Relias RN Pharmacology Test A:
Comprehensive Practice Exam with
Questions, Answers, and Rationales
Question: A patient is prescribed warfarin for atrial fibrillation. Which
laboratory value must the nurse monitor to evaluate the therapeutic
effectiveness of this medication?
(A) Activated partial thromboplastin time (aPTT)
(B) International Normalized Ratio (INR)
(C) Platelet count
(D) Hemoglobin and hematocrit
Correct Answer: (B)
Rationale: Warfarin is an oral anticoagulant that affects the extrinsic
pathway of coagulation . The INR is the standardized measure used to
monitor warfarin therapy, with a typical therapeutic range of 2.0 to 3.0 for
most indications. aPTT is used to monitor heparin therapy, while platelet
count and hemoglobin/hematocrit monitor for bleeding risk but do not
measure the drug's therapeutic effect .
Question: A patient receiving morphine develops a respiratory rate of 8
breaths per minute. What is the nurse's priority action?
(A) Increase IV fluids
(B) Administer naloxone
(C) Lower the dose
(D) Call the provider only
,Correct Answer: (B)
Rationale: Respiratory depression is the most serious and life-threatening
adverse effect of opioid analgesics like morphine . Naloxone is a
competitive opioid antagonist used to rapidly reverse opioid-induced
respiratory depression . While calling the provider is necessary,
administering naloxone is the immediate, life-saving priority.
Question: A patient starting lisinopril reports facial swelling. What is the
priority nursing action?
(A) Continue the medication and reassess
(B) Provide a diuretic
(C) Hold the medication and call the provider
(D) Give acetaminophen
Correct Answer: (C)
Rationale: Facial swelling is a sign of angioedema, a potentially life-
threatening adverse effect of ACE inhibitors like lisinopril . The medication
must be held immediately, and the provider must be notified. Continuing
the medication could lead to airway compromise.
Question: A patient is prescribed furosemide for heart failure. Which
electrolyte imbalance should the nurse monitor for most closely?
(A) Hyperkalemia
(B) Hypokalemia
(C) Hypercalcemia
(D) Hyponatremia only
Correct Answer: (B)
Rationale: Furosemide is a loop diuretic that promotes the excretion of
sodium, chloride, and potassium . Hypokalemia is a common and serious
, side effect that can lead to cardiac dysrhythmias . Hyperkalemia is more
associated with potassium-sparing diuretics.
Question: A nurse is administering insulin glargine to a patient with type 1
diabetes. What is the primary characteristic of this insulin?
(A) It has a rapid onset and short duration.
(B) It is administered immediately before meals.
(C) It provides a basal level of insulin with no peak.
(D) It can be mixed with regular insulin in the same syringe.
Correct Answer: (C)
Rationale: Insulin glargine is a long-acting insulin analog designed to
provide a steady, basal level of insulin over 24 hours with no significant
peak . It is typically administered once daily and should not be mixed with
other insulins, as this may alter its pharmacokinetics .
Question: A patient receiving vancomycin IV develops flushing, pruritus,
and erythema of the face, neck, and upper torso. What is the most likely
cause?
(A) Anaphylactic reaction
(B) Red man syndrome
(C) Stevens-Johnson syndrome
(D) Serum sickness
Correct Answer: (B)
Rationale: Red man syndrome is a histamine-mediated reaction
characterized by flushing, pruritus, and erythema of the face, neck, and
upper torso . It is a non-immunologic reaction often associated with rapid
infusion of vancomycin . Slowing the infusion rate is a key preventive
measure .
Comprehensive Practice Exam with
Questions, Answers, and Rationales
Question: A patient is prescribed warfarin for atrial fibrillation. Which
laboratory value must the nurse monitor to evaluate the therapeutic
effectiveness of this medication?
(A) Activated partial thromboplastin time (aPTT)
(B) International Normalized Ratio (INR)
(C) Platelet count
(D) Hemoglobin and hematocrit
Correct Answer: (B)
Rationale: Warfarin is an oral anticoagulant that affects the extrinsic
pathway of coagulation . The INR is the standardized measure used to
monitor warfarin therapy, with a typical therapeutic range of 2.0 to 3.0 for
most indications. aPTT is used to monitor heparin therapy, while platelet
count and hemoglobin/hematocrit monitor for bleeding risk but do not
measure the drug's therapeutic effect .
Question: A patient receiving morphine develops a respiratory rate of 8
breaths per minute. What is the nurse's priority action?
(A) Increase IV fluids
(B) Administer naloxone
(C) Lower the dose
(D) Call the provider only
,Correct Answer: (B)
Rationale: Respiratory depression is the most serious and life-threatening
adverse effect of opioid analgesics like morphine . Naloxone is a
competitive opioid antagonist used to rapidly reverse opioid-induced
respiratory depression . While calling the provider is necessary,
administering naloxone is the immediate, life-saving priority.
Question: A patient starting lisinopril reports facial swelling. What is the
priority nursing action?
(A) Continue the medication and reassess
(B) Provide a diuretic
(C) Hold the medication and call the provider
(D) Give acetaminophen
Correct Answer: (C)
Rationale: Facial swelling is a sign of angioedema, a potentially life-
threatening adverse effect of ACE inhibitors like lisinopril . The medication
must be held immediately, and the provider must be notified. Continuing
the medication could lead to airway compromise.
Question: A patient is prescribed furosemide for heart failure. Which
electrolyte imbalance should the nurse monitor for most closely?
(A) Hyperkalemia
(B) Hypokalemia
(C) Hypercalcemia
(D) Hyponatremia only
Correct Answer: (B)
Rationale: Furosemide is a loop diuretic that promotes the excretion of
sodium, chloride, and potassium . Hypokalemia is a common and serious
, side effect that can lead to cardiac dysrhythmias . Hyperkalemia is more
associated with potassium-sparing diuretics.
Question: A nurse is administering insulin glargine to a patient with type 1
diabetes. What is the primary characteristic of this insulin?
(A) It has a rapid onset and short duration.
(B) It is administered immediately before meals.
(C) It provides a basal level of insulin with no peak.
(D) It can be mixed with regular insulin in the same syringe.
Correct Answer: (C)
Rationale: Insulin glargine is a long-acting insulin analog designed to
provide a steady, basal level of insulin over 24 hours with no significant
peak . It is typically administered once daily and should not be mixed with
other insulins, as this may alter its pharmacokinetics .
Question: A patient receiving vancomycin IV develops flushing, pruritus,
and erythema of the face, neck, and upper torso. What is the most likely
cause?
(A) Anaphylactic reaction
(B) Red man syndrome
(C) Stevens-Johnson syndrome
(D) Serum sickness
Correct Answer: (B)
Rationale: Red man syndrome is a histamine-mediated reaction
characterized by flushing, pruritus, and erythema of the face, neck, and
upper torso . It is a non-immunologic reaction often associated with rapid
infusion of vancomycin . Slowing the infusion rate is a key preventive
measure .
