Pharmacology Nursing
Exam Solutions
1. A nurse is preparing to administer digoxin to a client. Which of the following findings should the
nurse report before administering the medication?
A) Heart rate of 88 beats per minute
B) Heart rate of 52 beats per minute
C) Blood pressure of 118/76 mm Hg
D) Respiratory rate of 18 breaths per minute
Correct Answer: B) Heart rate of 52 beats per minute
Rationale: Digoxin slows the heart rate. The nurse should hold the medication and notify the
provider if the adult client's apical pulse is below 60 beats per minute, as this indicates
bradycardia and risk for digoxin toxicity.
2. A nurse is teaching a client about warfarin therapy. Which of the following statements indicates the
client understands the teaching?
A) "I will take aspirin for my headaches."
B) "I will keep my intake of green leafy vegetables consistent."
C) "I will double my dose if I miss one."
D) "I will stop the medication when my bruising resolves."
Correct Answer: B) "I will keep my intake of green leafy vegetables consistent."
Rationale: Warfarin is a vitamin K antagonist. Clients should maintain a consistent intake of
vitamin K–rich foods to keep the INR stable. Aspirin increases bleeding risk, and doses should
never be doubled.
3. A nurse is administering intravenous furosemide to a client. Which of the following assessments is
the priority?
A) Daily weight
B) Serum potassium level
C) Blood pressure
D) Urine output
Correct Answer: C) Blood pressure
Rationale: Furosemide is a loop diuretic that can cause rapid fluid loss and hypotension. The
priority assessment immediately after IV administration is blood pressure to detect hypovolemia
and hypotension.
4. A nurse is reviewing the medication list of a client taking metformin. Which of the following
findings requires immediate intervention?
A) Blood glucose of 110 mg/dL
,B) Serum creatinine of 2.8 mg/dL
C) Hemoglobin A1c of 6.5%
D) Weight loss of 2 kg over 3 months
Correct Answer: B) Serum creatinine of 2.8 mg/dL
Rationale: Metformin is contraindicated in renal impairment because it increases the risk of
lactic acidosis. An elevated creatinine indicates decreased kidney function, and the medication
should be held and the provider notified.
5. A client is prescribed morphine sulfate intravenously. Which of the following findings is the most
concerning?
A) Respiratory rate of 10 breaths per minute
B) Blood pressure of 110/70 mm Hg
C) Pain relief rated 3/10
D) Drowsiness 30 minutes after administration
Correct Answer: A) Respiratory rate of 10 breaths per minute
Rationale: Opioids such as morphine cause respiratory depression. A respiratory rate below 12
breaths per minute is a life-threatening complication and requires immediate intervention,
including withholding the medication and administering naloxone if ordered.
6. A nurse is teaching a client about insulin administration. Which of the following statements
indicates correct understanding?
A) "I will rotate injection sites within the same area."
B) "I will inject into the same spot each time."
C) "I will massage the site after injection."
D) "I will store my insulin in the freezer."
Correct Answer: A) "I will rotate injection sites within the same area."
Rationale: Rotating sites within the same area promotes consistent absorption and prevents
lipohypertrophy. Massaging the site can alter absorption, and insulin should never be frozen.
7. A nurse is preparing to administer potassium chloride IV to a client. Which of the following actions
is correct?
A) Administer as a rapid IV push
B) Dilute the medication and administer via an infusion pump
C) Administer undiluted via a peripheral IV
D) Give the medication only when the client is NPO
Correct Answer: B) Dilute the medication and administer via an infusion pump
Rationale: IV potassium must always be diluted and infused slowly using an infusion pump
because undiluted or rapid administration can cause fatal cardiac dysrhythmias. IV push of
potassium is never permitted.
8. A nurse is caring for a client receiving heparin. Which of the following lab values should the nurse
monitor?
A) INR
B) aPTT
C) Platelet count only
,D) Hematocrit
Correct Answer: B) aPTT
Rationale: Unfractionated heparin therapy is monitored using the activated partial
thromboplastin time (aPTT). The INR is used to monitor warfarin therapy. Platelets should also
be monitored for heparin-induced thrombocytopenia, but the primary therapeutic lab is the
aPTT.
