RELIAS RN PHARMACOLOGY EXAM 300 ACTUAL
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY GRADED A+
ASSURED PASS
The Relias RN Pharmacology exam is a rigorous assessment evaluating a nurse's
comprehensive knowledge of pharmacotherapeutics, including drug classifications,
mechanisms of action, side effects, and nursing interventions. It covers critical
areas such as medication safety, the Six Rights, dosage calculations, high-alert
medications, and antidotes. The exam emphasizes clinical judgment in scenarios
involving anticoagulants, cardiac drugs, antibiotics, insulins, and pain
management. Test-takers must demonstrate proficiency in identifying drug
interactions, adverse reactions, and appropriate patient education. Success requires
mastery of pharmacokinetics, safe administration practices, and the ability to
prioritize care based on medication effects and patient responses within complex
healthcare environments.
Section 1: Medication Safety and the Six Rights
This section covers the foundational principles of safe medication administration,
including the "Six Rights," "Do Not Use" abbreviations, error prevention, and
patient identification protocols.
Question 1: The nurse is preparing to administer a medication and verifies the "Six
Rights" of medication administration. Which of the following is NOT included in
the Six Rights?
A. Right patient
B. Right drug
C. Right documentation
D. Right pharmacy
,Answer: D. Right pharmacy
Detailed Rationale: The Six Rights of medication administration are: right patient,
right drug, right dose, right route, right time, and right documentation. "Right
pharmacy" is not part of this foundational safety framework. Adherence to these
rights is a fundamental nursing standard to prevent medication errors per ISMP
Guidelines and Nursing Scope of Practice.
Question 2: A physician's written order for the person you are caring for is as
follows: "Insulin glargine (Lantus), 10 U, subQ QD." What changes would you
suggest for safety and to avoid the use of "do not use" abbreviations?
A. Change to "10 units subcutaneously daily"
B. Spell out "units" and "daily"
C. Write "10U subQ every day"
D. Change to "10 units SQ daily"
Answer: B. Spell out units and daily
Detailed Rationale: The Joint Commission's "Do Not Use" list prohibits the
abbreviation "U" for units (can be mistaken for "0" or "4") and "QD" (can be
mistaken for "QOD"). The correct order should spell out "units" and "daily".
Insulin is a high-alert medication requiring independent double-checks.
Question 3: What statement is correct for determining you have the correct patient
before administering a drug?
A. Verify the room number on the MAR
B. Ask them to state their name and DOB and compare it to the MAR and wrist
band
C. Call the patient by their first name
D. Check the chart only
Answer: B. Ask them to state their name and DOB and compare it to the MAR and
wrist band
Detailed Rationale: The most reliable method to verify a patient's identity is to use
at least two patient identifiers, such as asking them to state their name and date of
birth and comparing this to both the MAR and the wrist band. This aligns with
patient safety standards and prevents misidentification errors.
,Question 4: A patient refuses a dose of IV medication. What is the most
appropriate action?
A. Document the refusal and notify the MD
B. Coerce the patient to take the medication
C. Administer the medication via another route without consent
D. Ignore the refusal and leave the medication at the bedside
Answer: A. Document the refusal and notify the MD
Detailed Rationale: Patients have the right to refuse treatment. The nurse's
responsibility is to document the refusal, notify the provider, and explore the
reasons for refusal. This respects patient autonomy while ensuring the care team is
aware of the situation.
Question 5: A nurse is preparing to administer a medication. Which of the
following is a high-alert medication that requires independent double-checking?
A. Penicillin
B. Acetaminophen
C. Insulin
D. Ondansetron
Answer: C. Insulin
Detailed Rationale: Insulin is a high-alert medication that carries a heightened risk
of causing significant patient harm when used in error. It requires independent
double-checking to ensure the correct dose is prepared and administered, per ISMP
high-alert medication guidelines.
Question 6: The nurse is caring for a person who has a new prescription for a
medication that requires a peak and trough level draw. What is the priority nursing
action?
A. Draw the trough level just before the next dose is due
B. Draw the peak level immediately after the dose is administered
C. Draw both levels at the same time
D. Only draw the trough level if the patient has symptoms of toxicity
Answer: A. Draw the trough level just before the next dose is due
, Detailed Rationale: The trough level is the lowest concentration of a drug in the
patient's bloodstream and should be drawn immediately before the next dose is
administered to guide safe dosing intervals and prevent toxicity.
Question 7: An order was placed for a sublingual medication. The patient has an
NG tube. What is the most appropriate action?
A. Administer the medication via the NG tube.
B. Hold the medication and notify the physician.
C. Crush the medication and mix it with water.
D. Administer the medication under the tongue as prescribed.
Answer: B. Hold the medication and notify the physician.
Detailed Rationale: Sublingual medications are absorbed through the sublingual
mucosa and are ineffective if administered via an NG tube. The nurse should hold
the medication and clarify the order with the provider for an alternative route.
Question 8: The nurse is assessing a patient's IV site and notes redness, swelling,
and warmth. What is the priority action?
A. Discontinue the IV and restart it in another site
B. Apply a warm compress
C. Slow the infusion rate
D. Document the findings and continue to monitor
Answer: A. Discontinue the IV and restart it in another site
Detailed Rationale: Redness, swelling, and warmth are signs of phlebitis or
infiltration. The priority action is to discontinue the IV at that site to prevent
further complications and restart it in a new location.
Question 9: The nurse is about to administer a medication. Which of the following
is the final step in the medication administration process?
