Advanced Pharmacology Review Practice Exam 2026 |
100 NCLEX®, FNP & APRN-Style Questions with Verified
Answers and Detailed Rationales | Comprehensive
Clinical Pharmacology Study Guide
Question 1
A nurse practitioner prescribes lisinopril for a patient newly diagnosed with hypertension.
Which adverse effect should the patient be instructed to report immediately?
A. Dry mouth
B. Persistent dry cough
C. Constipation
D. Weight gain
Answer: B. Persistent dry cough
Rationale: ACE inhibitors commonly cause a persistent dry cough due to increased
bradykinin levels. Angioedema is a rare but serious adverse effect requiring emergency
care.
Question 2
A patient receiving unfractionated heparin has an elevated aPTT and develops bleeding.
Which medication should the provider administer?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Flumazenil
Answer: B. Protamine sulfate
Rationale: Protamine sulfate rapidly reverses the anticoagulant effects of unfractionated
heparin.
Question 3
Which laboratory value should be monitored routinely in a patient taking warfarin?
,A. aPTT
B. INR
C. Platelet count
D. Hemoglobin A1c
Answer: B. INR
Rationale: Warfarin therapy is monitored using the International Normalized Ratio (INR),
with a typical therapeutic goal of 2.0–3.0 for many indications.
Question 4
A patient taking furosemide is most at risk for developing:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase urinary potassium excretion, making hypokalemia a
common adverse effect.
Question 5
Which medication is classified as a potassium-sparing diuretic?
A. Hydrochlorothiazide
B. Bumetanide
C. Spironolactone
D. Torsemide
Answer: C. Spironolactone
Rationale: Spironolactone blocks aldosterone receptors and conserves potassium.
Question 6
Metformin should be used cautiously because of the rare risk of:
A. Pulmonary fibrosis
, B. Lactic acidosis
C. Pancreatitis
D. Hyperthyroidism
Answer: B. Lactic acidosis
Rationale: Although uncommon, lactic acidosis is a serious adverse effect, particularly in
patients with significant kidney dysfunction.
Question 7
Which medication class has demonstrated cardiovascular and renal benefits in many
patients with Type 2 diabetes?
A. Sulfonylureas
B. SGLT2 inhibitors
C. Meglitinides
D. Alpha-glucosidase inhibitors
Answer: B. SGLT2 inhibitors
Rationale: SGLT2 inhibitors reduce cardiovascular events and slow progression of chronic
kidney disease in appropriate patients.
Question 8
A patient taking sertraline develops agitation, hyperreflexia, and fever. The nurse
practitioner should suspect:
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Malignant hyperthermia
D. Thyroid storm
Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome is a potentially life-threatening reaction caused by
excessive serotonergic activity.
Question 9
100 NCLEX®, FNP & APRN-Style Questions with Verified
Answers and Detailed Rationales | Comprehensive
Clinical Pharmacology Study Guide
Question 1
A nurse practitioner prescribes lisinopril for a patient newly diagnosed with hypertension.
Which adverse effect should the patient be instructed to report immediately?
A. Dry mouth
B. Persistent dry cough
C. Constipation
D. Weight gain
Answer: B. Persistent dry cough
Rationale: ACE inhibitors commonly cause a persistent dry cough due to increased
bradykinin levels. Angioedema is a rare but serious adverse effect requiring emergency
care.
Question 2
A patient receiving unfractionated heparin has an elevated aPTT and develops bleeding.
Which medication should the provider administer?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Flumazenil
Answer: B. Protamine sulfate
Rationale: Protamine sulfate rapidly reverses the anticoagulant effects of unfractionated
heparin.
Question 3
Which laboratory value should be monitored routinely in a patient taking warfarin?
,A. aPTT
B. INR
C. Platelet count
D. Hemoglobin A1c
Answer: B. INR
Rationale: Warfarin therapy is monitored using the International Normalized Ratio (INR),
with a typical therapeutic goal of 2.0–3.0 for many indications.
Question 4
A patient taking furosemide is most at risk for developing:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypercalcemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase urinary potassium excretion, making hypokalemia a
common adverse effect.
Question 5
Which medication is classified as a potassium-sparing diuretic?
A. Hydrochlorothiazide
B. Bumetanide
C. Spironolactone
D. Torsemide
Answer: C. Spironolactone
Rationale: Spironolactone blocks aldosterone receptors and conserves potassium.
Question 6
Metformin should be used cautiously because of the rare risk of:
A. Pulmonary fibrosis
, B. Lactic acidosis
C. Pancreatitis
D. Hyperthyroidism
Answer: B. Lactic acidosis
Rationale: Although uncommon, lactic acidosis is a serious adverse effect, particularly in
patients with significant kidney dysfunction.
Question 7
Which medication class has demonstrated cardiovascular and renal benefits in many
patients with Type 2 diabetes?
A. Sulfonylureas
B. SGLT2 inhibitors
C. Meglitinides
D. Alpha-glucosidase inhibitors
Answer: B. SGLT2 inhibitors
Rationale: SGLT2 inhibitors reduce cardiovascular events and slow progression of chronic
kidney disease in appropriate patients.
Question 8
A patient taking sertraline develops agitation, hyperreflexia, and fever. The nurse
practitioner should suspect:
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Malignant hyperthermia
D. Thyroid storm
Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome is a potentially life-threatening reaction caused by
excessive serotonergic activity.
Question 9
