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PROPHECY PHARMACOLOGY TEST 2026/2027 | MED-SURG, ICU, OB |
160 VERIFIED QUESTIONS & ANSWERS WITH RATIONALES (A+
GRADED)
Q1.
A patient admitted with atrial fibrillation is prescribed warfarin. The nurse reviews
the latest INR result, which is 4.2.
What is the most appropriate nursing action regarding the patient’s anticoagulation
therapy?
A. Continue the dose as prescribed
B. Hold the warfarin and notify the provider
C. Administer vitamin K immediately
D. Schedule the next INR in 2 weeks
Answer: B. Hold the warfarin and notify the provider
Rationale: An INR > 4.0 indicates increased bleeding risk. Warfarin should be
held and the provider notified.
Q2.
A client with chronic heart failure is receiving IV furosemide. Shortly after
administration, the patient reports muscle weakness and cramping.
Which laboratory value should the nurse anticipate being abnormal?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B. Potassium
Rationale: Furosemide can cause hypokalemia, leading to muscle cramps and
weakness.
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Q3.
A patient with type 2 diabetes is prescribed metformin. Before administering the
drug, the nurse reviews lab results.
Which abnormal lab value would require withholding the medication?
A. Hemoglobin A1C of 8.2%
B. Creatinine of 2.0 mg/dL
C. Fasting glucose of 190 mg/dL
D. Sodium of 134 mEq/L
Answer: B. Creatinine of 2.0 mg/dL
Rationale: Metformin is contraindicated in renal impairment due to risk of lactic
acidosis.
Q4.
A postpartum patient is prescribed methylergonovine (Methergine) for uterine
atony.
Which vital sign change would require the nurse to hold the medication?
A. HR 78 bpm
B. BP 168/94 mmHg
C. Temp 99.8°F (37.6°C)
D. RR 20 breaths/min
Answer: B. BP 168/94 mmHg
Rationale: Methylergonovine causes vasoconstriction and is contraindicated in
hypertension.
Q5.
A patient is receiving IV vancomycin for MRSA pneumonia. During the infusion,
the nurse notes flushing, itching, and hypotension.
What is the most appropriate immediate nursing action?
A. Stop the infusion immediately
B. Slow the infusion rate
C. Administer diphenhydramine IV
D. Notify the provider after infusion ends
Answer: B. Slow the infusion rate
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Rationale: “Red Man Syndrome” is managed by slowing the infusion and giving
antihistamines if needed.
Q6.
A patient receiving digoxin reports nausea, blurred vision, and seeing halos around
lights.
Which lab value should the nurse review first?
A. Serum calcium
B. Serum potassium
C. Serum digoxin level
D. Serum sodium
Answer: C. Serum digoxin level
Rationale: These are classic signs of digoxin toxicity. Serum digoxin must be
assessed.
Q7.
A nurse is preparing to administer morphine IV to a patient with severe pain.
Before giving the dose, what assessment is most critical?
A. Blood pressure
B. Pain score
C. Respiratory rate
D. Heart rate
Answer: C. Respiratory rate
Rationale: Morphine can cause respiratory depression, so RR must be checked
before administration.
Q8.
A patient in the ICU is started on IV heparin for a pulmonary embolism. Which
laboratory value is used to monitor the effectiveness of this medication?
A. INR
B. PT
C. aPTT
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D. Platelet count
Answer: C. aPTT
Rationale: Heparin is monitored by aPTT, while warfarin is monitored by INR.
Q9.
A patient prescribed spironolactone for hypertension should avoid which dietary
habit?
A. Eating low-fat meals
B. Consuming large amounts of potassium-rich foods
C. Drinking milk with the medication
D. Taking the medication in the morning
Answer: B. Consuming large amounts of potassium-rich foods
Rationale: Spironolactone is a potassium-sparing diuretic, so excess K⁺ can
cause hyperkalemia.
Q10.
An obstetric patient at 34 weeks is given terbutaline to stop preterm labor.
What adverse effect requires immediate intervention?
A. Maternal tachycardia of 120 bpm
B. Blood glucose elevation
C. Fetal heart rate of 210 bpm
D. Tremors and nervousness
Answer: C. Fetal heart rate of 210 bpm
Rationale: Severe fetal tachycardia indicates danger and requires urgent
intervention.
Q11.
A patient taking phenytoin for seizure disorder reports gum bleeding and swelling.
What is the most appropriate nursing response?
