NCLEX PN EXAM PREP: PHARMACOLOGY
COMPLETE STUDY GUIDE 2026 | PRACTICE
QUESTIONS & ANSWERS
| GRADED A+ | GUARANTEED SUCCESS
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales Included
,The nurse is conducting intake interviews at the clinic. Correct Answers: A, D, and E
Which client situations would require the nurse to
intervene? Select all that apply. Iron is absorbed better on an empty stomach; ascorbic acid (vitamin C), such as
found in citrus fruits and juices, increases the absorption of iron. However, milk
A. Client with iron deficiency anemia takes iron products decrease iron absorption and should be avoided.
supplements with milk
B. Client takes levothyroxine early in the morning on an Metronidazole (Flagyl) is used to treat trichomoniasis and amebiasis. Consuming
empty stomach alcohol while taking the medication may elicit a disulfiram (Antabuse)-like
C. Client taking phenazopyridine for urine infection states reaction. Alcohol should be avoided for at least 48 hours after treatment is
that the urine has turned orange completed.
D. Client taking metronidazole mentions going to a wine-
tasting party tonight Many antihistamines also have anticholinergic effects. Anticholinergics have an
E. Client with closed-angle glaucoma takes over-the- antimuscarinic effect that can increase intraocular pressure and are therefore
counter diphenhydramine for a cold contraindicated in closed-angle glaucoma. Other contraindications include
urinary retention (benign prostatic hyperplasia) and bowel obstruction related to
the anticholinergic drug's effect on the smooth muscle in the urinary and
gastrointestinal tract.
Incorrect Answers:
[B. Client takes levothyroxine early in the morning on an empty stomach]
Enteral nutrition decreases levothyroxine absorption; as a result, it should be
taken early in the morning on an empty stomach (at least 30 minutes before food
intake).
[C. Client taking phenazopyridine for urine infection states that the urine has
turned orange] Phenazopyridine (Pyridium) is used as a local anesthetic in the
treatment of urinary tract infection. The azo dye turns the urine an orange-red
color. The client needs to be reassured that this is an expected result and could
stain clothing.
Educational objective:Clients taking metronidazole (Flagyl) should avoid alcohol.
Those with glaucoma or urinary retention should avoid anticholinergic drugs. Oral
iron is better absorbed on an empty stomach and with vitamin C. Phenazopyridine
(Pyridium) will turn urine an orange-red color.
,The nurse is assessing a client with rheumatoid arthritis Correct Answer: A. "I am taking an antibiotic for a urinary tract infection."
who is being considered for adalimumab therapy. Which
statement made by the client needs further investigation? Infliximab, adalimumab, and etanercept are tumor necrosis factor (TNF) inhibitors
that suppress the inflammatory response in autoimmune diseases such as
A. "I am taking an antibiotic for a urinary tract infection." rheumatoid arthritis, Crohn disease, and psoriasis. Due to the immunosuppressive
B. "I had a negative tuberculosis skin test 2 weeks ago." action of TNF inhibitors, clients taking these drugs are at increased risk for
C. "I just received my yearly flu shot a week ago." infection. A client with current, recent, or chronic infection should not take a TNF
D. "I will continue taking naproxen at night to help with inhibitor
pain."
Incorrect Answers:
[B. "I had a negative tuberculosis skin test 2 weeks ago."] The
immunosuppressive action of TNF inhibitors can activate latent tuberculosis (TB).
Therefore, a tuberculin skin test (TST) should be administered prior to beginning
TNF inhibitor therapy, and clients who test positively for latent TB must also
undergo treatment for TB before starting therapy. Clients should have a TST every
year while receiving the drug.
[C. "I just received my yearly flu shot a week ago."] Clients taking
immunosuppressive TNF inhibitors (eg, adalimumab) should receive an annual
inactivated (injectable) influenza vaccine to reduce the risk of contracting the flu
virus. Clients taking TNF inhibitors or other immunosuppressants are at risk for
infection and therefore should not receive live attenuated vaccines.
[D. "I will continue taking naproxen at night to help with pain."] Many clients with
rheumatoid arthritis use nonsteroidal anti-inflammatory medications (eg,
celecoxib, naproxen) in conjunction with antirheumatic and/or targeted therapies
(eg, methotrexate, adalimumab, etanercept) to effectively treat pain and minimize
inflammation.
Educational objective:Clients with infection should not take tumor necrosis factor
(TNF) inhibitors (eg, infliximab, adalimumab, etanercept) as these suppress the
immune response. Before starting drug therapy, clients should be tested for
tuberculosis and receive the inactivated (injectable) influenza vaccine. Clients
taking TNF inhibitors should avoid live vaccines.
