Prophecy/Relias RN Pharmacology Exam|
Pharmacology and Nursing Practice
Examination| A Comprehensive Review of
300 Multichoice Questions and Answers with
Rationales| Pass Guaranteed (Brand New!!)
Introduction
This comprehensive pharmacology examination is designed to assess nursing
knowledge and clinical reasoning in medication administration, monitoring, and
patient education. The 300 questions cover a wide range of pharmacological
concepts including drug classifications, mechanisms of action, side effects, nursing
interventions, dosage calculations, and patient teaching. Each question is followed
by the correct answer and a detailed rationale to enhance learning and clinical
application. This examination is particularly relevant for nursing students preparing
for the NCLEX-RN, practicing nurses seeking continuing education, and
healthcare professionals wishing to refresh their pharmacological knowledge. The
questions reflect real-world clinical scenarios that nurses encounter daily in various
healthcare settings.
1. A patient is prescribed a leukotriene receptor antagonist for asthma
management. Which medication belongs to this class?
A) Albuterol
B) Montelukast
C) Fluticasone
D) Theophylline
Answer: B) Montelukast
Rationale: Montelukast (Singulair) is a leukotriene receptor antagonist that works
by blocking the action of leukotrienes, which are inflammatory mediators in the
,airways. Albuterol is a beta-2 agonist bronchodilator. Fluticasone is a
corticosteroid. Theophylline is a methylxanthine bronchodilator.
2. A patient taking hydrochlorothiazide (HCTZ) makes which statement
indicating correct understanding of the medication?
A) "I can take this medication with potassium supplements without concern"
B) "I should take extra care when standing up or changing positions"
C) "This medication will increase my blood pressure"
D) "I don't need to monitor my blood pressure while taking this"
Answer: B) "I should take extra care when standing up or changing
positions"
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause orthostatic
hypotension due to volume depletion. Patients should be taught to change positions
slowly to prevent dizziness and falls. HCTZ can cause hypokalemia, so potassium
supplementation may be needed but should be monitored. HCTZ lowers blood
pressure, not increases it. Blood pressure monitoring is essential.
3. A physician orders 250mg of an oral medication, but it is only available in
100mg tablets. How many tablets should the nurse administer?
A) 1 tablet
B) 2 tablets
C) 2.5 tablets
D) 3 tablets
Answer: C) 2.5 tablets
Rationale: To calculate: 250mg ÷ 100mg = 2.5 tablets. The nurse would administer
two and one-half tablets. This calculation demonstrates basic dosage calculation
skills essential for safe medication administration.
,4. Which medication is classified as a potassium-sparing diuretic?
A) Furosemide
B) Hydrochlorothiazide
C) Spironolactone
D) Bumetanide
Answer: C) Spironolactone (Aldactone)
Rationale: Spironolactone is a potassium-sparing diuretic that works by blocking
aldosterone receptors, causing sodium and water excretion while retaining
potassium. Furosemide, hydrochlorothiazide, and bumetanide are all potassium-
wasting diuretics that can cause hypokalemia.
5. A patient just received their fourth dose of IV vancomycin infused over 30
minutes. Upon assessment, their face and neck are red and they are itching all
over. What should the nurse suspect?
A) Allergic reaction to the IV tubing
B) Red man syndrome due to rapid infusion rate
C) Anaphylactic shock
D) Medication overdose
Answer: B) Red man syndrome due to rapid infusion rate
Rationale: Red man syndrome is a histamine-mediated reaction to rapid
vancomycin infusion. Symptoms include flushing, erythema, and pruritus of the
face, neck, and upper torso. To prevent this, vancomycin should be infused over at
least 60 minutes. This is not an allergic reaction but rather a rate-related
phenomenon.
6. A patient with erectile dysfunction is prescribed sildenafil (Viagra). The
nurse should question this prescription if which finding is noted in the
patient's history?
A) Hypertension
B) Diabetes mellitus
, C) Nitroglycerin use
D) Hyperlipidemia
Answer: C) Nitroglycerin use
Rationale: Sildenafil is absolutely contraindicated with nitrates/nitroglycerin due to
the risk of severe hypotension and potentially fatal cardiovascular collapse. Both
medications cause vasodilation, and their combined effect can be dangerous.
Patients taking any form of nitrate should not receive sildenafil.
7. A patient has a capillary blood glucose of 33 mg/dL and is unable to tolerate
oral intake. Which intervention should the nurse implement?
A) Administer oral glucose gel
B) Give glucagon IM
C) Administer dextrose 50% IV push
D) Offer orange juice
Answer: C) Administer dextrose 50% IV push
Rationale: With a blood glucose of 33 mg/dL (severe hypoglycemia) and inability
to tolerate oral intake, IV dextrose is indicated. D50W is the standard treatment for
severe hypoglycemia when the patient cannot take oral glucose. Glucagon is an
alternative but D50W is preferred when IV access is available.
8. A physician's order reads: "Insulin glargine (Lantus), 10 U, subQ QD."
What safety change should the nurse suggest?
A) Change to 10 units and daily
B) Change route to IV
C) Change to 10 i.u.
