Pharmacology Mastery Test Bank: Medications & Dosages
1. A 68-year-old male with a history of heart failure is
admitted with new-onset atrial fibrillation. His current
medications include digoxin 0.125 mg daily and
furosemide 40 mg daily. Lab results: K⁺ 3.2 mEq/L (normal
3.5–5.0). The provider prescribes IV potassium chloride
(KCl) to correct hypokalemia. The nurse is preparing a
peripheral IV infusion of 40 mEq KCl in 500 mL normal
saline to run over 8 hours. What is the correct infusion rate
(mL/hr)?
A. 25 mL/hr
B. 62.5 mL/hr
C. 80 mL/hr
D. 125 mL/hr
Correct answer: B
Rationale:
• Why correct: Rate = total volume ÷ hours → 500 mL ÷ 8 hr
= 62.5 mL/hr. This is the correct infusion rate to deliver 40
mEq KCl over 8 hours. Peripheral IV potassium should be
diluted and infused at safe rates (commonly ≤10–20
mEq/hr per facility policy; this total dose over 8 hours fits
that safety range).
, • Why distractors wrong: A (25 mL/hr) would deliver only
200 mL over 8 hr (insufficient). C (80 mL/hr) would deliver
640 mL (faster than ordered). D (125 mL/hr) would deliver
1000 mL in 8 hr (wrong and could fluid overload the
patient).
• Safety/teaching tip: Always verify serum potassium and
renal function before replacement, use infusion pumps for
KCl, and monitor cardiac rhythm — rapid IV KCl can cause
life-threatening arrhythmias.
Difficulty: Easy
Bloom’s taxonomy: Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
2. A 52-year-old female with newly diagnosed type 1 diabetes
is learning about her insulin regimen. She is to take regular
insulin 6 units before breakfast and NPH 12 units at
bedtime. Her morning pre-meal blood glucose is 220
mg/dL. The nurse anticipates which immediate action is
appropriate?
A. Administer scheduled insulin doses as ordered.
B. Hold insulin and notify the provider immediately.
C. Give only half the regular insulin dose now and
document.
D. Check for signs of infection before administering insulin.
,Correct answer: A
Rationale:
• Why correct: Elevated pre-meal blood glucose is an
expected reason to give scheduled insulin — regular
(short-acting) insulin is given before meals to reduce
postprandial hyperglycemia. Holding insulin risks further
hyperglycemia and ketoacidosis in type 1 diabetes.
• Why distractors wrong: B overreacts — holding insulin is
not appropriate without hypoglycemia or explicit
contraindication. C is unsafe because arbitrary dose
reduction can worsen hyperglycemia. D — while infections
can affect glucose, waiting to check infection before giving
scheduled insulin is inappropriate; administer insulin and
evaluate for reasons for hyperglycemia.
• Safety/teaching tip: Teach patients to check pre-meal
glucose and follow individualized insulin sliding scales or
provider instructions; never skip insulin doses for type 1
diabetes without consulting provider.
Difficulty: Easy
Bloom’s taxonomy: Recall/Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
3. A 23-year-old female is prescribed isotretinoin for severe
cystic acne. She asks about precautions and potential side
, effects because she is sexually active. Which is the most
important teaching point?
A. “You should avoid eating grapefruit while on this
medication.”
B. “This medication can cause severe birth defects — use
two reliable forms of contraception.”
C. “You may breastfeed while taking isotretinoin.”
D. “You can stop contraception once you notice
improvement in acne.”
Correct answer: B
Rationale:
• Why correct: Isotretinoin is highly teratogenic and causes
severe fetal abnormalities. Standard safety protocols
require two reliable forms of contraception and negative
pregnancy tests before and during therapy.
• Why distractors wrong: A (grapefruit) is a relevant
interaction for some drugs but not the central safety
concern for isotretinoin. C is false — isotretinoin is
contraindicated in pregnancy and breastfeeding is
discouraged. D is unsafe — stopping contraception early
risks teratogenic exposure.
• Safety/teaching tip: Reinforce strict pregnancy prevention
programs (iPLEDGE-like protocols), monthly pregnancy
testing, and counseling on contraception adherence.
