RASMUSSEN COLLEGE
Practical Nursing Program · PN
PN Pharmacology Proctored Review
Academic Year: 2026/2027 Complete Question Bank — All Questions
Question 1
A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which laboratory
finding is most critical for the nurse to report to the provider before the procedure?
A. Serum potassium 6.2 mEq/L
B. Serum calcium 8.9 mg/dL
C. Hemoglobin 11.0 g/dL
D. Serum sodium 135 mEq/L
CORRECT ANSWER: A. Serum potassium 6.2 mEq/L
RATIONALE:
Hyperkalemia (K > 5.5) is critical in CKD; increases risk of cardiac arrhythmias. Dialysis may be needed
urgently. Other values are within acceptable ranges or less immediately life-threatening.
Question 2
A patient with heart failure is prescribed furosemide. Which assessment finding indicates that
the medication is having the desired therapeutic effect?
A. Weight gain of 1 kg in 24 hours
B. Decreased peripheral edema
C. Increased blood pressure
D. Heart rate 110 bpm
CORRECT ANSWER: B. Decreased peripheral edema
RATIONALE:
Furosemide is a loop diuretic; decreased peripheral edema indicates effective diuresis. Weight gain,
increased BP, and tachycardia suggest worsening failure.
, Question 3
The nurse is caring for a client with acute pancreatitis. Which intervention is the priority?
A. Administer oral pancreatic enzymes
B. Provide clear liquid diet as tolerated
C. Maintain NPO status and provide IV fluids
D. Place the client in a supine position
CORRECT ANSWER: C. Maintain NPO status and provide IV fluids
RATIONALE:
NPO rests the pancreas and decreases stimulation; IV fluids maintain hydration. Oral enzymes are for
chronic insufficiency; supine may increase pain.
Question 4
A client receiving warfarin has an INR of 5.2. Which action should the nurse take first?
A. Administer vitamin K as ordered
B. Hold the next dose of warfarin
C. Notify the healthcare provider
D. Assess for signs of bleeding
CORRECT ANSWER: D. Assess for signs of bleeding
RATIONALE:
INR 5.2 is above therapeutic range; first assess for active bleeding, then notify provider and consider
holding dose or vitamin K.
Question 5
The nurse is teaching a client with type 2 diabetes about foot care. Which statement indicates
a need for further teaching?
A. “I will trim my toenails straight across.”
B. “I will apply lotion between my toes.”
C. “I will wear closed-toe shoes.”
D. “I will inspect my feet daily.”
CORRECT ANSWER: B. “I will apply lotion between my toes.”
RATIONALE:
Lotion between toes increases fungal infection risk; apply to tops/bottoms only. Other statements reflect
proper care.
, Question 6
A patient with asthma is prescribed albuterol via MDI. Which finding indicates the medication
is effective?
A. Increased wheezing on auscultation
B. Decreased peak expiratory flow rate
C. Improved breath sounds and decreased dyspnea
D. Heart rate 100 bpm
CORRECT ANSWER: C. Improved breath sounds and decreased dyspnea
RATIONALE:
Albuterol is a bronchodilator; effective therapy improves air entry and reduces dyspnea. Tachycardia is a
side effect, not efficacy.
Question 7
A client is 1 day post-operative following a total hip arthroplasty. Which position is
contraindicated?
A. Supine with a pillow between the legs
B. Side-lying on the non-operative side
C. Crossing the legs at the ankles
D. Sitting in a high-backed chair
CORRECT ANSWER: C. Crossing the legs at the ankles
RATIONALE:
After hip arthroplasty, avoid adduction/internal rotation; crossing legs (even at ankles) can cause
dislocation.
, Question 8
The nurse is assessing a client with COPD. Which finding is most indicative of early respiratory
acidosis?
A. Drowsiness and confusion
B. Bounding pulse and flushed skin
C. Deep, rapid respirations (Kussmaul)
D. Complaint of headache and restlessness
CORRECT ANSWER: D. Complaint of headache and restlessness
RATIONALE:
Early CO2 retention causes headache, restlessness, confusion. Drowsiness occurs later; Kussmaul is seen
in metabolic acidosis.
Question 9
A client with anaphylaxis is receiving epinephrine. What is the primary expected effect of this
medication?
A. Bronchodilation and vasoconstriction
B. Bronchoconstriction and vasodilation
C. Decreased heart rate and contractility
D. Increased capillary permeability
CORRECT ANSWER: A. Bronchodilation and vasoconstriction
RATIONALE:
Epinephrine causes bronchodilation (beta-2) and vasoconstriction (alpha-1) to relieve airway obstruction
and increase BP.
Question 10
The nurse is providing discharge teaching to a client with new hypertension. Which dietary
recommendation is most appropriate?
A. Increase intake of processed meats
B. Limit sodium to less than 2,300 mg/day
C. Consume a high-fat diet
D. Avoid all fruits and vegetables
CORRECT ANSWER: B. Limit sodium to less than 2,300 mg/day
RATIONALE:
Sodium reduction is key; processed meats, high-fat diets, and avoiding produce are not recommended.
