Pharmacology and the Nursing Process – NCLEX-PN actual exam
1. The nurse verifies a client’s medication order before administration. Which step of the
nursing process is this?
A. Implementation
B. Assessment
C. Planning
D. Evaluation
Answer: B
Rationale: Checking medication orders and client data is part of the assessment phase,
ensuring safety before drug administration.
2. A client prescribed digoxin has a serum potassium level of 2.8 mEq/L. The nurse should:
A. Administer the medication as ordered
B. Hold the dose and notify the provider
C. Give half the prescribed dose
D. Increase the dose
Answer: B
Rationale: Hypokalemia increases digoxin toxicity risk; the nurse should hold the
medication and report findings.
3. The nurse is teaching a client about sublingual nitroglycerin. Which instruction is
correct?
A. Swallow the tablet with water
B. Take with food
C. Place under the tongue and let it dissolve
D. Chew the tablet for faster action
Answer: C
Rationale: Sublingual tablets should dissolve under the tongue for rapid absorption
through mucous membranes.
4. The nurse identifies which route of medication administration has the fastest onset of
action?
A. Oral
B. Intramuscular
C. Intravenous
D. Subcutaneous
Answer: C
Rationale: IV administration delivers medication directly into circulation, producing
immediate effects.
5. A client taking warfarin asks why regular blood tests are needed. The nurse responds:
A. “They check your kidney function.”
B. “They monitor how your blood clots.”
C. “They ensure you are not anemic.”
D. “They test your electrolyte balance.”
Answer: B
Rationale: Prothrombin time/INR monitoring ensures therapeutic anticoagulation and
prevents bleeding complications.
6. The nurse knows that an antidote for opioid overdose is:
A. Flumazenil
, B. Acetylcysteine
C. Naloxone
D. Protamine sulfate
Answer: C
Rationale: Naloxone reverses respiratory depression and CNS effects of opioid toxicity.
7. Before giving furosemide, the nurse should assess:
A. Pulse rate
B. Blood glucose
C. Serum potassium
D. Reflexes
Answer: C
Rationale: Furosemide causes potassium loss; checking serum potassium prevents
hypokalemia-related complications.
8. The nurse gives medication at 0900 when the order reads 0800. What action is most
appropriate?
A. Document as given on time
B. Report the late administration
C. Do not record the dose
D. Change the time on the MAR
Answer: B
Rationale: Accurate documentation ensures legal safety and supports continuity of care.
9. A client prescribed antibiotics develops diarrhea. The nurse should suspect:
A. Superinfection
B. Drug allergy
C. Hepatotoxicity
D. Nephrotoxicity
Answer: A
Rationale: Antibiotics can destroy normal flora, allowing resistant organisms like C.
difficile to overgrow.
10. The nurse understands that a black box warning indicates:
A. The drug is available only by prescription
B. Serious or life-threatening risks may occur
C. The drug is safe in pregnancy
D. It’s a controlled substance
Answer: B
Rationale: A black box warning alerts healthcare professionals to potentially fatal
adverse effects.
11. The nurse teaches a client on levothyroxine to:
A. Take with food
B. Take at bedtime
C. Take in the morning on an empty stomach
D. Skip a dose if feeling well
Answer: C
Rationale: Levothyroxine absorption is best on an empty stomach before breakfast for
consistent hormone levels.
, 12. Which nursing action prevents medication errors?
A. Skipping verification if busy
B. Relying on memory
C. Using two patient identifiers
D. Preparing multiple patients’ medications at once
Answer: C
Rationale: Using two identifiers (name, DOB) ensures correct patient and supports
medication safety.
13. A nurse administers insulin lispro. Which action is essential?
A. Administer 30 minutes before meals
B. Give with bedtime snack
C. Give immediately before eating
D. Hold if glucose is 180 mg/dL
Answer: C
Rationale: Rapid-acting insulin should be administered within 15 minutes of meals to
prevent hypoglycemia.
14. A client on lisinopril reports a dry cough. The nurse should:
A. Reassure that this is harmless
B. Hold the dose and notify the provider
C. Administer cough suppressant
D. Continue therapy as ordered
Answer: B
Rationale: ACE inhibitors can cause persistent cough; provider may switch to an ARB.
15. Which finding requires the nurse to hold a beta blocker?
A. BP 130/80 mmHg
B. Pulse 54 bpm
C. Pulse 78 bpm
D. BP 110/70 mmHg
Answer: B
Rationale: Beta blockers reduce heart rate; hold if HR < 60 bpm and notify the provider.
16. The nurse recognizes which as an example of a pharmacokinetic process?
A. Drug teaching
B. Drug absorption
C. Drug side effect
D. Allergic reaction
Answer: B
Rationale: Pharmacokinetics involves absorption, distribution, metabolism, and
excretion of drugs.
17. The nurse should caution a client taking warfarin to avoid:
A. Apples
B. Broccoli
C. Milk
D. Bananas
Answer: B
Rationale: Broccoli is rich in vitamin K, which reduces the effectiveness of warfarin.
