PROPHECY RN PHARMACOLOGY A PROPHECY EXAM 200
ACTUAL QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST 2026 ALREADY GRADED A+
This comprehensive 200-question Prophecy RN Pharmacology A exam bank
is designed for nurses preparing for pharmacology competency assessments.
It covers all core medication categories including cardiovascular, endocrine,
neurological, psychiatric, respiratory, and infectious disease agents. Each
unique question presents a realistic clinical scenario with multiple-choice
options, a correct answer, and a detailed rationale explaining the mechanism
of action, adverse effects, drug interactions, and nursing considerations. The
content emphasizes critical thinking, dosage calculations, and patient safety.
This resource helps nurses identify knowledge gaps, understand priority
actions, and build confidence in medication administration and monitoring.
1. Which of the following medications is known to cause orange-colored urine?
A) Phenazopyridine (Pyridium)
B) Rifampin
C) Ibuprofen
D) Metronidazole
Correct Answer: A) Phenazopyridine (Pyridium)
Rationale: Phenazopyridine is a urinary tract analgesic that causes a characteristic
orange or red-orange discoloration of urine. This is a harmless but expected side
effect that should be explained to the patient to prevent alarm. This medication is
commonly tested in pharmacology assessments for this specific side effect.
2. You are ordered to give digoxin. Your patient's vital signs are as follows: Blood
Pressure 130/75, Temp 97.9 oral, HR 52, O2 Sat 100% room air. What should you
do next?
A) Administer digoxin
B) Hold digoxin and call the provider
C) Assess the patient for digoxin toxicity
D) Give digoxin with food
Correct Answer: B) Hold digoxin and call the provider
,Rationale: A heart rate below 60 beats per minute in a patient receiving digoxin
warrants withholding the medication and notifying the healthcare provider.
Bradycardia may indicate digoxin toxicity. Digoxin increases the force of
myocardial contraction and slows conduction through the AV node, which can lead
to excessive bradycardia.
3. Normal Saline (NS) is the solution of choice over D5W when preparing to
administer a blood transfusion because:
A) D5W is isotonic
B) NS is a hypotonic solution
C) Normal Saline is an isotonic solution and prevents cell hemolysis
D) Normal Saline is a hypertonic solution
Correct Answer: C) Normal Saline is an isotonic solution and prevents cell
hemolysis
Rationale: Normal Saline is isotonic and helps maintain osmotic balance during
blood transfusions. Dextrose-containing solutions like D5W can cause hemolysis
of red blood cells due to changes in osmolality. NS is the only compatible primary
IV solution for blood products.
4. Patient is to receive 5mg/kg of medication. Patient weighs 80kg. How much
would you administer?
A) 400mg
B) 300mg
C) 500mg
D) 200mg
Correct Answer: A) 400mg
Rationale: To calculate the dose: 5 mg/kg × 80 kg = 400 mg. This is a
straightforward weight-based calculation that requires converting the patient's
weight and multiplying by the prescribed dose per kilogram.
5. Your patient taking digoxin (Lanoxin) has an AM Potassium level of 3.0. This
level may:
A) Decrease risk of digoxin toxicity
B) Have no effect on digoxin levels
C) Increase risk of digoxin toxicity
D) Require immediate potassium supplementation
Correct Answer: C) Increase risk of digoxin toxicity
,Rationale: A low potassium (hypokalemia) level may potentiate the effects of
digoxin, heightening the risk for toxicity. Monitoring potassium levels is critical
when a patient is on digoxin therapy. Hypokalemia makes the myocardium more
sensitive to digoxin.
6. The patient is diagnosed with multiple myeloma. The physician has ordered
cyclophosphamide (Cytoxan). Which instruction should be given to the patient?
A) Increase daily water intake
B) Limit sugar intake
C) Avoid contact with sick individuals
D) Take medication with food
Correct Answer: A) Increase daily water intake
Rationale: Adequate hydration is vital while taking cyclophosphamide to reduce
the risk of hemorrhagic cystitis by diluting the urine and minimizing the
concentration of the drug metabolites. Hemorrhagic cystitis is a serious adverse
effect of this chemotherapeutic agent.
7. Which of the following medications will crystallize when mixed with D5NS?
A) Phenytoin (Dilantin)
B) Furosemide (Lasix)
C) Ceftriaxone
D) Amiodarone
Correct Answer: A) Phenytoin (Dilantin)
Rationale: Phenytoin can precipitate when mixed in solutions containing dextrose,
such as D5NS. It must be administered separately to prevent crystallization and
ensure medication efficacy. Phenytoin should be administered via a dedicated IV
line with normal saline.
