Page 1 of 155
RELIAS RN PHARMACOLOGY TEST A
COMPREHENSIVE PRACTICE QUESTION
BANK
250+ QUESTIONS WITH VERIFIED ANSWERS
AND DETAILED RATIONALES
UPDATED FOR 2026-2027 ACADEMIC YEAR
# TABLE OF CONTENTS
| Section | Topic | Questions |
|---------|-------|-----------|
| **Section A** | Cardiovascular Pharmacology | 1-35 |
| **Section B** | Neurological and Psychiatric Pharmacology | 36-70 |
| **Section C** | Anti-Infective and Immunological Agents | 71-105 |
| **Section D** | Endocrine and Metabolic Pharmacology | 106-140 |
| **Section E** | Pain Management and Anesthesia | 141-170 |
| **Section F** | Respiratory and Gastrointestinal Pharmacology | 171-200 |
| **Section G** | Fluid, Electrolyte, and Renal Pharmacology | 201-225 |
| **Section H** | Medication Safety, Dosage Calculations, and Nursing Considerations | 226-
250+ |
---
,Page 2 of 155
# SECTION A: CARDIOVASCULAR PHARMACOLOGY
## Questions 1-35
**Question 1**
A nurse is preparing to administer digoxin to a patient with heart failure. Which assessment
finding would indicate the patient is at increased risk for digoxin toxicity?
A) Heart rate of 72 beats per minute
B) Serum potassium level of 3.2 mEq/L
C) Serum sodium level of 140 mEq/L
D) Blood pressure of 128/76 mm Hg
**Correct Answer: B**
**Rationale:** Hypokalemia (serum potassium < 3.5 mEq/L) potentiates digoxin toxicity by
enhancing the binding of digoxin to the sodium-potassium ATPase pump. Low potassium levels
increase the risk of dysrhythmias and other toxic effects. A heart rate of 72 bpm is within normal
range, serum sodium of 140 mEq/L is normal, and blood pressure of 128/76 mm Hg is
acceptable. The nurse should monitor potassium levels closely and report values below normal
range.
---
**Question 2**
What is the primary mechanism of action of ACE inhibitors in treating hypertension?
A) Increasing heart rate and cardiac output
B) Blocking the conversion of angiotensin I to angiotensin II
,Page 3 of 155
C) Promoting sodium and water retention
D) Stimulating the sympathetic nervous system
**Correct Answer: B**
**Rationale:** ACE inhibitors block the conversion of angiotensin I to angiotensin II, a potent
vasoconstrictor. This leads to vasodilation, decreased aldosterone secretion, and reduced sodium
and water retention, resulting in decreased blood pressure. They do not increase heart rate,
promote sodium retention, or stimulate the sympathetic nervous system.
---
**Question 3**
A patient on warfarin therapy for atrial fibrillation has an International Normalized Ratio (INR)
of 1.2. What is the nurse's priority action?
A) Administer the next scheduled dose as ordered
B) Hold the next dose and notify the healthcare provider
C) Increase the patient's dietary vitamin K intake
D) Administer protamine sulfate immediately
**Correct Answer: B**
**Rationale:** The therapeutic INR range for warfarin therapy is typically 2.0 to 3.0 for most
indications. An INR of 1.2 indicates subtherapeutic anticoagulation, meaning the patient is not
adequately protected against clot formation. The nurse should hold the dose and notify the
healthcare provider for possible dosage adjustment. Vitamin K is the antidote for warfarin
overdose (high INR), not low INR. Protamine sulfate is used to reverse heparin, not warfarin.
---
, Page 4 of 155
**Question 4**
Which laboratory value should the nurse monitor to evaluate the therapeutic effectiveness of
heparin therapy?
A) International Normalized Ratio (INR)
B) Activated Partial Thromboplastin Time (aPTT)
C) Platelet count
D) Prothrombin Time (PT)
**Correct Answer: B**
**Rationale:** Activated Partial Thromboplastin Time (aPTT) is the laboratory test used to
monitor heparin therapy. The therapeutic goal is typically 1.5 to 2.5 times the normal control
value. INR and PT are used to monitor warfarin therapy. Platelet count is monitored to detect
heparin-induced thrombocytopenia (HIT), a potential complication of heparin therapy.
---
**Question 5**
A patient is prescribed amlodipine for hypertension. Which adverse effect should the nurse
expect and monitor for?