Practical Nursing Program · PN
PN Pharmacology Proctored Review
Academic Year: 2026/2027 Complete Question Bank — All Questions
Question 1
A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which laboratory
finding is most critical for the nurse to report to the provider before the procedure?
A. Serum potassium 6.2 mEq/L
B. Serum calcium 8.9 mg/dL
C. Hemoglobin 11.0 g/dL
D. Serum sodium 135 mEq/L
CORRECT ANSWER: A. Serum potassium 6.2 mEq/L
RATIONALE:
Hyperkalemia (K > 5.5) is critical in CKD; increases risk of cardiac arrhythmias. Dialysis may be needed
urgently. Other values are within acceptable ranges or less immediately life-threatening.
Question 2
A patient with heart failure is prescribed furosemide. Which assessment finding indicates that
the medication is having the desired therapeutic effect?
A. Weight gain of 1 kg in 24 hours
B. Decreased peripheral edema
C. Increased blood pressure
D. Heart rate 110 bpm
CORRECT ANSWER: B. Decreased peripheral edema
RATIONALE:
Furosemide is a loop diuretic; decreased peripheral edema indicates effective diuresis. Weight gain,
increased BP, and tachycardia suggest worsening failure.
, Question 3
The nurse is caring for a client with acute pancreatitis. Which intervention is the priority?
A. Administer oral pancreatic enzymes
B. Provide clear liquid diet as tolerated
C. Maintain NPO status and provide IV fluids
D. Place the client in a supine position
CORRECT ANSWER: C. Maintain NPO status and provide IV fluids
RATIONALE:
NPO rests the pancreas and decreases stimulation; IV fluids maintain hydration. Oral enzymes are for
chronic insufficiency; supine may increase pain.
Question 4
A client receiving warfarin has an INR of 5.2. Which action should the nurse take first?
A. Administer vitamin K as ordered
B. Hold the next dose of warfarin
C. Notify the healthcare provider
D. Assess for signs of bleeding
CORRECT ANSWER: D. Assess for signs of bleeding
RATIONALE:
INR 5.2 is above therapeutic range; first assess for active bleeding, then notify provider and consider
holding dose or vitamin K.
Question 5
The nurse is teaching a client with type 2 diabetes about foot care. Which statement indicates
a need for further teaching?
A. “I will trim my toenails straight across.”
B. “I will apply lotion between my toes.”
C. “I will wear closed-toe shoes.”
D. “I will inspect my feet daily.”
CORRECT ANSWER: B. “I will apply lotion between my toes.”
RATIONALE:
Lotion between toes increases fungal infection risk; apply to tops/bottoms only. Other statements reflect
proper care.
, Question 6
A patient with asthma is prescribed albuterol via MDI. Which finding indicates the medication
is effective?
A. Increased wheezing on auscultation
B. Decreased peak expiratory flow rate
C. Improved breath sounds and decreased dyspnea
D. Heart rate 100 bpm
CORRECT ANSWER: C. Improved breath sounds and decreased dyspnea
RATIONALE:
Albuterol is a bronchodilator; effective therapy improves air entry and reduces dyspnea. Tachycardia is a
side effect, not efficacy.
Question 7
A client is 1 day post-operative following a total hip arthroplasty. Which position is
contraindicated?
A. Supine with a pillow between the legs
B. Side-lying on the non-operative side
C. Crossing the legs at the ankles
D. Sitting in a high-backed chair
CORRECT ANSWER: C. Crossing the legs at the ankles
RATIONALE:
After hip arthroplasty, avoid adduction/internal rotation; crossing legs (even at ankles) can cause
dislocation.
, Question 8
The nurse is assessing a client with COPD. Which finding is most indicative of early respiratory
acidosis?
A. Drowsiness and confusion
B. Bounding pulse and flushed skin
C. Deep, rapid respirations (Kussmaul)
D. Complaint of headache and restlessness
CORRECT ANSWER: D. Complaint of headache and restlessness
RATIONALE:
Early CO2 retention causes headache, restlessness, confusion. Drowsiness occurs later; Kussmaul is seen
in metabolic acidosis.
Question 9
A client with anaphylaxis is receiving epinephrine. What is the primary expected effect of this
medication?
A. Bronchodilation and vasoconstriction
B. Bronchoconstriction and vasodilation
C. Decreased heart rate and contractility
D. Increased capillary permeability
CORRECT ANSWER: A. Bronchodilation and vasoconstriction
RATIONALE:
Epinephrine causes bronchodilation (beta-2) and vasoconstriction (alpha-1) to relieve airway obstruction
and increase BP.
Question 10
The nurse is providing discharge teaching to a client with new hypertension. Which dietary
recommendation is most appropriate?
A. Increase intake of processed meats
B. Limit sodium to less than 2,300 mg/day
C. Consume a high-fat diet
D. Avoid all fruits and vegetables
CORRECT ANSWER: B. Limit sodium to less than 2,300 mg/day
RATIONALE:
Sodium reduction is key; processed meats, high-fat diets, and avoiding produce are not recommended.
