Latest NR565 /
Advanced Pharmacology Test Bank
2026/2027 New Update
QUESTIONS, ANSWERS and
RATIONALES/ GRADED A+ TESTED and
100% verified/ Fully Covered
1. A client with chronic kidney disease is prescribed metformin. Which assessment finding
requires the nurse to question this order?
A. BMI of 32 kg/m²
B. HbA1c of 8.2%
C. eGFR of 25 mL/min/1.73 m²
D. Fasting glucose of 160 mg/dL
Rationale: Metformin is contraindicated in severe renal impairment (eGFR <30)
due to increased risk of lactic acidosis. The nurse must question the order and notify
the provider immediately.
,2. A client receiving IV heparin develops sudden chest pain and shortness of breath. What is
the nurse’s priority action?
A. Increase oxygen flow
B. Check aPTT
C. Stop the heparin infusion and notify the provider
D. Place the client supine
Rationale: Sudden respiratory distress may indicate pulmonary embolism or
heparin-related complication. The infusion must be stopped immediately and the
provider notified.
3. A client taking warfarin has an INR of 5.8. What is the most appropriate nursing action?
A. Administer next scheduled dose
B. Encourage vitamin K foods
C. Hold warfarin and notify the provider
D. Recheck INR in one week
Rationale: An INR above therapeutic range significantly increases bleeding risk.
Warfarin must be held and the provider notified for possible reversal.
4. A client prescribed lisinopril reports swelling of the lips and tongue. What is the nurse’s
priority action?
A. Monitor oxygen saturation
B. Administer antihistamines
C. Notify the provider immediately
D. Document and reassess
Rationale: This presentation indicates angioedema, a life-threatening adverse effect
of ACE inhibitors requiring immediate medical intervention.
5. A client taking digoxin has a heart rate of 52 bpm. What should the nurse do first?
A. Administer the medication
B. Reassess in 30 minutes
C. Hold digoxin and notify the provider
D. Encourage oral fluids
Rationale: Digoxin should be held if heart rate is below 60 bpm due to risk of severe
bradycardia and toxicity.
,6. A client receiving furosemide reports muscle cramps and weakness. Which lab value
should the nurse assess first?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Rationale: Loop diuretics cause potassium loss, leading to muscle cramps, weakness,
and arrhythmias. Potassium must be assessed immediately.
7. A client prescribed insulin lispro develops tremors and diaphoresis. What is the priority
nursing intervention?
A. Administer long-acting insulin
B. Encourage rest
C. Check blood glucose and give a fast-acting carbohydrate
D. Notify the provider
Rationale: These are signs of hypoglycemia. Immediate glucose assessment and
correction prevent seizures and loss of consciousness.
8. A client taking prednisone long-term develops moon face and truncal obesity. Which
adverse effect is the nurse observing?
A. Addisonian crisis
B. Cushingoid syndrome
C. Hypoglycemia
D. Osteoporosis
Rationale: Chronic corticosteroid use causes Cushingoid features due to prolonged
exposure to excess glucocorticoids.
9. A client receiving vancomycin IV develops flushing and hypotension. What is the nurse’s
first action?
A. Administer epinephrine
B. Continue infusion
C. Slow or stop infusion and notify provider
D. Encourage fluids
Rationale: Red man syndrome is caused by rapid infusion of vancomycin. Slowing
or stopping the infusion prevents severe hypotension.
10. A client prescribed atorvastatin reports muscle pain and dark urine. What should the
nurse do?
, A. Encourage hydration
B. Administer analgesics
C. Hold medication and notify provider
D. Continue therapy
Rationale: These symptoms indicate possible rhabdomyolysis, a serious statin
adverse effect that can lead to renal failure.
11. A client taking spironolactone has a potassium level of 6.1 mEq/L. What is the priority
action?
A. Encourage potassium-rich foods
B. Continue medication
C. Hold medication and notify provider
D. Recheck potassium in 24 hours
Rationale: Spironolactone is potassium-sparing. Hyperkalemia is life-threatening
and requires immediate intervention.
12. A client receiving gentamicin reports tinnitus. What should the nurse do?
A. Administer antiemetic
B. Encourage fluids
C. Hold medication and notify provider
D. Continue therapy
Rationale: Tinnitus is an early sign of ototoxicity associated with aminoglycosides.
Immediate action prevents permanent hearing loss.
13. A client prescribed clopidogrel asks why bruising occurs easily. What is the best
response?
A. “This is unrelated to the medication.”
B. “Your platelet count is low.”
C. “The medication inhibits platelet aggregation.”
D. “You should stop the medication.”
Rationale: Clopidogrel prevents platelet aggregation, increasing bleeding and
bruising risk. This is an expected pharmacologic effect.
14. A client taking metformin develops rapid breathing and abdominal pain. What should the
nurse suspect?
