Page 1 of 76
“PHARMACOLOGY PRACTICE QUESTIONS -
YEAR 4 - NCLEX ”LATEST EXAM SOLVED
QUESTIONS & ANSWERS VERIFIED 100%
GRADED A+ (LATEST VERSION) WELL
REVISED GUARANTEE PASS
Pharmacology Practice Questions - Year 4 - NCLEX
A client is to take an antipsychotic medication twice a day.
Two-thirds of the daily dose is given in the evening and one-third in the
morning.
Which reason would the nurse give the client as the rationale for this
schedule?
To reduce sedation during the daytime
Antipsychotic medications tend to make the client listless or drowsy and can interfere
with the client's ability to participate in the therapeutic regimen.
Antipsychotic medications do not induce rapid eye movement sleep, which is when
most dreams occur.
Antipsychotic medications do not appreciably affect diurnal rhythms.
Assaultiveness is associated with increased anxiety and is unrelated to the time of
day.
Which adverse effect of metformin will a nurse teach a client with type 2
diabetes to monitor for when used as monotherapy?
Lactic acidosis
Metformin carries a black box warning regarding the possibility of lactic acidosis;
clients must know how to monitor for this condition.
, Page 2 of 76
An advantage of metformin over some other antidiabetic medications is that it does
not cause weight gain and may actually result in weight loss for some clients.
Constipation is not a problem, but many clients will develop diarrhea initially.
Metformin does not increase pancreatic production of insulin and, when used without
other antidiabetic medications, will not cause hypoglycemia.
Which medications are used as the first-line treatment for post-traumatic
stress disorder (PTSD)?
Sertraline and Paroxetine
Sertraline and paroxetine are selective serotonin reuptake inhibitors that are
approved by the US Food and Drug Administration as a first-line treatment for PTSD.
If these medications are ineffective, the use of phenelzine, venlafaxine, or
amitriptyline is indicated.
Which intervention would the nurse implement first when a client receiving
high-dosage risperidone exhibits hand tremors?
Contacting the primary health care provider
The primary health care provider is responsible for prescribing medications but
depends on the nurse's observations before making decisions.
This is not a severe enough finding to warrant withholding the medication.
It is a reaction to the risperidone and is not transitory.
Giving the client finger exercises will have no effect on the tremors.
Which factor must the nurse determine to adjust the drip rate when
administering intravenous (IV) fluids to be delivered at 80 mL/h?
Drops per milliliter delivered by the infusion set
Different infusion sets deliver different preset numbers of drops per milliliter.
Knowing this is a necessity for calculating the drip rate.
Total volume of fluid in the IV bag and size of the needle or catheter in the vein do
not determine the drip rate.
The diameter of the tubing being used to instill the fluid determines the size of the
drop, not the drip rate.
The nurse is administering hydroxyzine to a client. The nurse would monitor
the client for which side effect of this medication?
Drowsiness
Hydroxyzine suppresses activity in key regions of the subcortical area of the central
nervous system; it also has antihistaminic and anticholinergic effects.
Ataxia, vertigo and slurred speech are not associated with hydroxyzine.
, Page 3 of 76
Which information would be included in the teaching plan for the older adult
client with peptic ulcer disease who is taking an antacid and sucralfate?
Sucralfate should be taken on an empty stomach 1 hour before meals.
Sucralfate works best in a low pH environment; therefore it should be given on an
empty stomach either 1 hour before or 2 hours after meals.
Sucralfate also should be administered no sooner than 30 minutes before or after an
antacid.
The acid-neutralizing effects of antacids last approximately 30 minutes when taken
on an empty stomach and 3 to 4 hours when taken after meals.
When sucralfate and an antacid are both prescribed, they are each most effective
when the sucralfate is scheduled an hour before meals and the antacid is scheduled
after meals.
Sucralfate is prescribed for the short-term treatment of peptic ulcers.
Its use is limited to 4 to 8 weeks.
The client should follow the recommendations of the primary health care provider
with regard to antacid selection.
Sodium bicarbonate can produce acid-base imbalances, which could be harmful,
especially in older adult clients.
Which information would the nurse reinforce when teaching a client with
gastroesophageal reflux disease (GERD) about antacid therapy?
Antacids commonly interfere with the absorption of other medications.
Antacids interfere with absorption of medications such as anticholinergics,
barbiturates, tetracycline, and digoxin.
Antacids should be taken 1 or 2 hours after meals and at bedtime.
Antacid tablets may be taken more frequently than every 4 hours.
Liquid antacids are faster acting and more effective than antacid tablets.
