MARK KLIMEK NCLEX PHARMACOLOGY EXAM REVIEW 100
QUESTIONS AND CORRECT ANSWERS WITH RATIONALES
2026/2027 LATEST VERSION
OVERVIEW
This review covers key medications, nursing priorities, and lab monitoring across multiple
systems. Urinary drugs like bethanechol, oxybutynin, and phenazopyridine require attention
to contraindications and side effects, while diuretics and electrolyte management focus on
potassium levels and cardiac monitoring. Transplant immunosuppressants such as
cyclosporine and tacrolimus need precise dosing and lab checks. Insulin and diabetes
management highlight onset, peak, and hypoglycemia risk, while DKA and HHNS emphasize
emergency fluid and insulin therapy. Cardiac meds target specific arrhythmias, and
psychotropic drugs (phenothiazines, benzodiazepines, SSRIs, MAOIs, lithium) require
monitoring for safety, side effects, and interactions. In OB care, oxytocics, tocolytics, and fetal
lung medications have maternal and neonatal implications. General nursing principles stress the
Hold → Assess → Prepare → Call approach, patient safety, and critical thinking, with
mnemonics and rules for injections, peaks, and lab interpretation to guide practice.
1. Never hold a hormone for which patient?
A. Patient with hyperthyroidism
B. Patient who is NPO with myxedema
C. Patient with hypothyroidism
D. Patient with diabetes
Answer: B. Patient who is NPO with myxedema
Rationale: Patients with myxedema are critically dependent on thyroid hormone; withholding it can
precipitate life-threatening myxedema coma.
2. Easy way to remember Addison's disease medication?
A. Add a Sone
B. Take Coumadin
C. Give insulin
D. Hold potassium
Answer: A. Add a Sone
Rationale: “Sone” refers to steroids, which are required in Addison’s disease for adrenal hormone
replacement.
,3. Best default order for click-and-drag NCLEX prioritization questions?
A. Call, Prepare, Assess, Hold
B. Hold, Assess, Prepare, Call
C. Assess, Call, Prepare, Hold
D. Prepare, Hold, Assess, Call
Answer: B. Hold, Assess, Prepare, Call
Rationale: This sequence prioritizes immediate safety (hold dangerous meds), assess the effect, prepare
correction, then notify HCP.
4. Rarely, if ever, the NCLEX wants you to:
A. Hold medication
B. Call the doctor
C. Assess patient
D. Prepare antidote
Answer: B. Call the doctor
Rationale: NCLEX tests critical thinking; often you should intervene according to protocols before
notifying.
5. Normal INR lab value?
A. 1–2
B. 2–3
C. 3–4
D. 0.5–1.5
Answer: B. 2–3
Rationale: Therapeutic range for patients on Coumadin; outside this range, risk for bleeding or clotting
increases.
6. Potassium normal lab value?
A. 2.5–4.0
B. 3.5–5.3
C. 4.0–6.0
D. 5.0–6.5
Answer: B. 3.5–5.3
Rationale: Critical for cardiac function; abnormal levels require immediate assessment and
interventions.
, 7. If pitocin is running and complications occur, what is first action?
A. Increase pitocin
B. Stop pitocin first, then LIONpit
C. Call the doctor
D. Assess pain
Answer: B. Stop pitocin first, then LIONpit
Rationale: Stopping the medication causing the problem is the first priority in obstetric emergencies.
8. Pain meds in labor should be avoided if:
A. Patient has high blood pressure
B. Baby is likely to be born when the pain med peaks
C. Contractions are mild
D. Cervix is fully dilated
Answer: B. Baby is likely to be born when the pain med peaks
Rationale: Maternal analgesics can cause neonatal respiratory depression if baby is born at peak drug
effect.
9. Tocolytic drugs in OB, maternal side effect of Brethine?
A. Hypotension
B. Maternal tachycardia
C. Bradycardia
D. Nausea
Answer: B. Maternal tachycardia
Rationale: Brethine (terbutaline) stimulates beta-adrenergic receptors causing maternal tachycardia.
10. Tocolytic drugs in OB, maternal side effect of Nifedipine?
A. Tachycardia
B. Hypotension and headache
C. Hyperglycemia
D. Edema
Answer: B. Hypotension and headache
Rationale: Nifedipine is a calcium channel blocker; it relaxes smooth muscle and may lower BP.
