Page 1 of 391
NCLEX Pharmacology Question Bank 2025/2026 – Complete
1110 Practice Questions, Answers, and Rationales for Nursing
Students
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is
13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - Answer:3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium
gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a
result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin,
a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse
instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - Answer:4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer
the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the
iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple
juice.
Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client,
knowing that which of the following would indicate the presence of systemic toxicity from this
medication?
,Page 2 of 391
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - Answer:1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms
include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not
associated with salicylism.
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin.
The nurse reviews the client's medication record and would contact the (HCP) if the client is taking
which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - Answer:1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued
before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the
potential for increased systemic absorption of the medication if the medication were being applied to
which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - Answer:2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions
where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower
from regions in which permeability is poor (back, palms, soles).
,Page 3 of 391
The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-
thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing
information to the client about the medication. Which statement made by the client indicates a lack of
understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound." - Answer:3. "The medication will
permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-
negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in
healing. It does not stain the skin.
The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which
laboratory value while the client is taking this medication?
1. Glucose level
2. Calcium level
3. Potassium level
4. Prothrombin time - Answer:2. Calcium level
Rationale:
Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a
complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels,
along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The
nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia
include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of
muscles, and deep bone and flank pain.
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the
client. The nurse determines that this medication has been prescribed to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
, Page 4 of 391
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - Answer:3. Treat hypocalcemic tetany.
Rationale:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or
injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness
and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care
provider is notified immediately. Calcium gluconate should be kept at the bedside.
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin
injections. Which information should the nurse teach when carrying out plans for discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - Answer:2. Rotate the insulin
injection sites systematically.
Rationale:
Insulin dosages should not be adjusted or increased before unusual exercise. If acetone is found in the
urine, it may possibly indicate the need for additional insulin. To minimize the discomfort associated
with insulin injections, the insulin should be administered at room temperature. Injection sites should be
systematically rotated from one area to another. The client should be instructed to give injections in one
area, about 1 inch apart, until the whole area has been used and then to change to another site. This
prevents dramatic changes in daily insulin absorption.
A nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the
same syringe. Which of the following actions, if performed by the client, indicates the need for further
teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into the vial - Answer:1. Withdraws the
NPH insulin first
Rationale:
When preparing a mixture of regular insulin with another insulin preparation, the regular insulin is
drawn into the syringe first. This sequence will avoid contaminating the vial of regular insulin with
NCLEX Pharmacology Question Bank 2025/2026 – Complete
1110 Practice Questions, Answers, and Rationales for Nursing
Students
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is
13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - Answer:3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium
gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a
result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin,
a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the
serum calcium concentration.
Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse
instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - Answer:4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer
the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the
iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple
juice.
Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client,
knowing that which of the following would indicate the presence of systemic toxicity from this
medication?
,Page 2 of 391
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - Answer:1. Tinnitus
Rationale:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms
include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not
associated with salicylism.
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin.
The nurse reviews the client's medication record and would contact the (HCP) if the client is taking
which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - Answer:1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of isotretinoin
toxicity. Because of the potential for increased toxicity, vitamin A supplements should be discontinued
before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated with the use of isotretinoin.
The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the
potential for increased systemic absorption of the medication if the medication were being applied to
which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - Answer:2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions
where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower
from regions in which permeability is poor (back, palms, soles).
,Page 3 of 391
The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-
thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing
information to the client about the medication. Which statement made by the client indicates a lack of
understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound." - Answer:3. "The medication will
permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against gram-
negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to assist in
healing. It does not stain the skin.
The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which
laboratory value while the client is taking this medication?
1. Glucose level
2. Calcium level
3. Potassium level
4. Prothrombin time - Answer:2. Calcium level
Rationale:
Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of therapy, a
complete blood count, platelet count, and serum calcium levels should be assessed. These blood levels,
along with cholesterol and triglyceride levels, should be monitored periodically during therapy. The
nurse should assess for hypercalcemia while the client is taking this medication. Signs of hypercalcemia
include increased urine volume, excessive thirst, nausea, vomiting, constipation, hypotonicity of
muscles, and deep bone and flank pain.
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the
client. The nurse determines that this medication has been prescribed to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
, Page 4 of 391
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - Answer:3. Treat hypocalcemic tetany.
Rationale:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally removed or
injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client develops numbness
and tingling around the mouth, fingertips, or toes or muscle spasms or twitching, the health care
provider is notified immediately. Calcium gluconate should be kept at the bedside.
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin
injections. Which information should the nurse teach when carrying out plans for discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - Answer:2. Rotate the insulin
injection sites systematically.
Rationale:
Insulin dosages should not be adjusted or increased before unusual exercise. If acetone is found in the
urine, it may possibly indicate the need for additional insulin. To minimize the discomfort associated
with insulin injections, the insulin should be administered at room temperature. Injection sites should be
systematically rotated from one area to another. The client should be instructed to give injections in one
area, about 1 inch apart, until the whole area has been used and then to change to another site. This
prevents dramatic changes in daily insulin absorption.
A nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the
same syringe. Which of the following actions, if performed by the client, indicates the need for further
teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into the vial - Answer:1. Withdraws the
NPH insulin first
Rationale:
When preparing a mixture of regular insulin with another insulin preparation, the regular insulin is
drawn into the syringe first. This sequence will avoid contaminating the vial of regular insulin with
