High-Yield NCLEX-RN Test Bank
Pharmacology Mastery Test Bank: Medications & Dosages
1) A 68-year-old male with a history of heart failure is admitted
with acute decompensation. His home medications include
lisinopril 20 mg daily, metoprolol XL 50 mg daily, and
furosemide 40 mg daily. On assessment, he has crackles in both
lung bases, oxygen saturation of 89% on room air, and 3+ pitting
edema in his lower extremities. The provider orders furosemide
80 mg IV push now. The pharmacy supplies furosemide 10
mg/mL in a 4 mL vial. How many milliliters will the nurse
administer?
A) 0.8 mL
B) 2 mL
C) 8 mL
D) 12.5 mL
Correct Answer: C) 8 mL
Rationale: The correct dose is calculated using the formula:
Dose (mL) = Desired Dose (mg) / Concentration (mg/mL). The
desired dose is 80 mg. The concentration is 10 mg/mL.
Therefore, 80 mg / 10 mg/mL = 8 mL. This is the correct volume
to draw up for administration.
Option A (0.8 mL) is incorrect as it results from a misplaced
decimal (8 mg / 10 mg/mL). Option B (2 mL) is the volume for a
20 mg dose. Option D (12.5 mL) is incorrect and may result from
misreading the concentration or using an incorrect formula.
Clinical Safety Tip: When administering high-dose IV diuretics,
,closely monitor the patient's blood pressure, urine output, and
potassium levels. A rapid diuresis can lead to hypotension and
acute hypokalemia, which is dangerous for a patient on digoxin
(not listed here but common in HF). Ensure the patient has a
urinal or bedside commode readily available.
Difficulty: Moderate
Bloom’s Taxonomy: Application
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
2) A 55-year-old female is receiving a first dose of IV
vancomycin for a suspected MRSA wound infection. The nurse
knows that a rapid infusion of vancomycin can cause which of
the following adverse reactions, necessitating an infusion time
of at least 60 minutes?
A) Ototoxicity
B) "Red Man Syndrome"
C) Nephrotoxicity
D) C. difficile colitis
Correct Answer: B) "Red Man Syndrome"
Rationale: "Red Man Syndrome" is a histamine-mediated
reaction characterized by pruritus, flushing, and erythema of
the face, neck, and upper torso. It is directly related to a rapid
infusion rate and is not a true allergy. Slowing the infusion rate
is the primary preventative measure.
,Options A (Ototoxicity) and C (Nephrotoxicity) are potential
adverse effects of vancomycin but are not directly caused by a
rapid infusion rate; they are associated with prolonged high
trough levels. Option D (C. difficile colitis) is an adverse effect
related to the alteration of gut flora by antibiotics, not the
infusion rate.
Clinical Safety Tip: Always infuse vancomycin over at least 60
minutes. Monitor the patient's blood pressure during the
infusion, as "Red Man Syndrome" can be accompanied by
hypotension. Pre-medication with an antihistamine like
diphenhydramine may be ordered for subsequent doses if a
reaction occurs.
Difficulty: Easy
Bloom’s Taxonomy: Recall
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
3) A nurse is caring for a postoperative patient who has a
patient-controlled analgesia (PCA) pump delivering morphine.
The patient is drowsy and difficult to arouse, with a respiratory
rate of 8 breaths per minute. Which action should the nurse
take first?
A) Administer the opioid antagonist naloxone.
B) Stimulate the patient by calling their name and rubbing their
sternum.
, C) Discontinue the PCA pump.
D) Obtain an order for arterial blood gases (ABGs).
Correct Answer: B) Stimulate the patient by calling their name
and rubbing their sternum.
Rationale: The first action for suspected opioid-induced
respiratory depression is to stimulate the patient. This non-
pharmacological intervention can often increase the respiratory
rate effectively and is the least invasive initial step according to
the nursing process and airway-breathing-circulation (ABC)
priorities.
Option A (Administer naloxone) is correct but is not
the first action; it is reserved for severe depression where
stimulation is ineffective. Option C (Discontinue the PCA) is
important but will not immediately reverse the current
respiratory depression. Option D (Obtain ABGs) is a diagnostic
tool that will confirm the problem but does not address the
immediate, life-threatening need to increase ventilation.
Clinical Safety Tip: When using opioid PCA pumps, ensure
continuous monitoring of sedation level and respiratory status
using a validated tool. Educate the patient and family that only
the patient should push the medication button to avoid over-
sedation by a well-meaning family member.
