NCLEX – RN PHARMACOLOGY A+
NCLEX-RN PHARMACOLOGY
Complete Study Guide — 2025/2026 Edition
✦ 50 Verified Practice Q&A ✦ High-Yield Drug Classes ✦ Mnemonics & Rationales
Who is this for?
Nursing students preparing for NCLEX-RN, ATI Pharmacology, or HESI exit exams. This guide focuses on
the highest-yield pharmacology topics. All questions include detailed rationales to help you understand —
not just memorize.
TABLE OF CONTENTS
1. High-Yield Drug Classes Overview
2. Cardiovascular Medications
3. Respiratory Medications
4. Antibiotics and Anti-infectives
5. CNS (Central Nervous System) Drugs
6. Endocrine / Diabetes Medications
7. Pain and Analgesics
8. 50 Practice Questions with Rationales
9. Quick Reference: Key Antidotes
,NCLEX – RN PHARMACOLOGY A+
SECTION 1: High-Yield Drug Classes Overview
Drug Class Key Examples Primary Use NCLEX Alert
Beta-Blockers Metoprolol, Atenolol Hypertension, Heart failure Do NOT stop abruptly
ACE Inhibitors Lisinopril, Enalapril Hypertension, Heart failure Watch for dry cough
Diuretics Furosemide, HCTZ Edema, Hypertension Monitor K+ levels
Statins Atorvastatin, Simvastatin High cholesterol Report muscle pain
SSRIs Fluoxetine, Sertraline Depression, Anxiety Serotonin syndrome risk
Opioids Morphine, Oxycodone Moderate-severe pain Respiratory depression!
Insulin Regular, NPH, Glargine Diabetes Type 1 and 2 Hypoglycemia risk
Antibiotics Amoxicillin, Ciprofloxacin Bacterial infections Complete full course
Anticoagulants Warfarin, Heparin Clot prevention Bleeding risk, INR check
Bronchodilators Albuterol, Salmeterol Asthma, COPD Short vs long-acting
, NCLEX – RN PHARMACOLOGY A+
SECTION 2: Cardiovascular Medications
2.1 Beta-Blockers (-olol endings)
• Examples: Metoprolol (Lopressor), Atenolol, Propranolol, Carvedilol
• Uses: Hypertension, angina, heart failure, arrhythmias, post-MI
• Mechanism: Block beta-adrenergic receptors reduce heart rate and blood pressure
• Key Nursing Actions: Check pulse before giving (hold if HR < 60). Never stop abruptly — taper dose.
Monitor blood pressure. Assess for fatigue, dizziness.
• Side Effects: Bradycardia, hypotension, fatigue, cold extremities, masked hypoglycemia
[TIP] NCLEX: Beta-blockers MASK signs of hypoglycemia — very important for diabetic patients!
2.2 ACE Inhibitors (-pril endings)
• Examples: Lisinopril, Enalapril, Ramipril, Captopril
• Uses: Hypertension, heart failure, diabetic nephropathy, post-MI
• Mechanism: Block angiotensin-converting enzyme vasodilation
• Key Nursing Actions: Monitor BP closely after first dose. Check renal function and potassium. Teach
patient about persistent dry cough.
• Side Effects: Dry cough (most common), hyperkalemia, first-dose hypotension, angioedema
• Contraindications: Pregnancy (teratogenic), bilateral renal artery stenosis
[TIP] NCLEX: If cough is intolerable, ARBs (-sartan drugs) are used as alternatives and do NOT cause
cough!
2.3 Diuretics
Type Drug Example Electrolyte Effect Key Use
Loop Furosemide (Lasix) LOW K+, LOW Na+ Acute pulmonary edema
Thiazide Hydrochlorothiazide LOW K+ Hypertension
Potassium-sparing Spironolactone HIGH K+ Heart failure, ascites
Osmotic Mannitol HIGH urine output Cerebral edema, HIGH ICP
[TIP] NCLEX: Furosemide + Digoxin = dangerous combination! Furosemide lowers potassium
increases Digoxin toxicity risk.
