NU 150 PHARMACOLOGY EXAM 2 PRACTICE
QUESTIONS COMPLETE NCLEX-PN STYLE QUESTIONS
WITH ANSWERS AND RATIONALES
1. A client is prescribed warfarin for atrial fibrillation. Which laboratory value
should the nurse monitor to evaluate therapeutic effect?
A. aPTT
B. INR
C. Platelet count
D. Troponin
Correct Answer: B. INR
Rationale: INR is the standard test to monitor warfarin therapy (therapeutic range
2–3 for atrial fibrillation). aPTT monitors heparin, platelet count monitors bleeding
risk, and troponin assesses cardiac damage.
2. A client taking an ACE inhibitor reports "puffy" lips and cough. Which action is
most important for the LPN to take?
A. Reassure the client and schedule follow up appointment.
B. Notify the RN.
C. Teach the client that cough is expected.
D. Assess the client’s blood pressure.
Correct Answer: B. Notify the RN.
Rationale: Puffy lips (angioedema) is a serious ACE inhibitor adverse reaction that
,can compromise the airway. The LPN must notify the RN immediately. Cough is
common, but angioedema is an emergency.
3. A client is prescribed benzonatate for cough. Which client statement requires
immediate follow up by the nurse?
A. "I will store it in a child locked cabinet."
B. "I will swallow the capsule whole."
C. "I will chew the capsule if my cough is severe."
D. "I will call if my cough lasts more than one week."
Correct Answer: C. "I will chew the capsule if my cough is severe."
Rationale: Benzonatate capsules must be swallowed whole. Chewing releases the
drug too quickly and can cause serious adverse effects such as bronchospasm,
laryngospasm, or cardiovascular collapse.
4. A client has used oxymetazoline nasal spray twice daily for 6 days and reports
worsening congestion. Which action should the nurse take next?
A. Advise the client to increase to every 2 hours for 24 hours.
B. Stop the spray and notify the RN.
C. Assess the client’s oral temperature.
D. Call the provider for a second nasal decongestant spray.
Correct Answer: B. Stop the spray and notify the RN.
Rationale: Oxymetazoline should not be used for more than 3 days due to
rebound congestion (rhinitis medicamentosa). The nurse should stop the spray
and notify the RN for further orders.
5. A client taking rifampin reports fatigue and yellowing of the eyes. Which
action should the nurse take first?
A. Document the finding.
B. Review the client’s most recent BUN/Creatinine levels.
,C. Teach the client about the side effects of tuberculosis medications.
D. Notify the registered nurse.
Correct Answer: D. Notify the registered nurse.
Rationale: Yellowing of the eyes (jaundice) suggests hepatotoxicity, a serious
adverse effect of rifampin. The nurse must notify the RN immediately for further
evaluation and possible liver function testing.
6. A client is prescribed levothyroxine. The client also takes calcium carbonate
daily for reflux. Which client statement indicates a need for further teaching?
A. "I will take levothyroxine when I wake up and calcium at lunch."
B. "I will take levothyroxine with breakfast so my stomach is not upset."
C. "I will call if I develop chest pain or palpitations."
D. "I understand it may take several weeks to feel the full effect."
Correct Answer: B. "I will take levothyroxine with breakfast so my stomach is
not upset."
Rationale: Levothyroxine must be taken on an empty stomach, 30–60 minutes
before breakfast, to maximize absorption. Taking it with food or other medications
(especially calcium) reduces absorption.
7. The nurse is preparing to administer digoxin for a client with heart failure.
Which action should the nurse take first?
A. Review the most recent potassium level.
B. Count the apical pulse for one full minute.
C. Assess lung sounds for crackles.
D. Ask the client whether nausea is present.
Correct Answer: B. Count the apical pulse for one full minute.
Rationale: The priority action before giving digoxin is to assess the apical pulse for
one full minute. Hold the dose if the pulse is <60 bpm (or <50 bpm in some
protocols) and notify the provider. Hypokalemia increases digoxin toxicity risk, but
pulse assessment is the immediate priority.
, 8. A client is prescribed pseudoephedrine. Which assessment finding is most
important for the nurse to report to the RN before administration?
A. Heart rate 92 bpm.
B. Blood pressure 176/98 mmHg.
C. Client reports occasional headaches.
D. Oxygen saturation 96% on RA.
Correct Answer: B. Blood pressure 176/98 mmHg.
Rationale: Pseudoephedrine is a sympathomimetic that raises blood pressure and
heart rate. A BP of 176/98 mmHg is significantly elevated and poses a risk of
hypertensive crisis or stroke; the RN must be notified before administration.
9. A client is taking prednisone for an autoimmune disorder. Which assessment
finding should the nurse report to the RN immediately?
A. Increased appetite and insomnia.
B. Blood glucose 199 mg/dL and increased thirst.
C. Coffee ground emesis.
D. Facial fullness and weight gain of 2 pounds.
Correct Answer: C. Coffee ground emesis.
Rationale: Coffee ground emesis indicates gastrointestinal bleeding, a serious
adverse effect of corticosteroids. This requires immediate notification. Increased
appetite, insomnia, hyperglycemia, and mild weight gain are expected side effects
but are not immediately life-threatening.
10. A client with asthma reports sudden wheezing after ambulating the hall.
Which prescription should the nurse anticipate administering first?