, The nurse reinforces teaching about methotrexate to a Correct Answers: C. "I will make sure I have my eyes checked every 6 months."
28-year-old client with rheumatoid arthritis. Which client
statement indicates the need for further instruction Methotrexate (Rheumatrex) is classified as an antineoplastic immunosuppressant
regarding this drug? drug used to treat various malignancies and as a nonbiologic disease-modifying
antirheumatic drug (DMARD) used to treat rheumatoid arthritis and psoriasis.
A. "I should get a flu shot this year as my resistance to
germs will be lower." The client's statement about getting an eye checkup every 6 months indicates that
B. "I should not get pregnant while taking this medicine." further teaching is necessary. Eye examinations every 6 months are not indicated
C. "I will make sure I have my eyes checked every 6 for clients on methotrexate, whereas they are recommended for those who are
months." prescribed hydroxychloroquine (Plaquenil), a nonbiological antimalarial DMARD
D. "It will be difficult, but I will not have wine with my that can cause retinal damage.
dinner."
Incorrect Answers:
[A. "I should get a flu shot this year as my resistance to germs will be lower."]
Methotrexate is an immunosuppressant and can cause bone marrow suppression.
Clients are at risk for infection and should avoid crowded places and contact with
individuals who have known infections. Clients on methotrexate should receive
the recommended killed (inactivated) vaccines (eg, influenza, pneumococcal), but
live vaccines (eg, herpes zoster) are contraindicated.
[B. "I should not get pregnant while taking this medicine."] Methotrexate is
teratogenic and can cause congenital abnormalities and fetal death; therefore,
clients should not become pregnant while taking this drug and wait at least 3
months after it is discontinued to conceive.
[D. "It will be difficult, but I will not have wine with my dinner."] Methotrexate is
hepatotoxic; clients on this medication should avoid drinking alcohol as alcohol
use increases the risk for hepatotoxicity.
Educational objective:Methotrexate is a disease-modifying antirheumatic drug
used to treat rheumatoid arthritis. The major adverse effects associated with
methotrexate include bone marrow suppression, hepatotoxicity, congenital
abnormalities, and fetal death.
COMPLETE STUDY GUIDE 2026 | PRACTICE
QUESTIONS & ANSWERS
| GRADED A+ | GUARANTEED SUCCESS
Updated 2026 Questions and Answers
100% Verified Exam Prep and Comprehensive
Rationales Included
,The nurse is conducting intake interviews at the clinic. Correct Answers: A, D, and E
Which client situations would require the nurse to
intervene? Select all that apply. Iron is absorbed better on an empty stomach; ascorbic acid (vitamin C), such as
found in citrus fruits and juices, increases the absorption of iron. However, milk
A. Client with iron deficiency anemia takes iron products decrease iron absorption and should be avoided.
supplements with milk
B. Client takes levothyroxine early in the morning on an Metronidazole (Flagyl) is used to treat trichomoniasis and amebiasis. Consuming
empty stomach alcohol while taking the medication may elicit a disulfiram (Antabuse)-like
C. Client taking phenazopyridine for urine infection states reaction. Alcohol should be avoided for at least 48 hours after treatment is
that the urine has turned orange completed.
D. Client taking metronidazole mentions going to a wine-
tasting party tonight Many antihistamines also have anticholinergic effects. Anticholinergics have an
E. Client with closed-angle glaucoma takes over-the- antimuscarinic effect that can increase intraocular pressure and are therefore
counter diphenhydramine for a cold contraindicated in closed-angle glaucoma. Other contraindications include
urinary retention (benign prostatic hyperplasia) and bowel obstruction related to
the anticholinergic drug's effect on the smooth muscle in the urinary and
gastrointestinal tract.
Incorrect Answers:
[B. Client takes levothyroxine early in the morning on an empty stomach]
Enteral nutrition decreases levothyroxine absorption; as a result, it should be
taken early in the morning on an empty stomach (at least 30 minutes before food
intake).
[C. Client taking phenazopyridine for urine infection states that the urine has
turned orange] Phenazopyridine (Pyridium) is used as a local anesthetic in the
treatment of urinary tract infection. The azo dye turns the urine an orange-red
color. The client needs to be reassured that this is an expected result and could
stain clothing.
Educational objective:Clients taking metronidazole (Flagyl) should avoid alcohol.
