Pharmacology Nursing Exam Mastery
Guide | Fall 2026 BSN Pathway |
NCLEX‑Style Student Success Edition with
Rationales
100 Questions
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which assessment finding
would indicate the need to hold the medication and notify the healthcare provider?
A) Apical pulse of 52 beats per minute
B) Apical pulse of 72 beats per minute
C) Blood pressure of 140/90 mmHg
D) Respiratory rate of 18 breaths per minute
🎯CORRECT CHOICE: A) Apical pulse of 52 beats per minute
💡EXPLANATION: Digoxin has a narrow therapeutic index and can cause bradycardia. The medication
should be held if the apical pulse is below 60 beats per minute in an adult, and the provider should be
notified.
2. A patient is prescribed a selective serotonin reuptake inhibitor (SSRI) for depression. Which side effect
is most commonly associated with this class of medications?
A) Weight gain
B) Sexual dysfunction
C) Sedation
D) Hepatotoxicity
🎯CORRECT CHOICE: B) Sexual dysfunction
,💡EXPLANATION: SSRIs commonly cause sexual side effects, including decreased libido, erectile
dysfunction, and anorgasmia. Other common side effects include nausea, headache, and insomnia.
3. A nurse is administering morphine sulfate to a patient with severe pain. Which medication should be
readily available as an antagonist?
A) Naloxone
B) Flumazenil
C) Protamine sulfate
D) Vitamin K
🎯CORRECT CHOICE: A) Naloxone
💡EXPLANATION: Naloxone is a pure opioid antagonist that competes with opioid molecules for
receptor sites. It is used to reverse respiratory depression and other effects of opioid overdose.
4. A patient is prescribed warfarin for atrial fibrillation. Which laboratory value should the nurse monitor
to assess the therapeutic effect of this medication?
A) aPTT
B) INR
C) Platelet count
D) Serum creatinine
🎯CORRECT CHOICE: B) INR
💡EXPLANATION: Warfarin is an anticoagulant that inhibits vitamin K-dependent clotting factors. The
INR is the standardized measure used to monitor its therapeutic effect, with a target range typically
between 2.0 and 3.0.
5. A patient with type 2 diabetes is prescribed metformin. What is the most important teaching point
regarding this medication?
A) Take the medication with meals to reduce gastrointestinal side effects
B) Take the medication on an empty stomach for maximum absorption
C) Monitor for signs of hypoglycemia
,D) This medication may cause weight gain
🎯CORRECT CHOICE: A) Take the medication with meals to reduce gastrointestinal side effects
💡EXPLANATION: Metformin commonly causes gastrointestinal distress, including nausea, diarrhea, and
abdominal pain. Taking it with meals can significantly reduce these side effects.
6. A nurse is administering an aminoglycoside antibiotic. Which adverse effect requires careful
monitoring?
A) Nephrotoxicity and ototoxicity
B) Hepatotoxicity
C) Cardiotoxicity
D) Neurotoxicity
🎯CORRECT CHOICE: A) Nephrotoxicity and ototoxicity
💡EXPLANATION: Aminoglycosides (e.g., gentamicin) are associated with significant nephrotoxicity and
ototoxicity. Serum peak and trough levels must be monitored to prevent toxicity.
7. A patient is prescribed albuterol via metered-dose inhaler. What is the primary mechanism of action
of this medication?
A) Beta2-adrenergic agonist causing bronchodilation
B) Beta1-adrenergic agonist increasing heart rate
C) Alpha-adrenergic agonist causing vasoconstriction
D) Anticholinergic causing bronchodilation
🎯CORRECT CHOICE: A) Beta2-adrenergic agonist causing bronchodilation
💡EXPLANATION: Albuterol is a short-acting beta2-adrenergic agonist that stimulates beta2 receptors in
the bronchial smooth muscle, leading to bronchodilation. It is a rescue medication for acute
bronchospasm.
8. A patient is receiving heparin via continuous IV infusion. Which laboratory test is used to monitor the
effectiveness of this therapy?
, A) aPTT
B) INR
C) Platelet count
D) PT
🎯CORRECT CHOICE: A) aPTT
💡EXPLANATION: Heparin's therapeutic effect is monitored by the aPTT, with a target typically 1.5 to 2.5
times the normal control value. Protamine sulfate is the antidote.
9. A patient is prescribed furosemide for heart failure. Which electrolyte imbalance is a common adverse
effect?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypercalcemia
🎯CORRECT CHOICE: A) Hypokalemia
💡EXPLANATION: Furosemide is a loop diuretic that blocks sodium and chloride reabsorption in the
ascending loop of Henle. This leads to increased potassium excretion, causing hypokalemia.
10. A nurse is teaching a patient about the use of nitroglycerin sublingual tablets for angina. Which
instruction is most important?
A) Place the tablet under the tongue and allow it to dissolve completely
B) Swallow the tablet whole with a glass of water
C) Chew the tablet for faster absorption
D) Take the tablet with food to reduce stomach upset
🎯CORRECT CHOICE: A) Place the tablet under the tongue and allow it to dissolve completely
💡EXPLANATION: Nitroglycerin is administered sublingually to ensure rapid absorption through the
highly vascular mucous membranes, bypassing first-pass hepatic metabolism and providing quick relief.