8. Which of the following medications should be questioned by the nurse if
ordered by the provider to treat a patient's complaint of nausea and vomiting?
A) Ondansetron (Zofran)
B) Promethazine (Phenergan)
C) Metoclopramide (Reglan)
D) Famotidine (Pepcid)
Correct Answer: D) Famotidine (Pepcid)
Rationale: Famotidine is an H2 blocker used for gastric acid-related conditions and
is ineffective for treating nausea and vomiting. The nurse should clarify this order
, with the provider. Antiemetics such as ondansetron are more appropriate for
nausea.
9. Your patient has an epidural infusing hydromorphone with bupivacaine at
6ml/hr continuously. The patient's blood pressure at the beginning of your shift
was 92/58 with a heart rate of 68. You noticed the patient's blood pressures have
been around 130/70. What should you do FIRST?
A) Increase the infusion rate
B) Check infusion rate to confirm 6ml/hr, then notify anesthesia provider
C) Document the vital signs
D) Administer supplemental fluids
Correct Answer: B) Check infusion rate to confirm 6ml/hr, then notify anesthesia
provider
Rationale: Verifying the correct infusion rate is critical before taking further
actions and helps ensure the patient's safety while documenting changes promptly.
Epidural infusions containing local anesthetics (bupivacaine) can cause
hypotension but this patient's BP has normalized from a low baseline.
10. The dosage of which drug must be tapered off slowly to prevent acute adrenal
insufficiency?
A) Prednisone (Deltasone)
B) Hydrocodone
C) Levothyroxine
D) Metoprolol
Correct Answer: A) Prednisone (Deltasone)
Rationale: Tapering corticosteroids like prednisone is essential to allow the body to
gradually resume its own adrenal production of corticosteroids and prevent an
adrenal crisis. Abrupt withdrawal can cause life-threatening adrenal insufficiency.
11. When teaching a new nurse on how to administer IV push furosemide (Lasix),
you emphasize that it should be given over two minutes to avoid:
A) Nausea
B) Tinnitus
C) Hypotension
D) Headache
Correct Answer: B) Tinnitus
ACTUAL QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST 2026 ALREADY GRADED A+
This comprehensive 200-question Prophecy RN Pharmacology A exam bank
is designed for nurses preparing for pharmacology competency assessments.
It covers all core medication categories including cardiovascular, endocrine,
neurological, psychiatric, respiratory, and infectious disease agents. Each
unique question presents a realistic clinical scenario with multiple-choice
options, a correct answer, and a detailed rationale explaining the mechanism
of action, adverse effects, drug interactions, and nursing considerations. The
content emphasizes critical thinking, dosage calculations, and patient safety.
This resource helps nurses identify knowledge gaps, understand priority
actions, and build confidence in medication administration and monitoring.
1. Which of the following medications is known to cause orange-colored urine?
A) Phenazopyridine (Pyridium)
B) Rifampin
C) Ibuprofen
D) Metronidazole
Correct Answer: A) Phenazopyridine (Pyridium)
Rationale: Phenazopyridine is a urinary tract analgesic that causes a characteristic
orange or red-orange discoloration of urine. This is a harmless but expected side
effect that should be explained to the patient to prevent alarm. This medication is
commonly tested in pharmacology assessments for this specific side effect.
2. You are ordered to give digoxin. Your patient's vital signs are as follows: Blood
Pressure 130/75, Temp 97.9 oral, HR 52, O2 Sat 100% room air. What should you
do next?
A) Administer digoxin
B) Hold digoxin and call the provider
C) Assess the patient for digoxin toxicity
D) Give digoxin with food
Correct Answer: B) Hold digoxin and call the provider
,Rationale: A heart rate below 60 beats per minute in a patient receiving digoxin
warrants withholding the medication and notifying the healthcare provider.
Bradycardia may indicate digoxin toxicity. Digoxin increases the force of
myocardial contraction and slows conduction through the AV node, which can lead
to excessive bradycardia.
3. Normal Saline (NS) is the solution of choice over D5W when preparing to
administer a blood transfusion because:
A) D5W is isotonic
B) NS is a hypotonic solution
C) Normal Saline is an isotonic solution and prevents cell hemolysis
D) Normal Saline is a hypertonic solution
Correct Answer: C) Normal Saline is an isotonic solution and prevents cell
hemolysis
Rationale: Normal Saline is isotonic and helps maintain osmotic balance during
blood transfusions. Dextrose-containing solutions like D5W can cause hemolysis
of red blood cells due to changes in osmolality. NS is the only compatible primary
IV solution for blood products.