A) Reflex tachycardia
B) Bradycardia
C) Hyperkalemia
D) Bronchospasm
**Correct Answer: A**
RELIAS RN PHARMACOLOGY TEST A
COMPREHENSIVE PRACTICE QUESTION
BANK
250+ QUESTIONS WITH VERIFIED ANSWERS
AND DETAILED RATIONALES
UPDATED FOR 2026-2027 ACADEMIC YEAR
# TABLE OF CONTENTS
| Section | Topic | Questions |
|---------|-------|-----------|
| **Section A** | Cardiovascular Pharmacology | 1-35 |
| **Section B** | Neurological and Psychiatric Pharmacology | 36-70 |
| **Section C** | Anti-Infective and Immunological Agents | 71-105 |
| **Section D** | Endocrine and Metabolic Pharmacology | 106-140 |
| **Section E** | Pain Management and Anesthesia | 141-170 |
| **Section F** | Respiratory and Gastrointestinal Pharmacology | 171-200 |
| **Section G** | Fluid, Electrolyte, and Renal Pharmacology | 201-225 |
| **Section H** | Medication Safety, Dosage Calculations, and Nursing Considerations | 226-
250+ |
---
,Page 2 of 155
# SECTION A: CARDIOVASCULAR PHARMACOLOGY
## Questions 1-35
**Question 1**
A nurse is preparing to administer digoxin to a patient with heart failure. Which assessment
finding would indicate the patient is at increased risk for digoxin toxicity?
A) Heart rate of 72 beats per minute
B) Serum potassium level of 3.2 mEq/L
C) Serum sodium level of 140 mEq/L
D) Blood pressure of 128/76 mm Hg
**Correct Answer: B**
**Rationale:** Hypokalemia (serum potassium < 3.5 mEq/L) potentiates digoxin toxicity by
enhancing the binding of digoxin to the sodium-potassium ATPase pump. Low potassium levels
increase the risk of dysrhythmias and other toxic effects. A heart rate of 72 bpm is within normal
range, serum sodium of 140 mEq/L is normal, and blood pressure of 128/76 mm Hg is
acceptable. The nurse should monitor potassium levels closely and report values below normal
range.
---
**Question 2**
What is the primary mechanism of action of ACE inhibitors in treating hypertension?
A) Increasing heart rate and cardiac output
B) Blocking the conversion of angiotensin I to angiotensin II
,Page 3 of 155
C) Promoting sodium and water retention
D) Stimulating the sympathetic nervous system
**Correct Answer: B**
**Rationale:** ACE inhibitors block the conversion of angiotensin I to angiotensin II, a potent
vasoconstrictor. This leads to vasodilation, decreased aldosterone secretion, and reduced sodium
and water retention, resulting in decreased blood pressure. They do not increase heart rate,
promote sodium retention, or stimulate the sympathetic nervous system.
---
**Question 3**
A patient on warfarin therapy for atrial fibrillation has an International Normalized Ratio (INR)
of 1.2. What is the nurse's priority action?
A) Administer the next scheduled dose as ordered
B) Hold the next dose and notify the healthcare provider
C) Increase the patient's dietary vitamin K intake
D) Administer protamine sulfate immediately
**Correct Answer: B**
**Rationale:** The therapeutic INR range for warfarin therapy is typically 2.0 to 3.0 for most
indications. An INR of 1.2 indicates subtherapeutic anticoagulation, meaning the patient is not
adequately protected against clot formation. The nurse should hold the dose and notify the
healthcare provider for possible dosage adjustment. Vitamin K is the antidote for warfarin
overdose (high INR), not low INR. Protamine sulfate is used to reverse heparin, not warfarin.
---
, Page 4 of 155
**Question 4**
Which laboratory value should the nurse monitor to evaluate the therapeutic effectiveness of
heparin therapy?
A) International Normalized Ratio (INR)
B) Activated Partial Thromboplastin Time (aPTT)
C) Platelet count
D) Prothrombin Time (PT)
**Correct Answer: B**
**Rationale:** Activated Partial Thromboplastin Time (aPTT) is the laboratory test used to
monitor heparin therapy. The therapeutic goal is typically 1.5 to 2.5 times the normal control
value. INR and PT are used to monitor warfarin therapy. Platelet count is monitored to detect
heparin-induced thrombocytopenia (HIT), a potential complication of heparin therapy.
---
**Question 5**
A patient is prescribed amlodipine for hypertension. Which adverse effect should the nurse
expect and monitor for?
A) Reflex tachycardia
B) Bradycardia
C) Hyperkalemia
D) Bronchospasm
**Correct Answer: A**
