ATI Pharmacology Made Easy Introduction
to Pharmacology Exam |
20 NCLEX-RN Next Gen Practice Questions
with Detailed Rationales |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 72-year-old man is admitted with community-acquired
pneumonia. His medical history includes hypertension, type 2
diabetes mellitus, and chronic kidney disease (stage 3). The
provider prescribes ceftriaxone 1 g IV every 24 hours. Before
preparing the medication, the nurse reviews the electronic
health record and notes a documented allergy to ceftriaxone
with a previous episode of facial swelling and difficulty
breathing. Vital signs are stable.
Question Stem
Which action should the nurse take first?
,A. Administer the medication while closely monitoring for
adverse effects.
B. Contact the provider to clarify the prescription and report
the documented allergy.
C. Premedicate the client with diphenhydramine before
administering ceftriaxone.
D. Ask another nurse whether ceftriaxone is usually safe for
clients with allergies.
Correct Answer
Correct Answer: B. Contact the provider to clarify the
prescription and report the documented allergy.
Detailed Rationale
The nurse's first priority is patient safety. A documented history
of facial swelling and difficulty breathing following ceftriaxone
strongly suggests a previous anaphylactic or severe
hypersensitivity reaction. Administering the medication could
precipitate another life-threatening reaction. The nurse should
withhold the medication, verify the allergy, notify the provider,
and anticipate an alternative antibiotic.
Option A is unsafe because monitoring does not eliminate the
risk of anaphylaxis. Severe allergic reactions may occur rapidly
despite close observation.
,Option C is incorrect because antihistamines cannot reliably
prevent IgE-mediated anaphylaxis. Premedicating should never
be used to justify administration of a contraindicated
medication.
Option D delays appropriate intervention. Medication decisions
should rely on verified patient information, evidence-based
practice, and provider collaboration rather than informal
opinions.
This question illustrates the "rights" of medication
administration beyond simply giving the prescribed drug.
Nurses must assess allergies before every medication
administration and advocate for patient safety when prescribed
therapies conflict with documented contraindications.
Learning Objectives
After completing this question, the learner should be able to:
• Identify severe medication allergies before administration.
• Prioritize interventions that prevent medication-related
harm.
• Advocate for safe pharmacologic therapy through provider
communication.
Medication Safety Focus
Contraindications and Allergy Verification
, Question 2
Clinical Scenario
A nurse is preparing morning medications for four hospitalized
clients. Which client should the nurse assess first before
administering the prescribed medication?
Question Stem
Which client requires priority assessment before medication
administration?
A. A client prescribed lisinopril whose blood pressure is 88/54
mm Hg.
B. A client prescribed docusate sodium who has not had a
bowel movement in two days.
C. A client prescribed acetaminophen reporting a pain score of
5 out of 10.
D. A client prescribed a multivitamin who reports mild nausea.
Correct Answer
Correct Answer: A. A client prescribed lisinopril whose blood
pressure is 88/54 mm Hg.
Detailed Rationale
to Pharmacology Exam |
20 NCLEX-RN Next Gen Practice Questions
with Detailed Rationales |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 72-year-old man is admitted with community-acquired
pneumonia. His medical history includes hypertension, type 2
diabetes mellitus, and chronic kidney disease (stage 3). The
provider prescribes ceftriaxone 1 g IV every 24 hours. Before
preparing the medication, the nurse reviews the electronic
health record and notes a documented allergy to ceftriaxone
with a previous episode of facial swelling and difficulty
breathing. Vital signs are stable.
Question Stem
Which action should the nurse take first?
,A. Administer the medication while closely monitoring for
adverse effects.
B. Contact the provider to clarify the prescription and report
the documented allergy.
C. Premedicate the client with diphenhydramine before
administering ceftriaxone.
D. Ask another nurse whether ceftriaxone is usually safe for
clients with allergies.
Correct Answer
Correct Answer: B. Contact the provider to clarify the
prescription and report the documented allergy.
Detailed Rationale
The nurse's first priority is patient safety. A documented history
of facial swelling and difficulty breathing following ceftriaxone
strongly suggests a previous anaphylactic or severe
hypersensitivity reaction. Administering the medication could
precipitate another life-threatening reaction. The nurse should
withhold the medication, verify the allergy, notify the provider,
and anticipate an alternative antibiotic.
Option A is unsafe because monitoring does not eliminate the
risk of anaphylaxis. Severe allergic reactions may occur rapidly
despite close observation.
,Option C is incorrect because antihistamines cannot reliably
prevent IgE-mediated anaphylaxis. Premedicating should never
be used to justify administration of a contraindicated
medication.
Option D delays appropriate intervention. Medication decisions
should rely on verified patient information, evidence-based
practice, and provider collaboration rather than informal
opinions.
This question illustrates the "rights" of medication
administration beyond simply giving the prescribed drug.
Nurses must assess allergies before every medication
administration and advocate for patient safety when prescribed
therapies conflict with documented contraindications.
Learning Objectives
After completing this question, the learner should be able to:
• Identify severe medication allergies before administration.
• Prioritize interventions that prevent medication-related
harm.
• Advocate for safe pharmacologic therapy through provider
communication.
Medication Safety Focus
Contraindications and Allergy Verification
, Question 2
Clinical Scenario
A nurse is preparing morning medications for four hospitalized
clients. Which client should the nurse assess first before
administering the prescribed medication?
Question Stem
Which client requires priority assessment before medication
administration?
A. A client prescribed lisinopril whose blood pressure is 88/54
mm Hg.
B. A client prescribed docusate sodium who has not had a
bowel movement in two days.
C. A client prescribed acetaminophen reporting a pain score of
5 out of 10.
D. A client prescribed a multivitamin who reports mild nausea.
Correct Answer
Correct Answer: A. A client prescribed lisinopril whose blood
pressure is 88/54 mm Hg.
Detailed Rationale
