NCLEX PHARMACOLOGY ACTUAL EXAM REVIEW 2026/2027
LATEST VERSION 150 QUESTIONS AND CORRECT ANSWERS
OVERVIEW
This review provides a focused overview of cardiac medications and
anticoagulant therapy for nursing practice. It covers digoxin use, including its
therapeutic serum range (0.5–2.0 ng/mL), signs of digitalis toxicity, and the impact
of hypokalemia on drug sensitivity. Key nursing considerations for ACE
inhibitors, beta blockers, calcium channel blockers, and alpha-agonists are
highlighted, including monitoring for side effects such as cough, hypotension,
respiratory changes, constipation, and liver function alterations.
The review also addresses anticoagulants and antiplatelet agents: heparin, low-
molecular-weight heparins (LMWH), warfarin, enoxaparin, clopidogrel, cilostazol,
and abciximab, with emphasis on indications, routes, half-life, lab monitoring
(aPTT, INR), antidotes (protamine sulfate, vitamin K), and potential complications
such as bleeding. Nursing priorities include monitoring for toxicity, preventing clot
formation, and providing patient education on drug interactions, diet, and bleeding
precautions.
Overall, the content reinforces safe medication administration, recognition of
adverse effects, appropriate patient teaching, and critical prioritization in
cardiovascular pharmacology.
A newly admitted client takes digoxin 0.25 mg/day. The nurse knows that which is the serum
therapeutic range for digoxin?
a. 0.1 to 1.5 ng/mL
b. 0.5 to 2.0 ng/mL
c. 1.0 to 2.5 ng/mL
d. 2.0 to 4.0 ng/mL - correct answer -b. 0.5 to 2.0 ng/mL
The client's serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum digoxin
level?
a. It is in the high (elevated) range.
,b. It is in the low (decreased) range.
c. It is within the normal range.
d. It is in the low average range. - correct answer -a. It is in the high (elevated) range.
The nurse is assessing the client for possible evidence of digitalis toxicity. The nurse acknowledges
that which is included in the signs and symptoms for digitalis toxicity?
a. Pulse (heart) rate of 100 beats/min
b. Pulse of 72 with an irregular rate
c. Pulse greater than 60 beats/min and irregular rate
d. Pulse below 60 beats/min and irregular rate - correct answer -d. Pulse below 60 beats/min and
irregular rate
The client is also taking a diuretic that decreases her potassium level. The nurse expects that a low
potassium level (hypokalemia) could have what effect on the digoxin?
a. Increase the serum digoxin sensitivity level
b. Decrease the serum digoxin sensitivity level
c. Not have any effect on the serum digoxin sensitivity level
d. Cause a low average serum digoxin sensitivity level - correct answer -a. Increase the serum digoxin
sensitivity level
A nurse is caring for a client who is taking an angiotensin-converting enzyme inhibitor and develops a
dry, nonproductive cough. What is the nurse's priority action?
a. Call the health care provider to switch the medication.
b. Assess the client for other symptoms of upper respiratory infection.
c. Instruct the client to take antitussive medication until the symptoms subside.
d. Tell the client that the cough will subside in a few days. - correct answer -a. Call the health care
provider to switch the medication.
The nurse is reviewing a medication history on a client taking an ACE inhibitor. The nurse plans to
contact the health care provider if the client is also taking which medication?
a. docusate sodium (Colace)
,b. furosemide (Lasix)
c. morphine sulfate
d. spironolactone (Aldactone) - correct answer -d. spironolactone (Aldactone)
A client is prescribed a noncardioselective beta1 blocker. What nursing intervention is a priority for
this client?
a. Assessment of blood glucose levels
b. Respiratory assessment
c. Orthostatic blood pressure assessment
d. Teaching about potential tachycardia - correct answer -b. Respiratory assessment
Which client will the nurse assess first?
a. The client who has been on beta blockers for 1 day.
b. The client who is on a beta blocker and a thiazide diuretic.
c. The client who has stopped taking a beta blocker due to cost.
d. The client who is taking a beta blocker and Lasix (furosemide). - correct answer -c. The client who
has stopped taking a beta blocker due to cost.
