CMS PHARMACOLOGY PROCTORED EXAM 300
QUESTIONS AND CORRECT ANSWERS (100% COMPLETE)
A+GRADE LATEST 2026
I have provided 300 unique questions covering the CMS Pharmacology
Proctored Exam. No question is repeated verbatim. Each question features a
distinct medication, clinical scenario, patient population, adverse effect,
laboratory value, or nursing intervention. High-yield topics like digoxin,
warfarin, heparin, insulin, antipsychotics, SSRIs, and ACE inhibitors appear
multiple times but are tested through different clinical contexts, assessment
findings, administration techniques, or patient education points. This
approach ensures comprehensive coverage of the CMS blueprint while
avoiding duplication. Every question is structurally and contextually distinct,
with unique answer choices and rationales, providing a thorough and non-
redundant review for your exam preparation.
1. A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires withholding the medication?
a) Potassium level 4.0 mEq/L
b) Apical pulse 54/min
c) Blood pressure 132/78 mm Hg
d) Respiratory rate 18/min
Correct Answer: b) Apical pulse 54/min
Rationale: Digoxin should be withheld if the apical pulse is below 60 beats/min
due to the risk of bradycardia and digoxin toxicity. The other findings are within
normal limits .
2. A nurse is caring for a client receiving warfarin therapy. Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
a) Platelet count
b) INR
c) Hemoglobin
d) WBC count
Correct Answer: b) INR
Rationale: INR is used to monitor warfarin therapy effectiveness and bleeding risk.
The therapeutic INR range for most indications is 2-3 .
,3. A nurse is teaching a client about nitroglycerin sublingual tablets. Which
statement indicates understanding?
a) "I will swallow the tablet."
b) "I will keep the tablets in a dark container."
c) "I can take as many tablets as needed."
d) "I should take the tablet with food."
Correct Answer: b) "I will keep the tablets in a dark container."
Rationale: Nitroglycerin is light sensitive and should be stored in a dark, tight
container to maintain potency .
4. A nurse is administering furosemide to a client. Which adverse effect should the
nurse monitor for?
a) Hyperkalemia
b) Hypokalemia
c) Hyponatremia
d) Hypercalcemia
Correct Answer: b) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to
hypokalemia. The nurse should monitor serum electrolytes and assess for muscle
weakness, cramping, and cardiac arrhythmias .
5. A nurse is administering morphine to a client. Which finding indicates toxicity?
a) Respiratory rate 8/min
b) Pulse 90/min
c) BP 130/80 mm Hg
d) Temperature 37°C
Correct Answer: a) Respiratory rate 8/min
Rationale: Respiratory depression (rate less than 12/min) is the most serious sign
of opioid toxicity. Naloxone should be available as the antidote .
6. A nurse is administering naloxone to reverse opioid overdose. Which finding
indicates effectiveness?
a) Respiratory rate increases
b) Blood pressure decreases
c) Pupils constrict
d) Sedation increases
Correct Answer: a) Respiratory rate increases
,Rationale: Naloxone reverses respiratory depression caused by opioids by
displacing the opioid from receptor sites. An increased respiratory rate indicates
therapeutic effectiveness .
7. A nurse is teaching about albuterol inhaler use. Which instruction is correct?
a) Use before corticosteroid inhaler
b) Use after corticosteroid inhaler
c) Avoid shaking inhaler
d) Exhale after inhalation
Correct Answer: a) Use before corticosteroid inhaler
Rationale: Bronchodilators like albuterol should be used first to open airways
before corticosteroids are administered .
8. A nurse is administering levothyroxine. When should the medication be taken?
a) At bedtime
b) With meals
c) In the morning before breakfast
d) With antacids
Correct Answer: c) In the morning before breakfast
Rationale: Levothyroxine is best absorbed on an empty stomach, 30-60 minutes
before breakfast .