A. Encourage flossing daily
B. Notify the provider about gingival hyperplasia
C. Stop the medication immediately
PROPHECY PHARMACOLOGY TEST 2026/2027 | MED-SURG, ICU, OB |
160 VERIFIED QUESTIONS & ANSWERS WITH RATIONALES (A+
GRADED)
Q1.
A patient admitted with atrial fibrillation is prescribed warfarin. The nurse reviews
the latest INR result, which is 4.2.
What is the most appropriate nursing action regarding the patient’s anticoagulation
therapy?
A. Continue the dose as prescribed
B. Hold the warfarin and notify the provider
C. Administer vitamin K immediately
D. Schedule the next INR in 2 weeks
Answer: B. Hold the warfarin and notify the provider
Rationale: An INR > 4.0 indicates increased bleeding risk. Warfarin should be
held and the provider notified.
Q2.
A client with chronic heart failure is receiving IV furosemide. Shortly after
administration, the patient reports muscle weakness and cramping.
Which laboratory value should the nurse anticipate being abnormal?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B. Potassium
Rationale: Furosemide can cause hypokalemia, leading to muscle cramps and
weakness.
,2 | Page
Q3.
A patient with type 2 diabetes is prescribed metformin. Before administering the
drug, the nurse reviews lab results.
Which abnormal lab value would require withholding the medication?
A. Hemoglobin A1C of 8.2%
B. Creatinine of 2.0 mg/dL
C. Fasting glucose of 190 mg/dL
D. Sodium of 134 mEq/L
Answer: B. Creatinine of 2.0 mg/dL
Rationale: Metformin is contraindicated in renal impairment due to risk of lactic
acidosis.
Q4.
A postpartum patient is prescribed methylergonovine (Methergine) for uterine
atony.
Which vital sign change would require the nurse to hold the medication?
A. HR 78 bpm
B. BP 168/94 mmHg
C. Temp 99.8°F (37.6°C)
D. RR 20 breaths/min
Answer: B. BP 168/94 mmHg
Rationale: Methylergonovine causes vasoconstriction and is contraindicated in
hypertension.
Q5.
A patient is receiving IV vancomycin for MRSA pneumonia. During the infusion,
the nurse notes flushing, itching, and hypotension.
What is the most appropriate immediate nursing action?
A. Stop the infusion immediately
B. Slow the infusion rate
C. Administer diphenhydramine IV
D. Notify the provider after infusion ends
Answer: B. Slow the infusion rate
,3 | Page
Rationale: “Red Man Syndrome” is managed by slowing the infusion and giving
antihistamines if needed.
Q6.
A patient receiving digoxin reports nausea, blurred vision, and seeing halos around
lights.
Which lab value should the nurse review first?
A. Serum calcium
B. Serum potassium
C. Serum digoxin level
D. Serum sodium
Answer: C. Serum digoxin level
Rationale: These are classic signs of digoxin toxicity. Serum digoxin must be
assessed.
Q7.
A nurse is preparing to administer morphine IV to a patient with severe pain.
Before giving the dose, what assessment is most critical?
A. Blood pressure
B. Pain score
C. Respiratory rate
D. Heart rate
Answer: C. Respiratory rate
Rationale: Morphine can cause respiratory depression, so RR must be checked
before administration.
Q8.
A patient in the ICU is started on IV heparin for a pulmonary embolism. Which
laboratory value is used to monitor the effectiveness of this medication?
A. INR
B. PT
C. aPTT
, 4 | Page
D. Platelet count
Answer: C. aPTT
Rationale: Heparin is monitored by aPTT, while warfarin is monitored by INR.
Q9.
A patient prescribed spironolactone for hypertension should avoid which dietary
habit?
A. Eating low-fat meals
B. Consuming large amounts of potassium-rich foods
C. Drinking milk with the medication
D. Taking the medication in the morning
Answer: B. Consuming large amounts of potassium-rich foods
Rationale: Spironolactone is a potassium-sparing diuretic, so excess K⁺ can
cause hyperkalemia.
Q10.
An obstetric patient at 34 weeks is given terbutaline to stop preterm labor.
What adverse effect requires immediate intervention?
A. Maternal tachycardia of 120 bpm
B. Blood glucose elevation
C. Fetal heart rate of 210 bpm
D. Tremors and nervousness
Answer: C. Fetal heart rate of 210 bpm
Rationale: Severe fetal tachycardia indicates danger and requires urgent
intervention.
Q11.
A patient taking phenytoin for seizure disorder reports gum bleeding and swelling.
What is the most appropriate nursing response?
A. Encourage flossing daily
B. Notify the provider about gingival hyperplasia
C. Stop the medication immediately