The nurse is caring for a client with hypertension who is prescribed Clonidine transdermal
preparation. What is the correct information to teach this client?
a. Change the patch daily at the same time.
b. Remove the patch before taking a shower or bath.
c. Do not take other antihypertensive medications while on this patch.
d. Get up slowly from a sitting to a standing position. - correct answer -d. Get up slowly from a sitting
to a standing position.
The client taking Methyldopa (Aldomet) has elevated liver function tests. What is the nurse's best
action?
a. Document the finding and continue care.
b. Notify the health care provider.
, c. Immediately stop the medication.
d. Change the client's diet. - correct answer -b. Notify the health care provider.
A client taking prazosin has a blood pressure of 140/90. The client is complaining of swollen feet.
What is the nurse's best action?
a. Hold the medication.
b. Call the health care provider.
c. Determine the client's history.
d. Weigh the client. - correct answer -c. Determine the client's history.
A calcium channel blocker has been ordered for a client. Which condition in the client's history is a
contraindication to this medication?
a. Hypokalemia
b. Dysrhythmias
c. Hypotension
d. Increased intracranial pressure - correct answer -c. Hypotension
A client who takes clonidine (Catapres) is to be discharged to home. Which instruction will the nurse
include when teaching this client?
a. "Your blood pressure should be checked by a health care provider at least once a year."
b. "Increasing fluid and fiber in your diet can help prevent the side effect of constipation."
c. "Intense exercise or prolonged standing is not a problem with clonidine as it can be with other
antihypertensive agents."
d. "If you are having difficulty with the common side effect of drooling, notify your health care provider
so your dosage can be adjusted." - correct answer -b. "Increasing fluid and fiber in your diet can help
prevent the side effect of constipation."
During assessment of a client diagnosed with pheochromocytoma, the nurse auscultates a blood
pressure of 210/110 mm Hg. What is the nurse's best action?
a. To ask the client to lie down and rest
b. To assess the client?s dietary intake of sodium and fluid
LATEST VERSION 150 QUESTIONS AND CORRECT ANSWERS
OVERVIEW
This review provides a focused overview of cardiac medications and
anticoagulant therapy for nursing practice. It covers digoxin use, including its
therapeutic serum range (0.5–2.0 ng/mL), signs of digitalis toxicity, and the impact
of hypokalemia on drug sensitivity. Key nursing considerations for ACE
inhibitors, beta blockers, calcium channel blockers, and alpha-agonists are
highlighted, including monitoring for side effects such as cough, hypotension,
respiratory changes, constipation, and liver function alterations.
The review also addresses anticoagulants and antiplatelet agents: heparin, low-
molecular-weight heparins (LMWH), warfarin, enoxaparin, clopidogrel, cilostazol,
and abciximab, with emphasis on indications, routes, half-life, lab monitoring
(aPTT, INR), antidotes (protamine sulfate, vitamin K), and potential complications
such as bleeding. Nursing priorities include monitoring for toxicity, preventing clot
formation, and providing patient education on drug interactions, diet, and bleeding
precautions.
Overall, the content reinforces safe medication administration, recognition of
adverse effects, appropriate patient teaching, and critical prioritization in
cardiovascular pharmacology.
A newly admitted client takes digoxin 0.25 mg/day. The nurse knows that which is the serum
therapeutic range for digoxin?
a. 0.1 to 1.5 ng/mL
b. 0.5 to 2.0 ng/mL
c. 1.0 to 2.5 ng/mL
d. 2.0 to 4.0 ng/mL - correct answer -b. 0.5 to 2.0 ng/mL
The client's serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum digoxin
level?
a. It is in the high (elevated) range.
,b. It is in the low (decreased) range.
c. It is within the normal range.
d. It is in the low average range. - correct answer -a. It is in the high (elevated) range.
