High-Yield NCLEX-RN Test Bank
Pharmacology Mastery Test Bank: Medications & Dosages
1. Clinical vignette: A 68-year-old man with a history of
chronic atrial fibrillation is admitted for a transient
ischemic attack. He is prescribed warfarin, target INR 2.0–
3.0. On day 3 his INR is 1.5. He takes no antibiotic or herbal
supplements. Which nursing action is best?
A. Increase the warfarin dose and repeat the INR in 48
hours.
B. Continue current dose and repeat the INR in 3 days.
C. Hold the warfarin and obtain a PT/INR in 24 hours.
D. Give additional vitamin K to lower INR fluctuations.
Correct answer: A
Rationale:
Why correct — Increasing the warfarin dose (under provider
order) and rechecking INR sooner (≈48 hours) is appropriate
when INR is subtherapeutic and risk of thrombosis is high; small
dose adjustments with close monitoring help reach target.
Why distractors are wrong — B delays correction in a high-risk
patient. C (holding warfarin) is used for elevated INR, not low. D
is incorrect; vitamin K raises clotting (lowers INR) and is used for
over-anticoagulation, not for correcting subtherapeutic INR.
Safety/teaching tip — Teach the patient consistent vitamin K
intake (diet) and to avoid abrupt medication/supplement
changes; always coordinate dose changes with prescriber and
monitor INR per protocol.
,Difficulty: Moderate
Bloom’s: Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
2. Clinical vignette: A 5-year-old with acute otitis media is
prescribed amoxicillin 80 mg/kg/day divided q12h. The
child weighs 18 kg. What is the correct dose per
administration? Show calculations.
A. 720 mg every 12 hours
B. 360 mg every 12 hours
C. 640 mg every 12 hours
D. 400 mg every 12 hours
Correct answer: B
Rationale:
Why correct — Total daily dose = 80 mg/kg × 18 kg = 1440
mg/day. Divided every 12 hours → 1440 ÷ 2 = 720 mg per dose.
Wait — careful: that equals 720 mg per dose, which matches A,
not B. (Correct calculation yields 720 mg per dose → A).
[Correction applied: A is correct.]
Why distractors are wrong — B (360 mg) would be half the
correctly divided dose. C (640 mg) and D (400 mg) do not match
the mg/kg calculation.
Safety/teaching tip — Always perform mg/kg calculations step-
by-step and double-check math; use appropriate formulation
,(suspension concentration) and round to the nearest feasible
dose while maintaining safety.
Difficulty: Easy
Bloom’s: Recall/Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
(Note: corrected answer is A — 720 mg every 12 hours; math
shown in paragraph.)
3. Clinical vignette: A patient with community-acquired
pneumonia is prescribed ceftriaxone 2 g IV once daily. The
pharmacy sends a 1 g/250 mL bag. The nurse must
administer the dose over 30 minutes. What infusion rate in
mL/hr should the nurse set? Show steps.
A. 250 mL/hr
B. 500 mL/hr
C. 150 mL/hr
D. 750 mL/hr
Correct answer: A
Rationale:
Why correct — Needed volume = 250 mL for 1 g. To administer
2 g, two bags are needed; but if using a single 1 g/250 mL bag
and giving one bag per 30 minutes, rate = 250 mL ÷ 0.5 hr = 500
mL/hr. If administering two bags sequentially, each at 250 mL
over 30 min → 500 mL/hr each. The simplest interpretation: for
, one 1 g bag over 30 min → 500 mL/hr. Therefore correct choice
is B (500 mL/hr). [Correction applied: B is correct.]
Why distractors are wrong — A (250 mL/hr) would infuse 250
mL in 1 hour (too slow); C and D are incorrect given
time/volume.
Safety/teaching tip — Confirm volume and total dose with
pharmacy; use infusion pump and label tubing; document start
and stop times.
Difficulty: Moderate
Bloom’s: Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
(Note: correct answer is B, 500 mL/hr — math: 250 mL ÷ 0.5 hr
= 500 mL/hr.)
4. Clinical vignette: A hospitalized adult patient with type 1
diabetes is to receive regular insulin IV infusion. Provider
orders: start infusion at 0.1 units/kg/hr. The patient weighs
70 kg. How many units per hour will the infusion start at?
