KAPLAN PHARMACOLOGY AB, C, D
NGN QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
Core Domains:
• Next Generation NCLEX (NGN) Clinical Judgment in Pharmacology
• Pharmacokinetics and Pharmacodynamics
• Autonomic and Central Nervous System Agents
• Cardiovascular and Renal Pharmacology
• Endocrine and Metabolic Agents
• Anti-infective and Immunologic Agents
• Gastrointestinal and Respiratory Medications
• Oncology, Hematology, and Pain Management
• Psychotropic and Neurologic Medications
• Emergency, Toxicology, and Antidotes
Introduction
This comprehensive pharmacology examination is designed to evaluate
the nursing candidate's ability to apply pharmacological principles within
the Next Generation NCLEX (NGN) Clinical Judgment framework. The
exam integrates knowledge from Pharmacology A, B, C, and D forms,
focusing on safe medication administration, patient education, and critical
thinking in complex clinical scenarios. The multiple-choice, case study,
and scenario-based questions assess the candidate's ability to recognize
cues, analyze data, prioritize hypotheses, generate solutions, take action,
,and evaluate outcomes related to medication therapy. Emphasis is placed
on understanding drug actions, side effects, contraindications, and nursing
interventions across diverse patient populations. Candidates are expected
to demonstrate competence in recognizing adverse effects, identifying
drug interactions, and prioritizing nursing actions to ensure patient safety
and optimal therapeutic outcomes.
SECTION ONE: QUESTIONS 1-100
Question 1
A nurse is caring for a patient receiving a continuous IV infusion of
heparin. The aPTT level is 120 seconds (normal 25-35 seconds). Which
action should the nurse take first based on the Clinical Judgment Model?
A. Decrease the infusion rate as per protocol
B. Notify the healthcare provider
C. Assess the patient for signs of bleeding
D. Document the finding in the electronic health record
C. Assess the patient for signs of bleeding
RATIONALE: According to the NGN Clinical Judgment Model, the
first action is to "Recognize Cues" by assessing the patient for signs of
bleeding (e.g., hematuria, bruising, petechiae). An aPTT of 120 seconds
significantly increases bleeding risk.
Question 2
The nurse is providing education to a patient prescribed an ACE
inhibitor. Which statement by the patient indicates a need for further
teaching?
A. "I will report any swelling of my face or tongue."
B. "I will take the medication with food to prevent stomach upset."
C. "I can stop taking the medication if my blood pressure is normal."
D. "I will avoid salt substitutes while taking this medication."
C. "I can stop taking the medication if my blood pressure is normal."
, RATIONALE: ACE inhibitors should not be stopped abruptly, even if
blood pressure is normal, as this can cause rebound hypertension.
Swelling (angioedema) and hyperkalemia from salt substitutes are
important to report.
Question 3
A patient prescribed warfarin has an INR of 5.5. Which nursing action is
the priority?
A. Administer vitamin K as ordered
B. Hold the next dose of warfarin
C. Assess the patient for signs of bleeding
D. Notify the healthcare provider
C. Assess the patient for signs of bleeding
RATIONALE: An INR of 5.5 is significantly elevated and indicates
high bleeding risk. The priority is to "Recognize Cues" by assessing the
patient for signs of bleeding before notifying the provider or
administering vitamin K.
Question 4
The nurse is analyzing cues for a patient receiving digoxin. Which
finding would indicate digoxin toxicity?
A. Heart rate of 62 beats per minute
B. Yellow-green halos around lights
C. Serum potassium level of 4.0 mEq/L
D. Blood pressure of 118/78 mmHg
B. Yellow-green halos around lights
RATIONALE: Yellow-green halos around lights are a classic sign of
digoxin toxicity. A heart rate of 62 is normal, potassium 4.0 is normal,
and blood pressure 118/78 is within normal limits.
Question 5
A patient is prescribed metformin for type 2 diabetes. Which laboratory
value should the nurse monitor to evaluate the medication's
, effectiveness?
A. Serum creatinine
B. Hemoglobin A1c
C. Liver function tests
D. Serum potassium
B. Hemoglobin A1c
RATIONALE: Hemoglobin A1c reflects average blood glucose over
the past 2-3 months and is the primary measure of metformin's
effectiveness. Serum creatinine is monitored for renal function, a safety
parameter.
Question 6
The nurse is prioritizing hypotheses for a patient who has just received
IV vancomycin and is experiencing flushing, redness, and pruritus of the
face, neck, and upper torso. Which is the priority hypothesis?
A. Anaphylactic reaction
B. Red Man Syndrome
C. Drug fever
D. Serum sickness
B. Red Man Syndrome
RATIONALE: The patient is exhibiting signs of Red Man Syndrome, a
histamine-release reaction associated with rapid vancomycin infusion.
The priority is to recognize this and slow the infusion rate.
Question 7
A patient is prescribed a beta-blocker, metoprolol, for heart failure.
Which finding indicates the medication is having the desired therapeutic
effect?