Those with glaucoma or urinary retention should avoid anticholinergic drugs. Oral
iron is better absorbed on an empty stomach and with vitamin C. Phenazopyridine
(Pyridium) will turn urine an orange-red color.
,The nurse is assessing a client with rheumatoid arthritis Correct Answer: A. "I am taking an antibiotic for a urinary tract infection."
who is being considered for adalimumab therapy. Which
statement made by the client needs further investigation? Infliximab, adalimumab, and etanercept are tumor necrosis factor (TNF) inhibitors
that suppress the inflammatory response in autoimmune diseases such as
A. "I am taking an antibiotic for a urinary tract infection." rheumatoid arthritis, Crohn disease, and psoriasis. Due to the immunosuppressive
B. "I had a negative tuberculosis skin test 2 weeks ago." action of TNF inhibitors, clients taking these drugs are at increased risk for
C. "I just received my yearly flu shot a week ago." infection. A client with current, recent, or chronic infection should not take a TNF
D. "I will continue taking naproxen at night to help with inhibitor
pain."
Incorrect Answers:
[B. "I had a negative tuberculosis skin test 2 weeks ago."] The
immunosuppressive action of TNF inhibitors can activate latent tuberculosis (TB).
Therefore, a tuberculin skin test (TST) should be administered prior to beginning
TNF inhibitor therapy, and clients who test positively for latent TB must also
undergo treatment for TB before starting therapy. Clients should have a TST every
year while receiving the drug.
[C. "I just received my yearly flu shot a week ago."] Clients taking
immunosuppressive TNF inhibitors (eg, adalimumab) should receive an annual
inactivated (injectable) influenza vaccine to reduce the risk of contracting the flu
virus. Clients taking TNF inhibitors or other immunosuppressants are at risk for
infection and therefore should not receive live attenuated vaccines.
[D. "I will continue taking naproxen at night to help with pain."] Many clients with
rheumatoid arthritis use nonsteroidal anti-inflammatory medications (eg,
celecoxib, naproxen) in conjunction with antirheumatic and/or targeted therapies
(eg, methotrexate, adalimumab, etanercept) to effectively treat pain and minimize
inflammation.
Educational objective:Clients with infection should not take tumor necrosis factor
(TNF) inhibitors (eg, infliximab, adalimumab, etanercept) as these suppress the
immune response. Before starting drug therapy, clients should be tested for
tuberculosis and receive the inactivated (injectable) influenza vaccine. Clients
taking TNF inhibitors should avoid live vaccines.
, The nurse reinforces teaching about methotrexate to a Correct Answers: C. "I will make sure I have my eyes checked every 6 months."
28-year-old client with rheumatoid arthritis. Which client
statement indicates the need for further instruction Methotrexate (Rheumatrex) is classified as an antineoplastic immunosuppressant
regarding this drug? drug used to treat various malignancies and as a nonbiologic disease-modifying
antirheumatic drug (DMARD) used to treat rheumatoid arthritis and psoriasis.
A. "I should get a flu shot this year as my resistance to
germs will be lower." The client's statement about getting an eye checkup every 6 months indicates that
B. "I should not get pregnant while taking this medicine." further teaching is necessary. Eye examinations every 6 months are not indicated
C. "I will make sure I have my eyes checked every 6 for clients on methotrexate, whereas they are recommended for those who are
months." prescribed hydroxychloroquine (Plaquenil), a nonbiological antimalarial DMARD
D. "It will be difficult, but I will not have wine with my that can cause retinal damage.
dinner."
Incorrect Answers:
[A. "I should get a flu shot this year as my resistance to germs will be lower."]
Methotrexate is an immunosuppressant and can cause bone marrow suppression.
Clients are at risk for infection and should avoid crowded places and contact with
individuals who have known infections. Clients on methotrexate should receive
the recommended killed (inactivated) vaccines (eg, influenza, pneumococcal), but
live vaccines (eg, herpes zoster) are contraindicated.
[B. "I should not get pregnant while taking this medicine."] Methotrexate is
teratogenic and can cause congenital abnormalities and fetal death; therefore,
clients should not become pregnant while taking this drug and wait at least 3
months after it is discontinued to conceive.
[D. "It will be difficult, but I will not have wine with my dinner."] Methotrexate is
hepatotoxic; clients on this medication should avoid drinking alcohol as alcohol
use increases the risk for hepatotoxicity.
Educational objective:Methotrexate is a disease-modifying antirheumatic drug
used to treat rheumatoid arthritis. The major adverse effects associated with
methotrexate include bone marrow suppression, hepatotoxicity, congenital
abnormalities, and fetal death.
