| 20 NCLEX-RN Next Gen Pharmacology
Practice Questions with Detailed Rationales |
Introduction to Pharmacology Study Guide
Question 1
Clinical Scenario
A 72-year-old man is admitted with community-acquired
pneumonia. His medical history includes hypertension, chronic
kidney disease stage 3, and osteoarthritis. The nurse reviews
the medication administration record before administering the
morning medications. The patient states, "I take several
vitamins and herbal supplements at home, but I didn't mention
them because they're not prescriptions."
Question Stem
Which nursing action is the priority?
A. Document the statement and continue administering the
scheduled medications.
,B. Obtain a complete list of all prescription medications, over-
the-counter products, vitamins, and herbal supplements before
administering medications.
C. Instruct the patient to stop taking all herbal supplements
after discharge.
D. Notify the provider only if the patient reports taking
prescription medications from another provider.
Correct Answer
Correct Answer: B. Obtain a complete list of all prescription
medications, over-the-counter products, vitamins, and herbal
supplements before administering medications.
Detailed Rationale
Medication reconciliation is a fundamental medication safety
practice that reduces preventable adverse drug events. The
nurse should obtain a comprehensive medication history that
includes prescription medications, over-the-counter drugs,
vitamins, minerals, herbal supplements, and recently
discontinued medications. Many herbal products and
supplements have clinically significant interactions with
prescribed medications. For example, some supplements
increase bleeding risk, while others alter drug metabolism or
therapeutic effectiveness. A complete medication history
enables the healthcare team to identify duplications,
,contraindications, allergies, and potential interactions before
medications are administered.
Option A is incorrect because administering medications
without completing medication reconciliation increases the risk
of medication errors and adverse interactions.
Option C is incorrect because the nurse should not
independently advise discontinuation of all supplements.
Clinical decisions should be individualized after evaluation by
the healthcare team.
Option D is incorrect because all medications—including
nonprescription products—must be reviewed regardless of the
prescribing source. Medication safety depends on evaluating
the patient's entire medication regimen rather than only
prescription medications.
Medication reconciliation is especially important in older adults,
who commonly take multiple medications and dietary
supplements, increasing the risk of polypharmacy and drug
interactions.
Learning Objectives
After completing this question, the learner should be able to:
• Describe the purpose of medication reconciliation.
• Identify components of a complete medication history.
, • Explain why herbal supplements can affect medication
therapy.
• Prioritize nursing actions that promote medication safety.
Medication Safety Focus
Medication Reconciliation
Question 2
Clinical Scenario
A nurse prepares to administer an oral antihypertensive
medication to a 68-year-old patient. Before giving the
medication, the nurse verifies the patient's identity using two
approved identifiers, compares the medication label with the
medication administration record, and confirms the prescribed
dose. As the nurse approaches the bedside, the patient asks,
"What medication is this, and why am I taking it?"
Question Stem
Which nursing response best promotes safe medication
administration?
A. "I'm not sure, but your provider ordered it."
B. "Let's review the medication name, its purpose, and possible
side effects before you take it."