NCLEX-RN Pharmacology and Parenteral Therapies Comprehensive
Review 2026/2027 UPDATE
1. A patient is prescribed Warfarin for atrial fibrillation. Which laboratory value
should the nurse monitor to evaluate the effectiveness of this medication?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Hemoglobin and Hematocrit
Answer: B
Rationale: INR is the standard laboratory test used to monitor the effectiveness of
Warfarin therapy. aPTT is used for Heparin.
2. A client taking Lisinopril for hypertension reports a persistent, non-productive
cough. What is the nurse’s best action?
A. Tell the client this is a normal side effect and will subside.
B. Notify the healthcare provider, as this is a common side effect of ACE inhibitors.
C. Instruct the client to take an over-the-counter cough suppressant.
D. Encourage the client to increase fluid intake to loosen secretions.
Answer: B
Rationale: ACE inhibitors like Lisinopril often cause a dry cough due to the accumulation
of bradykinin. The provider may need to switch the medication to an ARB.
,3. Before administering Digoxin, the nurse should perform which assessment?
A. Check the radial pulse for 30 seconds.
B. Assess the blood pressure in both arms.
C. Auscultate the apical pulse for 1 full minute.
D. Evaluate the client’s deep tendon reflexes.
Answer: C
Rationale: Digoxin can cause bradycardia. An apical pulse must be taken for 60 seconds,
and the drug held if the rate is below 60 bpm in adults.
4. A patient is receiving Furosemide intravenously. Which electrolyte imbalance
should the nurse monitor for most closely?
A. Hyperkalemia
B. Hypercalcemia
C. Hypokalemia
D. Hypomagnesemia
Answer: C
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium, leading
to a risk of hypokalemia.
5. A nurse is preparing to administer Morphine Sulfate. Which vital sign is the
priority to assess before administration?
A. Blood Pressure
B. Temperature
C. Heart Rate
D. Respiratory Rate
Answer: D
Rationale: Opioids like Morphine cause respiratory depression. The nurse must assess the
respiratory rate and hold the dose if it is too low (typically <12 breaths/min).
, 6. A client is instructed on how to use sublingual Nitroglycerin for chest pain.
Which statement by the client indicates a need for further teaching?
A. I will keep the tablets in the original dark glass bottle.
B. I can take up to three tablets, 5 minutes apart.
C. I might get a headache after taking this medicine.
D. I should swallow the tablet with a full glass of water.
Answer: D
Rationale: Sublingual Nitroglycerin must be dissolved under the tongue for rapid
absorption. Swallowing it inactivates the drug due to the first-pass effect.
7. A patient with Type 1 Diabetes is found sweaty, shaky, and confused. What is
the nurse’s first action?
A. Administer the scheduled dose of regular insulin.
B. Call the physician immediately.
C. Provide 15 grams of simple carbohydrates.
D. Check the patient’s blood glucose level.
Answer: D
Rationale: The patient is showing signs of hypoglycemia. The nurse should confirm the
blood glucose level first before treating, if the equipment is immediately available.
8. Which medication is the antidote for Heparin toxicity?
A. Vitamin K
B. Protamine Sulfate
C. Calcium Gluconate
D. Acetylcysteine
Answer: B
Rationale: Protamine Sulfate is the specific reversal agent for Heparin. Vitamin K is for
Warfarin.
Review 2026/2027 UPDATE
1. A patient is prescribed Warfarin for atrial fibrillation. Which laboratory value
should the nurse monitor to evaluate the effectiveness of this medication?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Hemoglobin and Hematocrit
Answer: B
Rationale: INR is the standard laboratory test used to monitor the effectiveness of
Warfarin therapy. aPTT is used for Heparin.
2. A client taking Lisinopril for hypertension reports a persistent, non-productive
cough. What is the nurse’s best action?
A. Tell the client this is a normal side effect and will subside.
B. Notify the healthcare provider, as this is a common side effect of ACE inhibitors.
C. Instruct the client to take an over-the-counter cough suppressant.
D. Encourage the client to increase fluid intake to loosen secretions.
Answer: B
Rationale: ACE inhibitors like Lisinopril often cause a dry cough due to the accumulation
of bradykinin. The provider may need to switch the medication to an ARB.
,3. Before administering Digoxin, the nurse should perform which assessment?
A. Check the radial pulse for 30 seconds.
B. Assess the blood pressure in both arms.
C. Auscultate the apical pulse for 1 full minute.
D. Evaluate the client’s deep tendon reflexes.
Answer: C
Rationale: Digoxin can cause bradycardia. An apical pulse must be taken for 60 seconds,
and the drug held if the rate is below 60 bpm in adults.
4. A patient is receiving Furosemide intravenously. Which electrolyte imbalance
should the nurse monitor for most closely?
A. Hyperkalemia
B. Hypercalcemia
C. Hypokalemia
D. Hypomagnesemia
Answer: C
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium, leading
to a risk of hypokalemia.
5. A nurse is preparing to administer Morphine Sulfate. Which vital sign is the
priority to assess before administration?
A. Blood Pressure
B. Temperature
C. Heart Rate
D. Respiratory Rate
Answer: D
Rationale: Opioids like Morphine cause respiratory depression. The nurse must assess the
respiratory rate and hold the dose if it is too low (typically <12 breaths/min).
, 6. A client is instructed on how to use sublingual Nitroglycerin for chest pain.
Which statement by the client indicates a need for further teaching?
A. I will keep the tablets in the original dark glass bottle.
B. I can take up to three tablets, 5 minutes apart.
C. I might get a headache after taking this medicine.
D. I should swallow the tablet with a full glass of water.
Answer: D
Rationale: Sublingual Nitroglycerin must be dissolved under the tongue for rapid
absorption. Swallowing it inactivates the drug due to the first-pass effect.
7. A patient with Type 1 Diabetes is found sweaty, shaky, and confused. What is
the nurse’s first action?
A. Administer the scheduled dose of regular insulin.
B. Call the physician immediately.
C. Provide 15 grams of simple carbohydrates.
D. Check the patient’s blood glucose level.
Answer: D
Rationale: The patient is showing signs of hypoglycemia. The nurse should confirm the
blood glucose level first before treating, if the equipment is immediately available.
8. Which medication is the antidote for Heparin toxicity?
A. Vitamin K
B. Protamine Sulfate
C. Calcium Gluconate
D. Acetylcysteine
Answer: B
Rationale: Protamine Sulfate is the specific reversal agent for Heparin. Vitamin K is for
Warfarin.
