NCLEX-RN Introduction to Pharmacology
Practice Questions |
20 Original MCQs with Detailed Rationales &
NGN Clinical Judgment
Question 1
Clinical Scenario
A 72-year-old man is admitted with community-acquired
pneumonia. His medical history includes hypertension, chronic
kidney disease stage 3, and osteoarthritis. During medication
reconciliation, the nurse notes prescriptions from multiple
healthcare providers, including lisinopril, ibuprofen taken daily
for knee pain, and an over-the-counter herbal supplement. His
serum creatinine is 1.8 mg/dL (baseline 1.4 mg/dL), blood
pressure is 128/72 mm Hg, and he denies new symptoms.
Question Stem
Which nursing action is the highest priority before
administering the patient's scheduled medications?
,A. Administer all prescribed medications as ordered because
they have already been verified.
B. Review the complete medication list, including over-the-
counter and herbal products, for potential interactions and
nephrotoxic agents.
C. Instruct the patient to discontinue all herbal supplements
immediately without consulting the provider.
D. Delay all medications until repeat laboratory tests are
available.
Correct Answer
Correct Answer: B. Review the complete medication list,
including over-the-counter and herbal products, for potential
interactions and nephrotoxic agents.
Detailed Rationale
Medication reconciliation is a critical patient safety process that
helps identify duplicate therapies, drug interactions,
inappropriate medications, and medications that may worsen
existing conditions. This patient has chronic kidney disease and
an increasing serum creatinine level. Daily ibuprofen, a
nonsteroidal anti-inflammatory drug (NSAID), may reduce renal
blood flow and contribute to kidney injury, particularly when
combined with an ACE inhibitor such as lisinopril. Herbal
,supplements may also interact with prescription medications or
affect kidney function.
Option A is incorrect because medication orders should not be
administered blindly when assessment findings suggest
potential harm. Nursing judgment requires evaluating current
clinical data before medication administration.
Option C is incorrect because patients should not be instructed
to discontinue prescribed or complementary therapies
independently. The provider should evaluate the need for
discontinuation after a thorough assessment.
Option D is incorrect because withholding all medications
without a clinical indication or provider notification may
interrupt essential therapies. Instead, the nurse should identify
concerns, communicate with the provider, and administer
medications that remain appropriate.
This scenario highlights the importance of medication
reconciliation, especially in older adults with multiple chronic
conditions and polypharmacy. Nurses play a vital role in
identifying medication-related risks before adverse events
occur.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the purpose of medication reconciliation.
, • Identify medications that may increase the risk of kidney
injury.
• Recognize the importance of assessing over-the-counter
and herbal medication use.
• Prioritize nursing interventions that promote medication
safety.
Medication Safety Focus
Medication Reconciliation
Question 2
Clinical Scenario
A nurse prepares to administer an oral medication to a
hospitalized client. Before administration, the nurse verifies the
client's identity using two approved identifiers, reviews the
medication administration record, checks allergies, and
confirms the medication label. The client asks, "What is this
medicine for?"
Question Stem
Which nursing action best demonstrates safe medication
administration?
A. Ask another nurse whether the medication seems
appropriate.
Practice Questions |
20 Original MCQs with Detailed Rationales &
NGN Clinical Judgment
Question 1
Clinical Scenario
A 72-year-old man is admitted with community-acquired
pneumonia. His medical history includes hypertension, chronic
kidney disease stage 3, and osteoarthritis. During medication
reconciliation, the nurse notes prescriptions from multiple
healthcare providers, including lisinopril, ibuprofen taken daily
for knee pain, and an over-the-counter herbal supplement. His
serum creatinine is 1.8 mg/dL (baseline 1.4 mg/dL), blood
pressure is 128/72 mm Hg, and he denies new symptoms.
Question Stem
Which nursing action is the highest priority before
administering the patient's scheduled medications?
,A. Administer all prescribed medications as ordered because
they have already been verified.
B. Review the complete medication list, including over-the-
counter and herbal products, for potential interactions and
nephrotoxic agents.
C. Instruct the patient to discontinue all herbal supplements
immediately without consulting the provider.
D. Delay all medications until repeat laboratory tests are
available.
Correct Answer
Correct Answer: B. Review the complete medication list,
including over-the-counter and herbal products, for potential
interactions and nephrotoxic agents.
Detailed Rationale
Medication reconciliation is a critical patient safety process that
helps identify duplicate therapies, drug interactions,
inappropriate medications, and medications that may worsen
existing conditions. This patient has chronic kidney disease and
an increasing serum creatinine level. Daily ibuprofen, a
nonsteroidal anti-inflammatory drug (NSAID), may reduce renal
blood flow and contribute to kidney injury, particularly when
combined with an ACE inhibitor such as lisinopril. Herbal
,supplements may also interact with prescription medications or
affect kidney function.
Option A is incorrect because medication orders should not be
administered blindly when assessment findings suggest
potential harm. Nursing judgment requires evaluating current
clinical data before medication administration.
Option C is incorrect because patients should not be instructed
to discontinue prescribed or complementary therapies
independently. The provider should evaluate the need for
discontinuation after a thorough assessment.
Option D is incorrect because withholding all medications
without a clinical indication or provider notification may
interrupt essential therapies. Instead, the nurse should identify
concerns, communicate with the provider, and administer
medications that remain appropriate.
This scenario highlights the importance of medication
reconciliation, especially in older adults with multiple chronic
conditions and polypharmacy. Nurses play a vital role in
identifying medication-related risks before adverse events
occur.
Learning Objectives
After completing this question, the learner should be able to:
• Explain the purpose of medication reconciliation.
, • Identify medications that may increase the risk of kidney
injury.
• Recognize the importance of assessing over-the-counter
and herbal medication use.
• Prioritize nursing interventions that promote medication
safety.
Medication Safety Focus
Medication Reconciliation
Question 2
Clinical Scenario
A nurse prepares to administer an oral medication to a
hospitalized client. Before administration, the nurse verifies the
client's identity using two approved identifiers, reviews the
medication administration record, checks allergies, and
confirms the medication label. The client asks, "What is this
medicine for?"
Question Stem
Which nursing action best demonstrates safe medication
administration?
A. Ask another nurse whether the medication seems
appropriate.
