RN Pharmacology 2026
Proctored Exam Bundle-
Passing Versions
SECTION I — SAFE MEDICATION ADMINISTRATION &
LEGAL/ETHICAL PRINCIPLES
1. A nurse is preparing to administer a medication and notes the order reads
"digoxin 0.25 mg PO daily." The pharmacy supplies digoxin 0.125 mg tablets.
Which action should the nurse take?
Give 2 tablets (0.25 mg total) as ordered
• Give 1 tablet and clarify the remainder
• Hold the dose and call the provider
• Give 1 tablet and document the discrepancy
0.25 mg ÷ 0.125 mg = 2 tablets. The order is clear and safe; no clarification is
needed. Holding a dose without a clinical reason is inappropriate.
2. Which of the following are the "rights" of medication administration? SATA
Right patient
Right medication
Right dose
Right route
Right time
• Right diagnosis
The classic rights include patient, medication, dose, route, time,
documentation, reason, and to refuse. "Right diagnosis" is not a standard right.
,3. A nurse is administering a medication to a client who refuses it. Which action is
most appropriate?
Document the refusal and notify the provider
• Administer the medication covertly in food
• Restrain the client and administer the dose
• Skip documentation since no medication was given
Clients have the right to refuse. The nurse must document the refusal, notify
the provider, and continue to monitor the client. Administering covertly violates
consent and is illegal in most jurisdictions.
4. A nurse is transcribing a verbal order for a high-alert medication. Which action
is priority?
Read back the order to the prescriber for verification
• Ask another nurse to listen on the line
• Administer the medication immediately
• Wait until the provider writes the order
Read-back verification is required for verbal/telephone orders, especially high-
alert medications, to prevent errors.
5. Which client is at highest risk for a medication error?
A 78-year-old client taking 12 medications
• A 30-year-old client taking 2 medications
• A 45-year-old client taking 4 medications
• A 60-year-old client taking 6 medications
, Polypharmacy, advanced age, and altered pharmacokinetics (decreased
renal/hepatic function, decreased albumin) increase risk.
6. A nurse is preparing a controlled substance and notes the count is incorrect at the
beginning of the shift. What should the nurse do first?
Report the discrepancy to the charge nurse and pharmacy immediately
• Sign off and continue the shift
• Adjust the count to match the record
• Wait until the end of the shift to report
Discrepancies must be reported immediately per facility policy and DEA
regulations; failure to report can result in disciplinary action.
7. A nurse is teaching a client about a new prescription. Which statement indicates
understanding?
"I will keep a list of all my medications and bring it to every appointment."
• "I can stop this medication when I feel better."
• "I can share this medication with my spouse if they have the same
symptoms."
• "Herbal supplements don't interact with prescriptions."
Maintaining an accurate medication list is a key safety behavior. Abrupt
discontinuation, sharing medications, and assuming herbals are inert are all unsafe.
8. A nurse is reviewing a medication order that is illegible. Which action is
appropriate?
Contact the prescriber to clarify the order
• Guess based on the client's diagnosis
• Ask the pharmacist to interpret it
, • Give the most likely medication
Illegible or unclear orders must be clarified with the prescriber. Guessing or
interpreting can cause harm.
9. Which of the following are appropriate nursing actions to prevent medication
errors? SATA
Use two client identifiers before administration
Complete the "rights" check at the bedside
Document medications immediately after administration
• Pre-pour medications for multiple clients at once
Report all errors and near misses
Pre-pouring for multiple clients increases error risk. Two identifiers, bedside
checks, prompt documentation, and error reporting are best practices.
10. A nurse is about to administer a medication and the client states, "That pill
looks different from what I usually take." What should the nurse do?
Stop, verify the medication against the MAR and pharmacy label, and clarify
before administering
• Reassure the client and administer the medication
• Tell the client the manufacturer changed
• Document the client's concern and give the medication
Client concerns about appearance should always trigger verification. The client
is often the last line of defense against error.
11. A nurse is preparing to administer a medication via NG tube. Which action is
correct?
