NR341 PHARMACOLOGY CJE EXAM
2026/2027 – 300 PRACTICE
QUESTIONS WITH VERIFIED
ANSWERS & DETAILED RATIONALES
| CHAMBERLAIN UNIVERSITY | A+
GRADED | INSTANT DOWNLOAD
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1. A nurse is preparing to administer digoxin to an adult client. Which
assessment finding should cause the nurse to hold the dose and notify the
provider?
A. Apical pulse 88 beats/min
B. Serum potassium 4.2 mEq/L
C. Apical pulse 54 beats/min
D. Blood pressure 118/76 mm Hg
Answer: C. Rationale: Digoxin should generally be held for an adult apical pulse below
60 beats/min. Bradycardia may indicate digoxin toxicity. The nurse should assess the
apical pulse for a full minute before administration.
2. A client is prescribed regular insulin before breakfast. The nurse should
administer the insulin at what time?
A. Immediately after breakfast
B. 30 minutes before breakfast
C. 2 hours after breakfast
D. At bedtime only
Answer: B. Rationale: Regular insulin has an onset of about 30 minutes. It is typically
given 30 minutes before meals so its peak action coincides with postprandial glucose
elevation.
3. A client receiving heparin has a significantly elevated aPTT. Which antidote
should the nurse anticipate?
A. Vitamin K
B. Protamine sulfate
,C. Naloxone
D. Acetylcysteine
Answer: B. Rationale: Protamine sulfate reverses heparin. Vitamin K reverses warfarin.
Naloxone reverses opioids, and acetylcysteine is used for acetaminophen toxicity.
4. A nurse is caring for a client receiving morphine. Which finding is the priority
concern?
A. Respiratory rate 8 breaths/min
B. Blood pressure 110/70 mm Hg
C. Mild nausea
D. Constipation
Answer: A. Rationale: Respiratory depression is a life-threatening adverse effect of
opioids such as morphine. The nurse should withhold the opioid, stimulate the client,
and prepare to administer naloxone if ordered.
5. A client taking metformin is scheduled for a CT scan with iodinated contrast.
What is the nurse’s priority action?
A. Administer metformin with breakfast
B. Hold metformin as ordered and monitor renal function
C. Double the metformin dose after the scan
D. Give insulin instead without a prescription
Answer: B. Rationale: Metformin may increase the risk of lactic acidosis, especially if
renal function worsens after contrast media. It is often held before and after contrast
administration per provider order.
6. A client is started on lisinopril. Which adverse effect should the nurse include
in teaching?
A. Dry, persistent cough
B. Hyperglycemia
C. Bradycardia
D. Increased thirst
Answer: A. Rationale: ACE inhibitors such as lisinopril commonly cause a dry, persistent
cough due to bradykinin accumulation. The nurse should also monitor for
hyperkalemia, hypotension, and angioedema.
7. A client is receiving furosemide. Which laboratory value should the nurse
monitor most closely?
A. Serum potassium
B. Serum calcium
C. Serum sodium only
D. Serum chloride only
,Answer: A. Rationale: Furosemide is a loop diuretic that can cause hypokalemia. Low
potassium increases the risk of digoxin toxicity and dysrhythmias.
8. A nurse is teaching a client about levothyroxine. Which instruction is correct?
A. Take it with breakfast and coffee
B. Take it at bedtime with milk
C. Take it on an empty stomach 30–60 minutes before breakfast
D. Take it only when feeling tired
Answer: C. Rationale: Levothyroxine should be taken on an empty stomach, usually 30–
60 minutes before breakfast, for consistent absorption. Clients should not stop the
medication abruptly.
9. A client has been taking prednisone for several weeks. Which statement
indicates the client needs further teaching?
A. “I will take this medication with food.”
B. “I can stop it suddenly when I feel better.”
C. “I should monitor my blood glucose.”
D. “I should avoid people with infections.”
Answer: B. Rationale: Corticosteroids such as prednisone must be tapered gradually.
Sudden discontinuation can cause adrenal crisis. They can also increase blood glucose
and suppress the immune response.
10. A nurse is administering IV vancomycin. The client develops flushing, rash,
and itching during the infusion. What is the nurse’s priority action?
A. Stop the infusion and notify the provider
B. Increase the infusion rate
C. Document the finding as a normal effect
D. Administer a diuretic immediately
Answer: A. Rationale: Flushing, rash, and itching during vancomycin infusion may
indicate vancomycin flushing syndrome, formerly called red man syndrome. The nurse
should stop or slow the infusion and notify the provider. Slower infusion and
antihistamines may be ordered.