Which assessment will the nurse conduct before administering digoxin to a
client?
Apical heart rate
Because digoxin slows the heart rate, the apical pulse should be counted for 1
minute before administration.
If the apical rate is below a preset parameter (usually 60 beats/minute), digoxin
should be withheld because its administration may further decrease the heart rate.
Some protocols permit waiting for 1 hour and retaking the apical rate; the result
determines if it is administered or if the health care provider is notified.
, Page 4 of 76
Obtaining the radial pulse is not as accurate as an apical pulse; the client also may
have an atrial dysrhythmia, which cannot be detected through a radial rate alone.
Obtaining the difference between the carotid and radial pulse will not be of benefit.
Obtaining the difference between apical and radial pulses is a pulse deficit, not a
pulse rate.
Which condition would be prevented by the addition of spironolactone to the
medication regimen of a client with cirrhosis of the liver who has been taking
chlorothiazide?
Hypokalemia
Spironolactone is a potassium-sparing diuretic often used in conjunction with thiazide
diuretics.
The provider was prompted to add spironolactone to the chlorothiazide to prevent
potassium loss.
It stimulates sodium excretion so will not prevent hyponatremia.
Spironolactone is a relatively weak diuretic that will not have a significant effect on
ascites.
Peripheral neuropathy is not a concern in this scenario and spironolactone would not
have an effect on it if it was a concern.
Which type of insulin would the nurse recognize as compatible with IV
solutions when caring for a client with diabetes mellitus who is scheduled to
receive an intravenous (IV) administration of 25 units of insulin in 250 mL
normal saline?
Insulin lispro
Insulin lispro is compatible with IV solutions; it is a rapid-acting insulin.
NPH insulin is not compatible with IV solutions; it is an intermediate-acting insulin.
Insulin detemir is not compatible with IV solutions; it is a long-acting insulin.
Insulin glargine is not compatible with IV solutions; it is a long-acting insulin.
Which tissue affected by chemotherapy will the nurse consider when
formulating a response to a client receiving cancer chemotherapy who asks
the nurse why an antibiotic was prescribed?
Bone marrow
Prolonged chemotherapy may slow production of leukocytes in bone marrow, thus
suppressing the immune system.
Antibiotics may be required to help counter infections that the body can no longer
handle easily.
“PHARMACOLOGY PRACTICE QUESTIONS -
YEAR 4 - NCLEX ”LATEST EXAM SOLVED
QUESTIONS & ANSWERS VERIFIED 100%
GRADED A+ (LATEST VERSION) WELL
REVISED GUARANTEE PASS
Pharmacology Practice Questions - Year 4 - NCLEX
A client is to take an antipsychotic medication twice a day.
Two-thirds of the daily dose is given in the evening and one-third in the
morning.
Which reason would the nurse give the client as the rationale for this
schedule?
To reduce sedation during the daytime
Antipsychotic medications tend to make the client listless or drowsy and can interfere
with the client's ability to participate in the therapeutic regimen.
Antipsychotic medications do not induce rapid eye movement sleep, which is when
most dreams occur.
Antipsychotic medications do not appreciably affect diurnal rhythms.
Assaultiveness is associated with increased anxiety and is unrelated to the time of
day.
Which adverse effect of metformin will a nurse teach a client with type 2
diabetes to monitor for when used as monotherapy?
Lactic acidosis
Metformin carries a black box warning regarding the possibility of lactic acidosis;
clients must know how to monitor for this condition.
, Page 2 of 76
An advantage of metformin over some other antidiabetic medications is that it does
not cause weight gain and may actually result in weight loss for some clients.
Constipation is not a problem, but many clients will develop diarrhea initially.
Metformin does not increase pancreatic production of insulin and, when used without
other antidiabetic medications, will not cause hypoglycemia.
Which medications are used as the first-line treatment for post-traumatic
stress disorder (PTSD)?
Sertraline and Paroxetine
Sertraline and paroxetine are selective serotonin reuptake inhibitors that are
approved by the US Food and Drug Administration as a first-line treatment for PTSD.
If these medications are ineffective, the use of phenelzine, venlafaxine, or
amitriptyline is indicated.
Which intervention would the nurse implement first when a client receiving
high-dosage risperidone exhibits hand tremors?
Contacting the primary health care provider
The primary health care provider is responsible for prescribing medications but
depends on the nurse's observations before making decisions.
This is not a severe enough finding to warrant withholding the medication.
It is a reaction to the risperidone and is not transitory.
Giving the client finger exercises will have no effect on the tremors.
