High-Yield NCLEX-RN Test Bank
Pharmacology Mastery Test Bank: Medications & Dosages
1) A 68-year-old patient with heart failure is admitted with
nausea, vomiting, and yellow halos around lights. Their home
medications include digoxin 0.25 mg daily, furosemide 40 mg
daily, and lisinopril 10 mg daily. Their apical pulse is 52/min and
irregular. Serum electrolytes reveal a potassium level of 3.0
mEq/L. Which finding is the priority for the nurse to report to
the provider?
A) Apical pulse of 52/min
B) Serum potassium of 3.0 mEq/L
C) Report of yellow halos around lights
D) Nausea and vomiting
Correct Answer: B
Rationale: While all options are signs of digoxin toxicity, the
hypokalemia (low potassium) is the priority to report and
correct. Hypokalemia potentiates digoxin toxicity by increasing
the binding of digoxin to cardiac cells, significantly increasing
the risk of fatal dysrhythmias. The bradycardia (A) and visual
changes (C) are direct effects of the toxicity, and the GI
symptoms (D) are common side effects. The low potassium is a
major contributing factor that must be addressed immediately
to prevent further cardiac instability.
Clinical Safety Tip: Always monitor potassium levels closely in
patients on both digoxin and diuretics like furosemide. Teach
patients to report signs of toxicity, such as vision changes,
,nausea, or a very slow pulse, immediately.
Difficulty: Moderate
Bloom's: Analysis
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
2) A postoperative patient is prescribed morphine sulfate 4 mg
IV every 4 hours for pain. The available vial is labeled 10 mg/mL.
How many mL should the nurse administer?
A) 0.4 mL
B) 2.5 mL
C) 4 mL
D) 0.25 mL
Correct Answer: A
Rationale: The correct dose is calculated using the formula:
Desired dose / Dose on hand × Volume = mL to administer.
Therefore, (4 mg / 10 mg) × 1 mL = 0.4 mL. Administering 2.5
mL (B) would be 25 mg, a massive and dangerous overdose.
Administering 4 mL (C) would be 40 mg. Administering 0.25 mL
(D) would only be 2.5 mg, an underdose.
Clinical Safety Tip: Always double-check narcotic dosages with a
second nurse per facility policy. Monitor for respiratory
depression (RR <12/min), excessive sedation, and hypotension
after administration.
Difficulty: Easy
Bloom's: Application
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
,3) A patient with type 1 diabetes is prescribed regular insulin by
continuous IV infusion at 8 units/hour. The pharmacy prepares
the infusion by adding 100 units of regular insulin to 100 mL of
0.9% sodium chloride. At what rate (mL/hr) should the nurse
program the infusion pump?
A) 8 mL/hr
B) 10 mL/hr
C) 100 mL/hr
D) 0.08 mL/hr
Correct Answer: A
Rationale: The concentration is 100 units/100 mL, which
simplifies to 1 unit/1 mL. To deliver 8 units per hour, the pump
must be set to deliver 8 mL per hour. 10 mL/hr (B) would deliver
10 units/hr. 100 mL/hr (C) would deliver 100 units/hr. 0.08
mL/hr (D) is a miscalculation of the decimal place.
Clinical Safety Tip: IV insulin infusions are high-alert
medications. Blood glucose must be monitored hourly. The
infusion must never be disconnected; if it is interrupted, a new
line must be established to prevent sudden loss of insulin
delivery and rapid hyperglycemia.
Difficulty: Moderate
Bloom's: Application
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
4) A provider orders "cefazolin 1 gram IVPB every 8 hours." The
pharmacy supplies a 100 mL bag of normal saline with cefazolin
1 gram added. The instructions state to infuse it over 30
, minutes. What is the correct infusion rate in mL/hr?
A) 50 mL/hr
B) 100 mL/hr
C) 200 mL/hr
D) 30 mL/hr
Correct Answer: C
Rationale: To infuse 100 mL over 30 minutes, you must
calculate the hourly rate. The formula is: Total volume / Time (in
hours) = mL/hr. 30 minutes is 0.5 hours. Therefore, 100 mL / 0.5
hr = 200 mL/hr. 100 mL/hr (B) would infuse the bag over 60
minutes, which is too slow. 50 mL/hr (A) and 30 mL/hr (D) are
incorrect calculations.
Clinical Safety Tip: Always use an infusion pump for IV
antibiotics. Monitor for signs of an allergic reaction (rash, hives,
wheezing) during the first several doses, especially with the first
exposure to a new antibiotic.
Difficulty: Moderate
Bloom's: Application
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
5) A 55-year-old patient is started on clopidogrel after a
coronary stent placement. Which statement by the patient
indicates a need for further teaching?
A) "I will use a soft-bristled toothbrush to brush my teeth."
B) "I should avoid activities like contact sports that could cause
me to bleed."
