Pharmacology Mastery Test Bank: Medications & Dosages
1)
A 28-year-old pregnant woman (8 weeks gestation) with newly
diagnosed hypertension is prescribed lisinopril 10 mg PO daily.
Which action should the nurse take first?
A. Administer the lisinopril and advise follow-up prenatal care.
B. Hold the lisinopril and notify the prescriber immediately.
C. Teach the patient to take lisinopril at bedtime to reduce
dizziness.
D. Recommend fetal ultrasound after 20 weeks to check growth.
Correct answer: B
Rationale:
Why correct: ACE inhibitors (e.g., lisinopril) are contraindicated
in pregnancy due to fetal risk (renal dysplasia, oligohydramnios,
growth restriction). Holding the medication and notifying the
prescriber is the immediate, safe nursing action to prevent fetal
harm.
Why distractors are wrong: A (administer) would risk fetal
teratogenicity. C (timing) addresses orthostatic effects but
ignores the contraindication in pregnancy. D (ultrasound later)
is not an immediate corrective action and does not prevent
early teratogenic effects.
Safety/teaching tip: Always ask women of childbearing potential
,about pregnancy status before giving ACE inhibitors and
document the prescriber notification and alternative
antihypertensive plan (e.g., methyldopa, labetalol per
prescriber).
Difficulty: Moderate
Bloom’s level: Analysis
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
2)
A 70-kg adult requires vancomycin 15 mg/kg IV q12h. What
dose should the nurse prepare to administer?
A. 1,000 mg
B. 1,050 mg
C. 1,250 mg
D. 500 mg
Correct answer: B
Rationale:
Why correct: Calculate dose using weight × dose per kg. Step-
by-step math (digit-by-digit):
70 kg × 15 mg/kg = (70 × 10) + (70 × 5) = 700 + 350 = 1,050 mg.
So prepare 1,050 mg.
Why distractors are wrong: A (1,000 mg) is slightly less than the
calculated 1,050 mg; C (1,250 mg) and D (500 mg) are not the
correct weight-based dose. Administering a different amount
,without prescriber order is incorrect.
Safety/teaching tip: Verify vancomycin dose and infusion rate
with pharmacy; monitor trough levels per facility policy and
infuse over ≥60 minutes for doses ≥1 g to reduce infusion-
related reactions.
Difficulty: Application (Easy–Moderate)
Bloom’s level: Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
3)
A patient with suspected opioid overdose is found unresponsive
with shallow respirations and pinpoint pupils. Which order
should the nurse anticipate first?
A. Fentanyl 50 mcg IV bolus.
B. Naloxone 0.4 mg IV bolus.
C. Midazolam 2 mg IV push.
D. Atropine 0.4 mg IV push.
Correct answer: B
Rationale:
Why correct: Naloxone is the opioid antagonist of choice for
opioid overdose; 0.4 mg IV is a common initial bolus to reverse
respiratory depression. It should be titrated to maintain
adequate respiration while avoiding abrupt reversal if patient is
opioid-dependent.
, Why distractors are wrong: A (fentanyl) is an opioid and would
worsen overdose. C (midazolam) is a sedative and
contraindicated. D (atropine) treats symptomatic
bradycardia/organophosphate poisoning, not opioid toxicity.
Safety/teaching tip: After naloxone reversal, monitor closely—
shorter half-life of naloxone may require repeated doses or
infusion; observe for withdrawal and re-sedation.
Difficulty: Easy
Bloom’s level: Recall/Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
4)
A 22-year-old taking sertraline for depression is prescribed a
new medication that is an MAOI. Which sign should alert the
nurse to serotonin syndrome?
A. Bradycardia and dry skin.
B. Hypertension, hyperreflexia, and agitation.
C. Profuse diaphoresis and miosis only.
D. Hyporeflexia and hypothermia.
Correct answer: B
Rationale:
Why correct: Serotonin syndrome commonly presents with
autonomic instability (hypertension, tachycardia),
neuromuscular hyperactivity (hyperreflexia, clonus), and mental
1)
A 28-year-old pregnant woman (8 weeks gestation) with newly
diagnosed hypertension is prescribed lisinopril 10 mg PO daily.
