NSG 124
EXAM 2
(Pharmacology)
Actual Questions w/Correct Answers
(Next-Generation NCLEX (NGN) style)
Herzing University
What you Will Get:
• 60+ verified questions
• Correct answers with Rationales.
• Ideal for exam preparation and concept reinforcement.
,Question 1. A client with chronic hepatitis C is receiving ribavirin in combination
with interferon alfa. The client reports extreme fatigue and dyspnea on exertion.
Which laboratory value is most important for the nurse to monitor?
A. Serum glucose
B. Hemoglobin
C. Serum potassium
D. Serum sodium
Correct Answer: B
Rationale:
Ribavirin can cause significant hemolytic anemia. Extreme fatigue and dyspnea on
exertion can indicate decreased oxygen-carrying capacity; therefore, hemoglobin should
be evaluated promptly.
Why the other options are incorrect:
Option A: Altered glucose does not characteristically explain ribavirin-associated fatigue
and dyspnea.
Option C: Potassium abnormalities may cause weakness or dysrhythmias but are not
the classic toxicity of ribavirin.
Option D: Sodium abnormalities are not the priority adverse effect associated with
ribavirin therapy.
Question 2. A client receives ciprofloxacin 400 mg IV every 12 hours. The
medication is supplied as 400 mg in 200 mL and is to infuse over 1 hour. At what
rate should the nurse set the IV pump?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 400 mL/hr
Correct Answer: C
Rationale:
Formula:
,200 mL ÷ 1 hour = 200 mL/hr
Why the other options are incorrect:
Option A: Would require 2 hours to infuse.
Option B: Would not deliver the entire medication in 1 hour.
Option D: Would infuse the medication in only 30 minutes.
Question 3. A client reports taking five times the recommended daily amount of a
multivitamin. Which laboratory value is most suggestive of vitamin D toxicity?
A. Total bilirubin 4 mg/dL
B. Serum calcium 12 mg/dL
C. Serum glucose 170 mg/dL
D. Serum sodium 140 mEq/L
Correct Answer: B
Rationale:
Excessive vitamin D increases intestinal calcium absorption and can cause
hypercalcemia.
Why the other options are incorrect:
Option A: Elevated bilirubin suggests hepatic or biliary dysfunction.
Option C: Hyperglycemia is not the characteristic finding of vitamin D toxicity.
Option D: Sodium of 140 mEq/L is within the expected range.
Question 4. A client with diabetes insipidus is receiving an antidiuretic hormone.
Which serum laboratory test is most important for the nurse to monitor?
A. Calcium
B. Serum osmolality
C. Platelet count
D. Glucose
Correct Answer: B
Rationale:
Diabetes insipidus causes excessive free-water loss and increased serum osmolality.
Effective antidiuretic therapy decreases urine output and moves serum osmolality
toward normal.
Why the other options are incorrect:
Option A: Calcium is not the primary parameter used to evaluate ADH treatment.
, Option C: Platelet count does not reflect therapeutic effectiveness.
Option D: Glucose is important in diabetes mellitus but is not the key marker for
diabetes insipidus.
Question 5. A client has an order for heparin 1,000 units IV STAT. Only prefilled
low-molecular-weight heparin syringes are present in the medication drawer.
What should the nurse do?
A. Request that the route be changed to subcutaneous.
B. Dilute the available low-molecular-weight heparin in 250 mL normal saline.
C. Notify pharmacy that unfractionated heparin must be delivered immediately.
D. Calculate an equivalent low-molecular-weight heparin dose.
Correct Answer: C
Rationale:
Low-molecular-weight heparin and unfractionated heparin are different medications with
different dosing characteristics and cannot be independently substituted by the nurse.
Why the other options are incorrect:
Option A: The nurse cannot independently change the prescribed route.
Option B: The available product should not be substituted or diluted to imitate another
heparin product.
Option D: There is no simple nurse-calculated equivalent substitution.
Question 6. A client has received mydriatic eye drops. Which response should the
nurse expect during the therapeutic period?
A. Pupillary dilation with reduced ability to accommodate for near vision
B. Improved near accommodation
C. Increased eye convergence
D. Pupillary constriction
Correct Answer: A
Rationale:
Mydriatic medications dilate the pupil. Some mydriatic agents also cause cycloplegia,
resulting in temporary difficulty focusing on nearby objects.
Why the other options are incorrect:
Option B: Accommodation may be impaired rather than improved.