The nurse is assessing the client for possible evidence of digitalis toxicity. The nurse acknowledges
that which is included in the signs and symptoms for digitalis toxicity?
a. Pulse (heart) rate of 100 beats/min
b. Pulse of 72 with an irregular rate
c. Pulse greater than 60 beats/min and irregular rate
d. Pulse below 60 beats/min and irregular rate - correct answer -d. Pulse below 60 beats/min and
irregular rate
The client is also taking a diuretic that decreases her potassium level. The nurse expects that a low
potassium level (hypokalemia) could have what effect on the digoxin?
a. Increase the serum digoxin sensitivity level
b. Decrease the serum digoxin sensitivity level
c. Not have any effect on the serum digoxin sensitivity level
d. Cause a low average serum digoxin sensitivity level - correct answer -a. Increase the serum digoxin
sensitivity level
A nurse is caring for a client who is taking an angiotensin-converting enzyme inhibitor and develops a
dry, nonproductive cough. What is the nurse's priority action?
a. Call the health care provider to switch the medication.
b. Assess the client for other symptoms of upper respiratory infection.
c. Instruct the client to take antitussive medication until the symptoms subside.
d. Tell the client that the cough will subside in a few days. - correct answer -a. Call the health care
provider to switch the medication.
The nurse is reviewing a medication history on a client taking an ACE inhibitor. The nurse plans to
contact the health care provider if the client is also taking which medication?
a. docusate sodium (Colace)
,b. furosemide (Lasix)
c. morphine sulfate
d. spironolactone (Aldactone) - correct answer -d. spironolactone (Aldactone)
A client is prescribed a noncardioselective beta1 blocker. What nursing intervention is a priority for
this client?
a. Assessment of blood glucose levels
b. Respiratory assessment
c. Orthostatic blood pressure assessment
d. Teaching about potential tachycardia - correct answer -b. Respiratory assessment
Which client will the nurse assess first?
a. The client who has been on beta blockers for 1 day.
b. The client who is on a beta blocker and a thiazide diuretic.
c. The client who has stopped taking a beta blocker due to cost.
d. The client who is taking a beta blocker and Lasix (furosemide). - correct answer -c. The client who
has stopped taking a beta blocker due to cost.
The nurse is caring for a client with hypertension who is prescribed Clonidine transdermal
preparation. What is the correct information to teach this client?
a. Change the patch daily at the same time.
b. Remove the patch before taking a shower or bath.
c. Do not take other antihypertensive medications while on this patch.
d. Get up slowly from a sitting to a standing position. - correct answer -d. Get up slowly from a sitting
to a standing position.
The client taking Methyldopa (Aldomet) has elevated liver function tests. What is the nurse's best
action?
a. Document the finding and continue care.
b. Notify the health care provider.
, c. Immediately stop the medication.
d. Change the client's diet. - correct answer -b. Notify the health care provider.
A client taking prazosin has a blood pressure of 140/90. The client is complaining of swollen feet.
What is the nurse's best action?
a. Hold the medication.
b. Call the health care provider.
c. Determine the client's history.
d. Weigh the client. - correct answer -c. Determine the client's history.
A calcium channel blocker has been ordered for a client. Which condition in the client's history is a
contraindication to this medication?
a. Hypokalemia
b. Dysrhythmias
c. Hypotension
d. Increased intracranial pressure - correct answer -c. Hypotension
A client who takes clonidine (Catapres) is to be discharged to home. Which instruction will the nurse
include when teaching this client?
a. "Your blood pressure should be checked by a health care provider at least once a year."
b. "Increasing fluid and fiber in your diet can help prevent the side effect of constipation."
c. "Intense exercise or prolonged standing is not a problem with clonidine as it can be with other
antihypertensive agents."
d. "If you are having difficulty with the common side effect of drooling, notify your health care provider
so your dosage can be adjusted." - correct answer -b. "Increasing fluid and fiber in your diet can help
prevent the side effect of constipation."
During assessment of a client diagnosed with pheochromocytoma, the nurse auscultates a blood
pressure of 210/110 mm Hg. What is the nurse's best action?
a. To ask the client to lie down and rest
b. To assess the client?s dietary intake of sodium and fluid