9. A nurse is administering levothyroxine to a client. Which of the following instructions should the
nurse include?
A) "Take the medication at bedtime."
B) "Take the medication on an empty stomach in the morning."
C) "Take the medication with breakfast."
D) "Take the medication with an antacid."
Correct Answer: B) "Take the medication on an empty stomach in the morning."
Rationale: Levothyroxine should be taken on an empty stomach 30 to 60 minutes before
breakfast for optimal absorption. Antacids and food can decrease absorption.
10. A client is prescribed prednisone. Which of the following findings should the nurse report to the
provider?
A) Blood glucose of 100 mg/dL
B) Weight gain of 2 kg in one week
C) Mild nausea
D) Improved appetite
Correct Answer: B) Weight gain of 2 kg in one week
Rationale: Prednisone, a corticosteroid, causes fluid retention, weight gain, and hyperglycemia.
Rapid weight gain may indicate fluid overload and requires notification of the provider.
11. A nurse is teaching a client about phenytoin. Which of the following instructions should the nurse
include?
A) "Brush your teeth gently and maintain good oral hygiene."
B) "Take the medication with antacids."
C) "Stop the medication if you feel better."
D) "Drink grapefruit juice with the medication."
Correct Answer: A) "Brush your teeth gently and maintain good oral hygiene."
Rationale: Phenytoin can cause gingival hyperplasia. Clients should maintain meticulous oral
hygiene and see a dentist regularly. The medication should not be stopped abruptly, and
grapefruit juice may alter drug levels.
12. A nurse is preparing to administer atenolol. Which of the following findings should cause the nurse
to hold the medication?
A) Blood pressure of 128/82 mm Hg
B) Heart rate of 54 beats per minute
C) Respiratory rate of 16 breaths per minute
D) Blood glucose of 110 mg/dL
Correct Answer: B) Heart rate of 54 beats per minute
, Rationale: Atenolol is a beta-blocker that decreases heart rate and blood pressure. The nurse
should hold the medication and notify the provider if the heart rate is below 60 beats per
minute.
13. A nurse is teaching a client about the use of nitroglycerin sublingual tablets. Which of the
following statements indicates correct understanding?
A) "I will take one tablet every 5 minutes for up to three doses."
B) "I will swallow the tablet with water."
C) "I will take the medication only when my pain is severe."
D) "I will lie down after taking the medication."
Correct Answer: A) "I will take one tablet every 5 minutes for up to three doses."
Rationale: For angina, the client should take one sublingual nitroglycerin tablet every 5 minutes
for up to three doses. If chest pain persists after three doses, emergency services should be
called. The tablet should be dissolved under the tongue, not swallowed.
14. A client is prescribed lisinopril. Which of the following side effects should the nurse monitor for?
A) Dry, persistent cough
B) Bradycardia
C) Hyperkalemia only
D) Weight loss
Correct Answer: A) Dry, persistent cough
Rationale: ACE inhibitors such as lisinopril commonly cause a dry, persistent cough due to
bradykinin accumulation. Other side effects include hyperkalemia and angioedema.
15. A nurse is administering atorvastatin to a client. Which of the following instructions should the
nurse include?
A) "Take the medication in the evening."
B) "Take the medication in the morning."
C) "Avoid all dairy products."
D) "Take the medication with grapefruit juice."
Correct Answer: A) "Take the medication in the evening."
Rationale: Atorvastatin is best taken in the evening because cholesterol synthesis peaks at night.
Grapefruit juice should be avoided because it can increase drug levels and the risk of myopathy.
16. A nurse is reviewing the medication orders for a client with a peptic ulcer. Which of the following
medications is used to reduce gastric acid secretion?
A) Omeprazole
B) Acetaminophen
C) Ibuprofen
D) Furosemide
Correct Answer: A) Omeprazole
Rationale: Omeprazole is a proton pump inhibitor that reduces gastric acid secretion and is used
to treat peptic ulcers. Ibuprofen is an NSAID that can worsen ulcers.
