NCLEX-RN PHARMACOLOGY COMPREHENSIVE ACTUAL FINAL EXAM PREP 2026 ALL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|HIGHLY RECOMMENDED BY EXPERTS |RATED A+ |NEW AND UPDATED

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NCLEX-RN PHARMACOLOGY
COMPREHENSIVE ACTUAL FINAL EXAM PREP
2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH
RATIONALES|HIGHLY RECOMMENDED BY
EXPERTS |RATED A+ |NEW AND UPDATED



1. A client with heart failure is prescribed furosemide (Lasix) 40 mg IV
push. Which laboratory value should the nurse monitor most closely
before administering this medication?
 A) Serum sodium
 B) Serum potassium
 C) Serum calcium
 D) Serum magnesium
Rationale: Furosemide is a loop diuretic that causes potassium
wasting through increased excretion in the distal tubule. Hypokalemia
(potassium below 3.5 mEq/L) can precipitate life-threatening cardiac
dysrhythmias and is the most critical electrolyte imbalance to monitor.
While sodium, calcium, and magnesium may also be affected,
potassium is the priority concern with loop diuretic therapy.
2. A client is prescribed warfarin (Coumadin) for atrial fibrillation.
Which laboratory value should the nurse monitor to evaluate therapeutic
effect?
 A) Platelet count
 B) Hemoglobin

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 C) International Normalized Ratio (INR)
 D) Partial thromboplastin time (PTT)
Rationale: INR is the primary laboratory value used to monitor
warfarin therapy. The therapeutic INR range for atrial fibrillation is
typically 2.0-3.0. PTT is used to monitor heparin therapy. Platelet
count and hemoglobin are monitored for bleeding complications but
do not measure therapeutic effect. Warfarin's onset of action is
delayed, and heparin bridging may be required initially.
3. A client is receiving heparin via continuous IV infusion for treatment
of a deep vein thrombosis. Which laboratory value should the nurse
monitor to evaluate therapeutic effect?
 A) International Normalized Ratio (INR)
 B) Partial thromboplastin time (PTT)
 C) Platelet count
 D) Hemoglobin
Rationale: PTT is the primary laboratory value used to monitor
heparin therapy, with a therapeutic goal typically 1.5-2.5 times the
control value. INR is used to monitor warfarin therapy. Platelet count
should be monitored for heparin-induced thrombocytopenia (HIT), but
this does not measure therapeutic effect. Hemoglobin monitors for
bleeding complications.
4. A client with type 2 diabetes mellitus is prescribed metformin
(Glucophage). Which instruction is most important for the nurse to
include in discharge teaching?
 A) "Take this medication on an empty stomach for best
absorption."
 B) "Avoid consuming alcohol while taking this medication."

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 C) "Expect to gain weight while taking this medication."
 D) "Monitor for signs of hyperglycemia only."
Rationale: The most critical instruction for a client taking metformin
is to avoid alcohol. Metformin increases the risk of lactic acidosis, and
alcohol consumption further increases this risk because both
metformin and alcohol affect hepatic metabolism. Lactic acidosis is
rare but potentially fatal. Metformin should be taken with meals to
reduce gastrointestinal side effects, and weight loss (not gain) is
commonly associated with this medication.
5. A client is prescribed digoxin for heart failure. Which finding
indicates the client may be experiencing digoxin toxicity?
 A) Heart rate 72 beats/minute
 B) Nausea, vomiting, and visual disturbances
 C) Blood pressure 130/80 mmHg
 D) Respiratory rate 16 breaths/minute
Rationale: Nausea, vomiting, and visual disturbances (such as yellow
or green halos around lights) are classic signs of digoxin toxicity. A
heart rate of 72 is within normal limits. Digoxin toxicity can cause
bradycardia, not normal heart rate. Other signs include anorexia,
confusion, and cardiac dysrhythmias. The therapeutic range for
digoxin is narrow (0.8-2.0 ng/mL).
6. A client with asthma is prescribed an inhaled corticosteroid. Which
instruction should the nurse include to prevent oral thrush?
 A) Take the medication with food
 B) Use the medication only during exacerbations
 C) Rinse the mouth with water after each use
 D) Increase the dose if symptoms worsen

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Rationale: Rinsing the mouth with water after using an inhaled
corticosteroid removes residual medication from the oral mucosa,
reducing the risk of oral thrush (candidiasis). Taking with food does
not prevent thrush, and the medication should be used regularly as
prescribed, not only during exacerbations. Increasing the dose without
an order is unsafe.
7. A client with schizophrenia is prescribed haloperidol (Haldol). Which
side effect should the nurse monitor for?
 A) Weight gain
 B) Sedation
 C) Extrapyramidal symptoms
 D) Hyponatremia
Rationale: Haloperidol is a typical antipsychotic medication associated
with extrapyramidal symptoms (EPS) including dystonia,
parkinsonism, akathisia, and tardive dyskinesia. Weight gain and
sedation are more commonly associated with atypical antipsychotics.
Hyponatremia is not a typical side effect of haloperidol. EPS is caused
by dopamine blockade in the basal ganglia.
8. A client is prescribed an angiotensin-converting enzyme (ACE)
inhibitor for hypertension. Which adverse effect should the nurse
monitor for?
 A) Hyperkalemia
 B) Angioedema
 C) Hyperglycemia
 D) Tachycardia
Rationale: Angioedema is a serious adverse effect of ACE inhibitors
that requires immediate discontinuation and emergency treatment.