NCLEX-RN PHARMACOLOGY
Complete Practice Questions & Verified Answers
Pack 1 & Pack 2 Combined | 50 Questions with Rationales | 2025/2026 Edition
Topics: Core Pharmacology | Anticoagulants | Psychiatric Medications | Antibiotics
PACK 1 — Core Pharmacology (Questions 1–25)
A nurse is preparing to administer digoxin to a client. Which assessment finding
Q1
should prompt the nurse to withhold the medication and notify the provider?
A) Blood pressure of 130/85 mmHg
✓ B) Apical pulse of 54 bpm
C) Respiratory rate of 18
D) Temperature of 37.2°C
Correct Answer: B) Apical pulse of 54 bpm
Rationale: Digoxin slows the heart rate. An apical pulse below 60 bpm is a contraindication to
administration. Always take apical pulse for a full minute before giving digoxin.
A client is taking warfarin. Which food should the nurse instruct the client to consume
Q2
consistently and in moderate amounts?
A) Bananas
✓ B) Spinach
C) Oranges
D) White rice
Correct Answer: B) Spinach
,Rationale: Spinach is high in Vitamin K, which antagonizes warfarin's anticoagulant effect. Clients
don't need to avoid it entirely but must keep intake consistent to maintain stable INR levels.
A nurse administers IV vancomycin too rapidly. The client develops flushing and
Q3
redness of the face, neck, and chest. What is this reaction called?
A) Anaphylaxis
B) Stevens-Johnson syndrome
✓ C) Red Man Syndrome
D) Serum sickness
Correct Answer: C) Red Man Syndrome
Rationale: Red Man Syndrome is caused by rapid infusion of vancomycin, triggering histamine
release. It is not a true allergic reaction. The infusion should be slowed and diphenhydramine may
be given.
A client is prescribed lithium for bipolar disorder. Which lab value is most important for
Q4
the nurse to monitor?
A) Blood glucose
✓ B) Serum lithium level
C) Liver enzymes
D) Hemoglobin
Correct Answer: B) Serum lithium level
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L). Levels above 1.5 mEq/L are
toxic. Regular monitoring prevents toxicity, which presents as tremors, confusion, and seizures.
A nurse is teaching a client about metformin. Which condition is an absolute
Q5
contraindication for its use?
, A) Hypertension
B) Asthma
✓ C) Renal impairment
D) Hypothyroidism
Correct Answer: C) Renal impairment
Rationale: Metformin is contraindicated in renal impairment because it is excreted by the kidneys.
Accumulation leads to lactic acidosis, a life-threatening complication.
A client taking isoniazid (INH) for tuberculosis should be monitored for deficiency of
Q6
which vitamin?
A) Vitamin C
B) Vitamin D
✓ C) Vitamin B6 (Pyridoxine)
D) Vitamin B12
Correct Answer: C) Vitamin B6 (Pyridoxine)
Rationale: INH interferes with pyridoxine metabolism, leading to peripheral neuropathy. Vitamin B6
supplementation is routinely given alongside INH to prevent this.
A nurse is caring for a client receiving heparin infusion. Which medication should be
Q7
readily available as an antidote?
A) Vitamin K
✓ B) Protamine sulfate
C) Flumazenil
D) Naloxone
Complete Practice Questions & Verified Answers
Pack 1 & Pack 2 Combined | 50 Questions with Rationales | 2025/2026 Edition
Topics: Core Pharmacology | Anticoagulants | Psychiatric Medications | Antibiotics
PACK 1 — Core Pharmacology (Questions 1–25)
A nurse is preparing to administer digoxin to a client. Which assessment finding
Q1
should prompt the nurse to withhold the medication and notify the provider?
A) Blood pressure of 130/85 mmHg
✓ B) Apical pulse of 54 bpm
C) Respiratory rate of 18
D) Temperature of 37.2°C
Correct Answer: B) Apical pulse of 54 bpm
Rationale: Digoxin slows the heart rate. An apical pulse below 60 bpm is a contraindication to
administration. Always take apical pulse for a full minute before giving digoxin.
A client is taking warfarin. Which food should the nurse instruct the client to consume
Q2
consistently and in moderate amounts?
A) Bananas
✓ B) Spinach
C) Oranges
D) White rice
Correct Answer: B) Spinach
,Rationale: Spinach is high in Vitamin K, which antagonizes warfarin's anticoagulant effect. Clients
don't need to avoid it entirely but must keep intake consistent to maintain stable INR levels.
A nurse administers IV vancomycin too rapidly. The client develops flushing and
Q3
redness of the face, neck, and chest. What is this reaction called?
A) Anaphylaxis
B) Stevens-Johnson syndrome
✓ C) Red Man Syndrome
D) Serum sickness
Correct Answer: C) Red Man Syndrome
Rationale: Red Man Syndrome is caused by rapid infusion of vancomycin, triggering histamine
release. It is not a true allergic reaction. The infusion should be slowed and diphenhydramine may
be given.
A client is prescribed lithium for bipolar disorder. Which lab value is most important for
Q4
the nurse to monitor?
A) Blood glucose
✓ B) Serum lithium level
C) Liver enzymes
D) Hemoglobin
Correct Answer: B) Serum lithium level
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L). Levels above 1.5 mEq/L are
toxic. Regular monitoring prevents toxicity, which presents as tremors, confusion, and seizures.
A nurse is teaching a client about metformin. Which condition is an absolute
Q5
contraindication for its use?
, A) Hypertension
B) Asthma
✓ C) Renal impairment
D) Hypothyroidism
Correct Answer: C) Renal impairment
Rationale: Metformin is contraindicated in renal impairment because it is excreted by the kidneys.
Accumulation leads to lactic acidosis, a life-threatening complication.
A client taking isoniazid (INH) for tuberculosis should be monitored for deficiency of
Q6
which vitamin?
A) Vitamin C
B) Vitamin D
✓ C) Vitamin B6 (Pyridoxine)
D) Vitamin B12
Correct Answer: C) Vitamin B6 (Pyridoxine)
Rationale: INH interferes with pyridoxine metabolism, leading to peripheral neuropathy. Vitamin B6
supplementation is routinely given alongside INH to prevent this.
A nurse is caring for a client receiving heparin infusion. Which medication should be
Q7
readily available as an antidote?
A) Vitamin K
✓ B) Protamine sulfate
C) Flumazenil
D) Naloxone
