NR 293 Pharmacology Exam 1, Exam 2, and
Comprehensive Final Exam Bundle | Questions
And Well Graded Solutions With Rationales
Updated 2026-2027 | Chamberlain University
Unlock the ultimate study package for Chamberlain University's NR 293 Pharmacology. This complete
guide features authentic test bank questions, correct answers, and expert-level NCLEX-style
rationales covering Exam 1, Exam 2, and the Cumulative Final Exam. Ace critical topics like
pharmacokinetics, endocrine agents, cardiac medications, dosage math, and high-yield antidotes.
Verified solutions ensure top grades. Save time, study smart, and secure an A+ today
1. A nurse is reviewing a patient's medication profile and notes that a drug is a
Schedule II controlled substance. Which regulatory feature applies specifically to
Schedule II medications?
A) They have no accepted medical use in treatment.
B) They have a high potential for abuse but are acceptable for medical use with
severe restrictions.
C) They cannot cause physical or psychological dependence.
D) They can be refilled up to five times within a six-month period.
B) They have a high potential for abuse but are acceptable for medical use
with severe restrictions.
Rationale: Schedule II drugs (like morphine or oxycodone) have a high potential for
abuse and dependence but have an accepted medical use. Schedule I drugs have
no accepted medical use (Choice A). Schedule II drugs cannot be refilled without a
new written prescription; the five-refill rule applies to Schedules III and IV (Choice D).
2. During a pharmacokinetic clinical review, a nurse notes that a highly protein-bound
drug is prescribed to an elderly patient with low serum albumin levels. What is the
main clinical risk for this patient?
A) The drug will be excreted rapidly, leading to subtherapeutic levels.
B) The drug will remain inactive in the bloodstream.
C) There will be an increased fraction of free, active drug, risking toxic levels.
D) Gastric absorption will be entirely blocked.
C) There will be an increased fraction of free, active drug, risking toxic levels.
Rationale: Drugs that are highly protein-bound rely on albumin to bind them. If serum
albumin is low, there are fewer binding sites, leaving more "free" active drug in
circulation, which dramatically increases the risk of drug toxicity.
3. A patient is taking levothyroxine for the management of hypothyroidism. Which
clinical manifestation indicates to the nurse that the medication dosage is too high?
1|Page
, A) Bradycardia and weight gain
B) Somnolence and cold intolerance
C) Palpitations, tremors, and insomnia
D) Hypotension and constipation
C) Palpitations, tremors, and insomnia
Rationale: Levothyroxine overdose mimics hyperthyroidism. Symptoms like
tachycardia, palpitations, tremors, heat intolerance, and insomnia mean the
metabolic rate is overstimulated. Choices A, B, and D are signs of continuing
hypothyroidism, meaning the dose is too low.
4. A patient with a history of hyperthyroidism is prescribed propylthiouracil (PTU). The
nurse should instruct the patient to immediately report which adverse effect?
A) Sore throat and fever
B) Mild nausea after taking the drug
C) Increased urinary frequency
D) Intolerable metallic taste
A) Sore throat and fever
Rationale: Propylthiouracil (PTU) can cause agranulocytosis, a severe and
dangerous drop in white blood cells. Patients must report any signs of infection, such
as a sore throat or fever, so a complete blood count can be verified immediately.
5. A nurse administers 10 units of insulin lispro to a patient at 08:00 AM. At what time
should the nurse monitor the patient most closely for symptoms of a hypoglycemic
reaction?
A) 08:15 AM to 08:30 AM
B) 09:00 AM to 10:00 AM
C) 12:00 PM to 02:00 PM
D) 04:00 PM to 06:00 PM
B) 09:00 AM to 10:00 AM
Rationale: Insulin lispro is a rapid-acting insulin. Its onset is around 15 minutes, but
its peak effect occurs within 1 to 2 hours after administration (between 09:00 AM and
10:00 AM). Hypoglycemia is most likely to occur during a drug's peak effect.
