NCLEX Pharmacology Practice Exam – 100 Comprehensive Questions and Answers
with Detailed Rationales | Updated 2026–2027 Study Guide
Part 1 (Questions 1–20)
Question 1
A nurse is preparing to administer Digoxin to an adult client with heart failure. Which
assessment is the priority before administering the medication?
A. Check bowel sounds.
B. Measure the apical pulse for one full minute.
C. Assess oxygen saturation.
D. Check blood glucose.
Correct Answer: B
Rationale: Digoxin slows heart rate and conduction. The nurse should assess the apical
pulse for one full minute before administration. If the pulse is below the prescribed
parameter (commonly 60 bpm in adults), the medication should be withheld and the
provider notified.
Question 2
A client receiving Warfarin asks why frequent blood tests are necessary. The nurse explains
that the tests monitor:
A. Serum potassium.
B. International Normalized Ratio (INR).
C. White blood cell count.
D. Blood glucose.
Correct Answer: B
Rationale: Warfarin therapy is monitored using the INR to ensure effective anticoagulation
while minimizing bleeding risk.
,Question 3
Which adverse effect should the nurse monitor for after administering Morphine?
A. Hypertension
B. Respiratory depression
C. Hyperactivity
D. Increased urine output
Correct Answer: B
Rationale: Respiratory depression is the most serious adverse effect of opioid
medications and requires close monitoring.
Question 4
A client taking Furosemide is at greatest risk for which electrolyte imbalance?
A. Hypercalcemia
B. Hypernatremia
C. Hypokalemia
D. Hypermagnesemia
Correct Answer: C
Rationale: Loop diuretics commonly cause potassium loss, increasing the risk of
hypokalemia.
Question 5
Which laboratory value should be monitored most closely in a client receiving Heparin?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Creatinine kinase
Correct Answer: B
,Rationale: Activated partial thromboplastin time (aPTT) is used to monitor intravenous
heparin therapy.
Question 6
A nurse is teaching a client about Nitroglycerin tablets. Which statement by the client
indicates correct understanding?
A. "I will swallow the tablet with water."
B. "I should place the tablet under my tongue."
C. "I will chew the tablet before swallowing."
D. "I should take it only after eating."
Correct Answer: B
Rationale: Sublingual nitroglycerin is placed under the tongue for rapid absorption during
episodes of angina.
Question 7
Which medication should be available when administering opioids?
A. Naloxone
B. Atropine
C. Epinephrine
D. Diazepam
Correct Answer: A
Rationale: Naloxone rapidly reverses opioid-induced respiratory depression and
overdose.
Question 8
Which instruction is most important for a client taking Metformin?
A. Take it on an empty stomach.
B. Stop taking it whenever blood glucose is normal.
, C. Report symptoms such as unusual fatigue or difficulty breathing immediately.
D. Avoid all dairy products.
Correct Answer: C
Rationale: Although rare, metformin can cause lactic acidosis. Early recognition of
symptoms is essential.
Question 9
A client receiving Insulin glargine asks when it reaches its peak. The nurse responds:
A. 1–2 hours
B. 4–6 hours
C. 8–10 hours
D. It has no pronounced peak.
Correct Answer: D
Rationale: Insulin glargine provides relatively constant insulin levels with minimal or no
peak.
Question 10
Which assessment finding requires immediate intervention in a client taking Lisinopril?
A. Dry cough
B. Mild dizziness
C. Swelling of the lips and tongue
D. Blood pressure of 128/78 mm Hg
Correct Answer: C
Rationale: Angioedema is a potentially life-threatening adverse effect of ACE inhibitors
and requires emergency treatment.
with Detailed Rationales | Updated 2026–2027 Study Guide
Part 1 (Questions 1–20)
Question 1
A nurse is preparing to administer Digoxin to an adult client with heart failure. Which
assessment is the priority before administering the medication?
A. Check bowel sounds.
B. Measure the apical pulse for one full minute.
C. Assess oxygen saturation.
D. Check blood glucose.
Correct Answer: B
Rationale: Digoxin slows heart rate and conduction. The nurse should assess the apical
pulse for one full minute before administration. If the pulse is below the prescribed
parameter (commonly 60 bpm in adults), the medication should be withheld and the
provider notified.
Question 2
A client receiving Warfarin asks why frequent blood tests are necessary. The nurse explains
that the tests monitor:
A. Serum potassium.
B. International Normalized Ratio (INR).
C. White blood cell count.
D. Blood glucose.
Correct Answer: B
Rationale: Warfarin therapy is monitored using the INR to ensure effective anticoagulation
while minimizing bleeding risk.
,Question 3
Which adverse effect should the nurse monitor for after administering Morphine?
A. Hypertension
B. Respiratory depression
C. Hyperactivity
D. Increased urine output
Correct Answer: B
Rationale: Respiratory depression is the most serious adverse effect of opioid
medications and requires close monitoring.
Question 4
A client taking Furosemide is at greatest risk for which electrolyte imbalance?
A. Hypercalcemia
B. Hypernatremia
C. Hypokalemia
D. Hypermagnesemia
Correct Answer: C
Rationale: Loop diuretics commonly cause potassium loss, increasing the risk of
hypokalemia.
Question 5
Which laboratory value should be monitored most closely in a client receiving Heparin?
A. INR
B. aPTT
C. Hemoglobin A1C
D. Creatinine kinase
Correct Answer: B
,Rationale: Activated partial thromboplastin time (aPTT) is used to monitor intravenous
heparin therapy.
Question 6
A nurse is teaching a client about Nitroglycerin tablets. Which statement by the client
indicates correct understanding?
A. "I will swallow the tablet with water."
B. "I should place the tablet under my tongue."
C. "I will chew the tablet before swallowing."
D. "I should take it only after eating."
Correct Answer: B
Rationale: Sublingual nitroglycerin is placed under the tongue for rapid absorption during
episodes of angina.
Question 7
Which medication should be available when administering opioids?
A. Naloxone
B. Atropine
C. Epinephrine
D. Diazepam
Correct Answer: A
Rationale: Naloxone rapidly reverses opioid-induced respiratory depression and
overdose.
Question 8
Which instruction is most important for a client taking Metformin?
A. Take it on an empty stomach.
B. Stop taking it whenever blood glucose is normal.
, C. Report symptoms such as unusual fatigue or difficulty breathing immediately.
D. Avoid all dairy products.
Correct Answer: C
Rationale: Although rare, metformin can cause lactic acidosis. Early recognition of
symptoms is essential.
Question 9
A client receiving Insulin glargine asks when it reaches its peak. The nurse responds:
A. 1–2 hours
B. 4–6 hours
C. 8–10 hours
D. It has no pronounced peak.
Correct Answer: D
Rationale: Insulin glargine provides relatively constant insulin levels with minimal or no
peak.
Question 10
Which assessment finding requires immediate intervention in a client taking Lisinopril?
A. Dry cough
B. Mild dizziness
C. Swelling of the lips and tongue
D. Blood pressure of 128/78 mm Hg
Correct Answer: C
Rationale: Angioedema is a potentially life-threatening adverse effect of ACE inhibitors
and requires emergency treatment.
