NR341 PHARMACOLOGY ULTIMATE
BENCHMARK EXAM PREP HIGH-YIELD
Q&AS WITH RATIONALES
Master your nursing pharmacology exams with this
comprehensive, premium practice bank featuring high-yield
multiple-choice questions designed for maximum retention. Each
question includes clear italicized answers and deeply detailed,
bold-italicized rationales that break down complex mechanisms of
action, critical nursing interventions, and major drug side effects.
Perfect for last-minute benchmark remediation or NCLEX
preparation, this study tool transforms passive reading into active,
high-scoring recall.
1. A nurse is preparing to administer digoxin to a
patient with heart failure. Which of the following
laboratory values requires the nurse to hold the
medication and notify the healthcare provider?
A) Serum digoxin level 1.2 ng/mL
B) Serum potassium level 3.2 mEq/L
C) Serum sodium level 138 mEq/L
D) Serum calcium level 9.5 mg/dL
Answer: B) Serum potassium level 3.2 mEq/L
Rationale: Hypokalemia (low potassium)
greatly increases the risk of digoxin toxicity.
The nurse must check serum potassium and
apical pulse for a full minute prior to
administration. Normal potassium is 3.5 to
5.0 mEq/L.
,2. A patient is prescribed lisinopril for hypertension.
Which adverse effect should the nurse monitor
for that is caused by an accumulation of
bradykinin?
A) Peripheral edema
B) Dry, nonproductive cough
C) Hypokalemia
D) Tachycardia
Answer: B) Dry, nonproductive cough
Rationale: ACE inhibitors prevent the
breakdown of bradykinin in the lungs,
leading to a persistent, dry cough. If this
occurs, patients are typically switched to an
Angiotensin II Receptor Blocker (ARB).
3. A nurse is caring for a patient receiving a
continuous intravenous heparin infusion for a
deep vein thrombosis. Which laboratory value
should the nurse monitor to adjust the heparin
dosage?
A) Prothrombin time (PT)
B) International Normalized Ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Answer: C) Activated partial thromboplastin time
(aPTT)
, Rationale: Continuous IV heparin is
monitored and adjusted based on aPTT
levels. PT and INR are used to monitor oral
warfarin therapy. Platelet counts are
monitored to screen for Heparin-Induced
Thrombocytopenia (HIT).
4. A patient with a history of blood clots is being
discharged on warfarin therapy. Which
statement by the patient indicates a need for
further education?
A) "I will use a soft-bristled toothbrush to prevent
gum bleeding."
B) "I will increase my intake of spinach and
broccoli to stay healthy."
C) "I need to have my blood drawn regularly to
check my INR."
D) "I will avoid taking aspirin or ibuprofen for
pain relief."
Answer: B) "I will increase my intake of spinach
and broccoli to stay healthy."
Rationale: Green leafy vegetables like
spinach and broccoli are high in Vitamin K,
which is the antidote for warfarin. Patients
do not need to eliminate Vitamin K entirely
, but must maintain a consistent daily intake
to avoid fluctuating INR levels.
5. A nurse is preparing to administer regular insulin
and NPH insulin in the same syringe. Which
action should the nurse take first?
A) Inject air into the NPH insulin vial.
B) Inject air into the regular insulin vial.
C) Draw up the regular insulin into the syringe.
D) Draw up the NPH insulin into the syringe.
Answer: A) Inject air into the NPH insulin vial.
Rationale: The correct sequence for mixing
insulin is "Cloudy to Clear, Clear to Cloudy"
when injecting air, and "Clear before Cloudy"
when drawing up the medication. Air is
injected into NPH (cloudy) first, then air is
injected into regular (clear), regular is drawn
up, and finally NPH is drawn up.
6. A patient is prescribed extended-release
metformin for type 2 diabetes. What instruction
is most important for the nurse to include in the
teaching plan?
A) Crush the medication if it is too difficult to
swallow whole.
B) Take the medication on an empty stomach 1
hour before breakfast.