A. Verify the medication order
B. Perform the six rights of medication administration
C. Document the administration
D. Assess the patient's response
Answer: C. Document the administration
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALE LATEST UPDATE ALREADY GRADED A+
ASSURED PASS
The Relias RN Pharmacology exam is a rigorous assessment evaluating a nurse's
comprehensive knowledge of pharmacotherapeutics, including drug classifications,
mechanisms of action, side effects, and nursing interventions. It covers critical
areas such as medication safety, the Six Rights, dosage calculations, high-alert
medications, and antidotes. The exam emphasizes clinical judgment in scenarios
involving anticoagulants, cardiac drugs, antibiotics, insulins, and pain
management. Test-takers must demonstrate proficiency in identifying drug
interactions, adverse reactions, and appropriate patient education. Success requires
mastery of pharmacokinetics, safe administration practices, and the ability to
prioritize care based on medication effects and patient responses within complex
healthcare environments.
Section 1: Medication Safety and the Six Rights
This section covers the foundational principles of safe medication administration,
including the "Six Rights," "Do Not Use" abbreviations, error prevention, and
patient identification protocols.
Question 1: The nurse is preparing to administer a medication and verifies the "Six
Rights" of medication administration. Which of the following is NOT included in
the Six Rights?
A. Right patient
B. Right drug
C. Right documentation
D. Right pharmacy
,Answer: D. Right pharmacy
Detailed Rationale: The Six Rights of medication administration are: right patient,
right drug, right dose, right route, right time, and right documentation. "Right
pharmacy" is not part of this foundational safety framework. Adherence to these
rights is a fundamental nursing standard to prevent medication errors per ISMP
Guidelines and Nursing Scope of Practice.
Question 2: A physician's written order for the person you are caring for is as
follows: "Insulin glargine (Lantus), 10 U, subQ QD." What changes would you
suggest for safety and to avoid the use of "do not use" abbreviations?
A. Change to "10 units subcutaneously daily"
B. Spell out "units" and "daily"
C. Write "10U subQ every day"
D. Change to "10 units SQ daily"
Answer: B. Spell out units and daily
Detailed Rationale: The Joint Commission's "Do Not Use" list prohibits the
abbreviation "U" for units (can be mistaken for "0" or "4") and "QD" (can be
mistaken for "QOD"). The correct order should spell out "units" and "daily".
Insulin is a high-alert medication requiring independent double-checks.
Question 3: What statement is correct for determining you have the correct patient
before administering a drug?
A. Verify the room number on the MAR
B. Ask them to state their name and DOB and compare it to the MAR and wrist
band
C. Call the patient by their first name
D. Check the chart only
Answer: B. Ask them to state their name and DOB and compare it to the MAR and
wrist band
Detailed Rationale: The most reliable method to verify a patient's identity is to use
at least two patient identifiers, such as asking them to state their name and date of
birth and comparing this to both the MAR and the wrist band. This aligns with
patient safety standards and prevents misidentification errors.
,Question 4: A patient refuses a dose of IV medication. What is the most
appropriate action?
A. Document the refusal and notify the MD
B. Coerce the patient to take the medication
C. Administer the medication via another route without consent
D. Ignore the refusal and leave the medication at the bedside
Answer: A. Document the refusal and notify the MD
Detailed Rationale: Patients have the right to refuse treatment. The nurse's
responsibility is to document the refusal, notify the provider, and explore the
reasons for refusal. This respects patient autonomy while ensuring the care team is
aware of the situation.
Question 5: A nurse is preparing to administer a medication. Which of the
following is a high-alert medication that requires independent double-checking?
A. Penicillin
B. Acetaminophen
C. Insulin
D. Ondansetron
Answer: C. Insulin
Detailed Rationale: Insulin is a high-alert medication that carries a heightened risk
of causing significant patient harm when used in error. It requires independent
double-checking to ensure the correct dose is prepared and administered, per ISMP
high-alert medication guidelines.
Question 6: The nurse is caring for a person who has a new prescription for a
medication that requires a peak and trough level draw. What is the priority nursing
action?
A. Draw the trough level just before the next dose is due
B. Draw the peak level immediately after the dose is administered
C. Draw both levels at the same time
D. Only draw the trough level if the patient has symptoms of toxicity
Answer: A. Draw the trough level just before the next dose is due
, Detailed Rationale: The trough level is the lowest concentration of a drug in the
patient's bloodstream and should be drawn immediately before the next dose is
administered to guide safe dosing intervals and prevent toxicity.
Question 7: An order was placed for a sublingual medication. The patient has an
NG tube. What is the most appropriate action?
A. Administer the medication via the NG tube.
B. Hold the medication and notify the physician.
C. Crush the medication and mix it with water.
D. Administer the medication under the tongue as prescribed.
Answer: B. Hold the medication and notify the physician.
Detailed Rationale: Sublingual medications are absorbed through the sublingual
mucosa and are ineffective if administered via an NG tube. The nurse should hold
the medication and clarify the order with the provider for an alternative route.
Question 8: The nurse is assessing a patient's IV site and notes redness, swelling,
and warmth. What is the priority action?
A. Discontinue the IV and restart it in another site
B. Apply a warm compress
C. Slow the infusion rate
D. Document the findings and continue to monitor
Answer: A. Discontinue the IV and restart it in another site
Detailed Rationale: Redness, swelling, and warmth are signs of phlebitis or
infiltration. The priority action is to discontinue the IV at that site to prevent
further complications and restart it in a new location.
Question 9: The nurse is about to administer a medication. Which of the following
is the final step in the medication administration process?
A. Verify the medication order
B. Perform the six rights of medication administration
C. Document the administration
D. Assess the patient's response
Answer: C. Document the administration
