KAPLAN PHARMACOLOGICAL AND PARENTERAL
THERAPIES ASSESSMENT EXAM 2026/2027 | Complete
Practice Examination with 300 Questions, Verified
Answers & Detailed Rationales – Graded A+
1. A drug with a narrow therapeutic window requires monitoring of which
parameter?
A) Serum drug levels
B) Blood glucose
C) Liver enzymes
D) Urine output
Answer: A) Serum drug levels
Rationale: Drugs with a narrow therapeutic window (e.g., digoxin, lithium, warfarin)
require serum drug level monitoring to keep concentrations within the therapeutic
range and prevent toxicity.
2. A patient's digoxin level is 2.8 ng/mL. What is the appropriate nursing action?
A) Continue the medication as ordered
B) Hold the medication and notify the provider
C) Administer a lower dose
D) Increase the dose to reach therapeutic range
Answer: B) Hold the medication and notify the provider
Rationale: The therapeutic range for digoxin is 0.8-2.0 ng/mL. A level of 2.8 ng/mL is
toxic and requires holding the dose and provider notification.
3. Which of the following is the appropriate nursing action if a patient's apical
pulse is 52 bpm before administering digoxin?
A) Administer the medication as ordered
B) Hold the medication and reassess in 30 minutes
,C) Hold the medication and notify the provider
D) Double the dose to compensate
Answer: C) Hold the medication and notify the provider
Rationale: A pulse below 60 bpm is a standard criterion for holding digoxin to prevent
bradycardia. The provider must be notified for further instructions .
4. Which of the following is a Schedule I controlled substance?
A) Morphine
B) Diazepam
C) Heroin
D) Codeine
Answer: C) Heroin
Rationale: Schedule I substances have high abuse potential and no accepted medical
use (e.g., heroin, LSD, marijuana). Morphine is Schedule II, Diazepam is Schedule IV, and
Codeine is Schedule II, III, or V depending on formulation .
5. The nurse knows that disulfiram is most likely prescribed for which client?
A) A client with alcohol dependence
B) A client with opioid dependence
C) A client with nicotine dependence
D) A client with benzodiazepine dependence
Answer: A) A client with alcohol dependence
Rationale: Disulfiram (Antabuse) causes an aversive reaction when alcohol is consumed,
used for alcohol dependence treatment.
6. All of the following are parenteral routes of medication administration EXCEPT:
A) Intravenous
B) Intramuscular
,C) Rectal
D) Subcutaneous
Answer: C) Rectal
Rationale: Rectal administration is considered an enteral route because the rectum is
part of the digestive tract. Parenteral routes include IV, IM, SQ, ID, and IO .
7. The nurse is preparing to administer a medication by the intravenous route.
Which is a correct principle of IV administration?
A) IV medications are absorbed slowly
B) IV administration requires sterile technique
C) IV medications cannot be given as a bolus
D) IV administration is the safest route
Answer: B) IV administration requires sterile technique
Rationale: Sterile technique is essential for IV medication administration to prevent
infection.
8. A patient is prescribed a medication with a half-life of 8 hours. About how long
will it take for the drug to be completely eliminated from the body?
A) 8 hours
B) 24 hours
C) 40 hours
D) 80 hours
Answer: C) 40 hours
Rationale: Complete elimination typically requires about 5 half-lives. 5 × 8 hours = 40
hours.
9. Which route of administration provides the fastest onset of action?
A) Oral
B) Subcutaneous
, C) Intramuscular
D) Intravenous
Answer: D) Intravenous
Rationale: IV administration provides immediate delivery and the fastest onset of action.
10. The nurse is administering a medication that has a high first-pass effect. Which
route should the nurse anticipate?
A) Oral
B) Intravenous
C) Sublingual
D) Transdermal
Answer: A) Oral
Rationale: The first-pass effect occurs when oral medications are metabolized by the
liver before reaching systemic circulation.
SECTION 2: CARDIOVASCULAR PHARMACOLOGY
11. A patient with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is having the desired therapeutic effect?
A) Increased urine output and decreased peripheral edema
B) Decreased urine output and increased peripheral edema
C) Increased blood pressure and decreased heart rate
D) Decreased blood pressure and increased heart rate
Answer: A) Increased urine output and decreased peripheral edema
Rationale: Furosemide is a loop diuretic that promotes diuresis by blocking sodium and
chloride reabsorption. Desired effects are increased urine output and reduced fluid
overload .