Guide | Fall 2026 BSN Pathway |
NCLEX‑Style Student Success Edition with
Rationales
100 Questions
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which assessment finding
would indicate the need to hold the medication and notify the healthcare provider?
A) Apical pulse of 52 beats per minute
B) Apical pulse of 72 beats per minute
C) Blood pressure of 140/90 mmHg
D) Respiratory rate of 18 breaths per minute
🎯CORRECT CHOICE: A) Apical pulse of 52 beats per minute
💡EXPLANATION: Digoxin has a narrow therapeutic index and can cause bradycardia. The medication
should be held if the apical pulse is below 60 beats per minute in an adult, and the provider should be
notified.
2. A patient is prescribed a selective serotonin reuptake inhibitor (SSRI) for depression. Which side effect
is most commonly associated with this class of medications?
A) Weight gain
B) Sexual dysfunction
C) Sedation
D) Hepatotoxicity
🎯CORRECT CHOICE: B) Sexual dysfunction
,💡EXPLANATION: SSRIs commonly cause sexual side effects, including decreased libido, erectile
dysfunction, and anorgasmia. Other common side effects include nausea, headache, and insomnia.
3. A nurse is administering morphine sulfate to a patient with severe pain. Which medication should be
readily available as an antagonist?
A) Naloxone
B) Flumazenil
C) Protamine sulfate
D) Vitamin K
🎯CORRECT CHOICE: A) Naloxone
💡EXPLANATION: Naloxone is a pure opioid antagonist that competes with opioid molecules for
receptor sites. It is used to reverse respiratory depression and other effects of opioid overdose.
4. A patient is prescribed warfarin for atrial fibrillation. Which laboratory value should the nurse monitor
to assess the therapeutic effect of this medication?
A) aPTT
B) INR
C) Platelet count
D) Serum creatinine
🎯CORRECT CHOICE: B) INR
💡EXPLANATION: Warfarin is an anticoagulant that inhibits vitamin K-dependent clotting factors. The
INR is the standardized measure used to monitor its therapeutic effect, with a target range typically
between 2.0 and 3.0.
5. A patient with type 2 diabetes is prescribed metformin. What is the most important teaching point
regarding this medication?
A) Take the medication with meals to reduce gastrointestinal side effects
B) Take the medication on an empty stomach for maximum absorption
C) Monitor for signs of hypoglycemia
,D) This medication may cause weight gain
🎯CORRECT CHOICE: A) Take the medication with meals to reduce gastrointestinal side effects
💡EXPLANATION: Metformin commonly causes gastrointestinal distress, including nausea, diarrhea, and
abdominal pain. Taking it with meals can significantly reduce these side effects.
6. A nurse is administering an aminoglycoside antibiotic. Which adverse effect requires careful
monitoring?
A) Nephrotoxicity and ototoxicity
B) Hepatotoxicity
C) Cardiotoxicity
D) Neurotoxicity
🎯CORRECT CHOICE: A) Nephrotoxicity and ototoxicity
💡EXPLANATION: Aminoglycosides (e.g., gentamicin) are associated with significant nephrotoxicity and
ototoxicity. Serum peak and trough levels must be monitored to prevent toxicity.
7. A patient is prescribed albuterol via metered-dose inhaler. What is the primary mechanism of action
of this medication?
A) Beta2-adrenergic agonist causing bronchodilation
B) Beta1-adrenergic agonist increasing heart rate
C) Alpha-adrenergic agonist causing vasoconstriction
D) Anticholinergic causing bronchodilation
🎯CORRECT CHOICE: A) Beta2-adrenergic agonist causing bronchodilation
💡EXPLANATION: Albuterol is a short-acting beta2-adrenergic agonist that stimulates beta2 receptors in
the bronchial smooth muscle, leading to bronchodilation. It is a rescue medication for acute
bronchospasm.
8. A patient is receiving heparin via continuous IV infusion. Which laboratory test is used to monitor the
effectiveness of this therapy?
, A) aPTT
B) INR
C) Platelet count
D) PT
🎯CORRECT CHOICE: A) aPTT
💡EXPLANATION: Heparin's therapeutic effect is monitored by the aPTT, with a target typically 1.5 to 2.5
times the normal control value. Protamine sulfate is the antidote.
9. A patient is prescribed furosemide for heart failure. Which electrolyte imbalance is a common adverse
effect?
A) Hypokalemia
B) Hyperkalemia
C) Hyponatremia
D) Hypercalcemia
🎯CORRECT CHOICE: A) Hypokalemia
💡EXPLANATION: Furosemide is a loop diuretic that blocks sodium and chloride reabsorption in the
ascending loop of Henle. This leads to increased potassium excretion, causing hypokalemia.
10. A nurse is teaching a patient about the use of nitroglycerin sublingual tablets for angina. Which
instruction is most important?
A) Place the tablet under the tongue and allow it to dissolve completely
B) Swallow the tablet whole with a glass of water
C) Chew the tablet for faster absorption
D) Take the tablet with food to reduce stomach upset
🎯CORRECT CHOICE: A) Place the tablet under the tongue and allow it to dissolve completely
💡EXPLANATION: Nitroglycerin is administered sublingually to ensure rapid absorption through the
highly vascular mucous membranes, bypassing first-pass hepatic metabolism and providing quick relief.
