RN Pharmacology Online Practice 2023 B - Comprehensive Study
Guide (2025/2026 Syllabus)
Instructions: This guide covers major drug classes, nursing considerations, and patient
education. The focus is on application, safety, and clinical judgment, reflecting the
NCLEX's Next Generation model.
1. Cardiovascular Medications
1. A client is prescribed Lisinopril, an ACE inhibitor. What is the PRIORITY teaching
point the nurse should provide?
ANSWER: Instruct the client to report any signs of angioedema, such as swelling of the
face, lips, or tongue, or difficulty breathing, immediately. Also, advise them to rise slowly
from a sitting or lying position to prevent orthostatic hypotension.
2. A nurse is assessing a client taking Furosemide (Lasix). Which finding requires
immediate intervention?
ANSWER: A serum potassium level of 2.9 mEq/L. Furosemide is a potassium-wasting
diuretic, and severe hypokalemia can lead to life-threatening cardiac dysrhythmias.
3. What is the therapeutic purpose of administering Metoprolol (a beta-blocker) to
a client post-Myocardial Infarction (MI)?
ANSWER: Metoprolol reduces the heart's oxygen demand by decreasing heart rate and
contractility, which limits the extent of myocardial damage and prevents future cardiac
events.
4. A client on Digoxin reports nausea, vomiting, and seeing "yellow halos" around
lights. What should the nurse suspect and do?
ANSWER: Suspect digoxin toxicity. The nurse should hold the next dose, check the
client's apical pulse (as bradycardia is a sign), and draw a serum digoxin level and
potassium level (as hypokalemia potentiates toxicity).
, 5. When teaching a client about Warfarin (Coumadin), which statement by the
client indicates a need for further education?
ANSWER: "I can take aspirin for my occasional headaches." This is incorrect, as aspirin
increases the risk of bleeding. The nurse should emphasize using the prescribed
anticoagulant consistently, having regular INR monitoring, and maintaining a consistent
intake of Vitamin K-rich foods.
6. A nurse is preparing to administer Atenolol. What is the most important
assessment before giving this medication?
ANSWER: Assess the client's apical pulse and blood pressure. If the pulse is below 60
bpm (or per facility protocol) or the blood pressure is significantly low, the nurse should
hold the dose and notify the provider.
7. What is the antidote for Heparin overdose?
ANSWER: Protamine Sulfate.
8. What is the antidote for Warfarin (Coumadin) overdose?
ANSWER: Vitamin K (Phytonadione). For severe, active bleeding, fresh frozen plasma
(FFP) may be required.
9. A client on Atorvastatin (a statin) reports new, severe muscle pain and
weakness. What is the nurse's priority action?
ANSWER: Hold the medication and notify the provider, as this could indicate
rhabdomyolysis, a serious side effect that can lead to acute kidney injury.
10. Why is it critical to monitor for hyperkalemia in a client taking Spironolactone
(an aldosterone antagonist)?
ANSWER: Spironolactone is a potassium-sparing diuretic. It reduces the excretion of
potassium, which can lead to dangerously high serum potassium levels, causing cardiac
dysrhythmias.
2. Respiratory Medications
, 11. A client is using an Albuterol inhaler for asthma. What is a key teaching point
regarding its use?
ANSWER: Instruct the client to use this as a "rescue" inhaler for acute shortness of
breath. If they find they need it more frequently than prescribed, it indicates poor
asthma control, and they should contact their provider.
12. The nurse is teaching a client about Fluticasone (Flovent), an inhaled
corticosteroid. Which statement by the client demonstrates understanding?
ANSWER: "I will rinse my mouth with water after each use to prevent getting a yeast
infection (oral thrush)."
13. What is the priority action after administering a dose of Succinylcholine, a
depolarizing neuromuscular blocker, to facilitate intubation?
ANSWER: Ensure the client is connected to a mechanical ventilator or bag-valve-mask,
as Succinylcholine causes paralysis, including the diaphragm, and the client will be
unable to breathe spontaneously.
14. A client receiving Theophylline for COPD has a serum level of 25 mcg/mL
(therapeutic range is 10-20 mcg/mL). What findings should the nurse expect to
assess?
ANSWER: The nurse should assess for signs of toxicity, including nausea, vomiting,
tachycardia, tremors, and cardiac dysrhythmias.
3. Endocrine Medications
15. A client with Type 1 Diabetes has confusion, diaphoresis, and tachycardia.
Their blood glucose is 52 mg/dL. What is the nurse's priority action?
ANSWER: Administer 15-20 grams of a rapid-acting carbohydrate (e.g., 4 oz fruit juice,
3-4 glucose tablets) and recheck blood glucose in 15 minutes.
16. When teaching a client about mixing Regular insulin and NPH insulin, what key
point must the nurse emphasize?