6. Which medication will the nurse prepare to administer to a patient experiencing
severe insulin-induced hypoglycemia who is unconscious and lacks intravenous
access?
A) Subcutaneous insulin glargine
B) Oral orange juice with sugar
2|Page
, C) Intramuscular glucagon
D) Intravenous 50% dextrose
C) Intramuscular glucagon
Rationale: If a patient is unconscious, oral options (Choice B) are contraindicated
due to aspiration risks. Without IV access, IV dextrose (Choice D) cannot be given.
Intramuscular or subcutaneous glucagon is the correct intervention to rapidly
mobilize glucose from liver glycogen.
7. A patient is diagnosed with Type 2 diabetes and prescribed metformin. Which
diagnostic test must the nurse verify before administering the first dose?
A) Serum potassium level
B) Serum creatinine and eGFR
C) Liver biopsy report
D) Thyroid-stimulating hormone (TSH)
B) Serum creatinine and eGFR
Rationale: Metformin is excreted unchanged by the kidneys. If a patient has renal
impairment, metformin can accumulate, significantly increasing the risk of life-
threatening lactic acidosis. Kidney function tests must always be checked prior to
initiation.
8. A patient taking metformin is scheduled for an outpatient computed tomography (CT)
scan with intravenous iodinated contrast media. What instructions should the nurse
provide?
A) Double the metformin dose on the day of the procedure.
B) Take metformin normally before and after the procedure.
C) Hold the metformin on the day of the procedure and for 48 hours afterward.
D) Limit fluid intake after the contrast study is completed.
C) Hold the metformin on the day of the procedure and for 48 hours afterward.
Rationale: Iodinated contrast dye can cause temporary renal insufficiency. If a
patient continues to take metformin during this window, renal retention can lead to
lactic acidosis. Metformin is held on the day of the procedure and restarted 48 hours
later after verifying normal kidney function.
9. A patient is taking an oral corticosteroid (prednisone) daily for an autoimmune
condition. Which instruction should the nurse include in the teaching plan?
A) Stop taking the drug abruptly if you experience mild nausea.
B) Avoid taking this medication with food to increase absorption.
C) Monitor your blood glucose levels regularly, as this drug can cause
3|Page
, hyperglycemia.
D) Expect a significant drop in blood pressure while on this medication.
C) Monitor your blood glucose levels regularly, as this drug can cause
hyperglycemia.
Rationale: Corticosteroids like prednisone cause gluconeogenesis and decrease
peripheral glucose utilization, resulting in hyperglycemia. Stopping corticosteroids
abruptly (Choice A) can trigger an acute adrenal crisis, which is a medical
emergency.
10. A patient newly prescribed captopril for hypertension asks the nurse about potential
side effects. Which distinctive adverse effect should the nurse emphasize during
patient education?
A) Persistent, dry, hacking cough
B) Yellow-green visual halos
C) Severe muscle cramping in the calves
D) Significant weight gain and fluid retention
A) Persistent, dry, hacking cough
Rationale: Captopril is an ACE inhibitor. ACE inhibitors block the breakdown of
bradykinin in the lungs, leading to a persistent, dry, nonproductive cough in up to
20% of patients. This is a common reason for switching therapy to an ARB
medication.
11. A nurse is evaluating a patient taking lisinopril. Which laboratory result would prompt
the nurse to withhold the medication and contact the healthcare provider?
A) Serum sodium of 136 mEq/L
B) Serum potassium of 5.6 mEq/L
C) Hemoglobin of 12.5 g/dL
D) Fasting blood glucose of 110 mg/dL
B) Serum potassium of 5.6 mEq/L
Rationale: ACE inhibitors suppress aldosterone secretion, leading to potassium
retention by the kidneys. A potassium level of 5.6 mEq/L indicates hyperkalemia.
Administering lisinopril would worsen this condition, posing a risk of dangerous
cardiac dysrhythmias.
12. A patient is prescribed metoprolol for hypertension and stable angina. The nurse
knows that this drug belongs to which medication class?