1. A 68-year-old male with a history of heart failure is
admitted with new-onset atrial fibrillation. His current
medications include digoxin 0.125 mg daily and
furosemide 40 mg daily. Lab results: K⁺ 3.2 mEq/L (normal
3.5–5.0). The provider prescribes IV potassium chloride
(KCl) to correct hypokalemia. The nurse is preparing a
peripheral IV infusion of 40 mEq KCl in 500 mL normal
saline to run over 8 hours. What is the correct infusion rate
(mL/hr)?
A. 25 mL/hr
B. 62.5 mL/hr
C. 80 mL/hr
D. 125 mL/hr
Correct answer: B
Rationale:
• Why correct: Rate = total volume ÷ hours → 500 mL ÷ 8 hr
= 62.5 mL/hr. This is the correct infusion rate to deliver 40
mEq KCl over 8 hours. Peripheral IV potassium should be
diluted and infused at safe rates (commonly ≤10–20
mEq/hr per facility policy; this total dose over 8 hours fits
that safety range).
, • Why distractors wrong: A (25 mL/hr) would deliver only
200 mL over 8 hr (insufficient). C (80 mL/hr) would deliver
640 mL (faster than ordered). D (125 mL/hr) would deliver
1000 mL in 8 hr (wrong and could fluid overload the
patient).
• Safety/teaching tip: Always verify serum potassium and
renal function before replacement, use infusion pumps for
KCl, and monitor cardiac rhythm — rapid IV KCl can cause
life-threatening arrhythmias.
Difficulty: Easy
Bloom’s taxonomy: Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
2. A 52-year-old female with newly diagnosed type 1 diabetes
is learning about her insulin regimen. She is to take regular
insulin 6 units before breakfast and NPH 12 units at
bedtime. Her morning pre-meal blood glucose is 220
mg/dL. The nurse anticipates which immediate action is
appropriate?
A. Administer scheduled insulin doses as ordered.
B. Hold insulin and notify the provider immediately.
C. Give only half the regular insulin dose now and
document.
D. Check for signs of infection before administering insulin.
,Correct answer: A
Rationale:
• Why correct: Elevated pre-meal blood glucose is an
expected reason to give scheduled insulin — regular
(short-acting) insulin is given before meals to reduce
postprandial hyperglycemia. Holding insulin risks further
hyperglycemia and ketoacidosis in type 1 diabetes.
• Why distractors wrong: B overreacts — holding insulin is
not appropriate without hypoglycemia or explicit
contraindication. C is unsafe because arbitrary dose
reduction can worsen hyperglycemia. D — while infections
can affect glucose, waiting to check infection before giving
scheduled insulin is inappropriate; administer insulin and
evaluate for reasons for hyperglycemia.
• Safety/teaching tip: Teach patients to check pre-meal
glucose and follow individualized insulin sliding scales or
provider instructions; never skip insulin doses for type 1
diabetes without consulting provider.
Difficulty: Easy
Bloom’s taxonomy: Recall/Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
3. A 23-year-old female is prescribed isotretinoin for severe
cystic acne. She asks about precautions and potential side
, effects because she is sexually active. Which is the most
important teaching point?
A. “You should avoid eating grapefruit while on this
medication.”
B. “This medication can cause severe birth defects — use
two reliable forms of contraception.”
C. “You may breastfeed while taking isotretinoin.”
D. “You can stop contraception once you notice
improvement in acne.”
Correct answer: B
Rationale:
• Why correct: Isotretinoin is highly teratogenic and causes
severe fetal abnormalities. Standard safety protocols
require two reliable forms of contraception and negative
pregnancy tests before and during therapy.
• Why distractors wrong: A (grapefruit) is a relevant
interaction for some drugs but not the central safety
concern for isotretinoin. C is false — isotretinoin is
contraindicated in pregnancy and breastfeeding is
discouraged. D is unsafe — stopping contraception early
risks teratogenic exposure.
• Safety/teaching tip: Reinforce strict pregnancy prevention
programs (iPLEDGE-like protocols), monthly pregnancy
testing, and counseling on contraception adherence.
