Pharmacology NCLEX Questions
A newly admitted client takes digoxin 0.25 mg/day. The nurse knows that which is the serum
therapeutic range for digoxin?
a. 0.1 to 1.5 ng/mL
b. 0.5 to 2.0 ng/mL
c. 1.0 to 2.5 ng/mL
d. 2.0 to 4.0 ng/mL - ANSb. 0.5 to 2.0 ng/mL
The client's serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum
digoxin level?
a. It is in the high (elevated) range.
b. It is in the low (decreased) range.
c. It is within the normal range.
d. It is in the low average range. - ANSa. It is in the high (elevated) range.
The nurse is assessing the client for possible evidence of digitalis toxicity. The nurse
acknowledges that which is included in the signs and symptoms for digitalis toxicity?
a. Pulse (heart) rate of 100 beats/min
b. Pulse of 72 with an irregular rate
c. Pulse greater than 60 beats/min and irregular rate
d. Pulse below 60 beats/min and irregular rate - ANSd. Pulse below 60 beats/min and irregular
rate
The client is also taking a diuretic that decreases her potassium level. The nurse expects that a
low potassium level (hypokalemia) could have what effect on the digoxin?
a. Increase the serum digoxin sensitivity level
b. Decrease the serum digoxin sensitivity level
c. Not have any effect on the serum digoxin sensitivity level
d. Cause a low average serum digoxin sensitivity level - ANSa. Increase the serum digoxin
sensitivity level
When a client first takes a nitrate, the nurse expects which symptom that often occurs?
a. Nausea and vomiting
b. Headaches
c. Stomach cramps
d. Irregular pulse rate - ANSb. Headaches
,The nurse acknowledges that beta blockers are as effective as antianginals because they do
what?
a. Increase oxygen to the systemic circulation.
b. Maintain heart rate and blood pressure.
c. Decrease heart rate and decrease myocardial contractility.
d. Decrease heart rate and increase myocardial contractility. - ANSc. Decrease heart rate and
decrease myocardial contractility.
The health care provider is planning to discontinue a client's beta blocker. What instruction
should the nurse give the client regarding the beta blocker?
a. The beta blocker should be abruptly stopped when another cardiac drug is prescribed.
b. The beta blocker should NOT be abruptly stopped; the dose should be tapered down.
c. The beta blocker dose should be maintained while taking another antianginal drug.
d. Half the beta blocker dose should be taken for the next several weeks. - ANSb. The beta
blocker should NOT be abruptly stopped; the dose should be tapered down.
The beta blocker acebutolol (Sectral) is prescribed for dysrhythmias. The nurse knows that what
is the primary purpose of the drug?
a. To increase the beta1 and beta2 receptors in the cardiac tissues
b. To increase the flow of oxygen to the cardiac tissues
c. To block the beta1-adrenergic receptors in the cardiac tissues
d. To block the beta2-adrenergic receptors in the cardiac tissues - ANSc. To block the
beta1-adrenergic receptors in the cardiac tissues
A client is to be discharged home with a transdermal nitroglycerin patch. Which instruction will
the nurse include in the client's teaching plan?
a. "Apply the patch to a nonhairy area of the upper torso or arm."
b. "Apply the patch to the same site each day."
c. "If you have a headache, remove the patch for 4 hours and then reapply."
d. "If you have chest pain, apply a second patch next to the first patch." - ANSa. "Apply the
patch to a nonhairy area of the upper torso or arm."
A nurse is monitoring a client with angina for therapeutic effects of nitroglycerin. Which
assessment finding indicates that the nitroglycerin has been effective?
a. Blood pressure 120/80 mm Hg
b. Heart rate 70 beats per minute
c. ECG without evidence of ST changes
d. Client stating that pain is 0 out of 10 - ANSd. Client stating that pain is 0 out of 10
, The nurse is monitoring a client during IV nitroglycerin infusion. Which assessment finding will
cause the nurse to take action?
a. Blood pressure 110/90 mm Hg
b. Flushing
c. Headache
d. Chest pain - ANSd. Chest pain
Which statement made by the client demonstrates a need for further instruction regarding the
use of nitroglycerin?
a. "If I get a headache, I should keep taking nitroglycerin and use Tylenol for pain relief."
b. "I should keep my nitroglycerin in a cool, dry place."
c. "I should change positions slowly to avoid getting dizzy."
d. "I can take up to five tablets at 3-minute intervals for chest pain if necessary." - ANSd. "I can
take up to five tablets at 3-minute intervals for chest pain if necessary."
Which client assessment would assist the nurse in evaluating therapeutic effects of a calcium
channel blocker?
a. Client states that she has no chest pain.
b. Client states that the swelling in her feet is reduced.
c. Client states the she does not feel dizzy.
d. Client states that she feels stronger. - ANSa. Client states that she has no chest pain.
What statement is the most important for the nurse to include in the teaching plan for a client
who has started on a transdermal nitroglycerin patch?
a. "This medication works faster than sublingual nitroglycerin works."
b. "This medication is the strongest of any nitroglycerin preparation available."
c. "This medication should be used only when you are experiencing chest pain."
d. "This medication will work for 24 hours and you will need to change the patch daily." - ANSd.
"This medication will work for 24 hours and you will need to change the patch daily."
What will the nurse instruct the client to do to prevent the development of tolerance to
nitroglycerin?
a. Apply the nitroglycerin patch every other day.
b. Switch to sublingual nitroglycerin when the client's systolic blood pressure elevates to more
than 140 mm Hg.
c. Apply the nitroglycerin patch for 14 hours and remove it for 10 hours at night.
d. Use the nitroglycerin patch for acute episodes of angina only. - ANSc. Apply the nitroglycerin
patch for 14 hours and remove it for 10 hours at night.
