RN PHARMACOLOGY AND RN MATERNAL NEWBORN
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
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CORE DOMAINS
Pharmacology: Pharmacokinetics and Pharmacodynamics
Pharmacology: Medication Safety and Legal-Ethical Compliance
Pharmacology: Cardiovascular and Hematologic Agents
Pharmacology: Anti-Infective and Endocrine Agents
Maternal Newborn: Antepartum Assessment and Complications
Maternal Newborn: Intrapartum Fetal Surveillance and Emergencies
Maternal Newborn: Postpartum Assessment and Hemorrhage
Maternal Newborn: Newborn Transition and Neonatal Pharmacology
INTRODUCTION
This comprehensive assessment evaluates the applied pharmacological and maternal-
newborn knowledge required for safe registered nursing practice. It measures
foundational drug theory, clinical monitoring, patient education, legal accountability,
and evidence-based obstetric decision-making. The examination uses multiple-choice
and scenario-based items to simulate real-world clinical judgment, prioritization, and
risk reduction. Emphasis is placed on medication safety, fetal surveillance
interpretation, postpartum complication recognition, and neonatal pharmacologic
considerations. Candidates must demonstrate the ability to synthesize data, identify
urgent findings, and select defensible nursing actions within professional and
regulatory standards.
SECTION ONE: QUESTIONS 1–300
Question 1
,A nurse is preparing to administer intravenous nitroprusside to a client in hypertensive
crisis. Which action is the priority?
A. Monitor hourly urine output.
B. Continuously monitor blood pressure.
C. Check blood urea nitrogen levels.
D. Assess peripheral pulses every 4 hours.
B. Continuously monitor blood pressure.
RATIONALE: Nitroprusside is a potent, rapid-acting vasodilator capable of causing
profound hypotension. Continuous blood pressure monitoring, preferably via arterial
line, is essential to titrate the infusion safely and prevent hemodynamic collapse .
Question 2
A nurse notes a respiratory rate of 9/min in a client receiving a continuous morphine
infusion. Which medication should the nurse prepare to administer?
A. Flumazenil
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
C. Naloxone
RATIONALE: Opioid-induced respiratory depression is reversed by naloxone, a
competitive opioid antagonist. Flumazenil reverses benzodiazepines, protamine sulfate
reverses heparin, and acetylcysteine treats acetaminophen toxicity .
Question 3
A nurse is teaching a client about alendronate. Which instruction should be included?
A. Take this medication 30 minutes before bedtime.
B. Drink a full glass of milk immediately after taking the pill.
C. Sit or stand upright for at least 30 minutes after administration.
D. Chew the medication thoroughly before swallowing.
,C. Sit or stand upright for at least 30 minutes after administration.
RATIONALE: Alendronate can cause severe esophagitis. Clients must remain upright
for at least 30 minutes after taking it with a full glass of plain water on an empty
stomach to prevent esophageal irritation .
Question 4
A nurse is preparing to administer digoxin. Which laboratory value should be reviewed
to minimize toxicity risk?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
B. Serum potassium
RATIONALE: Hypokalemia increases digoxin toxicity risk because digoxin and
potassium compete for the same binding site on the sodium-potassium ATPase pump.
Low potassium allows more digoxin binding, magnifying its effects .
Question 5
A client taking lithium reports coarse hand tremor and ataxia with a serum lithium level
of 1.7 mEq/L. Which action should the nurse take?
A. Administer the next scheduled dose.
B. Reassure the client these are expected side effects.
C. Hold the next dose and notify the provider.
D. Request an order to increase fluid restriction.
C. Hold the next dose and notify the provider.
RATIONALE: Therapeutic lithium range is 0.6–1.2 mEq/L. A level of 1.7 mEq/L with
ataxia and coarse tremor indicates moderate to severe toxicity. The dose must be held
and the provider notified immediately .
Question 6
, A nurse is caring for a client receiving digoxin and furosemide. Which finding requires
immediate assessment?
A. Stomach upset and headache
B. Vomiting and halos around lights
C. Night sweats and headache
D. Low blood pressure and dark urine
B. Vomiting and halos around lights
RATIONALE: Visual disturbances (yellow-green halos) and vomiting are classic signs of
digoxin toxicity. Furosemide-induced hypokalemia potentiates digoxin toxicity. These
findings require immediate assessment and provider notification .
Question 7
A client on phenytoin asks about instructions. Which statement by the nurse is
INCORRECT?
A. You will need annual labs to determine the medication level in your body.
B. Remember to never skip a dose of this medication.
C. You need to increase your intake of vitamin D while taking this medication.
D. Maintain good oral hygiene and visit your dentist regularly.
A. You will need annual labs to determine the medication level in your body.
RATIONALE: Phenytoin has a narrow therapeutic index and requires frequent serum
level monitoring, not annual testing. Levels are typically checked more often, especially
during initiation or dose changes .
Question 8
A nurse is assessing a client who is at 32 weeks of gestation and presents with painless,
bright red vaginal bleeding. The nurse should identify that this clinical presentation is
most consistent with which condition?
A. Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Velamentous insertion of the umbilical cord
QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
CORE DOMAINS
Pharmacology: Pharmacokinetics and Pharmacodynamics
Pharmacology: Medication Safety and Legal-Ethical Compliance
Pharmacology: Cardiovascular and Hematologic Agents
Pharmacology: Anti-Infective and Endocrine Agents
Maternal Newborn: Antepartum Assessment and Complications
Maternal Newborn: Intrapartum Fetal Surveillance and Emergencies
Maternal Newborn: Postpartum Assessment and Hemorrhage
Maternal Newborn: Newborn Transition and Neonatal Pharmacology
INTRODUCTION
This comprehensive assessment evaluates the applied pharmacological and maternal-
newborn knowledge required for safe registered nursing practice. It measures
foundational drug theory, clinical monitoring, patient education, legal accountability,
and evidence-based obstetric decision-making. The examination uses multiple-choice
and scenario-based items to simulate real-world clinical judgment, prioritization, and
risk reduction. Emphasis is placed on medication safety, fetal surveillance
interpretation, postpartum complication recognition, and neonatal pharmacologic
considerations. Candidates must demonstrate the ability to synthesize data, identify
urgent findings, and select defensible nursing actions within professional and
regulatory standards.
SECTION ONE: QUESTIONS 1–300
Question 1
,A nurse is preparing to administer intravenous nitroprusside to a client in hypertensive
crisis. Which action is the priority?
A. Monitor hourly urine output.
B. Continuously monitor blood pressure.
C. Check blood urea nitrogen levels.
D. Assess peripheral pulses every 4 hours.
B. Continuously monitor blood pressure.
RATIONALE: Nitroprusside is a potent, rapid-acting vasodilator capable of causing
profound hypotension. Continuous blood pressure monitoring, preferably via arterial
line, is essential to titrate the infusion safely and prevent hemodynamic collapse .
Question 2
A nurse notes a respiratory rate of 9/min in a client receiving a continuous morphine
infusion. Which medication should the nurse prepare to administer?
A. Flumazenil
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
C. Naloxone
RATIONALE: Opioid-induced respiratory depression is reversed by naloxone, a
competitive opioid antagonist. Flumazenil reverses benzodiazepines, protamine sulfate
reverses heparin, and acetylcysteine treats acetaminophen toxicity .
Question 3
A nurse is teaching a client about alendronate. Which instruction should be included?
A. Take this medication 30 minutes before bedtime.
B. Drink a full glass of milk immediately after taking the pill.
C. Sit or stand upright for at least 30 minutes after administration.
D. Chew the medication thoroughly before swallowing.
,C. Sit or stand upright for at least 30 minutes after administration.
RATIONALE: Alendronate can cause severe esophagitis. Clients must remain upright
for at least 30 minutes after taking it with a full glass of plain water on an empty
stomach to prevent esophageal irritation .
Question 4
A nurse is preparing to administer digoxin. Which laboratory value should be reviewed
to minimize toxicity risk?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
B. Serum potassium
RATIONALE: Hypokalemia increases digoxin toxicity risk because digoxin and
potassium compete for the same binding site on the sodium-potassium ATPase pump.
Low potassium allows more digoxin binding, magnifying its effects .
Question 5
A client taking lithium reports coarse hand tremor and ataxia with a serum lithium level
of 1.7 mEq/L. Which action should the nurse take?
A. Administer the next scheduled dose.
B. Reassure the client these are expected side effects.
C. Hold the next dose and notify the provider.
D. Request an order to increase fluid restriction.
C. Hold the next dose and notify the provider.
RATIONALE: Therapeutic lithium range is 0.6–1.2 mEq/L. A level of 1.7 mEq/L with
ataxia and coarse tremor indicates moderate to severe toxicity. The dose must be held
and the provider notified immediately .
Question 6
, A nurse is caring for a client receiving digoxin and furosemide. Which finding requires
immediate assessment?
A. Stomach upset and headache
B. Vomiting and halos around lights
C. Night sweats and headache
D. Low blood pressure and dark urine
B. Vomiting and halos around lights
RATIONALE: Visual disturbances (yellow-green halos) and vomiting are classic signs of
digoxin toxicity. Furosemide-induced hypokalemia potentiates digoxin toxicity. These
findings require immediate assessment and provider notification .
Question 7
A client on phenytoin asks about instructions. Which statement by the nurse is
INCORRECT?
A. You will need annual labs to determine the medication level in your body.
B. Remember to never skip a dose of this medication.
C. You need to increase your intake of vitamin D while taking this medication.
D. Maintain good oral hygiene and visit your dentist regularly.
A. You will need annual labs to determine the medication level in your body.
RATIONALE: Phenytoin has a narrow therapeutic index and requires frequent serum
level monitoring, not annual testing. Levels are typically checked more often, especially
during initiation or dose changes .
Question 8
A nurse is assessing a client who is at 32 weeks of gestation and presents with painless,
bright red vaginal bleeding. The nurse should identify that this clinical presentation is
most consistent with which condition?
A. Abruptio placentae
B. Placenta previa
C. Uterine rupture
D. Velamentous insertion of the umbilical cord