Guide (2025/2026 Syllabus)
Instructions: This guide covers major drug classes, nursing considerations, and patient
education. The focus is on application, safety, and clinical judgment, reflecting the
NCLEX's Next Generation model.
1. Cardiovascular Medications
1. A client is prescribed Lisinopril, an ACE inhibitor. What is the PRIORITY teaching
point the nurse should provide?
ANSWER: Instruct the client to report any signs of angioedema, such as swelling of the
face, lips, or tongue, or difficulty breathing, immediately. Also, advise them to rise slowly
from a sitting or lying position to prevent orthostatic hypotension.
2. A nurse is assessing a client taking Furosemide (Lasix). Which finding requires
immediate intervention?
ANSWER: A serum potassium level of 2.9 mEq/L. Furosemide is a potassium-wasting
diuretic, and severe hypokalemia can lead to life-threatening cardiac dysrhythmias.
3. What is the therapeutic purpose of administering Metoprolol (a beta-blocker) to
a client post-Myocardial Infarction (MI)?
ANSWER: Metoprolol reduces the heart's oxygen demand by decreasing heart rate and
contractility, which limits the extent of myocardial damage and prevents future cardiac
events.
4. A client on Digoxin reports nausea, vomiting, and seeing "yellow halos" around
lights. What should the nurse suspect and do?
ANSWER: Suspect digoxin toxicity. The nurse should hold the next dose, check the
client's apical pulse (as bradycardia is a sign), and draw a serum digoxin level and
potassium level (as hypokalemia potentiates toxicity).
, 5. When teaching a client about Warfarin (Coumadin), which statement by the
client indicates a need for further education?
ANSWER: "I can take aspirin for my occasional headaches." This is incorrect, as aspirin
increases the risk of bleeding. The nurse should emphasize using the prescribed
anticoagulant consistently, having regular INR monitoring, and maintaining a consistent
intake of Vitamin K-rich foods.
6. A nurse is preparing to administer Atenolol. What is the most important
assessment before giving this medication?
ANSWER: Assess the client's apical pulse and blood pressure. If the pulse is below 60
bpm (or per facility protocol) or the blood pressure is significantly low, the nurse should
hold the dose and notify the provider.
7. What is the antidote for Heparin overdose?
ANSWER: Protamine Sulfate.
8. What is the antidote for Warfarin (Coumadin) overdose?
ANSWER: Vitamin K (Phytonadione). For severe, active bleeding, fresh frozen plasma
(FFP) may be required.
9. A client on Atorvastatin (a statin) reports new, severe muscle pain and
weakness. What is the nurse's priority action?
ANSWER: Hold the medication and notify the provider, as this could indicate
rhabdomyolysis, a serious side effect that can lead to acute kidney injury.
10. Why is it critical to monitor for hyperkalemia in a client taking Spironolactone
(an aldosterone antagonist)?
ANSWER: Spironolactone is a potassium-sparing diuretic. It reduces the excretion of
potassium, which can lead to dangerously high serum potassium levels, causing cardiac
dysrhythmias.
2. Respiratory Medications
, 11. A client is using an Albuterol inhaler for asthma. What is a key teaching point
regarding its use?
ANSWER: Instruct the client to use this as a "rescue" inhaler for acute shortness of
breath. If they find they need it more frequently than prescribed, it indicates poor
asthma control, and they should contact their provider.
12. The nurse is teaching a client about Fluticasone (Flovent), an inhaled
corticosteroid. Which statement by the client demonstrates understanding?
ANSWER: "I will rinse my mouth with water after each use to prevent getting a yeast
infection (oral thrush)."
13. What is the priority action after administering a dose of Succinylcholine, a
depolarizing neuromuscular blocker, to facilitate intubation?
ANSWER: Ensure the client is connected to a mechanical ventilator or bag-valve-mask,
as Succinylcholine causes paralysis, including the diaphragm, and the client will be
unable to breathe spontaneously.
14. A client receiving Theophylline for COPD has a serum level of 25 mcg/mL
(therapeutic range is 10-20 mcg/mL). What findings should the nurse expect to
assess?
ANSWER: The nurse should assess for signs of toxicity, including nausea, vomiting,
tachycardia, tremors, and cardiac dysrhythmias.
3. Endocrine Medications
15. A client with Type 1 Diabetes has confusion, diaphoresis, and tachycardia.
Their blood glucose is 52 mg/dL. What is the nurse's priority action?
ANSWER: Administer 15-20 grams of a rapid-acting carbohydrate (e.g., 4 oz fruit juice,
3-4 glucose tablets) and recheck blood glucose in 15 minutes.
16. When teaching a client about mixing Regular insulin and NPH insulin, what key
point must the nurse emphasize?