Difficulty: Moderate
Bloom’s Taxonomy: Analysis
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
Pharmacology Mastery Test Bank: Medications & Dosages
1) A 68-year-old male with a history of heart failure is admitted
with acute decompensation. His home medications include
lisinopril 20 mg daily, metoprolol XL 50 mg daily, and
furosemide 40 mg daily. On assessment, he has crackles in both
lung bases, oxygen saturation of 89% on room air, and 3+ pitting
edema in his lower extremities. The provider orders furosemide
80 mg IV push now. The pharmacy supplies furosemide 10
mg/mL in a 4 mL vial. How many milliliters will the nurse
administer?
A) 0.8 mL
B) 2 mL
C) 8 mL
D) 12.5 mL
Correct Answer: C) 8 mL
Rationale: The correct dose is calculated using the formula:
Dose (mL) = Desired Dose (mg) / Concentration (mg/mL). The
desired dose is 80 mg. The concentration is 10 mg/mL.
Therefore, 80 mg / 10 mg/mL = 8 mL. This is the correct volume
to draw up for administration.
Option A (0.8 mL) is incorrect as it results from a misplaced
decimal (8 mg / 10 mg/mL). Option B (2 mL) is the volume for a
20 mg dose. Option D (12.5 mL) is incorrect and may result from
misreading the concentration or using an incorrect formula.
Clinical Safety Tip: When administering high-dose IV diuretics,
,closely monitor the patient's blood pressure, urine output, and
potassium levels. A rapid diuresis can lead to hypotension and
acute hypokalemia, which is dangerous for a patient on digoxin
(not listed here but common in HF). Ensure the patient has a
urinal or bedside commode readily available.
Difficulty: Moderate
Bloom’s Taxonomy: Application
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
2) A 55-year-old female is receiving a first dose of IV
vancomycin for a suspected MRSA wound infection. The nurse
knows that a rapid infusion of vancomycin can cause which of
the following adverse reactions, necessitating an infusion time
of at least 60 minutes?
A) Ototoxicity
B) "Red Man Syndrome"
C) Nephrotoxicity
D) C. difficile colitis
Correct Answer: B) "Red Man Syndrome"
Rationale: "Red Man Syndrome" is a histamine-mediated
reaction characterized by pruritus, flushing, and erythema of
the face, neck, and upper torso. It is directly related to a rapid
infusion rate and is not a true allergy. Slowing the infusion rate
is the primary preventative measure.
,Options A (Ototoxicity) and C (Nephrotoxicity) are potential
adverse effects of vancomycin but are not directly caused by a
rapid infusion rate; they are associated with prolonged high
trough levels. Option D (C. difficile colitis) is an adverse effect
related to the alteration of gut flora by antibiotics, not the
infusion rate.
Clinical Safety Tip: Always infuse vancomycin over at least 60
minutes. Monitor the patient's blood pressure during the
infusion, as "Red Man Syndrome" can be accompanied by
hypotension. Pre-medication with an antihistamine like
diphenhydramine may be ordered for subsequent doses if a
reaction occurs.
Difficulty: Easy
Bloom’s Taxonomy: Recall
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
3) A nurse is caring for a postoperative patient who has a
patient-controlled analgesia (PCA) pump delivering morphine.
The patient is drowsy and difficult to arouse, with a respiratory
rate of 8 breaths per minute. Which action should the nurse
take first?
A) Administer the opioid antagonist naloxone.
B) Stimulate the patient by calling their name and rubbing their
sternum.
, C) Discontinue the PCA pump.
D) Obtain an order for arterial blood gases (ABGs).
Correct Answer: B) Stimulate the patient by calling their name
and rubbing their sternum.
Rationale: The first action for suspected opioid-induced
respiratory depression is to stimulate the patient. This non-
pharmacological intervention can often increase the respiratory
rate effectively and is the least invasive initial step according to
the nursing process and airway-breathing-circulation (ABC)
priorities.
Option A (Administer naloxone) is correct but is not
the first action; it is reserved for severe depression where
stimulation is ineffective. Option C (Discontinue the PCA) is
important but will not immediately reverse the current
respiratory depression. Option D (Obtain ABGs) is a diagnostic
tool that will confirm the problem but does not address the
immediate, life-threatening need to increase ventilation.
Clinical Safety Tip: When using opioid PCA pumps, ensure
continuous monitoring of sedation level and respiratory status
using a validated tool. Educate the patient and family that only
the patient should push the medication button to avoid over-
sedation by a well-meaning family member.
Difficulty: Moderate
Bloom’s Taxonomy: Analysis
NCLEX Client Need: Physiological Integrity: Pharmacological and
Parenteral Therapies
