RN Pharmacology A Relias Exam Questions and Answers
(Latest Update 2026-2027)
This study guide covers essential pharmacology concepts for nursing practice, including
medication classifications, mechanisms of action, therapeutic uses, adverse effects,
contraindications, and nursing considerations for safe medication administration. Learners will
review cardiovascular, respiratory, endocrine, neurological, antimicrobial, and pain management
medications, along with dosage calculations, medication safety principles, and patient education
strategies. The material is designed to strengthen pharmacological knowledge, support clinical
decision-making, and reinforce medication management concepts commonly assessed in nursing
competency and Relias-based evaluations.
Question 1
A nurse is preparing to administer 0.9% normal saline 1000 mL IV over 8 hours.
The drop factor is 20 gtt/mL. What is the infusion rate in gtt/min?
A) 31 gtt/min
B) 42 gtt/min
C) 50 gtt/min
D) 62 gtt/min
Answer: B) 42 gtt/min
Rationale: Total volume ÷ total time in minutes = 1000 mL ÷ 480 minutes = 2.08 mL/min.
Then 2.08 mL/min × 20 gtt/mL = 41.6, rounded to 42 gtt/min.
Question 2
A patient is prescribed diltiazem 30 mg PO. The available tablets are 15 mg each.
How many tablets should the nurse administer?
A) 0.5 tablet
B) 1 tablet
,C) 2 tablets
D) 3 tablets
Answer: C) 2 tablets
Rationale: Desired dose ÷ available dose per tablet = 30 mg ÷ 15 mg = 2 tablets.
Question 3
A nurse is administering IV acyclovir. Which assessment finding indicates a
potential adverse effect?
A) Increased serum creatinine
B) Decreased serum potassium
C) Increased serum glucose
D) Decreased serum sodium
Answer: A) Increased serum creatinine
Rationale: Acyclovir can cause nephrotoxicity; monitor renal function (serum creatinine,
BUN) and ensure adequate hydration.
Question 4
A patient is prescribed tamsulosin (Flomax). Which adverse effect should the nurse
monitor for?
A) Orthostatic hypotension
B) Hypertension
C) Tachycardia
D) Hyperglycemia
Answer: A) Orthostatic hypotension
Rationale: Tamsulosin is an alpha-1 blocker used for BPH; it can cause orthostatic
hypotension. Patients should be advised to rise slowly from sitting/lying positions.
,Question 5
A patient is prescribed finasteride (Proscar). What is the mechanism of action?
A) Alpha-1 adrenergic antagonist
B) 5-alpha-reductase inhibitor
C) Beta-3 adrenergic agonist
D) Anticholinergic
Answer: B) 5-alpha-reductase inhibitor
Rationale: Finasteride inhibits 5-alpha-reductase, reducing conversion of testosterone to
DHT, which shrinks the prostate. It takes months to show effect.
Question 6
A nurse is caring for a patient receiving patient-controlled analgesia (PCA) with
morphine. Which assessment finding indicates an adverse effect?
A) Respiratory rate of 10 breaths/min
B) Blood pressure 130/80 mmHg
C) Heart rate 80 bpm
D) Oxygen saturation 96%
Answer: A) Respiratory rate of 10 breaths/min
Rationale: Morphine can cause respiratory depression. A respiratory rate below 12
breaths/min requires immediate intervention, including possible naloxone administration.
Question 7
A patient is prescribed fentanyl transdermal patch. Which teaching is most
important?
A) Remove old patch before applying new one
B) Apply heat to the patch site to increase absorption
, C) Apply the patch to an area with hair for better adhesion
D) The patch should be changed every 12 hours
Answer: A) Remove old patch before applying new one
Rationale: Old patches must be removed to prevent overdose. Heat should NOT be applied
as it increases absorption. Patches are typically changed every 72 hours and applied to
hairless areas.
Question 8
A patient is prescribed hydromorphone (Dilaudid) 2 mg IV push. Which of the
following is the most important nursing action?
A) Administer over 2-5 minutes
B) Administer as a rapid bolus
C) Mix with normal saline before administration
D) Administer only intramuscularly
Answer: A) Administer over 2-5 minutes
Rationale: IV hydromorphone should be administered slowly over 2-5 minutes to prevent
adverse effects such as respiratory depression and hypotension.
Question 9
A patient is prescribed naloxone (Narcan) continuous infusion. The nurse should
monitor for which of the following?
A) Recurrence of respiratory depression
B) Hypertension
C) Hyperglycemia
D) Bradycardia
Answer: A) Recurrence of respiratory depression
Rationale: Naloxone has a shorter half-life than many opioids, so respiratory depression
can recur as the naloxone wears off. Patients must be monitored closely.