D) Change frequency to BID
Answer: A) Spell out units and daily
Rationale: The abbreviation "U" can be mistaken for "0" leading to tenfold dosing
errors. "QD" can be mistaken for "QID." The order should be written as "10 units
Pharmacology and Nursing Practice
Examination| A Comprehensive Review of
300 Multichoice Questions and Answers with
Rationales| Pass Guaranteed (Brand New!!)
Introduction
This comprehensive pharmacology examination is designed to assess nursing
knowledge and clinical reasoning in medication administration, monitoring, and
patient education. The 300 questions cover a wide range of pharmacological
concepts including drug classifications, mechanisms of action, side effects, nursing
interventions, dosage calculations, and patient teaching. Each question is followed
by the correct answer and a detailed rationale to enhance learning and clinical
application. This examination is particularly relevant for nursing students preparing
for the NCLEX-RN, practicing nurses seeking continuing education, and
healthcare professionals wishing to refresh their pharmacological knowledge. The
questions reflect real-world clinical scenarios that nurses encounter daily in various
healthcare settings.
1. A patient is prescribed a leukotriene receptor antagonist for asthma
management. Which medication belongs to this class?
A) Albuterol
B) Montelukast
C) Fluticasone
D) Theophylline
Answer: B) Montelukast
Rationale: Montelukast (Singulair) is a leukotriene receptor antagonist that works
by blocking the action of leukotrienes, which are inflammatory mediators in the
,airways. Albuterol is a beta-2 agonist bronchodilator. Fluticasone is a
corticosteroid. Theophylline is a methylxanthine bronchodilator.
2. A patient taking hydrochlorothiazide (HCTZ) makes which statement
indicating correct understanding of the medication?
A) "I can take this medication with potassium supplements without concern"
B) "I should take extra care when standing up or changing positions"
C) "This medication will increase my blood pressure"
D) "I don't need to monitor my blood pressure while taking this"
Answer: B) "I should take extra care when standing up or changing
positions"
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause orthostatic
hypotension due to volume depletion. Patients should be taught to change positions
slowly to prevent dizziness and falls. HCTZ can cause hypokalemia, so potassium
supplementation may be needed but should be monitored. HCTZ lowers blood
pressure, not increases it. Blood pressure monitoring is essential.
3. A physician orders 250mg of an oral medication, but it is only available in
100mg tablets. How many tablets should the nurse administer?
A) 1 tablet
B) 2 tablets
C) 2.5 tablets
D) 3 tablets
Answer: C) 2.5 tablets
Rationale: To calculate: 250mg ÷ 100mg = 2.5 tablets. The nurse would administer
two and one-half tablets. This calculation demonstrates basic dosage calculation
skills essential for safe medication administration.
,4. Which medication is classified as a potassium-sparing diuretic?
A) Furosemide
B) Hydrochlorothiazide
C) Spironolactone
D) Bumetanide
Answer: C) Spironolactone (Aldactone)
Rationale: Spironolactone is a potassium-sparing diuretic that works by blocking
aldosterone receptors, causing sodium and water excretion while retaining
potassium. Furosemide, hydrochlorothiazide, and bumetanide are all potassium-
wasting diuretics that can cause hypokalemia.
5. A patient just received their fourth dose of IV vancomycin infused over 30
minutes. Upon assessment, their face and neck are red and they are itching all
over. What should the nurse suspect?
A) Allergic reaction to the IV tubing
B) Red man syndrome due to rapid infusion rate
C) Anaphylactic shock
D) Medication overdose
Answer: B) Red man syndrome due to rapid infusion rate
Rationale: Red man syndrome is a histamine-mediated reaction to rapid
vancomycin infusion. Symptoms include flushing, erythema, and pruritus of the
face, neck, and upper torso. To prevent this, vancomycin should be infused over at
least 60 minutes. This is not an allergic reaction but rather a rate-related
phenomenon.
6. A patient with erectile dysfunction is prescribed sildenafil (Viagra). The
nurse should question this prescription if which finding is noted in the
patient's history?
A) Hypertension
B) Diabetes mellitus
, C) Nitroglycerin use
D) Hyperlipidemia
Answer: C) Nitroglycerin use
Rationale: Sildenafil is absolutely contraindicated with nitrates/nitroglycerin due to
the risk of severe hypotension and potentially fatal cardiovascular collapse. Both
medications cause vasodilation, and their combined effect can be dangerous.
Patients taking any form of nitrate should not receive sildenafil.
7. A patient has a capillary blood glucose of 33 mg/dL and is unable to tolerate
oral intake. Which intervention should the nurse implement?
A) Administer oral glucose gel
B) Give glucagon IM
C) Administer dextrose 50% IV push
D) Offer orange juice
Answer: C) Administer dextrose 50% IV push
Rationale: With a blood glucose of 33 mg/dL (severe hypoglycemia) and inability
to tolerate oral intake, IV dextrose is indicated. D50W is the standard treatment for
severe hypoglycemia when the patient cannot take oral glucose. Glucagon is an
alternative but D50W is preferred when IV access is available.
8. A physician's order reads: "Insulin glargine (Lantus), 10 U, subQ QD."
What safety change should the nurse suggest?
A) Change to 10 units and daily
B) Change route to IV
C) Change to 10 i.u.
D) Change frequency to BID
Answer: A) Spell out units and daily
Rationale: The abbreviation "U" can be mistaken for "0" leading to tenfold dosing
errors. "QD" can be mistaken for "QID." The order should be written as "10 units