11. A client is prescribed metoprolol. Which finding should cause the nurse to
withhold the medication?
A. Heart rate 52 beats/min
B. Blood pressure 138/86 mm Hg
C. Respiratory rate 18 breaths/min
D. Temperature 98.6°F
, Answer: A. Rationale: Beta blockers such as metoprolol can cause bradycardia and
hypotension. The nurse should usually hold the dose if the heart rate is below 60
beats/min or blood pressure is below 90 mm Hg systolic, depending on provider orders.
12. A client taking phenytoin reports swollen, tender gums. Which nursing
action is most appropriate?
A. Tell the client to stop the medication immediately
B. Encourage good oral hygiene and notify the provider
C. Increase the dose without an order
D. Restrict all fluids
Answer: B. Rationale: Gingival hyperplasia is a known adverse effect of phenytoin. The
nurse should reinforce good oral hygiene, encourage regular dental care, and notify the
provider. The medication should not be stopped abruptly without provider guidance.
13. A nurse is reviewing the medication list for a client with heart failure. Which
medication is considered first-line therapy for improving survival?
A. Digoxin
B. Furosemide
C. Lisinopril
D. Nitroglycerin
Answer: C. Rationale: ACE inhibitors such as lisinopril are first-line therapy for heart
failure with reduced ejection fraction because they reduce mortality and improve
survival. Digoxin and furosemide provide symptom relief but do not improve survival.
14. A client is receiving nitroglycerin sublingual for angina. Which instruction
should the nurse include in teaching?
A. Take up to three tablets, 5 minutes apart, and call 911 if pain persists
B. Swallow the tablet with a full glass of water
C. Take the medication only when pain is severe
D. Store the medication in a warm, humid place
Answer: A. Rationale: Sublingual nitroglycerin should be taken at the onset of chest
pain. The client may take up to three tablets, 5 minutes apart. If chest pain persists
after three doses, the client should call 911. The medication should be stored in a cool,
dry place and not swallowed.
15. A nurse is administering amiodarone. Which adverse effect requires the
most immediate attention?
A. Blue-gray skin discoloration
B. Pulmonary toxicity with dyspnea
C. Corneal microdeposits
D. Photosensitivity
2026/2027 – 300 PRACTICE
QUESTIONS WITH VERIFIED
ANSWERS & DETAILED RATIONALES
| CHAMBERLAIN UNIVERSITY | A+
GRADED | INSTANT DOWNLOAD
1. A nurse is preparing to administer digoxin to an adult client. Which
assessment finding should cause the nurse to hold the dose and notify the
provider?
A. Apical pulse 88 beats/min
B. Serum potassium 4.2 mEq/L
C. Apical pulse 54 beats/min
D. Blood pressure 118/76 mm Hg
Answer: C. Rationale: Digoxin should generally be held for an adult apical pulse below
60 beats/min. Bradycardia may indicate digoxin toxicity. The nurse should assess the
apical pulse for a full minute before administration.
2. A client is prescribed regular insulin before breakfast. The nurse should
administer the insulin at what time?
A. Immediately after breakfast
B. 30 minutes before breakfast
C. 2 hours after breakfast
D. At bedtime only
Answer: B. Rationale: Regular insulin has an onset of about 30 minutes. It is typically
given 30 minutes before meals so its peak action coincides with postprandial glucose
elevation.
3. A client receiving heparin has a significantly elevated aPTT. Which antidote
should the nurse anticipate?
A. Vitamin K
B. Protamine sulfate
,C. Naloxone
D. Acetylcysteine
Answer: B. Rationale: Protamine sulfate reverses heparin. Vitamin K reverses warfarin.
Naloxone reverses opioids, and acetylcysteine is used for acetaminophen toxicity.
4. A nurse is caring for a client receiving morphine. Which finding is the priority
concern?
A. Respiratory rate 8 breaths/min
B. Blood pressure 110/70 mm Hg
C. Mild nausea
D. Constipation
Answer: A. Rationale: Respiratory depression is a life-threatening adverse effect of
opioids such as morphine. The nurse should withhold the opioid, stimulate the client,
and prepare to administer naloxone if ordered.
5. A client taking metformin is scheduled for a CT scan with iodinated contrast.
What is the nurse’s priority action?
A. Administer metformin with breakfast
B. Hold metformin as ordered and monitor renal function
C. Double the metformin dose after the scan
D. Give insulin instead without a prescription
Answer: B. Rationale: Metformin may increase the risk of lactic acidosis, especially if
renal function worsens after contrast media. It is often held before and after contrast
administration per provider order.
