,NCLEX Pharmacology and ATI
Pharmacology Assessment Practice Exam
questions and correct answers– Updated
2026 (Graded A+) instant download pdf
Subject: Pharmacology
Subtopic: Pharmacokinetics and Medication Administration
Question 1: A nurse administers an extended-release oral opioid to a postoperative patient who
reports severe pain 20 minutes later. Which nursing action is most appropriate?
A) Crush the next dose to increase absorption
B) Explain that extended-release formulations require additional time to achieve therapeutic
levels
C) Administer an additional full dose immediately without further assessment
D) Withhold future doses because the medication is ineffective
Correct Answer: B - Explain that extended-release formulations require additional time to
achieve therapeutic levels
Rationale: Extended-release medications are designed to release drug gradually over time and
do not provide immediate analgesia. Option B reflects an understanding of pharmacokinetics
and appropriate patient education. Crushing extended-release medications (Option A) may
cause dose dumping and toxicity. Administering an additional full dose without assessment
(Option C) may result in overdose. Option D is inappropriate because therapeutic effectiveness
cannot be judged after only 20 minutes.
Question 2: A nurse reviews laboratory results before administering gentamicin. Which finding
requires immediate intervention?
A) Serum creatinine 2.1 mg/dL
B) Potassium 4.0 mEq/L
C) Hemoglobin 13 g/dL
D) White blood cell count 8,000/mm³
Correct Answer: A - Serum creatinine 2.1 mg/dL
Rationale: Gentamicin is nephrotoxic and is eliminated primarily by the kidneys. An elevated
serum creatinine indicates impaired renal function and increases the risk for toxicity. The
remaining laboratory values are within expected ranges and do not independently contraindicate
administration.
,Question 3: A patient taking warfarin asks why frequent INR monitoring is necessary. Which
response by the nurse is best?
A) "The test measures your kidney function."
B) "The INR determines whether your dosage provides adequate anticoagulation while
minimizing bleeding risk."
C) "The test measures liver enzyme concentrations only."
D) "The INR determines whether you have developed drug allergies."
Correct Answer: B - The INR determines whether your dosage provides adequate
anticoagulation while minimizing bleeding risk
Rationale: INR monitoring evaluates warfarin effectiveness and safety by measuring coagulation
status. Excessively high values increase bleeding risk, whereas low values may indicate
inadequate anticoagulation. Options A, C, and D incorrectly describe the purpose of INR testing.
Question 4: Which factor most significantly affects first-pass metabolism?
A) Intramuscular administration
B) Sublingual administration
C) Oral administration
D) Transdermal administration
Correct Answer: C - Oral administration
Rationale: Oral medications pass through the gastrointestinal tract and portal circulation before
reaching systemic circulation, exposing them to hepatic first-pass metabolism. Sublingual and
transdermal routes largely bypass first-pass metabolism. Intramuscular administration also
avoids significant first-pass effects.
Question 5: A nurse is preparing to administer digoxin. Which assessment finding requires
withholding the medication and notifying the provider?
A) Apical pulse of 54/min
B) Blood pressure 138/82 mm Hg
C) Respiratory rate 18/min
D) Temperature 37.1°C (98.8°F)
Correct Answer: A - Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. Most guidelines recommend withholding the
medication when the adult apical pulse is below 60/min and notifying the provider. The
remaining findings are not contraindications to administration.
, Subtopic: Autonomic Nervous System Pharmacology
Question 6: A patient receiving atropine for symptomatic bradycardia should be monitored for
which adverse effect?
A) Bronchoconstriction
B) Excessive salivation
C) Urinary retention
D) Diarrhea
Correct Answer: C - Urinary retention
Rationale: Atropine is an anticholinergic medication that commonly causes urinary retention,
dry mouth, tachycardia, and blurred vision. Bronchoconstriction, excessive salivation, and
diarrhea are associated with cholinergic activity rather than anticholinergic effects.
Question 7: Which patient statement indicates understanding of beta-blocker therapy?
A) "I will stop the medication abruptly if I feel better."
B) "I should monitor my pulse regularly while taking this medication."
C) "This medication will increase my heart rate."
D) "I can double the dose if my blood pressure rises."
Correct Answer: B - I should monitor my pulse regularly while taking this medication
Rationale: Beta-blockers reduce heart rate and blood pressure; therefore, patients should
monitor their pulse. Abrupt discontinuation may precipitate rebound hypertension or angina.
The medication generally lowers, not increases, heart rate, and dose adjustments should occur
only under provider direction.
Question 8: A patient with asthma is prescribed propranolol. Which concern should the nurse
prioritize?
A) Orthostatic hypotension
B) Bronchospasm
C) Hyperglycemia
D) Constipation
Correct Answer: B - Bronchospasm
Rationale: Propranolol is a nonselective beta-blocker that blocks beta₂ receptors in the lungs,
potentially causing bronchospasm. This adverse effect is particularly concerning in patients with
asthma.
