(2025/2026 Syllabus)
Instructions: This practice exam tests application and analysis skills crucial for the
NCLEX. Read each question carefully and select the best answer. Rationales are provided
to enhance understanding.
Section 1: Fundamental Principles & Safety (Questions 1-15)
1. The nurse is preparing to administer a new cardiac medication. The patient
states, "My brother had a terrible reaction to this pill." What is the nurse's best
initial action?
A. Reassure the patient that reactions are very rare.
B. Document the patient's concern and administer the medication.
C. Hold the medication and notify the prescribing provider.
D. Check the patient's identification bracelet to ensure it is the correct drug.
ANSWER: ✓ C. Hold the medication and notify the prescribing provider.
2. A patient has a documented allergy to Sulfa drugs. Which medication should
the nurse question before administering?
A. Lisinopril
B. Metoprolol
C. Furosemide
D. Acetaminophen
ANSWER: ✓ C. Furosemide
3. The nurse understands that which laboratory value is most critical to monitor
before administering I.V. Heparin?
A. Serum Creatinine
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Hemoglobin and Hematocrit
ANSWER: ✓ C. Activated Partial Thromboplastin Time (aPTT)
4. When teaching a patient about taking Enteric-coated tablets, the nurse should
include which instruction?
, A. "Crush the tablet and mix it with applesauce if you have trouble swallowing."
B. "Take this medication with an antacid to prevent stomach upset."
C. "Do not crush or chew this tablet; it must be swallowed whole."
D. "This medication should be placed under your tongue to dissolve."
ANSWER: ✓ C. "Do not crush or chew this tablet; it must be swallowed whole."
5. A patient is receiving a drug that is known to be teratogenic. The nurse's
priority action is to:
A. Ensure the patient is using two reliable forms of contraception.
B. Administer the medication with food to minimize nausea.
C. Monitor the patient's liver function tests monthly.
D. Teach the patient to avoid direct sunlight.
ANSWER: ✓ A. Ensure the patient is using two reliable forms of contraception.
6. The nurse is administering an I.M. injection to an adult. Which site is preferred
for a 2-mL volume of a viscous medication?
A. Deltoid
B. Dorsogluteal
C. Vastus Lateralis
D. Ventrogluteal
ANSWER: ✓ D. Ventrogluteal
7. A patient is started on a medication with a narrow therapeutic index. The nurse
anticipates that this will require:
A. Frequent dosing throughout the day.
B. Close monitoring of serum drug levels.
C. Administration via the intravenous route only.
D. A loading dose before beginning maintenance therapy.
ANSWER: ✓ B. Close monitoring of serum drug levels.
8. The nurse is preparing to administer a sublingual nitroglycerin tablet. The
correct instruction is to:
A. Swallow the tablet with a full glass of water.
B. Place the tablet in the buccal pouch between the cheek and gum.
C. Let the tablet dissolve completely under the tongue.
D. Chew the tablet thoroughly before swallowing.
ANSWER: ✓ C. Let the tablet dissolve completely under the tongue.
9. A patient with severe liver cirrhosis is prescribed a new medication. The nurse
should be alert for which potential consequence?
A. Increased drug metabolism and reduced effect.