✨Step-by-Step NCLEX-RN
Review Guide: Pharmacology,
Med-Surg, and Pediatrics
Developed by ASI1-Mini for for high-yield NCLEX preparation.
(Attributed to: Your Name / Institution Optional — Edit Later)
📘 Page 1 – Pharmacology Focus 📘
💊 Advanced Practice Questions
1. A nurse is caring for a client prescribed digoxin (Lanoxin) and furosemide (Lasix).
Which of the following complications should the nurse most closely monitor for?
A. Hypokalemia and increased risk of digoxin toxicity
B. Hypernatremia and increased cardiac contractility
C. Increased urine output and hypoglycemia
. Hypocalcemia and prolonged QT interval
Correct Answer: A
Rationale: Furosemide, a loop diuretic, can lead to potassium loss, which increases the
risk of digoxin toxicity (which is enhanced in low potassium environments). Monitor both
electrolytes and digoxin levels closely.
2. A post-MI client is receiving alteplase (tPA). Which sign would necessitate
immediate discontinuation of the medication?
, A. Elevated heart rate
B. Drop in blood pressure
C. Severe headache and confusion
D. Blood glucose above 200 mg/dL
Correct Answer: C
Rationale: Alteplase is a thrombolytic agent, and neurologic changes like headache and
confusion are red flags for intracranial hemorrhage.
3. A patient is prescribed tramadol for moderate postoperative pain. You must
especially assess for which contraindication?
A. History of hypertension
B. History of substance abuse
C. History of GERD
D. History of asthma
Correct Answer: B
Rationale: Tramadol has opioid-like properties and potential for abuse. Caution with
patients having a history of substance misuse is necessary.
4. A nurse should question an order for propranolol in a client with a co-existing
condition of:
A. Hypertension
B. Asthma
C. Atrial fibrillation
D. Migraine headaches
Review Guide: Pharmacology,
Med-Surg, and Pediatrics
Developed by ASI1-Mini for for high-yield NCLEX preparation.
(Attributed to: Your Name / Institution Optional — Edit Later)
📘 Page 1 – Pharmacology Focus 📘
💊 Advanced Practice Questions
1. A nurse is caring for a client prescribed digoxin (Lanoxin) and furosemide (Lasix).
Which of the following complications should the nurse most closely monitor for?
A. Hypokalemia and increased risk of digoxin toxicity
B. Hypernatremia and increased cardiac contractility
C. Increased urine output and hypoglycemia
. Hypocalcemia and prolonged QT interval
Correct Answer: A
Rationale: Furosemide, a loop diuretic, can lead to potassium loss, which increases the
risk of digoxin toxicity (which is enhanced in low potassium environments). Monitor both
electrolytes and digoxin levels closely.
2. A post-MI client is receiving alteplase (tPA). Which sign would necessitate
immediate discontinuation of the medication?
, A. Elevated heart rate
B. Drop in blood pressure
C. Severe headache and confusion
D. Blood glucose above 200 mg/dL
Correct Answer: C
Rationale: Alteplase is a thrombolytic agent, and neurologic changes like headache and
confusion are red flags for intracranial hemorrhage.
3. A patient is prescribed tramadol for moderate postoperative pain. You must
especially assess for which contraindication?
A. History of hypertension
B. History of substance abuse
C. History of GERD
D. History of asthma
Correct Answer: B
Rationale: Tramadol has opioid-like properties and potential for abuse. Caution with
patients having a history of substance misuse is necessary.
4. A nurse should question an order for propranolol in a client with a co-existing
condition of:
A. Hypertension
B. Asthma
C. Atrial fibrillation
D. Migraine headaches