6. A client is started on lisinopril. Which adverse effect should the nurse include
in teaching?
A. Dry, persistent cough
B. Hyperglycemia
C. Bradycardia
D. Increased thirst
Answer: A. Rationale: ACE inhibitors such as lisinopril commonly cause a dry, persistent
cough due to bradykinin accumulation. The nurse should also monitor for
hyperkalemia, hypotension, and angioedema.
7. A client is receiving furosemide. Which laboratory value should the nurse
monitor most closely?
A. Serum potassium
B. Serum calcium
C. Serum sodium only
D. Serum chloride only
,Answer: A. Rationale: Furosemide is a loop diuretic that can cause hypokalemia. Low
potassium increases the risk of digoxin toxicity and dysrhythmias.
8. A nurse is teaching a client about levothyroxine. Which instruction is correct?
A. Take it with breakfast and coffee
B. Take it at bedtime with milk
C. Take it on an empty stomach 30–60 minutes before breakfast
D. Take it only when feeling tired
Answer: C. Rationale: Levothyroxine should be taken on an empty stomach, usually 30–
60 minutes before breakfast, for consistent absorption. Clients should not stop the
medication abruptly.
9. A client has been taking prednisone for several weeks. Which statement
indicates the client needs further teaching?
A. “I will take this medication with food.”
B. “I can stop it suddenly when I feel better.”
C. “I should monitor my blood glucose.”
D. “I should avoid people with infections.”
Answer: B. Rationale: Corticosteroids such as prednisone must be tapered gradually.
Sudden discontinuation can cause adrenal crisis. They can also increase blood glucose
and suppress the immune response.
10. A nurse is administering IV vancomycin. The client develops flushing, rash,
and itching during the infusion. What is the nurse’s priority action?
A. Stop the infusion and notify the provider
B. Increase the infusion rate
C. Document the finding as a normal effect
D. Administer a diuretic immediately
Answer: A. Rationale: Flushing, rash, and itching during vancomycin infusion may
indicate vancomycin flushing syndrome, formerly called red man syndrome. The nurse
should stop or slow the infusion and notify the provider. Slower infusion and
antihistamines may be ordered.
11. A client is prescribed metoprolol. Which finding should cause the nurse to
withhold the medication?
A. Heart rate 52 beats/min
B. Blood pressure 138/86 mm Hg
C. Respiratory rate 18 breaths/min
D. Temperature 98.6°F
, Answer: A. Rationale: Beta blockers such as metoprolol can cause bradycardia and
hypotension. The nurse should usually hold the dose if the heart rate is below 60
beats/min or blood pressure is below 90 mm Hg systolic, depending on provider orders.
12. A client taking phenytoin reports swollen, tender gums. Which nursing
action is most appropriate?
A. Tell the client to stop the medication immediately
B. Encourage good oral hygiene and notify the provider
C. Increase the dose without an order
D. Restrict all fluids
Answer: B. Rationale: Gingival hyperplasia is a known adverse effect of phenytoin. The
nurse should reinforce good oral hygiene, encourage regular dental care, and notify the
provider. The medication should not be stopped abruptly without provider guidance.
13. A nurse is reviewing the medication list for a client with heart failure. Which
medication is considered first-line therapy for improving survival?
A. Digoxin
B. Furosemide
C. Lisinopril
D. Nitroglycerin
Answer: C. Rationale: ACE inhibitors such as lisinopril are first-line therapy for heart
failure with reduced ejection fraction because they reduce mortality and improve
survival. Digoxin and furosemide provide symptom relief but do not improve survival.
14. A client is receiving nitroglycerin sublingual for angina. Which instruction
should the nurse include in teaching?
A. Take up to three tablets, 5 minutes apart, and call 911 if pain persists
B. Swallow the tablet with a full glass of water
C. Take the medication only when pain is severe
D. Store the medication in a warm, humid place
Answer: A. Rationale: Sublingual nitroglycerin should be taken at the onset of chest
pain. The client may take up to three tablets, 5 minutes apart. If chest pain persists
after three doses, the client should call 911. The medication should be stored in a cool,
dry place and not swallowed.
15. A nurse is administering amiodarone. Which adverse effect requires the
most immediate attention?
A. Blue-gray skin discoloration
B. Pulmonary toxicity with dyspnea
C. Corneal microdeposits
D. Photosensitivity