4. Patient is to receive 5mg/kg of medication. Patient weighs 80kg. How much
would you administer?
A) 400mg
B) 300mg
C) 500mg
D) 200mg
Correct Answer: A) 400mg
Rationale: To calculate the dose: 5 mg/kg × 80 kg = 400 mg. This is a
straightforward weight-based calculation that requires converting the patient's
weight and multiplying by the prescribed dose per kilogram.
5. Your patient taking digoxin (Lanoxin) has an AM Potassium level of 3.0. This
level may:
A) Decrease risk of digoxin toxicity
B) Have no effect on digoxin levels
C) Increase risk of digoxin toxicity
D) Require immediate potassium supplementation
Correct Answer: C) Increase risk of digoxin toxicity
,Rationale: A low potassium (hypokalemia) level may potentiate the effects of
digoxin, heightening the risk for toxicity. Monitoring potassium levels is critical
when a patient is on digoxin therapy. Hypokalemia makes the myocardium more
sensitive to digoxin.
6. The patient is diagnosed with multiple myeloma. The physician has ordered
cyclophosphamide (Cytoxan). Which instruction should be given to the patient?
A) Increase daily water intake
B) Limit sugar intake
C) Avoid contact with sick individuals
D) Take medication with food
Correct Answer: A) Increase daily water intake
Rationale: Adequate hydration is vital while taking cyclophosphamide to reduce
the risk of hemorrhagic cystitis by diluting the urine and minimizing the
concentration of the drug metabolites. Hemorrhagic cystitis is a serious adverse
effect of this chemotherapeutic agent.
7. Which of the following medications will crystallize when mixed with D5NS?
A) Phenytoin (Dilantin)
B) Furosemide (Lasix)
C) Ceftriaxone
D) Amiodarone
Correct Answer: A) Phenytoin (Dilantin)
Rationale: Phenytoin can precipitate when mixed in solutions containing dextrose,
such as D5NS. It must be administered separately to prevent crystallization and
ensure medication efficacy. Phenytoin should be administered via a dedicated IV
line with normal saline.
8. Which of the following medications should be questioned by the nurse if
ordered by the provider to treat a patient's complaint of nausea and vomiting?
A) Ondansetron (Zofran)
B) Promethazine (Phenergan)
C) Metoclopramide (Reglan)
D) Famotidine (Pepcid)
Correct Answer: D) Famotidine (Pepcid)
Rationale: Famotidine is an H2 blocker used for gastric acid-related conditions and
is ineffective for treating nausea and vomiting. The nurse should clarify this order
, with the provider. Antiemetics such as ondansetron are more appropriate for
nausea.
9. Your patient has an epidural infusing hydromorphone with bupivacaine at
6ml/hr continuously. The patient's blood pressure at the beginning of your shift
was 92/58 with a heart rate of 68. You noticed the patient's blood pressures have
been around 130/70. What should you do FIRST?
A) Increase the infusion rate
B) Check infusion rate to confirm 6ml/hr, then notify anesthesia provider
C) Document the vital signs
D) Administer supplemental fluids
Correct Answer: B) Check infusion rate to confirm 6ml/hr, then notify anesthesia
provider
Rationale: Verifying the correct infusion rate is critical before taking further
actions and helps ensure the patient's safety while documenting changes promptly.
Epidural infusions containing local anesthetics (bupivacaine) can cause
hypotension but this patient's BP has normalized from a low baseline.
10. The dosage of which drug must be tapered off slowly to prevent acute adrenal
insufficiency?
A) Prednisone (Deltasone)
B) Hydrocodone
C) Levothyroxine
D) Metoprolol
Correct Answer: A) Prednisone (Deltasone)
Rationale: Tapering corticosteroids like prednisone is essential to allow the body to
gradually resume its own adrenal production of corticosteroids and prevent an
adrenal crisis. Abrupt withdrawal can cause life-threatening adrenal insufficiency.
11. When teaching a new nurse on how to administer IV push furosemide (Lasix),
you emphasize that it should be given over two minutes to avoid:
A) Nausea
B) Tinnitus
C) Hypotension
D) Headache
Correct Answer: B) Tinnitus