1. The nurse verifies a client’s medication order before administration. Which step of the
nursing process is this?
A. Implementation
B. Assessment
C. Planning
D. Evaluation
Answer: B
Rationale: Checking medication orders and client data is part of the assessment phase,
ensuring safety before drug administration.
2. A client prescribed digoxin has a serum potassium level of 2.8 mEq/L. The nurse should:
A. Administer the medication as ordered
B. Hold the dose and notify the provider
C. Give half the prescribed dose
D. Increase the dose
Answer: B
Rationale: Hypokalemia increases digoxin toxicity risk; the nurse should hold the
medication and report findings.
3. The nurse is teaching a client about sublingual nitroglycerin. Which instruction is
correct?
A. Swallow the tablet with water
B. Take with food
C. Place under the tongue and let it dissolve
D. Chew the tablet for faster action
Answer: C
Rationale: Sublingual tablets should dissolve under the tongue for rapid absorption
through mucous membranes.
4. The nurse identifies which route of medication administration has the fastest onset of
action?
A. Oral
B. Intramuscular
C. Intravenous
D. Subcutaneous
Answer: C
Rationale: IV administration delivers medication directly into circulation, producing
immediate effects.
5. A client taking warfarin asks why regular blood tests are needed. The nurse responds:
A. “They check your kidney function.”
B. “They monitor how your blood clots.”
C. “They ensure you are not anemic.”
D. “They test your electrolyte balance.”
Answer: B
Rationale: Prothrombin time/INR monitoring ensures therapeutic anticoagulation and
prevents bleeding complications.
6. The nurse knows that an antidote for opioid overdose is:
A. Flumazenil
, B. Acetylcysteine
C. Naloxone
D. Protamine sulfate
Answer: C
Rationale: Naloxone reverses respiratory depression and CNS effects of opioid toxicity.
7. Before giving furosemide, the nurse should assess:
A. Pulse rate
B. Blood glucose
C. Serum potassium
D. Reflexes
Answer: C
Rationale: Furosemide causes potassium loss; checking serum potassium prevents
hypokalemia-related complications.
8. The nurse gives medication at 0900 when the order reads 0800. What action is most
appropriate?
A. Document as given on time
B. Report the late administration
C. Do not record the dose
D. Change the time on the MAR
Answer: B
Rationale: Accurate documentation ensures legal safety and supports continuity of care.
9. A client prescribed antibiotics develops diarrhea. The nurse should suspect:
A. Superinfection
B. Drug allergy
C. Hepatotoxicity
D. Nephrotoxicity
Answer: A
Rationale: Antibiotics can destroy normal flora, allowing resistant organisms like C.
difficile to overgrow.
10. The nurse understands that a black box warning indicates:
A. The drug is available only by prescription
B. Serious or life-threatening risks may occur
C. The drug is safe in pregnancy
D. It’s a controlled substance
Answer: B
Rationale: A black box warning alerts healthcare professionals to potentially fatal
adverse effects.
11. The nurse teaches a client on levothyroxine to:
A. Take with food
B. Take at bedtime
C. Take in the morning on an empty stomach
D. Skip a dose if feeling well
Answer: C
Rationale: Levothyroxine absorption is best on an empty stomach before breakfast for
consistent hormone levels.
, 12. Which nursing action prevents medication errors?
A. Skipping verification if busy
B. Relying on memory
C. Using two patient identifiers
D. Preparing multiple patients’ medications at once
Answer: C
Rationale: Using two identifiers (name, DOB) ensures correct patient and supports
medication safety.
13. A nurse administers insulin lispro. Which action is essential?
A. Administer 30 minutes before meals
B. Give with bedtime snack
C. Give immediately before eating
D. Hold if glucose is 180 mg/dL
Answer: C
Rationale: Rapid-acting insulin should be administered within 15 minutes of meals to
prevent hypoglycemia.
14. A client on lisinopril reports a dry cough. The nurse should:
A. Reassure that this is harmless
B. Hold the dose and notify the provider
C. Administer cough suppressant
D. Continue therapy as ordered
Answer: B
Rationale: ACE inhibitors can cause persistent cough; provider may switch to an ARB.
15. Which finding requires the nurse to hold a beta blocker?
A. BP 130/80 mmHg
B. Pulse 54 bpm
C. Pulse 78 bpm
D. BP 110/70 mmHg
Answer: B
Rationale: Beta blockers reduce heart rate; hold if HR < 60 bpm and notify the provider.
16. The nurse recognizes which as an example of a pharmacokinetic process?
A. Drug teaching
B. Drug absorption
C. Drug side effect
D. Allergic reaction
Answer: B
Rationale: Pharmacokinetics involves absorption, distribution, metabolism, and
excretion of drugs.
17. The nurse should caution a client taking warfarin to avoid:
A. Apples
B. Broccoli
C. Milk
D. Bananas
Answer: B
Rationale: Broccoli is rich in vitamin K, which reduces the effectiveness of warfarin.