A. Inhaled fluticasone.
B. Inhaled salmeterol.
C. Inhaled albuterol.
D. Oral prednisone.
QUESTIONS COMPLETE NCLEX-PN STYLE QUESTIONS
WITH ANSWERS AND RATIONALES
1. A client is prescribed warfarin for atrial fibrillation. Which laboratory value
should the nurse monitor to evaluate therapeutic effect?
A. aPTT
B. INR
C. Platelet count
D. Troponin
Correct Answer: B. INR
Rationale: INR is the standard test to monitor warfarin therapy (therapeutic range
2–3 for atrial fibrillation). aPTT monitors heparin, platelet count monitors bleeding
risk, and troponin assesses cardiac damage.
2. A client taking an ACE inhibitor reports "puffy" lips and cough. Which action is
most important for the LPN to take?
A. Reassure the client and schedule follow up appointment.
B. Notify the RN.
C. Teach the client that cough is expected.
D. Assess the client’s blood pressure.
Correct Answer: B. Notify the RN.
Rationale: Puffy lips (angioedema) is a serious ACE inhibitor adverse reaction that
,can compromise the airway. The LPN must notify the RN immediately. Cough is
common, but angioedema is an emergency.
3. A client is prescribed benzonatate for cough. Which client statement requires
immediate follow up by the nurse?
A. "I will store it in a child locked cabinet."
B. "I will swallow the capsule whole."
C. "I will chew the capsule if my cough is severe."
D. "I will call if my cough lasts more than one week."
Correct Answer: C. "I will chew the capsule if my cough is severe."
Rationale: Benzonatate capsules must be swallowed whole. Chewing releases the
drug too quickly and can cause serious adverse effects such as bronchospasm,
laryngospasm, or cardiovascular collapse.
4. A client has used oxymetazoline nasal spray twice daily for 6 days and reports
worsening congestion. Which action should the nurse take next?
A. Advise the client to increase to every 2 hours for 24 hours.
B. Stop the spray and notify the RN.
C. Assess the client’s oral temperature.
D. Call the provider for a second nasal decongestant spray.
Correct Answer: B. Stop the spray and notify the RN.
Rationale: Oxymetazoline should not be used for more than 3 days due to
rebound congestion (rhinitis medicamentosa). The nurse should stop the spray
and notify the RN for further orders.
5. A client taking rifampin reports fatigue and yellowing of the eyes. Which
action should the nurse take first?
A. Document the finding.
B. Review the client’s most recent BUN/Creatinine levels.
,C. Teach the client about the side effects of tuberculosis medications.
D. Notify the registered nurse.
Correct Answer: D. Notify the registered nurse.
Rationale: Yellowing of the eyes (jaundice) suggests hepatotoxicity, a serious
adverse effect of rifampin. The nurse must notify the RN immediately for further
evaluation and possible liver function testing.
6. A client is prescribed levothyroxine. The client also takes calcium carbonate
daily for reflux. Which client statement indicates a need for further teaching?
A. "I will take levothyroxine when I wake up and calcium at lunch."
B. "I will take levothyroxine with breakfast so my stomach is not upset."
C. "I will call if I develop chest pain or palpitations."
D. "I understand it may take several weeks to feel the full effect."
Correct Answer: B. "I will take levothyroxine with breakfast so my stomach is
not upset."
Rationale: Levothyroxine must be taken on an empty stomach, 30–60 minutes
before breakfast, to maximize absorption. Taking it with food or other medications
(especially calcium) reduces absorption.
7. The nurse is preparing to administer digoxin for a client with heart failure.
Which action should the nurse take first?
A. Review the most recent potassium level.
B. Count the apical pulse for one full minute.
C. Assess lung sounds for crackles.
D. Ask the client whether nausea is present.
Correct Answer: B. Count the apical pulse for one full minute.
Rationale: The priority action before giving digoxin is to assess the apical pulse for
one full minute. Hold the dose if the pulse is <60 bpm (or <50 bpm in some
protocols) and notify the provider. Hypokalemia increases digoxin toxicity risk, but
pulse assessment is the immediate priority.
, 8. A client is prescribed pseudoephedrine. Which assessment finding is most
important for the nurse to report to the RN before administration?
A. Heart rate 92 bpm.
B. Blood pressure 176/98 mmHg.
C. Client reports occasional headaches.
D. Oxygen saturation 96% on RA.
Correct Answer: B. Blood pressure 176/98 mmHg.
Rationale: Pseudoephedrine is a sympathomimetic that raises blood pressure and
heart rate. A BP of 176/98 mmHg is significantly elevated and poses a risk of
hypertensive crisis or stroke; the RN must be notified before administration.
9. A client is taking prednisone for an autoimmune disorder. Which assessment
finding should the nurse report to the RN immediately?
A. Increased appetite and insomnia.
B. Blood glucose 199 mg/dL and increased thirst.
C. Coffee ground emesis.
D. Facial fullness and weight gain of 2 pounds.
Correct Answer: C. Coffee ground emesis.
Rationale: Coffee ground emesis indicates gastrointestinal bleeding, a serious
adverse effect of corticosteroids. This requires immediate notification. Increased
appetite, insomnia, hyperglycemia, and mild weight gain are expected side effects
but are not immediately life-threatening.
10. A client with asthma reports sudden wheezing after ambulating the hall.
Which prescription should the nurse anticipate administering first?
A. Inhaled fluticasone.
B. Inhaled salmeterol.
C. Inhaled albuterol.
D. Oral prednisone.