(Latest Update 2026-2027)
This study guide covers essential pharmacology concepts for nursing practice, including
medication classifications, mechanisms of action, therapeutic uses, adverse effects,
contraindications, and nursing considerations for safe medication administration. Learners will
review cardiovascular, respiratory, endocrine, neurological, antimicrobial, and pain management
medications, along with dosage calculations, medication safety principles, and patient education
strategies. The material is designed to strengthen pharmacological knowledge, support clinical
decision-making, and reinforce medication management concepts commonly assessed in nursing
competency and Relias-based evaluations.
Question 1
A nurse is preparing to administer 0.9% normal saline 1000 mL IV over 8 hours.
The drop factor is 20 gtt/mL. What is the infusion rate in gtt/min?
A) 31 gtt/min
B) 42 gtt/min
C) 50 gtt/min
D) 62 gtt/min
Answer: B) 42 gtt/min
Rationale: Total volume ÷ total time in minutes = 1000 mL ÷ 480 minutes = 2.08 mL/min.
Then 2.08 mL/min × 20 gtt/mL = 41.6, rounded to 42 gtt/min.
Question 2
A patient is prescribed diltiazem 30 mg PO. The available tablets are 15 mg each.
How many tablets should the nurse administer?
A) 0.5 tablet
B) 1 tablet
,C) 2 tablets
D) 3 tablets
Answer: C) 2 tablets
Rationale: Desired dose ÷ available dose per tablet = 30 mg ÷ 15 mg = 2 tablets.
Question 3
A nurse is administering IV acyclovir. Which assessment finding indicates a
potential adverse effect?
A) Increased serum creatinine
B) Decreased serum potassium
C) Increased serum glucose
D) Decreased serum sodium
Answer: A) Increased serum creatinine
Rationale: Acyclovir can cause nephrotoxicity; monitor renal function (serum creatinine,
BUN) and ensure adequate hydration.
Question 4
A patient is prescribed tamsulosin (Flomax). Which adverse effect should the nurse
monitor for?
A) Orthostatic hypotension
B) Hypertension
C) Tachycardia
D) Hyperglycemia
Answer: A) Orthostatic hypotension
Rationale: Tamsulosin is an alpha-1 blocker used for BPH; it can cause orthostatic
hypotension. Patients should be advised to rise slowly from sitting/lying positions.
,Question 5
A patient is prescribed finasteride (Proscar). What is the mechanism of action?
A) Alpha-1 adrenergic antagonist
B) 5-alpha-reductase inhibitor
C) Beta-3 adrenergic agonist
D) Anticholinergic
Answer: B) 5-alpha-reductase inhibitor
Rationale: Finasteride inhibits 5-alpha-reductase, reducing conversion of testosterone to
DHT, which shrinks the prostate. It takes months to show effect.
Question 6
A nurse is caring for a patient receiving patient-controlled analgesia (PCA) with
morphine. Which assessment finding indicates an adverse effect?
A) Respiratory rate of 10 breaths/min
B) Blood pressure 130/80 mmHg
C) Heart rate 80 bpm
D) Oxygen saturation 96%
Answer: A) Respiratory rate of 10 breaths/min
Rationale: Morphine can cause respiratory depression. A respiratory rate below 12
breaths/min requires immediate intervention, including possible naloxone administration.
Question 7
A patient is prescribed fentanyl transdermal patch. Which teaching is most
important?
A) Remove old patch before applying new one
B) Apply heat to the patch site to increase absorption
, C) Apply the patch to an area with hair for better adhesion
D) The patch should be changed every 12 hours
Answer: A) Remove old patch before applying new one
Rationale: Old patches must be removed to prevent overdose. Heat should NOT be applied
as it increases absorption. Patches are typically changed every 72 hours and applied to
hairless areas.
Question 8
A patient is prescribed hydromorphone (Dilaudid) 2 mg IV push. Which of the
following is the most important nursing action?
A) Administer over 2-5 minutes
B) Administer as a rapid bolus
C) Mix with normal saline before administration
D) Administer only intramuscularly
Answer: A) Administer over 2-5 minutes
Rationale: IV hydromorphone should be administered slowly over 2-5 minutes to prevent
adverse effects such as respiratory depression and hypotension.
Question 9
A patient is prescribed naloxone (Narcan) continuous infusion. The nurse should
monitor for which of the following?
A) Recurrence of respiratory depression
B) Hypertension
C) Hyperglycemia
D) Bradycardia
Answer: A) Recurrence of respiratory depression
Rationale: Naloxone has a shorter half-life than many opioids, so respiratory depression
can recur as the naloxone wears off. Patients must be monitored closely.