Which factor must the nurse determine to adjust the drip rate when
administering intravenous (IV) fluids to be delivered at 80 mL/h?
Drops per milliliter delivered by the infusion set
Different infusion sets deliver different preset numbers of drops per milliliter.
Knowing this is a necessity for calculating the drip rate.
Total volume of fluid in the IV bag and size of the needle or catheter in the vein do
not determine the drip rate.
The diameter of the tubing being used to instill the fluid determines the size of the
drop, not the drip rate.
The nurse is administering hydroxyzine to a client. The nurse would monitor
the client for which side effect of this medication?
Drowsiness
Hydroxyzine suppresses activity in key regions of the subcortical area of the central
nervous system; it also has antihistaminic and anticholinergic effects.
Ataxia, vertigo and slurred speech are not associated with hydroxyzine.
, Page 3 of 76
Which information would be included in the teaching plan for the older adult
client with peptic ulcer disease who is taking an antacid and sucralfate?
Sucralfate should be taken on an empty stomach 1 hour before meals.
Sucralfate works best in a low pH environment; therefore it should be given on an
empty stomach either 1 hour before or 2 hours after meals.
Sucralfate also should be administered no sooner than 30 minutes before or after an
antacid.
The acid-neutralizing effects of antacids last approximately 30 minutes when taken
on an empty stomach and 3 to 4 hours when taken after meals.
When sucralfate and an antacid are both prescribed, they are each most effective
when the sucralfate is scheduled an hour before meals and the antacid is scheduled
after meals.
Sucralfate is prescribed for the short-term treatment of peptic ulcers.
Its use is limited to 4 to 8 weeks.
The client should follow the recommendations of the primary health care provider
with regard to antacid selection.
Sodium bicarbonate can produce acid-base imbalances, which could be harmful,
especially in older adult clients.
Which information would the nurse reinforce when teaching a client with
gastroesophageal reflux disease (GERD) about antacid therapy?
Antacids commonly interfere with the absorption of other medications.
Antacids interfere with absorption of medications such as anticholinergics,
barbiturates, tetracycline, and digoxin.
Antacids should be taken 1 or 2 hours after meals and at bedtime.
Antacid tablets may be taken more frequently than every 4 hours.
Liquid antacids are faster acting and more effective than antacid tablets.
Which assessment will the nurse conduct before administering digoxin to a
client?
Apical heart rate
Because digoxin slows the heart rate, the apical pulse should be counted for 1
minute before administration.
If the apical rate is below a preset parameter (usually 60 beats/minute), digoxin
should be withheld because its administration may further decrease the heart rate.
Some protocols permit waiting for 1 hour and retaking the apical rate; the result
determines if it is administered or if the health care provider is notified.
, Page 4 of 76
Obtaining the radial pulse is not as accurate as an apical pulse; the client also may
have an atrial dysrhythmia, which cannot be detected through a radial rate alone.
Obtaining the difference between the carotid and radial pulse will not be of benefit.
Obtaining the difference between apical and radial pulses is a pulse deficit, not a
pulse rate.
Which condition would be prevented by the addition of spironolactone to the
medication regimen of a client with cirrhosis of the liver who has been taking
chlorothiazide?
Hypokalemia
Spironolactone is a potassium-sparing diuretic often used in conjunction with thiazide
diuretics.
The provider was prompted to add spironolactone to the chlorothiazide to prevent
potassium loss.
It stimulates sodium excretion so will not prevent hyponatremia.
Spironolactone is a relatively weak diuretic that will not have a significant effect on
ascites.
Peripheral neuropathy is not a concern in this scenario and spironolactone would not
have an effect on it if it was a concern.
Which type of insulin would the nurse recognize as compatible with IV
solutions when caring for a client with diabetes mellitus who is scheduled to
receive an intravenous (IV) administration of 25 units of insulin in 250 mL
normal saline?
Insulin lispro
Insulin lispro is compatible with IV solutions; it is a rapid-acting insulin.
NPH insulin is not compatible with IV solutions; it is an intermediate-acting insulin.
Insulin detemir is not compatible with IV solutions; it is a long-acting insulin.
Insulin glargine is not compatible with IV solutions; it is a long-acting insulin.
Which tissue affected by chemotherapy will the nurse consider when
formulating a response to a client receiving cancer chemotherapy who asks
the nurse why an antibiotic was prescribed?
Bone marrow
Prolonged chemotherapy may slow production of leukocytes in bone marrow, thus
suppressing the immune system.
Antibiotics may be required to help counter infections that the body can no longer
handle easily.