A) Calcium channel blockers
B) Beta-adrenergic antagonists (Beta-blockers)
4|Page
Comprehensive Final Exam Bundle | Questions
And Well Graded Solutions With Rationales
Updated 2026-2027 | Chamberlain University
Unlock the ultimate study package for Chamberlain University's NR 293 Pharmacology. This complete
guide features authentic test bank questions, correct answers, and expert-level NCLEX-style
rationales covering Exam 1, Exam 2, and the Cumulative Final Exam. Ace critical topics like
pharmacokinetics, endocrine agents, cardiac medications, dosage math, and high-yield antidotes.
Verified solutions ensure top grades. Save time, study smart, and secure an A+ today
1. A nurse is reviewing a patient's medication profile and notes that a drug is a
Schedule II controlled substance. Which regulatory feature applies specifically to
Schedule II medications?
A) They have no accepted medical use in treatment.
B) They have a high potential for abuse but are acceptable for medical use with
severe restrictions.
C) They cannot cause physical or psychological dependence.
D) They can be refilled up to five times within a six-month period.
B) They have a high potential for abuse but are acceptable for medical use
with severe restrictions.
Rationale: Schedule II drugs (like morphine or oxycodone) have a high potential for
abuse and dependence but have an accepted medical use. Schedule I drugs have
no accepted medical use (Choice A). Schedule II drugs cannot be refilled without a
new written prescription; the five-refill rule applies to Schedules III and IV (Choice D).
2. During a pharmacokinetic clinical review, a nurse notes that a highly protein-bound
drug is prescribed to an elderly patient with low serum albumin levels. What is the
main clinical risk for this patient?
A) The drug will be excreted rapidly, leading to subtherapeutic levels.
B) The drug will remain inactive in the bloodstream.
C) There will be an increased fraction of free, active drug, risking toxic levels.
D) Gastric absorption will be entirely blocked.
C) There will be an increased fraction of free, active drug, risking toxic levels.
Rationale: Drugs that are highly protein-bound rely on albumin to bind them. If serum
albumin is low, there are fewer binding sites, leaving more "free" active drug in
circulation, which dramatically increases the risk of drug toxicity.
3. A patient is taking levothyroxine for the management of hypothyroidism. Which
clinical manifestation indicates to the nurse that the medication dosage is too high?
1|Page
, A) Bradycardia and weight gain
B) Somnolence and cold intolerance
C) Palpitations, tremors, and insomnia
D) Hypotension and constipation
C) Palpitations, tremors, and insomnia
Rationale: Levothyroxine overdose mimics hyperthyroidism. Symptoms like
tachycardia, palpitations, tremors, heat intolerance, and insomnia mean the
metabolic rate is overstimulated. Choices A, B, and D are signs of continuing
hypothyroidism, meaning the dose is too low.
4. A patient with a history of hyperthyroidism is prescribed propylthiouracil (PTU). The
nurse should instruct the patient to immediately report which adverse effect?
A) Sore throat and fever
B) Mild nausea after taking the drug
C) Increased urinary frequency
D) Intolerable metallic taste
A) Sore throat and fever
Rationale: Propylthiouracil (PTU) can cause agranulocytosis, a severe and
dangerous drop in white blood cells. Patients must report any signs of infection, such
as a sore throat or fever, so a complete blood count can be verified immediately.
5. A nurse administers 10 units of insulin lispro to a patient at 08:00 AM. At what time
should the nurse monitor the patient most closely for symptoms of a hypoglycemic
reaction?
A) 08:15 AM to 08:30 AM
B) 09:00 AM to 10:00 AM
C) 12:00 PM to 02:00 PM
D) 04:00 PM to 06:00 PM
B) 09:00 AM to 10:00 AM
Rationale: Insulin lispro is a rapid-acting insulin. Its onset is around 15 minutes, but
its peak effect occurs within 1 to 2 hours after administration (between 09:00 AM and
10:00 AM). Hypoglycemia is most likely to occur during a drug's peak effect.
6. Which medication will the nurse prepare to administer to a patient experiencing
severe insulin-induced hypoglycemia who is unconscious and lacks intravenous
access?