C) "I can stop taking this medication in a few weeks once my
Pharmacology Mastery Test Bank: Medications & Dosages
1) A 68-year-old patient with heart failure is admitted with
nausea, vomiting, and yellow halos around lights. Their home
medications include digoxin 0.25 mg daily, furosemide 40 mg
daily, and lisinopril 10 mg daily. Their apical pulse is 52/min and
irregular. Serum electrolytes reveal a potassium level of 3.0
mEq/L. Which finding is the priority for the nurse to report to
the provider?
A) Apical pulse of 52/min
B) Serum potassium of 3.0 mEq/L
C) Report of yellow halos around lights
D) Nausea and vomiting
Correct Answer: B
Rationale: While all options are signs of digoxin toxicity, the
hypokalemia (low potassium) is the priority to report and
correct. Hypokalemia potentiates digoxin toxicity by increasing
the binding of digoxin to cardiac cells, significantly increasing
the risk of fatal dysrhythmias. The bradycardia (A) and visual
changes (C) are direct effects of the toxicity, and the GI
symptoms (D) are common side effects. The low potassium is a
major contributing factor that must be addressed immediately
to prevent further cardiac instability.
Clinical Safety Tip: Always monitor potassium levels closely in
patients on both digoxin and diuretics like furosemide. Teach
patients to report signs of toxicity, such as vision changes,
,nausea, or a very slow pulse, immediately.
Difficulty: Moderate
Bloom's: Analysis
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
2) A postoperative patient is prescribed morphine sulfate 4 mg
IV every 4 hours for pain. The available vial is labeled 10 mg/mL.
How many mL should the nurse administer?
A) 0.4 mL
B) 2.5 mL
C) 4 mL
D) 0.25 mL
Correct Answer: A
Rationale: The correct dose is calculated using the formula:
Desired dose / Dose on hand × Volume = mL to administer.
Therefore, (4 mg / 10 mg) × 1 mL = 0.4 mL. Administering 2.5
mL (B) would be 25 mg, a massive and dangerous overdose.
Administering 4 mL (C) would be 40 mg. Administering 0.25 mL
(D) would only be 2.5 mg, an underdose.
Clinical Safety Tip: Always double-check narcotic dosages with a
second nurse per facility policy. Monitor for respiratory
depression (RR <12/min), excessive sedation, and hypotension
after administration.
Difficulty: Easy
Bloom's: Application
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
,3) A patient with type 1 diabetes is prescribed regular insulin by
continuous IV infusion at 8 units/hour. The pharmacy prepares
the infusion by adding 100 units of regular insulin to 100 mL of
0.9% sodium chloride. At what rate (mL/hr) should the nurse
program the infusion pump?
A) 8 mL/hr
B) 10 mL/hr
C) 100 mL/hr
D) 0.08 mL/hr
Correct Answer: A
Rationale: The concentration is 100 units/100 mL, which
simplifies to 1 unit/1 mL. To deliver 8 units per hour, the pump
must be set to deliver 8 mL per hour. 10 mL/hr (B) would deliver
10 units/hr. 100 mL/hr (C) would deliver 100 units/hr. 0.08
mL/hr (D) is a miscalculation of the decimal place.
Clinical Safety Tip: IV insulin infusions are high-alert
medications. Blood glucose must be monitored hourly. The
infusion must never be disconnected; if it is interrupted, a new
line must be established to prevent sudden loss of insulin
delivery and rapid hyperglycemia.
Difficulty: Moderate
Bloom's: Application
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
4) A provider orders "cefazolin 1 gram IVPB every 8 hours." The
pharmacy supplies a 100 mL bag of normal saline with cefazolin
1 gram added. The instructions state to infuse it over 30
, minutes. What is the correct infusion rate in mL/hr?
A) 50 mL/hr
B) 100 mL/hr
C) 200 mL/hr
D) 30 mL/hr
Correct Answer: C
Rationale: To infuse 100 mL over 30 minutes, you must
calculate the hourly rate. The formula is: Total volume / Time (in
hours) = mL/hr. 30 minutes is 0.5 hours. Therefore, 100 mL / 0.5
hr = 200 mL/hr. 100 mL/hr (B) would infuse the bag over 60
minutes, which is too slow. 50 mL/hr (A) and 30 mL/hr (D) are
incorrect calculations.
Clinical Safety Tip: Always use an infusion pump for IV
antibiotics. Monitor for signs of an allergic reaction (rash, hives,
wheezing) during the first several doses, especially with the first
exposure to a new antibiotic.
Difficulty: Moderate
Bloom's: Application
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
5) A 55-year-old patient is started on clopidogrel after a
coronary stent placement. Which statement by the patient
indicates a need for further teaching?
A) "I will use a soft-bristled toothbrush to brush my teeth."
B) "I should avoid activities like contact sports that could cause
me to bleed."
C) "I can stop taking this medication in a few weeks once my