BENCHMARK EXAM PREP HIGH-YIELD
Q&AS WITH RATIONALES
Master your nursing pharmacology exams with this
comprehensive, premium practice bank featuring high-yield
multiple-choice questions designed for maximum retention. Each
question includes clear italicized answers and deeply detailed,
bold-italicized rationales that break down complex mechanisms of
action, critical nursing interventions, and major drug side effects.
Perfect for last-minute benchmark remediation or NCLEX
preparation, this study tool transforms passive reading into active,
high-scoring recall.
1. A nurse is preparing to administer digoxin to a
patient with heart failure. Which of the following
laboratory values requires the nurse to hold the
medication and notify the healthcare provider?
A) Serum digoxin level 1.2 ng/mL
B) Serum potassium level 3.2 mEq/L
C) Serum sodium level 138 mEq/L
D) Serum calcium level 9.5 mg/dL
Answer: B) Serum potassium level 3.2 mEq/L
Rationale: Hypokalemia (low potassium)
greatly increases the risk of digoxin toxicity.
The nurse must check serum potassium and
apical pulse for a full minute prior to
administration. Normal potassium is 3.5 to
5.0 mEq/L.
,2. A patient is prescribed lisinopril for hypertension.
Which adverse effect should the nurse monitor
for that is caused by an accumulation of
bradykinin?
A) Peripheral edema
B) Dry, nonproductive cough
C) Hypokalemia
D) Tachycardia
Answer: B) Dry, nonproductive cough
Rationale: ACE inhibitors prevent the
breakdown of bradykinin in the lungs,
leading to a persistent, dry cough. If this
occurs, patients are typically switched to an
Angiotensin II Receptor Blocker (ARB).
3. A nurse is caring for a patient receiving a
continuous intravenous heparin infusion for a
deep vein thrombosis. Which laboratory value
should the nurse monitor to adjust the heparin
dosage?
A) Prothrombin time (PT)
B) International Normalized Ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Answer: C) Activated partial thromboplastin time
(aPTT)
, Rationale: Continuous IV heparin is
monitored and adjusted based on aPTT
levels. PT and INR are used to monitor oral
warfarin therapy. Platelet counts are
monitored to screen for Heparin-Induced
Thrombocytopenia (HIT).
4. A patient with a history of blood clots is being
discharged on warfarin therapy. Which
statement by the patient indicates a need for
further education?
A) "I will use a soft-bristled toothbrush to prevent
gum bleeding."
B) "I will increase my intake of spinach and
broccoli to stay healthy."
C) "I need to have my blood drawn regularly to
check my INR."
D) "I will avoid taking aspirin or ibuprofen for
pain relief."
Answer: B) "I will increase my intake of spinach
and broccoli to stay healthy."
Rationale: Green leafy vegetables like
spinach and broccoli are high in Vitamin K,
which is the antidote for warfarin. Patients
do not need to eliminate Vitamin K entirely
, but must maintain a consistent daily intake
to avoid fluctuating INR levels.
5. A nurse is preparing to administer regular insulin
and NPH insulin in the same syringe. Which
action should the nurse take first?
A) Inject air into the NPH insulin vial.
B) Inject air into the regular insulin vial.
C) Draw up the regular insulin into the syringe.
D) Draw up the NPH insulin into the syringe.
Answer: A) Inject air into the NPH insulin vial.
Rationale: The correct sequence for mixing
insulin is "Cloudy to Clear, Clear to Cloudy"
when injecting air, and "Clear before Cloudy"
when drawing up the medication. Air is
injected into NPH (cloudy) first, then air is
injected into regular (clear), regular is drawn
up, and finally NPH is drawn up.
6. A patient is prescribed extended-release
metformin for type 2 diabetes. What instruction
is most important for the nurse to include in the
teaching plan?
A) Crush the medication if it is too difficult to
swallow whole.
B) Take the medication on an empty stomach 1
hour before breakfast.