A) Subcutaneous insulin glargine
B) Oral orange juice with sugar
2|Page
, C) Intramuscular glucagon
D) Intravenous 50% dextrose
C) Intramuscular glucagon
Rationale: If a patient is unconscious, oral options (Choice B) are contraindicated
due to aspiration risks. Without IV access, IV dextrose (Choice D) cannot be given.
Intramuscular or subcutaneous glucagon is the correct intervention to rapidly
mobilize glucose from liver glycogen.
7. A patient is diagnosed with Type 2 diabetes and prescribed metformin. Which
diagnostic test must the nurse verify before administering the first dose?
A) Serum potassium level
B) Serum creatinine and eGFR
C) Liver biopsy report
D) Thyroid-stimulating hormone (TSH)
B) Serum creatinine and eGFR
Rationale: Metformin is excreted unchanged by the kidneys. If a patient has renal
impairment, metformin can accumulate, significantly increasing the risk of life-
threatening lactic acidosis. Kidney function tests must always be checked prior to
initiation.
8. A patient taking metformin is scheduled for an outpatient computed tomography (CT)
scan with intravenous iodinated contrast media. What instructions should the nurse
provide?
A) Double the metformin dose on the day of the procedure.
B) Take metformin normally before and after the procedure.
C) Hold the metformin on the day of the procedure and for 48 hours afterward.
D) Limit fluid intake after the contrast study is completed.
C) Hold the metformin on the day of the procedure and for 48 hours afterward.
Rationale: Iodinated contrast dye can cause temporary renal insufficiency. If a
patient continues to take metformin during this window, renal retention can lead to
lactic acidosis. Metformin is held on the day of the procedure and restarted 48 hours
later after verifying normal kidney function.
9. A patient is taking an oral corticosteroid (prednisone) daily for an autoimmune
condition. Which instruction should the nurse include in the teaching plan?
A) Stop taking the drug abruptly if you experience mild nausea.
B) Avoid taking this medication with food to increase absorption.
C) Monitor your blood glucose levels regularly, as this drug can cause
3|Page
, hyperglycemia.
D) Expect a significant drop in blood pressure while on this medication.
C) Monitor your blood glucose levels regularly, as this drug can cause
hyperglycemia.
Rationale: Corticosteroids like prednisone cause gluconeogenesis and decrease
peripheral glucose utilization, resulting in hyperglycemia. Stopping corticosteroids
abruptly (Choice A) can trigger an acute adrenal crisis, which is a medical
emergency.
10. A patient newly prescribed captopril for hypertension asks the nurse about potential
side effects. Which distinctive adverse effect should the nurse emphasize during
patient education?
A) Persistent, dry, hacking cough
B) Yellow-green visual halos
C) Severe muscle cramping in the calves
D) Significant weight gain and fluid retention
A) Persistent, dry, hacking cough
Rationale: Captopril is an ACE inhibitor. ACE inhibitors block the breakdown of
bradykinin in the lungs, leading to a persistent, dry, nonproductive cough in up to
20% of patients. This is a common reason for switching therapy to an ARB
medication.
11. A nurse is evaluating a patient taking lisinopril. Which laboratory result would prompt
the nurse to withhold the medication and contact the healthcare provider?
A) Serum sodium of 136 mEq/L
B) Serum potassium of 5.6 mEq/L
C) Hemoglobin of 12.5 g/dL
D) Fasting blood glucose of 110 mg/dL
B) Serum potassium of 5.6 mEq/L
Rationale: ACE inhibitors suppress aldosterone secretion, leading to potassium
retention by the kidneys. A potassium level of 5.6 mEq/L indicates hyperkalemia.
Administering lisinopril would worsen this condition, posing a risk of dangerous
cardiac dysrhythmias.
12. A patient is prescribed metoprolol for hypertension and stable angina. The nurse
knows that this drug belongs to which medication class?
A) Calcium channel blockers
B) Beta-adrenergic antagonists (Beta-blockers)
4|Page