Exam Solutions
1. A nurse is preparing to administer digoxin to a client. Which of the following findings should the
nurse report before administering the medication?
A) Heart rate of 88 beats per minute
B) Heart rate of 52 beats per minute
C) Blood pressure of 118/76 mm Hg
D) Respiratory rate of 18 breaths per minute
Correct Answer: B) Heart rate of 52 beats per minute
Rationale: Digoxin slows the heart rate. The nurse should hold the medication and notify the
provider if the adult client's apical pulse is below 60 beats per minute, as this indicates
bradycardia and risk for digoxin toxicity.
2. A nurse is teaching a client about warfarin therapy. Which of the following statements indicates the
client understands the teaching?
A) "I will take aspirin for my headaches."
B) "I will keep my intake of green leafy vegetables consistent."
C) "I will double my dose if I miss one."
D) "I will stop the medication when my bruising resolves."
Correct Answer: B) "I will keep my intake of green leafy vegetables consistent."
Rationale: Warfarin is a vitamin K antagonist. Clients should maintain a consistent intake of
vitamin K–rich foods to keep the INR stable. Aspirin increases bleeding risk, and doses should
never be doubled.
3. A nurse is administering intravenous furosemide to a client. Which of the following assessments is
the priority?
A) Daily weight
B) Serum potassium level
C) Blood pressure
D) Urine output
Correct Answer: C) Blood pressure
Rationale: Furosemide is a loop diuretic that can cause rapid fluid loss and hypotension. The
priority assessment immediately after IV administration is blood pressure to detect hypovolemia
and hypotension.
4. A nurse is reviewing the medication list of a client taking metformin. Which of the following
findings requires immediate intervention?
A) Blood glucose of 110 mg/dL
,B) Serum creatinine of 2.8 mg/dL
C) Hemoglobin A1c of 6.5%
D) Weight loss of 2 kg over 3 months
Correct Answer: B) Serum creatinine of 2.8 mg/dL
Rationale: Metformin is contraindicated in renal impairment because it increases the risk of
lactic acidosis. An elevated creatinine indicates decreased kidney function, and the medication
should be held and the provider notified.
5. A client is prescribed morphine sulfate intravenously. Which of the following findings is the most
concerning?
A) Respiratory rate of 10 breaths per minute
B) Blood pressure of 110/70 mm Hg
C) Pain relief rated 3/10
D) Drowsiness 30 minutes after administration
Correct Answer: A) Respiratory rate of 10 breaths per minute
Rationale: Opioids such as morphine cause respiratory depression. A respiratory rate below 12
breaths per minute is a life-threatening complication and requires immediate intervention,
including withholding the medication and administering naloxone if ordered.
6. A nurse is teaching a client about insulin administration. Which of the following statements
indicates correct understanding?
A) "I will rotate injection sites within the same area."
B) "I will inject into the same spot each time."
C) "I will massage the site after injection."
D) "I will store my insulin in the freezer."
Correct Answer: A) "I will rotate injection sites within the same area."
Rationale: Rotating sites within the same area promotes consistent absorption and prevents
lipohypertrophy. Massaging the site can alter absorption, and insulin should never be frozen.
7. A nurse is preparing to administer potassium chloride IV to a client. Which of the following actions
is correct?
A) Administer as a rapid IV push
B) Dilute the medication and administer via an infusion pump
C) Administer undiluted via a peripheral IV
D) Give the medication only when the client is NPO
Correct Answer: B) Dilute the medication and administer via an infusion pump
Rationale: IV potassium must always be diluted and infused slowly using an infusion pump
because undiluted or rapid administration can cause fatal cardiac dysrhythmias. IV push of
potassium is never permitted.
8. A nurse is caring for a client receiving heparin. Which of the following lab values should the nurse
monitor?
A) INR
B) aPTT
C) Platelet count only
,D) Hematocrit
Correct Answer: B) aPTT
Rationale: Unfractionated heparin therapy is monitored using the activated partial
thromboplastin time (aPTT). The INR is used to monitor warfarin therapy. Platelets should also
be monitored for heparin-induced thrombocytopenia, but the primary therapeutic lab is the
aPTT.