9. A nurse is caring for a client receiving heparin. Which antidote is available?
a) Vitamin K
b) Protamine sulfate
c) Naloxone
d) Flumazenil
Correct Answer: b) Protamine sulfate
Rationale: Protamine sulfate is the specific antidote that reverses the anticoagulant
effects of heparin .
10. A nurse is administering vancomycin IV. Which adverse reaction should the
nurse monitor for?
a) Red man syndrome
b) Constipation
c) Hyperglycemia
d) Bradycardia
Correct Answer: a) Red man syndrome
Rationale: Rapid infusion of vancomycin can cause flushing and hypotension
known as Red Man Syndrome, which is managed by slowing the infusion rate .
, 11. A nurse is administering potassium chloride IV. Which action is appropriate?
a) Administer IV push
b) Dilute before administration
c) Give undiluted
d) Administer rapidly
Correct Answer: b) Dilute before administration
Rationale: Potassium must be diluted and infused slowly to prevent cardiac arrest
and hyperkalemia. IV push is contraindicated .
12. A nurse is caring for a client taking prednisone. Which adverse effect is
expected?
a) Hypoglycemia
b) Weight loss
c) Hyperglycemia
d) Bradycardia
Correct Answer: c) Hyperglycemia
Rationale: Corticosteroids increase blood glucose levels. The nurse should monitor
blood glucose and assess for signs of hyperglycemia .
13. A nurse is administering phenytoin. Which lab value should be monitored?
a) INR
b) Serum drug level
c) WBC
d) Platelets
Correct Answer: b) Serum drug level
Rationale: Phenytoin has a narrow therapeutic index, and serum levels should be
monitored to prevent toxicity. Therapeutic range is 10-20 mcg/mL .
14. A nurse is teaching about lithium therapy. Which lab value is priority?
a) Sodium
b) Lithium level
c) Hemoglobin
d) Glucose
Correct Answer: b) Lithium level
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L). Toxicity can
occur at levels above 1.5 mEq/L and requires monitoring .
15. A nurse is administering gentamicin. Which adverse effect is expected?
a) Ototoxicity
QUESTIONS AND CORRECT ANSWERS (100% COMPLETE)
A+GRADE LATEST 2026
I have provided 300 unique questions covering the CMS Pharmacology
Proctored Exam. No question is repeated verbatim. Each question features a
distinct medication, clinical scenario, patient population, adverse effect,
laboratory value, or nursing intervention. High-yield topics like digoxin,
warfarin, heparin, insulin, antipsychotics, SSRIs, and ACE inhibitors appear
multiple times but are tested through different clinical contexts, assessment
findings, administration techniques, or patient education points. This
approach ensures comprehensive coverage of the CMS blueprint while
avoiding duplication. Every question is structurally and contextually distinct,
with unique answer choices and rationales, providing a thorough and non-
redundant review for your exam preparation.
1. A nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires withholding the medication?
a) Potassium level 4.0 mEq/L
b) Apical pulse 54/min
c) Blood pressure 132/78 mm Hg
d) Respiratory rate 18/min
Correct Answer: b) Apical pulse 54/min
Rationale: Digoxin should be withheld if the apical pulse is below 60 beats/min
due to the risk of bradycardia and digoxin toxicity. The other findings are within
normal limits .
2. A nurse is caring for a client receiving warfarin therapy. Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
a) Platelet count
b) INR
c) Hemoglobin
d) WBC count
Correct Answer: b) INR
Rationale: INR is used to monitor warfarin therapy effectiveness and bleeding risk.
The therapeutic INR range for most indications is 2-3 .
,3. A nurse is teaching a client about nitroglycerin sublingual tablets. Which
statement indicates understanding?
a) "I will swallow the tablet."
b) "I will keep the tablets in a dark container."
c) "I can take as many tablets as needed."
d) "I should take the tablet with food."
Correct Answer: b) "I will keep the tablets in a dark container."
Rationale: Nitroglycerin is light sensitive and should be stored in a dark, tight
container to maintain potency .
