Pharmacology NCLEX Exam 2026
Questions and Answers
27.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A
nurse reviews the client's medical record and would question the prescription if
which of the following is noted in the client's history?
1. Neuralgia
2. Insomnia
3. Use of nitroglycerin
4. Use of multivitamins - Correct answer-3. Use of nitroglycerin
Rationale:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus
cavernosum of the penis, thus sustaining an erection. Because of the effect of the
medication, it is contraindicated with concurrent use of organic nitrates and
nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia
and insomnia are side effects of the medication.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,54.) A nurse reinforces discharge instructions to a postoperative client who is
taking warfarin sodium (Coumadin). Which statement, if made by the client,
reflects the need for further teaching?
1. "I will take my pills every day at the same time."
2. "I will be certain to avoid alcohol consumption."
3. "I have already called my family to pick up a Medic-Alert bracelet."
4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is
coated." - Correct answer-4. "I will take Ecotrin (enteric-coated aspirin) for my
headaches because it is coated."
Rationale:
Ecotrin is an aspirin-containing product and should be avoided. Alcohol
consumption should be avoided by a client taking warfarin sodium. Taking
prescribed medication at the same time each day increases client compliance. The
Medic-Alert bracelet provides health care personnel emergency information.
55.) A client who is receiving digoxin (Lanoxin) daily has a serum potassium level
of 3.0 mEq/L and is complaining of anorexia. A health care provider prescribes a
digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that
which of the following is the therapeutic serum level (range) for digoxin?
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,1. 3 to 5 ng/mL
2. 0.5 to 2 ng/mL
3. 1.2 to 2.8 ng/mL
4. 3.5 to 5.5 ng/mL - Correct answer-2.) 0.5 to 2 ng/mL
Rationale:
Therapeutic levels for digoxin range from 0.5 to 2 ng/mL. Therefore, options 1, 3,
and 4 are incorrect.
56.) Heparin sodium is prescribed for the client. The nurse expects that the health
care provider will prescribe which of the following to monitor for a therapeutic
effect of the medication?
1. Hematocrit level
2. Hemoglobin level
3. Prothrombin time (PT)
4. Activated partial thromboplastin time (aPTT) - Correct answer-4. Activated
partial thromboplastin time (aPTT)
Rationale:
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, The PT will assess for the therapeutic effect of warfarin sodium (Coumadin) and
the aPTT will assess the therapeutic effect of heparin sodium. Heparin sodium
doses are determined based on these laboratory results. The hemoglobin and
hematocrit values assess red blood cell concentrations.
57.) A nurse is monitoring a client who is taking propranolol (Inderal LA). Which
data collection finding would indicate a potential serious complication associated
with propranolol?
1. The development of complaints of insomnia
2. The development of audible expiratory wheezes
3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of
138/72 mm Hg after two doses of the medication
4. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of
72 beats/min after two doses of the medication - Correct answer-2. The
development of audible expiratory wheezes
Rationale:
Audible expiratory wheezes may indicate a serious adverse reaction,
bronchospasm. β-Blockers may induce this reaction, particularly in clients with
chronic obstructive pulmonary disease or asthma. Normal decreases in blood
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
Questions and Answers
27.) Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A
nurse reviews the client's medical record and would question the prescription if
which of the following is noted in the client's history?
1. Neuralgia
2. Insomnia
3. Use of nitroglycerin
4. Use of multivitamins - Correct answer-3. Use of nitroglycerin
Rationale:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in the corpus
cavernosum of the penis, thus sustaining an erection. Because of the effect of the
medication, it is contraindicated with concurrent use of organic nitrates and
nitroglycerin. Sildenafil is not contraindicated with the use of vitamins. Neuralgia
and insomnia are side effects of the medication.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,54.) A nurse reinforces discharge instructions to a postoperative client who is
taking warfarin sodium (Coumadin). Which statement, if made by the client,
reflects the need for further teaching?
1. "I will take my pills every day at the same time."
2. "I will be certain to avoid alcohol consumption."
3. "I have already called my family to pick up a Medic-Alert bracelet."
4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is
coated." - Correct answer-4. "I will take Ecotrin (enteric-coated aspirin) for my
headaches because it is coated."
Rationale:
Ecotrin is an aspirin-containing product and should be avoided. Alcohol
consumption should be avoided by a client taking warfarin sodium. Taking
prescribed medication at the same time each day increases client compliance. The
Medic-Alert bracelet provides health care personnel emergency information.
55.) A client who is receiving digoxin (Lanoxin) daily has a serum potassium level
of 3.0 mEq/L and is complaining of anorexia. A health care provider prescribes a
digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that
which of the following is the therapeutic serum level (range) for digoxin?
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,1. 3 to 5 ng/mL
2. 0.5 to 2 ng/mL
3. 1.2 to 2.8 ng/mL
4. 3.5 to 5.5 ng/mL - Correct answer-2.) 0.5 to 2 ng/mL
Rationale:
Therapeutic levels for digoxin range from 0.5 to 2 ng/mL. Therefore, options 1, 3,
and 4 are incorrect.
56.) Heparin sodium is prescribed for the client. The nurse expects that the health
care provider will prescribe which of the following to monitor for a therapeutic
effect of the medication?
1. Hematocrit level
2. Hemoglobin level
3. Prothrombin time (PT)
4. Activated partial thromboplastin time (aPTT) - Correct answer-4. Activated
partial thromboplastin time (aPTT)
Rationale:
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, The PT will assess for the therapeutic effect of warfarin sodium (Coumadin) and
the aPTT will assess the therapeutic effect of heparin sodium. Heparin sodium
doses are determined based on these laboratory results. The hemoglobin and
hematocrit values assess red blood cell concentrations.
57.) A nurse is monitoring a client who is taking propranolol (Inderal LA). Which
data collection finding would indicate a potential serious complication associated
with propranolol?
1. The development of complaints of insomnia
2. The development of audible expiratory wheezes
3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of
138/72 mm Hg after two doses of the medication
4. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of
72 beats/min after two doses of the medication - Correct answer-2. The
development of audible expiratory wheezes
Rationale:
Audible expiratory wheezes may indicate a serious adverse reaction,
bronchospasm. β-Blockers may induce this reaction, particularly in clients with
chronic obstructive pulmonary disease or asthma. Normal decreases in blood
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4