EXAM 2
(Pharmacology)
Actual Questions w/Correct Answers
(Next-Generation NCLEX (NGN) style)
Herzing University
What you Will Get:
• 60+ verified questions
• Correct answers with Rationales.
• Ideal for exam preparation and concept reinforcement.
,Question 1. A client with chronic hepatitis C is receiving ribavirin in combination
with interferon alfa. The client reports extreme fatigue and dyspnea on exertion.
Which laboratory value is most important for the nurse to monitor?
A. Serum glucose
B. Hemoglobin
C. Serum potassium
D. Serum sodium
Correct Answer: B
Rationale:
Ribavirin can cause significant hemolytic anemia. Extreme fatigue and dyspnea on
exertion can indicate decreased oxygen-carrying capacity; therefore, hemoglobin should
be evaluated promptly.
Why the other options are incorrect:
Option A: Altered glucose does not characteristically explain ribavirin-associated fatigue
and dyspnea.
Option C: Potassium abnormalities may cause weakness or dysrhythmias but are not
the classic toxicity of ribavirin.
Option D: Sodium abnormalities are not the priority adverse effect associated with
ribavirin therapy.
Question 2. A client receives ciprofloxacin 400 mg IV every 12 hours. The
medication is supplied as 400 mg in 200 mL and is to infuse over 1 hour. At what
rate should the nurse set the IV pump?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 400 mL/hr
Correct Answer: C
Rationale:
Formula:
,200 mL ÷ 1 hour = 200 mL/hr
Why the other options are incorrect:
Option A: Would require 2 hours to infuse.
Option B: Would not deliver the entire medication in 1 hour.
Option D: Would infuse the medication in only 30 minutes.
Question 3. A client reports taking five times the recommended daily amount of a
multivitamin. Which laboratory value is most suggestive of vitamin D toxicity?
A. Total bilirubin 4 mg/dL
B. Serum calcium 12 mg/dL
C. Serum glucose 170 mg/dL
D. Serum sodium 140 mEq/L
Correct Answer: B
Rationale:
Excessive vitamin D increases intestinal calcium absorption and can cause
hypercalcemia.
Why the other options are incorrect:
Option A: Elevated bilirubin suggests hepatic or biliary dysfunction.
Option C: Hyperglycemia is not the characteristic finding of vitamin D toxicity.
Option D: Sodium of 140 mEq/L is within the expected range.
Question 4. A client with diabetes insipidus is receiving an antidiuretic hormone.
Which serum laboratory test is most important for the nurse to monitor?
A. Calcium
B. Serum osmolality
C. Platelet count
D. Glucose
Correct Answer: B
Rationale:
Diabetes insipidus causes excessive free-water loss and increased serum osmolality.
Effective antidiuretic therapy decreases urine output and moves serum osmolality
toward normal.
Why the other options are incorrect:
Option A: Calcium is not the primary parameter used to evaluate ADH treatment.
, Option C: Platelet count does not reflect therapeutic effectiveness.
Option D: Glucose is important in diabetes mellitus but is not the key marker for
diabetes insipidus.
Question 5. A client has an order for heparin 1,000 units IV STAT. Only prefilled
low-molecular-weight heparin syringes are present in the medication drawer.
What should the nurse do?
A. Request that the route be changed to subcutaneous.
B. Dilute the available low-molecular-weight heparin in 250 mL normal saline.
C. Notify pharmacy that unfractionated heparin must be delivered immediately.
D. Calculate an equivalent low-molecular-weight heparin dose.
Correct Answer: C
Rationale:
Low-molecular-weight heparin and unfractionated heparin are different medications with
different dosing characteristics and cannot be independently substituted by the nurse.
Why the other options are incorrect:
Option A: The nurse cannot independently change the prescribed route.
Option B: The available product should not be substituted or diluted to imitate another
heparin product.
Option D: There is no simple nurse-calculated equivalent substitution.
Question 6. A client has received mydriatic eye drops. Which response should the
nurse expect during the therapeutic period?
A. Pupillary dilation with reduced ability to accommodate for near vision
B. Improved near accommodation
C. Increased eye convergence
D. Pupillary constriction
Correct Answer: A
Rationale:
Mydriatic medications dilate the pupil. Some mydriatic agents also cause cycloplegia,
resulting in temporary difficulty focusing on nearby objects.
Why the other options are incorrect:
Option B: Accommodation may be impaired rather than improved.
