NCLEX Pharmacology- Questions And
Answers with rationales 2026
Updated.
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium
level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to
the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - Answer 3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia.
Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which
occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be
avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone
resorption and lowering the serum calcium concentration.
Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
nurse instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - Answer 4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to
administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect
absorption of the iron. Water will not assist in absorption. Orange juice contains a greater
amount of vitamin C than apple juice.
Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the
client, knowing that which of the following would indicate the presence of systemic toxicity
from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - Answer 1. Tinnitus
Rationale:
,Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result.
Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation
and diarrhea are not associated with salicylism.
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the
client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - Answer 1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of
isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements
should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated
with the use of isotretinoin.
The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor
for the potential for increased systemic absorption of the medication if the medication were
being applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - Answer 2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from
regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum,
genitalia), and lower from regions in which permeability is poor (back, palms, soles).
The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a
partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is
reinforcing information to the client about the medication. Which statement made by the client
indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound." - Answer 3. "The medication
will permanently stain my skin."
Rationale:
, Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against
gram-negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to
assist in healing. It does not stain the skin.
The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors
which laboratory value while the client is taking this medication?
1. Glucose level
2. Calcium level
3. Potassium level
4. Prothrombin time - Answer 2. Calcium level
Rationale:
Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of
therapy, a complete blood count, platelet count, and serum calcium levels should be assessed.
These blood levels, along with cholesterol and triglyceride levels, should be monitored
periodically during therapy. The nurse should assess for hypercalcemia while the client is taking
this medication. Signs of hypercalcemia include increased urine volume, excessive thirst,
nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain.
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed
for the client. The nurse determines that this medication has been prescribed to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - Answer 3. Treat hypocalcemic tetany.
Rationale:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally
removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client
develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or
twitching, the health care provider is notified immediately. Calcium gluconate should be kept at
the bedside.
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily
insulin injections. Which information should the nurse teach when carrying out plans for
discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - Answer 2. Rotate the
insulin injection sites systematically.
Rationale:
Answers with rationales 2026
Updated.
A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium
level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to
the client?
1. Calcium chloride
2. Calcium gluconate
3. Calcitonin (Miacalcin)
4. Large doses of vitamin D - Answer 3. Calcitonin (Miacalcin)
Rationale:
The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia.
Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which
occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be
avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone
resorption and lowering the serum calcium concentration.
Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
nurse instructs the mother to administer the iron with which best food item?
1. Milk
2. Water
3. Apple juice
4. Orange juice - Answer 4. Orange juice
Rationale:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to
administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect
absorption of the iron. Water will not assist in absorption. Orange juice contains a greater
amount of vitamin C than apple juice.
Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the
client, knowing that which of the following would indicate the presence of systemic toxicity
from this medication?
1. Tinnitus
2. Diarrhea
3. Constipation
4. Decreased respirations - Answer 1. Tinnitus
Rationale:
,Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result.
Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation
and diarrhea are not associated with salicylism.
A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the
client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - Answer 1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of
isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements
should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not contraindicated
with the use of isotretinoin.
The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor
for the potential for increased systemic absorption of the medication if the medication were
being applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - Answer 2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from
regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck, perineum,
genitalia), and lower from regions in which permeability is poor (back, palms, soles).
The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a
partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is
reinforcing information to the client about the medication. Which statement made by the client
indicates a lack of understanding about the treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound." - Answer 3. "The medication
will permanently stain my skin."
Rationale:
, Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against
gram-negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound to
assist in healing. It does not stain the skin.
The client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors
which laboratory value while the client is taking this medication?
1. Glucose level
2. Calcium level
3. Potassium level
4. Prothrombin time - Answer 2. Calcium level
Rationale:
Tamoxifen may increase calcium, cholesterol, and triglyceride levels. Before the initiation of
therapy, a complete blood count, platelet count, and serum calcium levels should be assessed.
These blood levels, along with cholesterol and triglyceride levels, should be monitored
periodically during therapy. The nurse should assess for hypercalcemia while the client is taking
this medication. Signs of hypercalcemia include increased urine volume, excessive thirst,
nausea, vomiting, constipation, hypotonicity of muscles, and deep bone and flank pain.
A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed
for the client. The nurse determines that this medication has been prescribed to:
1. Treat thyroid storm.
2. Prevent cardiac irritability.
3. Treat hypocalcemic tetany.
4. Stimulate the release of parathyroid hormone. - Answer 3. Treat hypocalcemic tetany.
Rationale:
Hypocalcemia can develop after thyroidectomy if the parathyroid glands are accidentally
removed or injured during surgery. Manifestations develop 1 to 7 days after surgery. If the client
develops numbness and tingling around the mouth, fingertips, or toes or muscle spasms or
twitching, the health care provider is notified immediately. Calcium gluconate should be kept at
the bedside.
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily
insulin injections. Which information should the nurse teach when carrying out plans for
discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage. - Answer 2. Rotate the
insulin injection sites systematically.
Rationale:
