Pharmacology Midterm study guide with nclex-styled questions ans 2025
A patient with hypothyroidism is prescribed levothyroxine. Which
Correct Answer: B
statement by the patient indicates a need for further teaching?
Rationale:
A. "I will take this medication every morning on an empty stom-
Levothyroxine is a lifelong therapy for hypothyroidism. Stopping
ach."
the medication abruptly can cause symptoms to return, leading
B. "If I feel better, I can stop taking this medication."
to myxedema coma in severe cases. The other statements reflect
C. "I should have my thyroid levels checked regularly."
proper understanding of levothyroxine therapy.
D. "This medication may take a few weeks to show improvement."
The nurse knows that which finding suggests a patient is receiving Correct Answer: C
too much levothyroxine? Rationale:
A. Bradycardia and cold intolerance Excessive levothyroxine can lead to hyperthyroid symptoms such
B. Weight gain and fatigue as insomnia, tachycardia, weight loss, and heat intolerance. Hy-
C. Insomnia and tachycardia pothyroid symptoms (cold intolerance, bradycardia, fatigue, con-
D. Dry skin and constipation stipation) suggest underdosing.
A patient taking levothyroxine develops symptoms of hyperthy- Correct Answer: A
roidism. What is the priority nursing intervention? Rationale:
A. Assess the patient's heart rate and blood pressure Hyperthyroidism increases heart rate and blood pressure, leading
B. Administer an additional dose of levothyroxine to potential complications like atrial fibrillation. Assessment is
C. Encourage the patient to eat iodine-rich foods the priority before contacting the provider to adjust the dosage.
D. Discontinue the medication immediately Stopping the medication suddenly is not safe.
A patient taking potassium iodide should be monitored for which Correct Answer: C
potential adverse effect? Rationale:
A. Hypokalemia Iodine toxicity can cause symptoms like metallic taste, stomach
B. Hypernatremia pain, mouth sores, and swelling of the throat. Potassium iodide
C. Iodine toxicity does not cause hypoglycemia or significant changes in sodium
D. Hypoglycemia levels.
The nurse is educating a patient about potassium iodide therapy.
Correct Answer: B
Which statement by the patient indicates correct understanding?
Rationale:
A. "I should take this medication on an empty stomach."
Metallic taste and mouth sores are signs of iodine toxicity and
B. "I will report any metallic taste or mouth sores to my provider."
should be reported immediately. Potassium iodide should be taken
C. "This medication is safe to take with potassium supplements."
with food or milk to reduce GI irritation. Avoiding all iodine-rich
D. "I should avoid all iodine-containing foods while on this med-
foods is not necessary but should be discussed with the provider.
ication."
A patient is prescribed potassium iodide for hyperthyroidism. The Correct Answer: B
nurse should advise the patient to avoid which food?
Rationale:
A. Bananas
Shellfish is rich in iodine, which can interact with potassium iodide
B. Shellfish
and exacerbate thyroid dysfunction. Bananas, milk, and rice do
C. Milk
not significantly affect iodine levels.
D. Rice
The nurse is educating a patient taking prednisone. Which state-
Correct Answer: C
ment indicates the patient understands the medication instruc-
Rationale:
tions?
Prednisone suppresses the immune system, making the patient
A. "I can stop taking this medication as soon as I feel better."
more susceptible to infections. Stopping it suddenly can cause
B. "I should take this medication on an empty stomach."
adrenal insufficiency. It should be taken with food to prevent GI
C. "I need to avoid people with infections while taking this drug."
irritation.
D. "I should increase my sodium intake while taking prednisone."
A patient on long-term prednisone therapy is at risk for which
Correct Answer: B
complication?
Rationale:
A. Hypoglycemia
Long-term corticosteroid use can lead to osteoporosis due to
B. Osteoporosis
calcium depletion, hyperglycemia, weight gain, and hypertension
C. Weight loss
(not hypotension).
D. Hypotension
The nurse is preparing to administer prednisone. What is the
Correct Answer: A
priority assessment?
Rationale:
A. Monitor blood glucose levels
Prednisone can increase blood glucose, especially in diabetic
B. Assess lung sounds
patients. Other assessments are important but monitoring for hy-
C. Check the patient's sodium level
perglycemia is the priority.
D. Assess bowel sounds
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,Pharmacology Midterm study guide with nclex-styled questions ans 2025
A patient receiving nitroprusside for hypertensive crisis is at risk
Correct Answer: B
for which serious adverse effect?
Rationale:
A. Pulmonary edema
Nitroprusside can cause cyanide toxicity, leading to confusion,
B. Cyanide toxicity
metabolic acidosis, and muscle weakness. Close monitoring is
C. Hyperkalemia
required, especially in prolonged infusions.
D. Bradycardia
Which nursing intervention is priority when administering nitro-
Correct Answer: A
prusside IV?
Rationale:
A. Monitor blood pressure continuously
Nitroprusside is a potent vasodilator, requiring continuous BP
B. Administer the drug via IM injection
monitoring to prevent hypotension. It is given IV only, and sodium
C. Encourage the patient to increase sodium intake
intake is not directly related to its action.
D. Assess deep tendon reflexes every 2 hours
A patient on nitroprusside develops confusion, metabolic acidosis,
and respiratory distress. What is the nurse's best action? Correct Answer: B
A. Slow the infusion rate Rationale:
B. Administer sodium thiosulfate Sodium thiosulfate is the antidote for cyanide toxicity, a potential
C. Increase the IV fluids adverse effect of nitroprusside.
D. Discontinue the drug permanently
The nurse is educating a patient about NPH insulin. Which state-
Correct Answer: B
ment by the patient indicates correct understanding?
Rationale:
A. "I will take this insulin right before meals."
NPH insulin is intermediate-acting, with an onset of 2-4 hours
B. "NPH insulin peaks 6-10 hours after injection."
and a peak of 6-10 hours, making it important to monitor for
C. "This insulin works immediately after injection."
hypoglycemia.
D. "NPH insulin should be taken at bedtime only."
The nurse should instruct the patient to mix NPH insulin with
Correct Answer: B
regular insulin by:
Rationale:
A. Drawing up NPH insulin first
When mixing insulins, draw up regular insulin (clear) first, then
B. Drawing up regular insulin first
NPH (cloudy) to prevent contamination. Insulin should be rolled,
C. Shaking the insulin vial before drawing it up
not shaken to avoid bubbles.
D. Mixing both insulins in the vial before drawing
What is the most important nursing intervention after administer-
ing NPH insulin? Correct Answer: B
A. Monitor the patient for hyperglycemia Rationale:
B. Assess for signs of hypoglycemia NPH insulin peaks 6-10 hours after administration, increasing the
C. Check urine ketones risk for hypoglycemia, especially at night.
D. Encourage the patient to eat a bedtime snack
Which assessment finding is most concerning in a patient taking Correct Answer: C
a beta blocker?
Rationale:
A. Heart rate of 55 bpm
Beta blockers can cause bronchoconstriction, especially in pa-
B. Blood pressure of 100/60 mmHg
tients with asthma or COPD. Bradycardia (HR <60 bpm) is also
C. Wheezing and shortness of breath
concerning but not immediately life-threatening.
D. Fatigue and dizziness
A patient taking atenolol asks if they can stop taking the medica-
tion. What is the best response? Correct Answer: D
A. "You can stop it if your blood pressure is normal." Rationale:
B. "Taper the dose slowly over two weeks." Stopping beta blockers abruptly can cause rebound hypertension,
C. "You should stop it immediately if you feel dizzy." angina, or MI. The dose should be tapered under provider super-
D. "Avoid stopping the drug abruptly to prevent rebound hyperten- vision.
sion."
Which of the following is a priority nursing intervention before
administering a beta blocker? Correct Answer: C
A. Check the patient's blood sugar Rationale:
B. Monitor the patient's urine output Beta blockers lower heart rate and blood pressure, so these
C. Assess the patient's heart rate and blood pressure should be checked before administration.
D. Evaluate bowel sounds
A patient with diabetes insipidus is receiving desmopressin. Which
finding suggests the medication is effective?
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A patient with hypothyroidism is prescribed levothyroxine. Which
Correct Answer: B
statement by the patient indicates a need for further teaching?
Rationale:
A. "I will take this medication every morning on an empty stom-
Levothyroxine is a lifelong therapy for hypothyroidism. Stopping
ach."
the medication abruptly can cause symptoms to return, leading
B. "If I feel better, I can stop taking this medication."
to myxedema coma in severe cases. The other statements reflect
C. "I should have my thyroid levels checked regularly."
proper understanding of levothyroxine therapy.
D. "This medication may take a few weeks to show improvement."
The nurse knows that which finding suggests a patient is receiving Correct Answer: C
too much levothyroxine? Rationale:
A. Bradycardia and cold intolerance Excessive levothyroxine can lead to hyperthyroid symptoms such
B. Weight gain and fatigue as insomnia, tachycardia, weight loss, and heat intolerance. Hy-
C. Insomnia and tachycardia pothyroid symptoms (cold intolerance, bradycardia, fatigue, con-
D. Dry skin and constipation stipation) suggest underdosing.
A patient taking levothyroxine develops symptoms of hyperthy- Correct Answer: A
roidism. What is the priority nursing intervention? Rationale:
A. Assess the patient's heart rate and blood pressure Hyperthyroidism increases heart rate and blood pressure, leading
B. Administer an additional dose of levothyroxine to potential complications like atrial fibrillation. Assessment is
C. Encourage the patient to eat iodine-rich foods the priority before contacting the provider to adjust the dosage.
D. Discontinue the medication immediately Stopping the medication suddenly is not safe.
A patient taking potassium iodide should be monitored for which Correct Answer: C
potential adverse effect? Rationale:
A. Hypokalemia Iodine toxicity can cause symptoms like metallic taste, stomach
B. Hypernatremia pain, mouth sores, and swelling of the throat. Potassium iodide
C. Iodine toxicity does not cause hypoglycemia or significant changes in sodium
D. Hypoglycemia levels.
The nurse is educating a patient about potassium iodide therapy.
Correct Answer: B
Which statement by the patient indicates correct understanding?
Rationale:
A. "I should take this medication on an empty stomach."
Metallic taste and mouth sores are signs of iodine toxicity and
B. "I will report any metallic taste or mouth sores to my provider."
should be reported immediately. Potassium iodide should be taken
C. "This medication is safe to take with potassium supplements."
with food or milk to reduce GI irritation. Avoiding all iodine-rich
D. "I should avoid all iodine-containing foods while on this med-
foods is not necessary but should be discussed with the provider.
ication."
A patient is prescribed potassium iodide for hyperthyroidism. The Correct Answer: B
nurse should advise the patient to avoid which food?
Rationale:
A. Bananas
Shellfish is rich in iodine, which can interact with potassium iodide
B. Shellfish
and exacerbate thyroid dysfunction. Bananas, milk, and rice do
C. Milk
not significantly affect iodine levels.
D. Rice
The nurse is educating a patient taking prednisone. Which state-
Correct Answer: C
ment indicates the patient understands the medication instruc-
Rationale:
tions?
Prednisone suppresses the immune system, making the patient
A. "I can stop taking this medication as soon as I feel better."
more susceptible to infections. Stopping it suddenly can cause
B. "I should take this medication on an empty stomach."
adrenal insufficiency. It should be taken with food to prevent GI
C. "I need to avoid people with infections while taking this drug."
irritation.
D. "I should increase my sodium intake while taking prednisone."
A patient on long-term prednisone therapy is at risk for which
Correct Answer: B
complication?
Rationale:
A. Hypoglycemia
Long-term corticosteroid use can lead to osteoporosis due to
B. Osteoporosis
calcium depletion, hyperglycemia, weight gain, and hypertension
C. Weight loss
(not hypotension).
D. Hypotension
The nurse is preparing to administer prednisone. What is the
Correct Answer: A
priority assessment?