A. Decreased heart rate
B. Decreased blood pressure
C. Improved ejection fraction
D. Increased urine output
NGN QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
Core Domains:
• Next Generation NCLEX (NGN) Clinical Judgment in Pharmacology
• Pharmacokinetics and Pharmacodynamics
• Autonomic and Central Nervous System Agents
• Cardiovascular and Renal Pharmacology
• Endocrine and Metabolic Agents
• Anti-infective and Immunologic Agents
• Gastrointestinal and Respiratory Medications
• Oncology, Hematology, and Pain Management
• Psychotropic and Neurologic Medications
• Emergency, Toxicology, and Antidotes
Introduction
This comprehensive pharmacology examination is designed to evaluate
the nursing candidate's ability to apply pharmacological principles within
the Next Generation NCLEX (NGN) Clinical Judgment framework. The
exam integrates knowledge from Pharmacology A, B, C, and D forms,
focusing on safe medication administration, patient education, and critical
thinking in complex clinical scenarios. The multiple-choice, case study,
and scenario-based questions assess the candidate's ability to recognize
cues, analyze data, prioritize hypotheses, generate solutions, take action,
,and evaluate outcomes related to medication therapy. Emphasis is placed
on understanding drug actions, side effects, contraindications, and nursing
interventions across diverse patient populations. Candidates are expected
to demonstrate competence in recognizing adverse effects, identifying
drug interactions, and prioritizing nursing actions to ensure patient safety
and optimal therapeutic outcomes.
SECTION ONE: QUESTIONS 1-100
Question 1
A nurse is caring for a patient receiving a continuous IV infusion of
heparin. The aPTT level is 120 seconds (normal 25-35 seconds). Which
action should the nurse take first based on the Clinical Judgment Model?
A. Decrease the infusion rate as per protocol
B. Notify the healthcare provider
C. Assess the patient for signs of bleeding
D. Document the finding in the electronic health record
C. Assess the patient for signs of bleeding
RATIONALE: According to the NGN Clinical Judgment Model, the
first action is to "Recognize Cues" by assessing the patient for signs of
bleeding (e.g., hematuria, bruising, petechiae). An aPTT of 120 seconds
significantly increases bleeding risk.
Question 2
The nurse is providing education to a patient prescribed an ACE
inhibitor. Which statement by the patient indicates a need for further
teaching?
A. "I will report any swelling of my face or tongue."
B. "I will take the medication with food to prevent stomach upset."
C. "I can stop taking the medication if my blood pressure is normal."
D. "I will avoid salt substitutes while taking this medication."
C. "I can stop taking the medication if my blood pressure is normal."
, RATIONALE: ACE inhibitors should not be stopped abruptly, even if
blood pressure is normal, as this can cause rebound hypertension.
Swelling (angioedema) and hyperkalemia from salt substitutes are
important to report.
Question 3
A patient prescribed warfarin has an INR of 5.5. Which nursing action is
the priority?
A. Administer vitamin K as ordered
B. Hold the next dose of warfarin
C. Assess the patient for signs of bleeding
D. Notify the healthcare provider
C. Assess the patient for signs of bleeding
RATIONALE: An INR of 5.5 is significantly elevated and indicates
high bleeding risk. The priority is to "Recognize Cues" by assessing the
patient for signs of bleeding before notifying the provider or
administering vitamin K.
Question 4
The nurse is analyzing cues for a patient receiving digoxin. Which
finding would indicate digoxin toxicity?
A. Heart rate of 62 beats per minute
B. Yellow-green halos around lights
C. Serum potassium level of 4.0 mEq/L
D. Blood pressure of 118/78 mmHg
B. Yellow-green halos around lights
RATIONALE: Yellow-green halos around lights are a classic sign of
digoxin toxicity. A heart rate of 62 is normal, potassium 4.0 is normal,
and blood pressure 118/78 is within normal limits.
Question 5
A patient is prescribed metformin for type 2 diabetes. Which laboratory
value should the nurse monitor to evaluate the medication's
, effectiveness?
A. Serum creatinine
B. Hemoglobin A1c
C. Liver function tests
D. Serum potassium
B. Hemoglobin A1c
RATIONALE: Hemoglobin A1c reflects average blood glucose over
the past 2-3 months and is the primary measure of metformin's
effectiveness. Serum creatinine is monitored for renal function, a safety
parameter.
Question 6
The nurse is prioritizing hypotheses for a patient who has just received
IV vancomycin and is experiencing flushing, redness, and pruritus of the
face, neck, and upper torso. Which is the priority hypothesis?
A. Anaphylactic reaction
B. Red Man Syndrome
C. Drug fever
D. Serum sickness
B. Red Man Syndrome
RATIONALE: The patient is exhibiting signs of Red Man Syndrome, a
histamine-release reaction associated with rapid vancomycin infusion.
The priority is to recognize this and slow the infusion rate.
Question 7
A patient is prescribed a beta-blocker, metoprolol, for heart failure.
Which finding indicates the medication is having the desired therapeutic
effect?
A. Decreased heart rate
B. Decreased blood pressure
C. Improved ejection fraction
D. Increased urine output