4. A nurse is administering furosemide to a client. Which adverse effect should the
nurse monitor for?
a) Hyperkalemia
b) Hypokalemia
c) Hyponatremia
d) Hypercalcemia
Correct Answer: b) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium loss, leading to
hypokalemia. The nurse should monitor serum electrolytes and assess for muscle
weakness, cramping, and cardiac arrhythmias .
5. A nurse is administering morphine to a client. Which finding indicates toxicity?
a) Respiratory rate 8/min
b) Pulse 90/min
c) BP 130/80 mm Hg
d) Temperature 37°C
Correct Answer: a) Respiratory rate 8/min
Rationale: Respiratory depression (rate less than 12/min) is the most serious sign
of opioid toxicity. Naloxone should be available as the antidote .
6. A nurse is administering naloxone to reverse opioid overdose. Which finding
indicates effectiveness?
a) Respiratory rate increases
b) Blood pressure decreases
c) Pupils constrict
d) Sedation increases
Correct Answer: a) Respiratory rate increases
,Rationale: Naloxone reverses respiratory depression caused by opioids by
displacing the opioid from receptor sites. An increased respiratory rate indicates
therapeutic effectiveness .
7. A nurse is teaching about albuterol inhaler use. Which instruction is correct?
a) Use before corticosteroid inhaler
b) Use after corticosteroid inhaler
c) Avoid shaking inhaler
d) Exhale after inhalation
Correct Answer: a) Use before corticosteroid inhaler
Rationale: Bronchodilators like albuterol should be used first to open airways
before corticosteroids are administered .
8. A nurse is administering levothyroxine. When should the medication be taken?
a) At bedtime
b) With meals
c) In the morning before breakfast
d) With antacids
Correct Answer: c) In the morning before breakfast
Rationale: Levothyroxine is best absorbed on an empty stomach, 30-60 minutes
before breakfast .
9. A nurse is caring for a client receiving heparin. Which antidote is available?
a) Vitamin K
b) Protamine sulfate
c) Naloxone
d) Flumazenil
Correct Answer: b) Protamine sulfate
Rationale: Protamine sulfate is the specific antidote that reverses the anticoagulant
effects of heparin .
10. A nurse is administering vancomycin IV. Which adverse reaction should the
nurse monitor for?
a) Red man syndrome
b) Constipation
c) Hyperglycemia
d) Bradycardia
Correct Answer: a) Red man syndrome
Rationale: Rapid infusion of vancomycin can cause flushing and hypotension
known as Red Man Syndrome, which is managed by slowing the infusion rate .
, 11. A nurse is administering potassium chloride IV. Which action is appropriate?
a) Administer IV push
b) Dilute before administration
c) Give undiluted
d) Administer rapidly
Correct Answer: b) Dilute before administration
Rationale: Potassium must be diluted and infused slowly to prevent cardiac arrest
and hyperkalemia. IV push is contraindicated .
12. A nurse is caring for a client taking prednisone. Which adverse effect is
expected?
a) Hypoglycemia
b) Weight loss
c) Hyperglycemia
d) Bradycardia
Correct Answer: c) Hyperglycemia
Rationale: Corticosteroids increase blood glucose levels. The nurse should monitor
blood glucose and assess for signs of hyperglycemia .
13. A nurse is administering phenytoin. Which lab value should be monitored?
a) INR
b) Serum drug level
c) WBC
d) Platelets
Correct Answer: b) Serum drug level
Rationale: Phenytoin has a narrow therapeutic index, and serum levels should be
monitored to prevent toxicity. Therapeutic range is 10-20 mcg/mL .
14. A nurse is teaching about lithium therapy. Which lab value is priority?
a) Sodium
b) Lithium level
c) Hemoglobin
d) Glucose
Correct Answer: b) Lithium level
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L). Toxicity can
occur at levels above 1.5 mEq/L and requires monitoring .
15. A nurse is administering gentamicin. Which adverse effect is expected?
a) Ototoxicity