Rationale:
A. Monitor blood glucose levels
Prednisone can increase blood glucose, especially in diabetic
B. Assess lung sounds
patients. Other assessments are important but monitoring for hy-
C. Check the patient's sodium level
perglycemia is the priority.
D. Assess bowel sounds
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,Pharmacology Midterm study guide with nclex-styled questions ans 2025
A patient receiving nitroprusside for hypertensive crisis is at risk
Correct Answer: B
for which serious adverse effect?
Rationale:
A. Pulmonary edema
Nitroprusside can cause cyanide toxicity, leading to confusion,
B. Cyanide toxicity
metabolic acidosis, and muscle weakness. Close monitoring is
C. Hyperkalemia
required, especially in prolonged infusions.
D. Bradycardia
Which nursing intervention is priority when administering nitro-
Correct Answer: A
prusside IV?
Rationale:
A. Monitor blood pressure continuously
Nitroprusside is a potent vasodilator, requiring continuous BP
B. Administer the drug via IM injection
monitoring to prevent hypotension. It is given IV only, and sodium
C. Encourage the patient to increase sodium intake
intake is not directly related to its action.
D. Assess deep tendon reflexes every 2 hours
A patient on nitroprusside develops confusion, metabolic acidosis,
and respiratory distress. What is the nurse's best action? Correct Answer: B
A. Slow the infusion rate Rationale:
B. Administer sodium thiosulfate Sodium thiosulfate is the antidote for cyanide toxicity, a potential
C. Increase the IV fluids adverse effect of nitroprusside.
D. Discontinue the drug permanently
The nurse is educating a patient about NPH insulin. Which state-
Correct Answer: B
ment by the patient indicates correct understanding?
Rationale:
A. "I will take this insulin right before meals."
NPH insulin is intermediate-acting, with an onset of 2-4 hours
B. "NPH insulin peaks 6-10 hours after injection."
and a peak of 6-10 hours, making it important to monitor for
C. "This insulin works immediately after injection."
hypoglycemia.
D. "NPH insulin should be taken at bedtime only."
The nurse should instruct the patient to mix NPH insulin with
Correct Answer: B
regular insulin by:
Rationale:
A. Drawing up NPH insulin first
When mixing insulins, draw up regular insulin (clear) first, then
B. Drawing up regular insulin first
NPH (cloudy) to prevent contamination. Insulin should be rolled,
C. Shaking the insulin vial before drawing it up
not shaken to avoid bubbles.
D. Mixing both insulins in the vial before drawing
What is the most important nursing intervention after administer-
ing NPH insulin? Correct Answer: B
A. Monitor the patient for hyperglycemia Rationale:
B. Assess for signs of hypoglycemia NPH insulin peaks 6-10 hours after administration, increasing the
C. Check urine ketones risk for hypoglycemia, especially at night.
D. Encourage the patient to eat a bedtime snack
Which assessment finding is most concerning in a patient taking Correct Answer: C
a beta blocker?
Rationale:
A. Heart rate of 55 bpm
Beta blockers can cause bronchoconstriction, especially in pa-
B. Blood pressure of 100/60 mmHg
tients with asthma or COPD. Bradycardia (HR <60 bpm) is also
C. Wheezing and shortness of breath
concerning but not immediately life-threatening.
D. Fatigue and dizziness
A patient taking atenolol asks if they can stop taking the medica-
tion. What is the best response? Correct Answer: D
A. "You can stop it if your blood pressure is normal." Rationale:
B. "Taper the dose slowly over two weeks." Stopping beta blockers abruptly can cause rebound hypertension,
C. "You should stop it immediately if you feel dizzy." angina, or MI. The dose should be tapered under provider super-
D. "Avoid stopping the drug abruptly to prevent rebound hyperten- vision.
sion."
Which of the following is a priority nursing intervention before
administering a beta blocker? Correct Answer: C
A. Check the patient's blood sugar Rationale:
B. Monitor the patient's urine output Beta blockers lower heart rate and blood pressure, so these
C. Assess the patient's heart rate and blood pressure should be checked before administration.
D. Evaluate bowel sounds
A patient with diabetes insipidus is receiving desmopressin. Which
finding suggests the medication is effective?
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