Which action should the nurse take first?
A. Administer the lisinopril and advise follow-up prenatal care.
B. Hold the lisinopril and notify the prescriber immediately.
C. Teach the patient to take lisinopril at bedtime to reduce
dizziness.
D. Recommend fetal ultrasound after 20 weeks to check growth.
Correct answer: B
Rationale:
Why correct: ACE inhibitors (e.g., lisinopril) are contraindicated
in pregnancy due to fetal risk (renal dysplasia, oligohydramnios,
growth restriction). Holding the medication and notifying the
prescriber is the immediate, safe nursing action to prevent fetal
harm.
Why distractors are wrong: A (administer) would risk fetal
teratogenicity. C (timing) addresses orthostatic effects but
ignores the contraindication in pregnancy. D (ultrasound later)
is not an immediate corrective action and does not prevent
early teratogenic effects.
Safety/teaching tip: Always ask women of childbearing potential
,about pregnancy status before giving ACE inhibitors and
document the prescriber notification and alternative
antihypertensive plan (e.g., methyldopa, labetalol per
prescriber).
Difficulty: Moderate
Bloom’s level: Analysis
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
2)
A 70-kg adult requires vancomycin 15 mg/kg IV q12h. What
dose should the nurse prepare to administer?
A. 1,000 mg
B. 1,050 mg
C. 1,250 mg
D. 500 mg
Correct answer: B
Rationale:
Why correct: Calculate dose using weight × dose per kg. Step-
by-step math (digit-by-digit):
70 kg × 15 mg/kg = (70 × 10) + (70 × 5) = 700 + 350 = 1,050 mg.
So prepare 1,050 mg.
Why distractors are wrong: A (1,000 mg) is slightly less than the
calculated 1,050 mg; C (1,250 mg) and D (500 mg) are not the
correct weight-based dose. Administering a different amount
,without prescriber order is incorrect.
Safety/teaching tip: Verify vancomycin dose and infusion rate
with pharmacy; monitor trough levels per facility policy and
infuse over ≥60 minutes for doses ≥1 g to reduce infusion-
related reactions.
Difficulty: Application (Easy–Moderate)
Bloom’s level: Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
3)
A patient with suspected opioid overdose is found unresponsive
with shallow respirations and pinpoint pupils. Which order
should the nurse anticipate first?
A. Fentanyl 50 mcg IV bolus.
B. Naloxone 0.4 mg IV bolus.
C. Midazolam 2 mg IV push.
D. Atropine 0.4 mg IV push.
Correct answer: B
Rationale:
Why correct: Naloxone is the opioid antagonist of choice for
opioid overdose; 0.4 mg IV is a common initial bolus to reverse
respiratory depression. It should be titrated to maintain
adequate respiration while avoiding abrupt reversal if patient is
opioid-dependent.
, Why distractors are wrong: A (fentanyl) is an opioid and would
worsen overdose. C (midazolam) is a sedative and
contraindicated. D (atropine) treats symptomatic
bradycardia/organophosphate poisoning, not opioid toxicity.
Safety/teaching tip: After naloxone reversal, monitor closely—
shorter half-life of naloxone may require repeated doses or
infusion; observe for withdrawal and re-sedation.
Difficulty: Easy
Bloom’s level: Recall/Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
4)
A 22-year-old taking sertraline for depression is prescribed a
new medication that is an MAOI. Which sign should alert the
nurse to serotonin syndrome?
A. Bradycardia and dry skin.
B. Hypertension, hyperreflexia, and agitation.
C. Profuse diaphoresis and miosis only.
D. Hyporeflexia and hypothermia.
Correct answer: B
Rationale:
Why correct: Serotonin syndrome commonly presents with
autonomic instability (hypertension, tachycardia),
neuromuscular hyperactivity (hyperreflexia, clonus), and mental
