NCLEX-RN Pharmacology Practice Questions |
20 ATI & NGN-Style MCQs with Detailed
Rationales |
Introduction to Pharmacology
Question 1
Clinical Scenario
A nurse is caring for a 72-year-old woman who was admitted
with community-acquired pneumonia. Her medical history
includes hypertension, chronic kidney disease (stage 3), and
osteoarthritis. The provider prescribes several new medications.
During medication reconciliation, the nurse discovers that the
client has been taking an over-the-counter herbal supplement
and occasionally doubles her prescribed pain medication when
,her arthritis worsens. Vital signs are stable, and laboratory
values show a serum creatinine of 1.8 mg/dL.
Question Stem
Which nursing action is the priority before administering the
newly prescribed medications?
A. Assess the client's understanding of her medication
schedule.
B. Complete a comprehensive medication reconciliation,
including prescription, over-the-counter, and herbal products.
C. Teach the client to avoid skipping antibiotic doses.
D. Administer the prescribed medications and monitor for
adverse effects.
Correct Answer
Correct Answer: B. Complete a comprehensive medication
reconciliation, including prescription, over-the-counter, and
herbal products.
Detailed Rationale
Medication reconciliation is a critical safety process performed
whenever a client is admitted, transferred, or discharged. It
involves comparing all prescription medications, over-the-
counter (OTC) products, vitamins, and herbal supplements with
newly prescribed medications to identify omissions,
,duplications, interactions, or contraindications. This client
already reports taking herbal supplements and occasionally
altering her prescribed analgesic dosage, increasing the risk of
adverse drug events. Her chronic kidney disease further
heightens the importance of reviewing medications because
impaired renal function affects the elimination of many drugs
and increases toxicity risk. Identifying all medications before
administration helps prevent harmful interactions and
medication errors.
Option A is important because assessing health literacy
supports safe medication use, but it should occur after
obtaining a complete medication history.
Option C provides appropriate patient education but does not
address the immediate safety concern of unidentified
medications or interactions.
Option D is unsafe because administering medications before
reconciliation may expose the client to preventable adverse
reactions or duplicate therapy.
Medication reconciliation represents one of the most effective
nursing interventions for reducing medication-related harm and
promoting safe transitions of care.
Learning Objectives
After completing this question, the learner should be able to:
, • Explain the purpose of medication reconciliation.
• Identify components of a complete medication history.
• Prioritize nursing actions that reduce medication errors.
• Recognize factors that increase medication-related risk in
older adults.
Medication Safety Focus
Medication Reconciliation
Question 2
Clinical Scenario
A nurse is preparing to administer a prescribed oral medication
to a hospitalized client. Before entering the room, the nurse
compares the medication administration record (MAR) with the
medication label. At the bedside, the client states, "I've never
taken this medicine before."
Question Stem
Which nursing action best reflects adherence to the principles
of safe medication administration?
A. Administer the medication because it matches the provider's
prescription.
B. Ask another nurse to administer the medication.
20 ATI & NGN-Style MCQs with Detailed
Rationales |
Introduction to Pharmacology
Question 1
Clinical Scenario
A nurse is caring for a 72-year-old woman who was admitted
with community-acquired pneumonia. Her medical history
includes hypertension, chronic kidney disease (stage 3), and
osteoarthritis. The provider prescribes several new medications.
During medication reconciliation, the nurse discovers that the
client has been taking an over-the-counter herbal supplement
and occasionally doubles her prescribed pain medication when
,her arthritis worsens. Vital signs are stable, and laboratory
values show a serum creatinine of 1.8 mg/dL.
Question Stem
Which nursing action is the priority before administering the
newly prescribed medications?
A. Assess the client's understanding of her medication
schedule.
B. Complete a comprehensive medication reconciliation,
including prescription, over-the-counter, and herbal products.
C. Teach the client to avoid skipping antibiotic doses.
D. Administer the prescribed medications and monitor for
adverse effects.
Correct Answer
Correct Answer: B. Complete a comprehensive medication
reconciliation, including prescription, over-the-counter, and
herbal products.
Detailed Rationale
Medication reconciliation is a critical safety process performed
whenever a client is admitted, transferred, or discharged. It
involves comparing all prescription medications, over-the-
counter (OTC) products, vitamins, and herbal supplements with
newly prescribed medications to identify omissions,
,duplications, interactions, or contraindications. This client
already reports taking herbal supplements and occasionally
altering her prescribed analgesic dosage, increasing the risk of
adverse drug events. Her chronic kidney disease further
heightens the importance of reviewing medications because
impaired renal function affects the elimination of many drugs
and increases toxicity risk. Identifying all medications before
administration helps prevent harmful interactions and
medication errors.
Option A is important because assessing health literacy
supports safe medication use, but it should occur after
obtaining a complete medication history.
Option C provides appropriate patient education but does not
address the immediate safety concern of unidentified
medications or interactions.
Option D is unsafe because administering medications before
reconciliation may expose the client to preventable adverse
reactions or duplicate therapy.
Medication reconciliation represents one of the most effective
nursing interventions for reducing medication-related harm and
promoting safe transitions of care.
Learning Objectives
After completing this question, the learner should be able to:
, • Explain the purpose of medication reconciliation.
• Identify components of a complete medication history.
• Prioritize nursing actions that reduce medication errors.
• Recognize factors that increase medication-related risk in
older adults.
Medication Safety Focus
Medication Reconciliation
Question 2
Clinical Scenario
A nurse is preparing to administer a prescribed oral medication
to a hospitalized client. Before entering the room, the nurse
compares the medication administration record (MAR) with the
medication label. At the bedside, the client states, "I've never
taken this medicine before."
Question Stem
Which nursing action best reflects adherence to the principles
of safe medication administration?
A. Administer the medication because it matches the provider's
prescription.
B. Ask another nurse to administer the medication.