Verify tube placement before administration
Proctored Exam Bundle-
Passing Versions
SECTION I — SAFE MEDICATION ADMINISTRATION &
LEGAL/ETHICAL PRINCIPLES
1. A nurse is preparing to administer a medication and notes the order reads
"digoxin 0.25 mg PO daily." The pharmacy supplies digoxin 0.125 mg tablets.
Which action should the nurse take?
Give 2 tablets (0.25 mg total) as ordered
• Give 1 tablet and clarify the remainder
• Hold the dose and call the provider
• Give 1 tablet and document the discrepancy
0.25 mg ÷ 0.125 mg = 2 tablets. The order is clear and safe; no clarification is
needed. Holding a dose without a clinical reason is inappropriate.
2. Which of the following are the "rights" of medication administration? SATA
Right patient
Right medication
Right dose
Right route
Right time
• Right diagnosis
The classic rights include patient, medication, dose, route, time,
documentation, reason, and to refuse. "Right diagnosis" is not a standard right.
,3. A nurse is administering a medication to a client who refuses it. Which action is
most appropriate?
Document the refusal and notify the provider
• Administer the medication covertly in food
• Restrain the client and administer the dose
• Skip documentation since no medication was given
Clients have the right to refuse. The nurse must document the refusal, notify
the provider, and continue to monitor the client. Administering covertly violates
consent and is illegal in most jurisdictions.
4. A nurse is transcribing a verbal order for a high-alert medication. Which action
is priority?
Read back the order to the prescriber for verification
• Ask another nurse to listen on the line
• Administer the medication immediately
• Wait until the provider writes the order
Read-back verification is required for verbal/telephone orders, especially high-
alert medications, to prevent errors.
5. Which client is at highest risk for a medication error?
A 78-year-old client taking 12 medications
• A 30-year-old client taking 2 medications
• A 45-year-old client taking 4 medications
• A 60-year-old client taking 6 medications
, Polypharmacy, advanced age, and altered pharmacokinetics (decreased
renal/hepatic function, decreased albumin) increase risk.
6. A nurse is preparing a controlled substance and notes the count is incorrect at the
beginning of the shift. What should the nurse do first?
Report the discrepancy to the charge nurse and pharmacy immediately
• Sign off and continue the shift
• Adjust the count to match the record
• Wait until the end of the shift to report
Discrepancies must be reported immediately per facility policy and DEA
regulations; failure to report can result in disciplinary action.
7. A nurse is teaching a client about a new prescription. Which statement indicates
understanding?
"I will keep a list of all my medications and bring it to every appointment."
• "I can stop this medication when I feel better."
• "I can share this medication with my spouse if they have the same
symptoms."
• "Herbal supplements don't interact with prescriptions."
Maintaining an accurate medication list is a key safety behavior. Abrupt
discontinuation, sharing medications, and assuming herbals are inert are all unsafe.
8. A nurse is reviewing a medication order that is illegible. Which action is
appropriate?
Contact the prescriber to clarify the order
• Guess based on the client's diagnosis
• Ask the pharmacist to interpret it
, • Give the most likely medication
Illegible or unclear orders must be clarified with the prescriber. Guessing or
interpreting can cause harm.
9. Which of the following are appropriate nursing actions to prevent medication
errors? SATA
Use two client identifiers before administration
Complete the "rights" check at the bedside
Document medications immediately after administration
• Pre-pour medications for multiple clients at once
Report all errors and near misses
Pre-pouring for multiple clients increases error risk. Two identifiers, bedside
checks, prompt documentation, and error reporting are best practices.
10. A nurse is about to administer a medication and the client states, "That pill
looks different from what I usually take." What should the nurse do?
Stop, verify the medication against the MAR and pharmacy label, and clarify
before administering
• Reassure the client and administer the medication
• Tell the client the manufacturer changed
• Document the client's concern and give the medication
Client concerns about appearance should always trigger verification. The client
is often the last line of defense against error.
11. A nurse is preparing to administer a medication via NG tube. Which action is
correct?
Verify tube placement before administration
