NCLEX RN Pharmacological Parenteral
Therapies Exam 4 Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
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1. A nurse is preparing to administer digoxin to an adult client. Which
assessment finding requires the nurse to hold the medication and
notify the provider?
A. Blood pressure 128/76 mm Hg
B. Respiratory rate 18/min
C. Apical pulse 52/min
D. Temperature 37.0°C (98.6°F)
Answer: C. Apical pulse 52/min
Rationale: Digoxin can cause bradycardia. The nurse should withhold
the medication and notify the provider when the adult apical pulse is
below 60/min.
2. A client taking warfarin has an INR of 5.2. Which action should the
nurse anticipate?
A. Administer the prescribed dose
B. Increase the warfarin dose
C. Hold warfarin and notify the provider
D. Administer aspirin
Answer: C. Hold warfarin and notify the provider
,Rationale: An INR of 5.2 indicates excessive anticoagulation and
increased bleeding risk. Warfarin should generally be held and the
provider notified.
3. Which medication reverses the effects of heparin?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: B. Protamine sulfate
Rationale: Protamine sulfate binds to and neutralizes heparin.
4. A client receiving IV potassium chloride reports burning at the IV site.
What should the nurse do first?
A. Increase the infusion rate
B. Apply a warm compress
C. Stop the infusion and assess the IV site
D. Flush the catheter rapidly
Answer: C. Stop the infusion and assess the IV site
Rationale: IV potassium is highly irritating and can cause tissue injury if
infiltration occurs. The infusion should be stopped and the site assessed.
5. Which finding is most concerning in a client receiving morphine?
A. Constipation
B. Nausea
,C. Respiratory rate of 8/min
D. Mild drowsiness
Answer: C. Respiratory rate of 8/min
Rationale: Respiratory depression is a potentially life-threatening
adverse effect of opioids. Naloxone may be required.
6. Which medication should the nurse administer to a client
experiencing opioid-induced respiratory depression?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: B. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-
induced respiratory and central nervous system depression.
7. A client taking lisinopril develops swelling of the lips and tongue.
What is the priority nursing action?
A. Give the next dose with food
B. Place the client in a supine position
C. Hold the medication and obtain emergency assistance
D. Encourage oral fluids
Answer: C. Hold the medication and obtain emergency assistance
Rationale: Facial and tongue swelling can indicate angioedema, which
may rapidly compromise the airway.
, 8. Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hyperchloremia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Low potassium levels increase myocardial sensitivity to
digoxin and increase the risk of toxicity.
9. A client receiving furosemide should be monitored closely for which
electrolyte abnormality?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary
potassium excretion.
10. Which assessment finding indicates a possible adverse effect of
gentamicin?
A. Hearing changes
B. Increased appetite
C. Hypertension
D. Constipation
Therapies Exam 4 Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
1. A nurse is preparing to administer digoxin to an adult client. Which
assessment finding requires the nurse to hold the medication and
notify the provider?
A. Blood pressure 128/76 mm Hg
B. Respiratory rate 18/min
C. Apical pulse 52/min
D. Temperature 37.0°C (98.6°F)
Answer: C. Apical pulse 52/min
Rationale: Digoxin can cause bradycardia. The nurse should withhold
the medication and notify the provider when the adult apical pulse is
below 60/min.
2. A client taking warfarin has an INR of 5.2. Which action should the
nurse anticipate?
A. Administer the prescribed dose
B. Increase the warfarin dose
C. Hold warfarin and notify the provider
D. Administer aspirin
Answer: C. Hold warfarin and notify the provider
,Rationale: An INR of 5.2 indicates excessive anticoagulation and
increased bleeding risk. Warfarin should generally be held and the
provider notified.
3. Which medication reverses the effects of heparin?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: B. Protamine sulfate
Rationale: Protamine sulfate binds to and neutralizes heparin.
4. A client receiving IV potassium chloride reports burning at the IV site.
What should the nurse do first?
A. Increase the infusion rate
B. Apply a warm compress
C. Stop the infusion and assess the IV site
D. Flush the catheter rapidly
Answer: C. Stop the infusion and assess the IV site
Rationale: IV potassium is highly irritating and can cause tissue injury if
infiltration occurs. The infusion should be stopped and the site assessed.
5. Which finding is most concerning in a client receiving morphine?
A. Constipation
B. Nausea
,C. Respiratory rate of 8/min
D. Mild drowsiness
Answer: C. Respiratory rate of 8/min
Rationale: Respiratory depression is a potentially life-threatening
adverse effect of opioids. Naloxone may be required.
6. Which medication should the nurse administer to a client
experiencing opioid-induced respiratory depression?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: B. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse opioid-
induced respiratory and central nervous system depression.
7. A client taking lisinopril develops swelling of the lips and tongue.
What is the priority nursing action?
A. Give the next dose with food
B. Place the client in a supine position
C. Hold the medication and obtain emergency assistance
D. Encourage oral fluids
Answer: C. Hold the medication and obtain emergency assistance
Rationale: Facial and tongue swelling can indicate angioedema, which
may rapidly compromise the airway.
, 8. Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hyperchloremia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Low potassium levels increase myocardial sensitivity to
digoxin and increase the risk of toxicity.
9. A client receiving furosemide should be monitored closely for which
electrolyte abnormality?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary
potassium excretion.
10. Which assessment finding indicates a possible adverse effect of
gentamicin?
A. Hearing changes
B. Increased appetite
C. Hypertension
D. Constipation
