔ Covers Pharmacokinetics, Pharmacodynamics, and Drug Interactions
✔ Ideal for Nursing Students Preparing for NCLEX, HESI, or Pharmacology Exams
This NCLEX-style test bank is an original educational resource based on Chapter 3 of Focus on Nursing Pharmacology
(8th Edition) by Amy M. Karch. It is not affiliated with or endorsed by the publisher, NCLEX®, ATI, or HESI. For
educational use only.
,NCLEX Pharmacology Test Bank – Chapter 3 Toxic Effects of Drugs – 50 Questions + Rationales
+ Cheat Sheet – Karch Focus on Nursing Pharmacology 8th Edition
1. A nurse is caring for a client who developed tinnitus after receiving high doses of aspirin.
Which adverse effect should the nurse document?
A. Hepatotoxicity
B. Ototoxicity
C. Nephrotoxicity
D. Neurotoxicity
Correct Answer: B. Ototoxicity
Rationale: Tinnitus is a classic sign of ototoxicity, especially with salicylate toxicity. Monitoring
hearing function is essential.
2. A patient experiences an anaphylactic reaction to penicillin. Which priority action should
the nurse take?
A. Administer antihistamines
B. Apply oxygen via nasal cannula
C. Start IV fluids
D. Administer epinephrine
Correct Answer: D. Administer epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis as it reverses
bronchoconstriction and vasodilation. Airway management is critical.
3. A client taking isoniazid begins to show signs of jaundice. The nurse should suspect which
type of organ toxicity?
A. Hepatotoxicity
B. Nephrotoxicity
C. Cardiotoxicity
D. Pulmonary toxicity
Correct Answer: A. Hepatotoxicity
Rationale: Jaundice indicates liver dysfunction. Isoniazid is known for its potential hepatotoxic
effects, especially in older adults.
4. Which assessment finding would indicate bone marrow suppression in a patient taking
chemotherapy?
A. Bradycardia
B. Frequent nosebleeds
2
, NCLEX Pharmacology Test Bank – Chapter 3 Toxic Effects of Drugs – 50 Questions + Rationales
+ Cheat Sheet – Karch Focus on Nursing Pharmacology 8th Edition
C. Constipation
D. Tinnitus
Correct Answer: B. Frequent nosebleeds
Rationale: Bone marrow suppression decreases platelet count, increasing bleeding risk.
Nosebleeds are a common sign.
5. A nurse is reviewing a new prescription for a pregnant client. Which classification indicates
the drug poses the highest fetal risk?
A. Category B
B. Category C
C. Category D
D. Category X
Correct Answer: D. Category X
Rationale: Category X drugs are contraindicated in pregnancy due to known teratogenic effects.
6. Which term best describes a harmful, unintended reaction to a normal drug dose?
A. Toxic reaction
B. Drug interaction
C. Adverse effect
D. Idiosyncratic response
Correct Answer: C. Adverse effect
Rationale: An adverse effect is any harmful or unintended response at normal doses. Toxic
reactions are dose-related.
7. A nurse is caring for a client prescribed gentamicin. Which lab value should be monitored
closely for nephrotoxicity?
A. Hematocrit
B. ALT
C. Creatinine
D. Glucose
Correct Answer: C. Creatinine
Rationale: Gentamicin can cause nephrotoxicity. Elevated creatinine indicates impaired renal
function.
3
Chapter 3: Toxic Effects of Drugs
Based on: Focus on Nursing Pharmacology – 8th Edition
by Amy M. Karch
✔ 50 NCLEX-Style Questions + Cheat Sheet
✔ Detailed Rationales for Every Answer
✔ Covers Pharmacokinetics, Pharmacodynamics, and Drug Interactions
✔ Ideal for Nursing Students Preparing for NCLEX, HESI, or Pharmacology Exams
This NCLEX-style test bank is an original educational resource based on Chapter 3 of Focus on Nursing Pharmacology
(8th Edition) by Amy M. Karch. It is not affiliated with or endorsed by the publisher, NCLEX®, ATI, or HESI. For
educational use only.
,NCLEX Pharmacology Test Bank – Chapter 3 Toxic Effects of Drugs – 50 Questions + Rationales
+ Cheat Sheet – Karch Focus on Nursing Pharmacology 8th Edition
1. A nurse is caring for a client who developed tinnitus after receiving high doses of aspirin.
Which adverse effect should the nurse document?
A. Hepatotoxicity
B. Ototoxicity
C. Nephrotoxicity
D. Neurotoxicity
Correct Answer: B. Ototoxicity
Rationale: Tinnitus is a classic sign of ototoxicity, especially with salicylate toxicity. Monitoring
hearing function is essential.
2. A patient experiences an anaphylactic reaction to penicillin. Which priority action should
the nurse take?
A. Administer antihistamines
B. Apply oxygen via nasal cannula
C. Start IV fluids
D. Administer epinephrine
Correct Answer: D. Administer epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis as it reverses
bronchoconstriction and vasodilation. Airway management is critical.
3. A client taking isoniazid begins to show signs of jaundice. The nurse should suspect which
type of organ toxicity?
A. Hepatotoxicity
B. Nephrotoxicity
C. Cardiotoxicity
D. Pulmonary toxicity
Correct Answer: A. Hepatotoxicity
Rationale: Jaundice indicates liver dysfunction. Isoniazid is known for its potential hepatotoxic
effects, especially in older adults.
4. Which assessment finding would indicate bone marrow suppression in a patient taking
chemotherapy?
A. Bradycardia
B. Frequent nosebleeds
2
, NCLEX Pharmacology Test Bank – Chapter 3 Toxic Effects of Drugs – 50 Questions + Rationales
+ Cheat Sheet – Karch Focus on Nursing Pharmacology 8th Edition
C. Constipation
D. Tinnitus
Correct Answer: B. Frequent nosebleeds
Rationale: Bone marrow suppression decreases platelet count, increasing bleeding risk.
Nosebleeds are a common sign.
5. A nurse is reviewing a new prescription for a pregnant client. Which classification indicates
the drug poses the highest fetal risk?
A. Category B
B. Category C
C. Category D
D. Category X
Correct Answer: D. Category X
Rationale: Category X drugs are contraindicated in pregnancy due to known teratogenic effects.
6. Which term best describes a harmful, unintended reaction to a normal drug dose?
A. Toxic reaction
B. Drug interaction
C. Adverse effect
D. Idiosyncratic response
Correct Answer: C. Adverse effect
Rationale: An adverse effect is any harmful or unintended response at normal doses. Toxic
reactions are dose-related.
7. A nurse is caring for a client prescribed gentamicin. Which lab value should be monitored
closely for nephrotoxicity?
A. Hematocrit
B. ALT
C. Creatinine
D. Glucose
Correct Answer: C. Creatinine
Rationale: Gentamicin can cause nephrotoxicity. Elevated creatinine indicates impaired renal
function.
3