12. Which lab test should be monitored in a patient receiving furosemide therapy?
A) Serum potassium
THERAPIES ASSESSMENT EXAM 2026/2027 | Complete
Practice Examination with 300 Questions, Verified
Answers & Detailed Rationales – Graded A+
1. A drug with a narrow therapeutic window requires monitoring of which
parameter?
A) Serum drug levels
B) Blood glucose
C) Liver enzymes
D) Urine output
Answer: A) Serum drug levels
Rationale: Drugs with a narrow therapeutic window (e.g., digoxin, lithium, warfarin)
require serum drug level monitoring to keep concentrations within the therapeutic
range and prevent toxicity.
2. A patient's digoxin level is 2.8 ng/mL. What is the appropriate nursing action?
A) Continue the medication as ordered
B) Hold the medication and notify the provider
C) Administer a lower dose
D) Increase the dose to reach therapeutic range
Answer: B) Hold the medication and notify the provider
Rationale: The therapeutic range for digoxin is 0.8-2.0 ng/mL. A level of 2.8 ng/mL is
toxic and requires holding the dose and provider notification.
3. Which of the following is the appropriate nursing action if a patient's apical
pulse is 52 bpm before administering digoxin?
A) Administer the medication as ordered
B) Hold the medication and reassess in 30 minutes
,C) Hold the medication and notify the provider
D) Double the dose to compensate
Answer: C) Hold the medication and notify the provider
Rationale: A pulse below 60 bpm is a standard criterion for holding digoxin to prevent
bradycardia. The provider must be notified for further instructions .
4. Which of the following is a Schedule I controlled substance?
A) Morphine
B) Diazepam
C) Heroin
D) Codeine
Answer: C) Heroin
Rationale: Schedule I substances have high abuse potential and no accepted medical
use (e.g., heroin, LSD, marijuana). Morphine is Schedule II, Diazepam is Schedule IV, and
Codeine is Schedule II, III, or V depending on formulation .
5. The nurse knows that disulfiram is most likely prescribed for which client?
A) A client with alcohol dependence
B) A client with opioid dependence
C) A client with nicotine dependence
D) A client with benzodiazepine dependence
Answer: A) A client with alcohol dependence
Rationale: Disulfiram (Antabuse) causes an aversive reaction when alcohol is consumed,
used for alcohol dependence treatment.
6. All of the following are parenteral routes of medication administration EXCEPT:
A) Intravenous
B) Intramuscular
,C) Rectal
D) Subcutaneous
Answer: C) Rectal
Rationale: Rectal administration is considered an enteral route because the rectum is
part of the digestive tract. Parenteral routes include IV, IM, SQ, ID, and IO .
7. The nurse is preparing to administer a medication by the intravenous route.
Which is a correct principle of IV administration?
A) IV medications are absorbed slowly
B) IV administration requires sterile technique
C) IV medications cannot be given as a bolus
D) IV administration is the safest route
Answer: B) IV administration requires sterile technique
Rationale: Sterile technique is essential for IV medication administration to prevent
infection.
8. A patient is prescribed a medication with a half-life of 8 hours. About how long
will it take for the drug to be completely eliminated from the body?
A) 8 hours
B) 24 hours
C) 40 hours
D) 80 hours
Answer: C) 40 hours
Rationale: Complete elimination typically requires about 5 half-lives. 5 × 8 hours = 40
hours.
9. Which route of administration provides the fastest onset of action?
A) Oral
B) Subcutaneous
, C) Intramuscular
D) Intravenous
Answer: D) Intravenous
Rationale: IV administration provides immediate delivery and the fastest onset of action.
10. The nurse is administering a medication that has a high first-pass effect. Which
route should the nurse anticipate?
A) Oral
B) Intravenous
C) Sublingual
D) Transdermal
Answer: A) Oral
Rationale: The first-pass effect occurs when oral medications are metabolized by the
liver before reaching systemic circulation.
SECTION 2: CARDIOVASCULAR PHARMACOLOGY
11. A patient with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is having the desired therapeutic effect?
A) Increased urine output and decreased peripheral edema
B) Decreased urine output and increased peripheral edema
C) Increased blood pressure and decreased heart rate
D) Decreased blood pressure and increased heart rate
Answer: A) Increased urine output and decreased peripheral edema
Rationale: Furosemide is a loop diuretic that promotes diuresis by blocking sodium and
chloride reabsorption. Desired effects are increased urine output and reduced fluid
overload .
12. Which lab test should be monitored in a patient receiving furosemide therapy?
A) Serum potassium