11. Oxytocics function in labor?
QUESTIONS AND CORRECT ANSWERS WITH RATIONALES
2026/2027 LATEST VERSION
OVERVIEW
This review covers key medications, nursing priorities, and lab monitoring across multiple
systems. Urinary drugs like bethanechol, oxybutynin, and phenazopyridine require attention
to contraindications and side effects, while diuretics and electrolyte management focus on
potassium levels and cardiac monitoring. Transplant immunosuppressants such as
cyclosporine and tacrolimus need precise dosing and lab checks. Insulin and diabetes
management highlight onset, peak, and hypoglycemia risk, while DKA and HHNS emphasize
emergency fluid and insulin therapy. Cardiac meds target specific arrhythmias, and
psychotropic drugs (phenothiazines, benzodiazepines, SSRIs, MAOIs, lithium) require
monitoring for safety, side effects, and interactions. In OB care, oxytocics, tocolytics, and fetal
lung medications have maternal and neonatal implications. General nursing principles stress the
Hold → Assess → Prepare → Call approach, patient safety, and critical thinking, with
mnemonics and rules for injections, peaks, and lab interpretation to guide practice.
1. Never hold a hormone for which patient?
A. Patient with hyperthyroidism
B. Patient who is NPO with myxedema
C. Patient with hypothyroidism
D. Patient with diabetes
Answer: B. Patient who is NPO with myxedema
Rationale: Patients with myxedema are critically dependent on thyroid hormone; withholding it can
precipitate life-threatening myxedema coma.
2. Easy way to remember Addison's disease medication?
A. Add a Sone
B. Take Coumadin
C. Give insulin
D. Hold potassium
Answer: A. Add a Sone
Rationale: “Sone” refers to steroids, which are required in Addison’s disease for adrenal hormone
replacement.
,3. Best default order for click-and-drag NCLEX prioritization questions?
A. Call, Prepare, Assess, Hold
B. Hold, Assess, Prepare, Call
C. Assess, Call, Prepare, Hold
D. Prepare, Hold, Assess, Call
Answer: B. Hold, Assess, Prepare, Call
Rationale: This sequence prioritizes immediate safety (hold dangerous meds), assess the effect, prepare
correction, then notify HCP.
4. Rarely, if ever, the NCLEX wants you to:
A. Hold medication
B. Call the doctor
C. Assess patient
D. Prepare antidote
Answer: B. Call the doctor
Rationale: NCLEX tests critical thinking; often you should intervene according to protocols before
notifying.
5. Normal INR lab value?
A. 1–2
B. 2–3
C. 3–4
D. 0.5–1.5
Answer: B. 2–3
Rationale: Therapeutic range for patients on Coumadin; outside this range, risk for bleeding or clotting
increases.
6. Potassium normal lab value?
A. 2.5–4.0
B. 3.5–5.3
C. 4.0–6.0
D. 5.0–6.5
Answer: B. 3.5–5.3
Rationale: Critical for cardiac function; abnormal levels require immediate assessment and
interventions.
, 7. If pitocin is running and complications occur, what is first action?
A. Increase pitocin
B. Stop pitocin first, then LIONpit
C. Call the doctor
D. Assess pain
Answer: B. Stop pitocin first, then LIONpit
Rationale: Stopping the medication causing the problem is the first priority in obstetric emergencies.
8. Pain meds in labor should be avoided if:
A. Patient has high blood pressure
B. Baby is likely to be born when the pain med peaks
C. Contractions are mild
D. Cervix is fully dilated
Answer: B. Baby is likely to be born when the pain med peaks
Rationale: Maternal analgesics can cause neonatal respiratory depression if baby is born at peak drug
effect.
9. Tocolytic drugs in OB, maternal side effect of Brethine?
A. Hypotension
B. Maternal tachycardia
C. Bradycardia
D. Nausea
Answer: B. Maternal tachycardia
Rationale: Brethine (terbutaline) stimulates beta-adrenergic receptors causing maternal tachycardia.
10. Tocolytic drugs in OB, maternal side effect of Nifedipine?
A. Tachycardia
B. Hypotension and headache
C. Hyperglycemia
D. Edema
Answer: B. Hypotension and headache
Rationale: Nifedipine is a calcium channel blocker; it relaxes smooth muscle and may lower BP.
11. Oxytocics function in labor?