NCLEX-RN PHARMACOLOGY
Complete Study Guide — 2025/2026 Edition
✦ 50 Verified Practice Q&A ✦ High-Yield Drug Classes ✦ Mnemonics & Rationales
Who is this for?
Nursing students preparing for NCLEX-RN, ATI Pharmacology, or HESI exit exams. This guide focuses on
the highest-yield pharmacology topics. All questions include detailed rationales to help you understand —
not just memorize.
TABLE OF CONTENTS
1. High-Yield Drug Classes Overview
2. Cardiovascular Medications
3. Respiratory Medications
4. Antibiotics and Anti-infectives
5. CNS (Central Nervous System) Drugs
6. Endocrine / Diabetes Medications
7. Pain and Analgesics
8. 50 Practice Questions with Rationales
9. Quick Reference: Key Antidotes
,NCLEX – RN PHARMACOLOGY A+
SECTION 1: High-Yield Drug Classes Overview
Drug Class Key Examples Primary Use NCLEX Alert
Beta-Blockers Metoprolol, Atenolol Hypertension, Heart failure Do NOT stop abruptly
ACE Inhibitors Lisinopril, Enalapril Hypertension, Heart failure Watch for dry cough
Diuretics Furosemide, HCTZ Edema, Hypertension Monitor K+ levels
Statins Atorvastatin, Simvastatin High cholesterol Report muscle pain
SSRIs Fluoxetine, Sertraline Depression, Anxiety Serotonin syndrome risk
Opioids Morphine, Oxycodone Moderate-severe pain Respiratory depression!
Insulin Regular, NPH, Glargine Diabetes Type 1 and 2 Hypoglycemia risk
Antibiotics Amoxicillin, Ciprofloxacin Bacterial infections Complete full course
Anticoagulants Warfarin, Heparin Clot prevention Bleeding risk, INR check
Bronchodilators Albuterol, Salmeterol Asthma, COPD Short vs long-acting
, NCLEX – RN PHARMACOLOGY A+
SECTION 2: Cardiovascular Medications
2.1 Beta-Blockers (-olol endings)
• Examples: Metoprolol (Lopressor), Atenolol, Propranolol, Carvedilol
• Uses: Hypertension, angina, heart failure, arrhythmias, post-MI
• Mechanism: Block beta-adrenergic receptors reduce heart rate and blood pressure
• Key Nursing Actions: Check pulse before giving (hold if HR < 60). Never stop abruptly — taper dose.
Monitor blood pressure. Assess for fatigue, dizziness.
• Side Effects: Bradycardia, hypotension, fatigue, cold extremities, masked hypoglycemia
[TIP] NCLEX: Beta-blockers MASK signs of hypoglycemia — very important for diabetic patients!
2.2 ACE Inhibitors (-pril endings)
• Examples: Lisinopril, Enalapril, Ramipril, Captopril
• Uses: Hypertension, heart failure, diabetic nephropathy, post-MI
• Mechanism: Block angiotensin-converting enzyme vasodilation
• Key Nursing Actions: Monitor BP closely after first dose. Check renal function and potassium. Teach
patient about persistent dry cough.
• Side Effects: Dry cough (most common), hyperkalemia, first-dose hypotension, angioedema
• Contraindications: Pregnancy (teratogenic), bilateral renal artery stenosis
[TIP] NCLEX: If cough is intolerable, ARBs (-sartan drugs) are used as alternatives and do NOT cause
cough!
2.3 Diuretics
Type Drug Example Electrolyte Effect Key Use
Loop Furosemide (Lasix) LOW K+, LOW Na+ Acute pulmonary edema
Thiazide Hydrochlorothiazide LOW K+ Hypertension
Potassium-sparing Spironolactone HIGH K+ Heart failure, ascites
Osmotic Mannitol HIGH urine output Cerebral edema, HIGH ICP
[TIP] NCLEX: Furosemide + Digoxin = dangerous combination! Furosemide lowers potassium
increases Digoxin toxicity risk.