Pharmacology Assessment Practice Exam
questions and correct answers– Updated
2026 (Graded A+) instant download pdf
Subject: Pharmacology
Subtopic: Pharmacokinetics and Medication Administration
Question 1: A nurse administers an extended-release oral opioid to a postoperative patient who
reports severe pain 20 minutes later. Which nursing action is most appropriate?
A) Crush the next dose to increase absorption
B) Explain that extended-release formulations require additional time to achieve therapeutic
levels
C) Administer an additional full dose immediately without further assessment
D) Withhold future doses because the medication is ineffective
Correct Answer: B - Explain that extended-release formulations require additional time to
achieve therapeutic levels
Rationale: Extended-release medications are designed to release drug gradually over time and
do not provide immediate analgesia. Option B reflects an understanding of pharmacokinetics
and appropriate patient education. Crushing extended-release medications (Option A) may
cause dose dumping and toxicity. Administering an additional full dose without assessment
(Option C) may result in overdose. Option D is inappropriate because therapeutic effectiveness
cannot be judged after only 20 minutes.
Question 2: A nurse reviews laboratory results before administering gentamicin. Which finding
requires immediate intervention?
A) Serum creatinine 2.1 mg/dL
B) Potassium 4.0 mEq/L
C) Hemoglobin 13 g/dL
D) White blood cell count 8,000/mm³
Correct Answer: A - Serum creatinine 2.1 mg/dL
Rationale: Gentamicin is nephrotoxic and is eliminated primarily by the kidneys. An elevated
serum creatinine indicates impaired renal function and increases the risk for toxicity. The
remaining laboratory values are within expected ranges and do not independently contraindicate
administration.
,Question 3: A patient taking warfarin asks why frequent INR monitoring is necessary. Which
response by the nurse is best?
A) "The test measures your kidney function."
B) "The INR determines whether your dosage provides adequate anticoagulation while
minimizing bleeding risk."
C) "The test measures liver enzyme concentrations only."
D) "The INR determines whether you have developed drug allergies."
Correct Answer: B - The INR determines whether your dosage provides adequate
anticoagulation while minimizing bleeding risk
Rationale: INR monitoring evaluates warfarin effectiveness and safety by measuring coagulation
status. Excessively high values increase bleeding risk, whereas low values may indicate
inadequate anticoagulation. Options A, C, and D incorrectly describe the purpose of INR testing.
Question 4: Which factor most significantly affects first-pass metabolism?
A) Intramuscular administration
B) Sublingual administration
C) Oral administration
D) Transdermal administration
Correct Answer: C - Oral administration
Rationale: Oral medications pass through the gastrointestinal tract and portal circulation before
reaching systemic circulation, exposing them to hepatic first-pass metabolism. Sublingual and
transdermal routes largely bypass first-pass metabolism. Intramuscular administration also
avoids significant first-pass effects.
Question 5: A nurse is preparing to administer digoxin. Which assessment finding requires
withholding the medication and notifying the provider?
A) Apical pulse of 54/min
B) Blood pressure 138/82 mm Hg
C) Respiratory rate 18/min
D) Temperature 37.1°C (98.8°F)
Correct Answer: A - Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. Most guidelines recommend withholding the
medication when the adult apical pulse is below 60/min and notifying the provider. The
remaining findings are not contraindications to administration.
, Subtopic: Autonomic Nervous System Pharmacology
Question 6: A patient receiving atropine for symptomatic bradycardia should be monitored for
which adverse effect?
A) Bronchoconstriction
B) Excessive salivation
C) Urinary retention
D) Diarrhea
Correct Answer: C - Urinary retention
Rationale: Atropine is an anticholinergic medication that commonly causes urinary retention,
dry mouth, tachycardia, and blurred vision. Bronchoconstriction, excessive salivation, and
diarrhea are associated with cholinergic activity rather than anticholinergic effects.
Question 7: Which patient statement indicates understanding of beta-blocker therapy?
A) "I will stop the medication abruptly if I feel better."
B) "I should monitor my pulse regularly while taking this medication."
C) "This medication will increase my heart rate."
D) "I can double the dose if my blood pressure rises."
Correct Answer: B - I should monitor my pulse regularly while taking this medication
Rationale: Beta-blockers reduce heart rate and blood pressure; therefore, patients should
monitor their pulse. Abrupt discontinuation may precipitate rebound hypertension or angina.
The medication generally lowers, not increases, heart rate, and dose adjustments should occur
only under provider direction.
Question 8: A patient with asthma is prescribed propranolol. Which concern should the nurse
prioritize?
A) Orthostatic hypotension
B) Bronchospasm
C) Hyperglycemia
D) Constipation
Correct Answer: B - Bronchospasm
Rationale: Propranolol is a nonselective beta-blocker that blocks beta₂ receptors in the lungs,
potentially causing bronchospasm. This adverse effect is particularly concerning in patients with
asthma.