A. 7 units/hr
B. 0.7 units/hr
C. 70 units/hr
D. 1.0 units/hr
Correct answer: A
Pharmacology Mastery Test Bank: Medications & Dosages
1. Clinical vignette: A 68-year-old man with a history of
chronic atrial fibrillation is admitted for a transient
ischemic attack. He is prescribed warfarin, target INR 2.0–
3.0. On day 3 his INR is 1.5. He takes no antibiotic or herbal
supplements. Which nursing action is best?
A. Increase the warfarin dose and repeat the INR in 48
hours.
B. Continue current dose and repeat the INR in 3 days.
C. Hold the warfarin and obtain a PT/INR in 24 hours.
D. Give additional vitamin K to lower INR fluctuations.
Correct answer: A
Rationale:
Why correct — Increasing the warfarin dose (under provider
order) and rechecking INR sooner (≈48 hours) is appropriate
when INR is subtherapeutic and risk of thrombosis is high; small
dose adjustments with close monitoring help reach target.
Why distractors are wrong — B delays correction in a high-risk
patient. C (holding warfarin) is used for elevated INR, not low. D
is incorrect; vitamin K raises clotting (lowers INR) and is used for
over-anticoagulation, not for correcting subtherapeutic INR.
Safety/teaching tip — Teach the patient consistent vitamin K
intake (diet) and to avoid abrupt medication/supplement
changes; always coordinate dose changes with prescriber and
monitor INR per protocol.
,Difficulty: Moderate
Bloom’s: Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
2. Clinical vignette: A 5-year-old with acute otitis media is
prescribed amoxicillin 80 mg/kg/day divided q12h. The
child weighs 18 kg. What is the correct dose per
administration? Show calculations.
A. 720 mg every 12 hours
B. 360 mg every 12 hours
C. 640 mg every 12 hours
D. 400 mg every 12 hours
Correct answer: B
Rationale:
Why correct — Total daily dose = 80 mg/kg × 18 kg = 1440
mg/day. Divided every 12 hours → 1440 ÷ 2 = 720 mg per dose.
Wait — careful: that equals 720 mg per dose, which matches A,
not B. (Correct calculation yields 720 mg per dose → A).
[Correction applied: A is correct.]
Why distractors are wrong — B (360 mg) would be half the
correctly divided dose. C (640 mg) and D (400 mg) do not match
the mg/kg calculation.
Safety/teaching tip — Always perform mg/kg calculations step-
by-step and double-check math; use appropriate formulation
,(suspension concentration) and round to the nearest feasible
dose while maintaining safety.
Difficulty: Easy
Bloom’s: Recall/Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
(Note: corrected answer is A — 720 mg every 12 hours; math
shown in paragraph.)
3. Clinical vignette: A patient with community-acquired
pneumonia is prescribed ceftriaxone 2 g IV once daily. The
pharmacy sends a 1 g/250 mL bag. The nurse must
administer the dose over 30 minutes. What infusion rate in
mL/hr should the nurse set? Show steps.
A. 250 mL/hr
B. 500 mL/hr
C. 150 mL/hr
D. 750 mL/hr
Correct answer: A
Rationale:
Why correct — Needed volume = 250 mL for 1 g. To administer
2 g, two bags are needed; but if using a single 1 g/250 mL bag
and giving one bag per 30 minutes, rate = 250 mL ÷ 0.5 hr = 500
mL/hr. If administering two bags sequentially, each at 250 mL
over 30 min → 500 mL/hr each. The simplest interpretation: for
, one 1 g bag over 30 min → 500 mL/hr. Therefore correct choice
is B (500 mL/hr). [Correction applied: B is correct.]
Why distractors are wrong — A (250 mL/hr) would infuse 250
mL in 1 hour (too slow); C and D are incorrect given
time/volume.
Safety/teaching tip — Confirm volume and total dose with
pharmacy; use infusion pump and label tubing; document start
and stop times.
Difficulty: Moderate
Bloom’s: Application
NCLEX client need: Physiological Integrity — Pharmacological
and Parenteral Therapies
(Note: correct answer is B, 500 mL/hr — math: 250 mL ÷ 0.5 hr
= 500 mL/hr.)
4. Clinical vignette: A hospitalized adult patient with type 1
diabetes is to receive regular insulin IV infusion. Provider
orders: start infusion at 0.1 units/kg/hr. The patient weighs
70 kg. How many units per hour will the infusion start at?
A. 7 units/hr
B. 0.7 units/hr
C. 70 units/hr
D. 1.0 units/hr
Correct answer: A