A. Hypoglycemia
B. Diabetic ketoacidosis
C. Lactic acidosis
Advanced Pharmacology Test Bank
2026/2027 New Update
QUESTIONS, ANSWERS and
RATIONALES/ GRADED A+ TESTED and
100% verified/ Fully Covered
1. A client with chronic kidney disease is prescribed metformin. Which assessment finding
requires the nurse to question this order?
A. BMI of 32 kg/m²
B. HbA1c of 8.2%
C. eGFR of 25 mL/min/1.73 m²
D. Fasting glucose of 160 mg/dL
Rationale: Metformin is contraindicated in severe renal impairment (eGFR <30)
due to increased risk of lactic acidosis. The nurse must question the order and notify
the provider immediately.
,2. A client receiving IV heparin develops sudden chest pain and shortness of breath. What is
the nurse’s priority action?
A. Increase oxygen flow
B. Check aPTT
C. Stop the heparin infusion and notify the provider
D. Place the client supine
Rationale: Sudden respiratory distress may indicate pulmonary embolism or
heparin-related complication. The infusion must be stopped immediately and the
provider notified.
3. A client taking warfarin has an INR of 5.8. What is the most appropriate nursing action?
A. Administer next scheduled dose
B. Encourage vitamin K foods
C. Hold warfarin and notify the provider
D. Recheck INR in one week
Rationale: An INR above therapeutic range significantly increases bleeding risk.
Warfarin must be held and the provider notified for possible reversal.
4. A client prescribed lisinopril reports swelling of the lips and tongue. What is the nurse’s
priority action?
A. Monitor oxygen saturation
B. Administer antihistamines
C. Notify the provider immediately
D. Document and reassess
Rationale: This presentation indicates angioedema, a life-threatening adverse effect
of ACE inhibitors requiring immediate medical intervention.
5. A client taking digoxin has a heart rate of 52 bpm. What should the nurse do first?
A. Administer the medication
B. Reassess in 30 minutes
C. Hold digoxin and notify the provider
D. Encourage oral fluids
Rationale: Digoxin should be held if heart rate is below 60 bpm due to risk of severe
bradycardia and toxicity.
,6. A client receiving furosemide reports muscle cramps and weakness. Which lab value
should the nurse assess first?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Rationale: Loop diuretics cause potassium loss, leading to muscle cramps, weakness,
and arrhythmias. Potassium must be assessed immediately.
7. A client prescribed insulin lispro develops tremors and diaphoresis. What is the priority
nursing intervention?
A. Administer long-acting insulin
B. Encourage rest
C. Check blood glucose and give a fast-acting carbohydrate
D. Notify the provider
Rationale: These are signs of hypoglycemia. Immediate glucose assessment and
correction prevent seizures and loss of consciousness.
8. A client taking prednisone long-term develops moon face and truncal obesity. Which
adverse effect is the nurse observing?
A. Addisonian crisis
B. Cushingoid syndrome
C. Hypoglycemia
D. Osteoporosis
Rationale: Chronic corticosteroid use causes Cushingoid features due to prolonged
exposure to excess glucocorticoids.
9. A client receiving vancomycin IV develops flushing and hypotension. What is the nurse’s
first action?
A. Administer epinephrine
B. Continue infusion
C. Slow or stop infusion and notify provider
D. Encourage fluids
Rationale: Red man syndrome is caused by rapid infusion of vancomycin. Slowing
or stopping the infusion prevents severe hypotension.
10. A client prescribed atorvastatin reports muscle pain and dark urine. What should the
nurse do?
, A. Encourage hydration
B. Administer analgesics
C. Hold medication and notify provider
D. Continue therapy
Rationale: These symptoms indicate possible rhabdomyolysis, a serious statin
adverse effect that can lead to renal failure.
11. A client taking spironolactone has a potassium level of 6.1 mEq/L. What is the priority
action?
A. Encourage potassium-rich foods
B. Continue medication
C. Hold medication and notify provider
D. Recheck potassium in 24 hours
Rationale: Spironolactone is potassium-sparing. Hyperkalemia is life-threatening
and requires immediate intervention.
12. A client receiving gentamicin reports tinnitus. What should the nurse do?
A. Administer antiemetic
B. Encourage fluids
C. Hold medication and notify provider
D. Continue therapy
Rationale: Tinnitus is an early sign of ototoxicity associated with aminoglycosides.
Immediate action prevents permanent hearing loss.
13. A client prescribed clopidogrel asks why bruising occurs easily. What is the best
response?
A. “This is unrelated to the medication.”
B. “Your platelet count is low.”
C. “The medication inhibits platelet aggregation.”
D. “You should stop the medication.”
Rationale: Clopidogrel prevents platelet aggregation, increasing bleeding and
bruising risk. This is an expected pharmacologic effect.
14. A client taking metformin develops rapid breathing and abdominal pain. What should the
nurse suspect?
A. Hypoglycemia
B. Diabetic ketoacidosis
C. Lactic acidosis