9. A nurse is administering levothyroxine to a client. Which of the following instructions should the
nurse include?
A) "Take the medication at bedtime."
B) "Take the medication on an empty stomach in the morning."
C) "Take the medication with breakfast."
D) "Take the medication with an antacid."
Correct Answer: B) "Take the medication on an empty stomach in the morning."
Rationale: Levothyroxine should be taken on an empty stomach 30 to 60 minutes before
breakfast for optimal absorption. Antacids and food can decrease absorption.
10. A client is prescribed prednisone. Which of the following findings should the nurse report to the
provider?
A) Blood glucose of 100 mg/dL
B) Weight gain of 2 kg in one week
C) Mild nausea
D) Improved appetite
Correct Answer: B) Weight gain of 2 kg in one week
Rationale: Prednisone, a corticosteroid, causes fluid retention, weight gain, and hyperglycemia.
Rapid weight gain may indicate fluid overload and requires notification of the provider.
11. A nurse is teaching a client about phenytoin. Which of the following instructions should the nurse
include?
A) "Brush your teeth gently and maintain good oral hygiene."
B) "Take the medication with antacids."
C) "Stop the medication if you feel better."
D) "Drink grapefruit juice with the medication."
Correct Answer: A) "Brush your teeth gently and maintain good oral hygiene."
Rationale: Phenytoin can cause gingival hyperplasia. Clients should maintain meticulous oral
hygiene and see a dentist regularly. The medication should not be stopped abruptly, and
grapefruit juice may alter drug levels.
12. A nurse is preparing to administer atenolol. Which of the following findings should cause the nurse
to hold the medication?
A) Blood pressure of 128/82 mm Hg
B) Heart rate of 54 beats per minute
C) Respiratory rate of 16 breaths per minute
D) Blood glucose of 110 mg/dL
Correct Answer: B) Heart rate of 54 beats per minute
, Rationale: Atenolol is a beta-blocker that decreases heart rate and blood pressure. The nurse
should hold the medication and notify the provider if the heart rate is below 60 beats per
minute.
13. A nurse is teaching a client about the use of nitroglycerin sublingual tablets. Which of the
following statements indicates correct understanding?
A) "I will take one tablet every 5 minutes for up to three doses."
B) "I will swallow the tablet with water."
C) "I will take the medication only when my pain is severe."
D) "I will lie down after taking the medication."
Correct Answer: A) "I will take one tablet every 5 minutes for up to three doses."
Rationale: For angina, the client should take one sublingual nitroglycerin tablet every 5 minutes
for up to three doses. If chest pain persists after three doses, emergency services should be
called. The tablet should be dissolved under the tongue, not swallowed.
14. A client is prescribed lisinopril. Which of the following side effects should the nurse monitor for?
A) Dry, persistent cough
B) Bradycardia
C) Hyperkalemia only
D) Weight loss
Correct Answer: A) Dry, persistent cough
Rationale: ACE inhibitors such as lisinopril commonly cause a dry, persistent cough due to
bradykinin accumulation. Other side effects include hyperkalemia and angioedema.
15. A nurse is administering atorvastatin to a client. Which of the following instructions should the
nurse include?
A) "Take the medication in the evening."
B) "Take the medication in the morning."
C) "Avoid all dairy products."
D) "Take the medication with grapefruit juice."
Correct Answer: A) "Take the medication in the evening."
Rationale: Atorvastatin is best taken in the evening because cholesterol synthesis peaks at night.
Grapefruit juice should be avoided because it can increase drug levels and the risk of myopathy.
16. A nurse is reviewing the medication orders for a client with a peptic ulcer. Which of the following
medications is used to reduce gastric acid secretion?
A) Omeprazole
B) Acetaminophen
C) Ibuprofen
D) Furosemide
Correct Answer: A) Omeprazole
Rationale: Omeprazole is a proton pump inhibitor that reduces gastric acid secretion and is used
to treat peptic ulcers. Ibuprofen is an NSAID that can worsen ulcers.