A newly admitted client takes digoxin 0.25 mg/day. The nurse knows that which is the serum
therapeutic range for digoxin?
a. 0.1 to 1.5 ng/mL
b. 0.5 to 2.0 ng/mL
c. 1.0 to 2.5 ng/mL
d. 2.0 to 4.0 ng/mL - ANSb. 0.5 to 2.0 ng/mL
The client's serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum
digoxin level?
a. It is in the high (elevated) range.
b. It is in the low (decreased) range.
c. It is within the normal range.
d. It is in the low average range. - ANSa. It is in the high (elevated) range.
The nurse is assessing the client for possible evidence of digitalis toxicity. The nurse
acknowledges that which is included in the signs and symptoms for digitalis toxicity?
a. Pulse (heart) rate of 100 beats/min
b. Pulse of 72 with an irregular rate
c. Pulse greater than 60 beats/min and irregular rate
d. Pulse below 60 beats/min and irregular rate - ANSd. Pulse below 60 beats/min and irregular
rate
The client is also taking a diuretic that decreases her potassium level. The nurse expects that a
low potassium level (hypokalemia) could have what effect on the digoxin?
a. Increase the serum digoxin sensitivity level
b. Decrease the serum digoxin sensitivity level
c. Not have any effect on the serum digoxin sensitivity level
d. Cause a low average serum digoxin sensitivity level - ANSa. Increase the serum digoxin
sensitivity level
When a client first takes a nitrate, the nurse expects which symptom that often occurs?
a. Nausea and vomiting
b. Headaches
c. Stomach cramps
d. Irregular pulse rate - ANSb. Headaches
,The nurse acknowledges that beta blockers are as effective as antianginals because they do
what?
a. Increase oxygen to the systemic circulation.
b. Maintain heart rate and blood pressure.
c. Decrease heart rate and decrease myocardial contractility.
d. Decrease heart rate and increase myocardial contractility. - ANSc. Decrease heart rate and
decrease myocardial contractility.
The health care provider is planning to discontinue a client's beta blocker. What instruction
should the nurse give the client regarding the beta blocker?
a. The beta blocker should be abruptly stopped when another cardiac drug is prescribed.
b. The beta blocker should NOT be abruptly stopped; the dose should be tapered down.
c. The beta blocker dose should be maintained while taking another antianginal drug.
d. Half the beta blocker dose should be taken for the next several weeks. - ANSb. The beta
blocker should NOT be abruptly stopped; the dose should be tapered down.
The beta blocker acebutolol (Sectral) is prescribed for dysrhythmias. The nurse knows that what
is the primary purpose of the drug?
a. To increase the beta1 and beta2 receptors in the cardiac tissues
b. To increase the flow of oxygen to the cardiac tissues
c. To block the beta1-adrenergic receptors in the cardiac tissues
d. To block the beta2-adrenergic receptors in the cardiac tissues - ANSc. To block the
beta1-adrenergic receptors in the cardiac tissues
A client is to be discharged home with a transdermal nitroglycerin patch. Which instruction will
the nurse include in the client's teaching plan?
a. "Apply the patch to a nonhairy area of the upper torso or arm."
b. "Apply the patch to the same site each day."
c. "If you have a headache, remove the patch for 4 hours and then reapply."
d. "If you have chest pain, apply a second patch next to the first patch." - ANSa. "Apply the
patch to a nonhairy area of the upper torso or arm."
A nurse is monitoring a client with angina for therapeutic effects of nitroglycerin. Which
assessment finding indicates that the nitroglycerin has been effective?
a. Blood pressure 120/80 mm Hg
b. Heart rate 70 beats per minute
c. ECG without evidence of ST changes
d. Client stating that pain is 0 out of 10 - ANSd. Client stating that pain is 0 out of 10
, The nurse is monitoring a client during IV nitroglycerin infusion. Which assessment finding will
cause the nurse to take action?
a. Blood pressure 110/90 mm Hg
b. Flushing
c. Headache
d. Chest pain - ANSd. Chest pain
Which statement made by the client demonstrates a need for further instruction regarding the
use of nitroglycerin?
a. "If I get a headache, I should keep taking nitroglycerin and use Tylenol for pain relief."
b. "I should keep my nitroglycerin in a cool, dry place."
c. "I should change positions slowly to avoid getting dizzy."
d. "I can take up to five tablets at 3-minute intervals for chest pain if necessary." - ANSd. "I can
take up to five tablets at 3-minute intervals for chest pain if necessary."
Which client assessment would assist the nurse in evaluating therapeutic effects of a calcium
channel blocker?
a. Client states that she has no chest pain.
b. Client states that the swelling in her feet is reduced.
c. Client states the she does not feel dizzy.
d. Client states that she feels stronger. - ANSa. Client states that she has no chest pain.
What statement is the most important for the nurse to include in the teaching plan for a client
who has started on a transdermal nitroglycerin patch?
a. "This medication works faster than sublingual nitroglycerin works."
b. "This medication is the strongest of any nitroglycerin preparation available."
c. "This medication should be used only when you are experiencing chest pain."
d. "This medication will work for 24 hours and you will need to change the patch daily." - ANSd.
"This medication will work for 24 hours and you will need to change the patch daily."
What will the nurse instruct the client to do to prevent the development of tolerance to
nitroglycerin?
a. Apply the nitroglycerin patch every other day.
b. Switch to sublingual nitroglycerin when the client's systolic blood pressure elevates to more
than 140 mm Hg.
c. Apply the nitroglycerin patch for 14 hours and remove it for 10 hours at night.
d. Use the nitroglycerin patch for acute episodes of angina only. - ANSc. Apply the nitroglycerin
patch for 14 hours and remove it for 10 hours at night.
