NCLEX-RN Pharmacology 2026 — 150
Prac ce Ques ons, Drug Classes &
Ra onales
1. A client taking lisinopril develops swelling of the lips and tongue. What is the
nurse's priority action?
A. Encourage oral fluids
B. Administer the next dose with food
C. Hold the medication and seek immediate emergency evaluation
D. Reassure the client that this is expected
Answer: C
Rationale: Lip and tongue swelling may indicate angioedema, a potentially life-threatening
reaction involving the airway. The medication should be withheld and urgent evaluation
obtained.
2. Which adverse effect is commonly associated with ACE inhibitors?
A. Dry cough
B. Hearing loss
C. Constipation
D. Hypoglycemia
Answer: A
Rationale: A persistent dry cough is a well-known adverse effect of ACE inhibitors.
3. Which assessment is most important before administering metoprolol?
A. Pupil size
B. Heart rate and blood pressure
C. Abdominal circumference
D. Visual acuity
,Answer: B
Rationale: Beta-blockers can decrease heart rate and blood pressure. The nurse should assess
these parameters before administration according to the prescription and clinical situation.
4. A client taking a beta-blocker reports dizziness when standing. Which
instruction is appropriate?
A. Stop the medication immediately
B. Change positions slowly
C. Double the next dose
D. Restrict all fluids
Answer: B
Rationale: Beta-blockers may contribute to hypotension. Rising slowly can help reduce dizziness
and fall risk.
5. Which medication belongs to the angiotensin II receptor blocker (ARB) class?
A. Losartan
B. Lisinopril
C. Metoprolol
D. Furosemide
Answer: A
Rationale: ARBs commonly have the suffix -sartan. Losartan is an ARB.
6. Which finding should a nurse monitor closely in a client receiving furosemide?
A. Potassium level
B. Blood glucose only
C. Pupillary response
D. Hearing acuity only
Answer: A
Rationale: Loop diuretics can cause significant electrolyte loss, including hypokalemia.
,7. Which finding is most consistent with hypokalemia?
A. Muscle weakness
B. Increased reflexes only
C. Facial flushing
D. Increased thirst only
Answer: A
Rationale: Low potassium can contribute to muscle weakness and potentially dangerous cardiac
dysrhythmias.
8. A client takes spironolactone. Which laboratory value is particularly
important?
A. Potassium
B. Hemoglobin A1C only
C. Bilirubin only
D. Amylase only
Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic and may cause hyperkalemia.
9. Which symptom should a client taking a statin report promptly?
A. Muscle pain or unexplained weakness
B. Mild hunger before meals
C. Increased interest in exercise
D. Occasional sneezing
Answer: A
Rationale: Significant muscle pain or weakness may indicate a serious adverse effect requiring
evaluation.
, 10. A client taking warfarin has a new prescription for another medication. What
should the nurse emphasize?
A. Start all new medications without consultation
B. Discuss potential interactions with the health care provider or pharmacist
C. Stop warfarin before taking any other medication
D. Double the warfarin dose
Answer: B
Rationale: Warfarin has many potential drug interactions that may increase or decrease
anticoagulant effects.
11. Which assessment finding is most concerning in a client receiving
anticoagulant therapy?
A. New black, tarry stool
B. Mild hunger
C. Dry skin
D. Occasional yawning
Answer: A
Rationale: Black, tarry stool can indicate gastrointestinal bleeding.
12. Which medication reverses the anticoagulant effects of heparin?
A. Protamine sulfate
B. Naloxone
C. Vitamin C
D. Acetylcysteine
Answer: A
Rationale: Protamine sulfate is used to reverse heparin's anticoagulant effect.
13. Which medication is commonly used to reverse excessive warfarin
anticoagulation?
Prac ce Ques ons, Drug Classes &
Ra onales
1. A client taking lisinopril develops swelling of the lips and tongue. What is the
nurse's priority action?
A. Encourage oral fluids
B. Administer the next dose with food
C. Hold the medication and seek immediate emergency evaluation
D. Reassure the client that this is expected
Answer: C
Rationale: Lip and tongue swelling may indicate angioedema, a potentially life-threatening
reaction involving the airway. The medication should be withheld and urgent evaluation
obtained.
2. Which adverse effect is commonly associated with ACE inhibitors?
A. Dry cough
B. Hearing loss
C. Constipation
D. Hypoglycemia
Answer: A
Rationale: A persistent dry cough is a well-known adverse effect of ACE inhibitors.
3. Which assessment is most important before administering metoprolol?
A. Pupil size
B. Heart rate and blood pressure
C. Abdominal circumference
D. Visual acuity
,Answer: B
Rationale: Beta-blockers can decrease heart rate and blood pressure. The nurse should assess
these parameters before administration according to the prescription and clinical situation.
4. A client taking a beta-blocker reports dizziness when standing. Which
instruction is appropriate?
A. Stop the medication immediately
B. Change positions slowly
C. Double the next dose
D. Restrict all fluids
Answer: B
Rationale: Beta-blockers may contribute to hypotension. Rising slowly can help reduce dizziness
and fall risk.
5. Which medication belongs to the angiotensin II receptor blocker (ARB) class?
A. Losartan
B. Lisinopril
C. Metoprolol
D. Furosemide
Answer: A
Rationale: ARBs commonly have the suffix -sartan. Losartan is an ARB.
6. Which finding should a nurse monitor closely in a client receiving furosemide?
A. Potassium level
B. Blood glucose only
C. Pupillary response
D. Hearing acuity only
Answer: A
Rationale: Loop diuretics can cause significant electrolyte loss, including hypokalemia.
,7. Which finding is most consistent with hypokalemia?
A. Muscle weakness
B. Increased reflexes only
C. Facial flushing
D. Increased thirst only
Answer: A
Rationale: Low potassium can contribute to muscle weakness and potentially dangerous cardiac
dysrhythmias.
8. A client takes spironolactone. Which laboratory value is particularly
important?
A. Potassium
B. Hemoglobin A1C only
C. Bilirubin only
D. Amylase only
Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic and may cause hyperkalemia.
9. Which symptom should a client taking a statin report promptly?
A. Muscle pain or unexplained weakness
B. Mild hunger before meals
C. Increased interest in exercise
D. Occasional sneezing
Answer: A
Rationale: Significant muscle pain or weakness may indicate a serious adverse effect requiring
evaluation.
, 10. A client taking warfarin has a new prescription for another medication. What
should the nurse emphasize?
A. Start all new medications without consultation
B. Discuss potential interactions with the health care provider or pharmacist
C. Stop warfarin before taking any other medication
D. Double the warfarin dose
Answer: B
Rationale: Warfarin has many potential drug interactions that may increase or decrease
anticoagulant effects.
11. Which assessment finding is most concerning in a client receiving
anticoagulant therapy?
A. New black, tarry stool
B. Mild hunger
C. Dry skin
D. Occasional yawning
Answer: A
Rationale: Black, tarry stool can indicate gastrointestinal bleeding.
12. Which medication reverses the anticoagulant effects of heparin?
A. Protamine sulfate
B. Naloxone
C. Vitamin C
D. Acetylcysteine
Answer: A
Rationale: Protamine sulfate is used to reverse heparin's anticoagulant effect.
13. Which medication is commonly used to reverse excessive warfarin
anticoagulation?
