NCLEX RN Pharmacology
Comprehensive Exam 1 100 Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026
1. A nurse is preparing to administer digoxin to an adult client. Which
assessment finding requires the nurse to withhold the medication and
notify the provider?
A. Apical pulse of 54/min
B. Blood pressure of 138/82 mm Hg
C. Respiratory rate of 18/min
D. Potassium level of 4.2 mEq/L
Answer: Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. The nurse should generally
withhold digoxin when the adult apical pulse is below 60/min and notify the
provider.
2. A client taking warfarin has an INR of 5.2. Which action should the nurse
anticipate?
A. Administer the next dose as scheduled
B. Hold warfarin and notify the provider
C. Encourage foods high in vitamin K immediately
D. Administer aspirin
Answer: Hold warfarin and notify the provider
Rationale: An INR of 5.2 indicates excessive anticoagulation and increased
bleeding risk. Warfarin should be held and the provider notified for further
management.
, 3. A client taking lisinopril reports swelling of the lips and tongue. What is
the nurse's priority action?
A. Administer the next dose with food
B. Place the client in Trendelenburg position
C. Hold the medication and assess the airway
D. Encourage oral fluids
Answer: Hold the medication and assess the airway
Rationale: Lisinopril can cause angioedema, which may rapidly compromise
the airway. The medication should be stopped and airway management
prioritized.
4. Which adverse effect is most important for the nurse to monitor in a
client receiving morphine?
A. Constipation
B. Respiratory depression
C. Mild nausea
D. Dry mouth
Answer: Respiratory depression
Rationale: Opioids suppress the respiratory center. Severe respiratory
depression is potentially life-threatening and requires immediate
intervention.
5. A client receiving IV heparin develops bleeding from the gums. Which
medication should the nurse anticipate administering if heparin toxicity
is confirmed?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: Protamine sulfate
Rationale: Protamine sulfate is the antidote for unfractionated heparin.
Vitamin K reverses warfarin, while naloxone reverses opioids.
, 6. A nurse is teaching a client who takes levothyroxine. Which statement
indicates correct understanding?
A. "I will take it at bedtime with a glass of milk."
B. "I will take it in the morning on an empty stomach."
C. "I will stop taking it when I feel better."
D. "I will take it with an iron supplement."
Answer: "I will take it in the morning on an empty stomach."
Rationale: Levothyroxine is best absorbed when taken consistently on an
empty stomach, usually 30–60 minutes before breakfast.
7. Which laboratory value is most important to monitor in a client receiving
furosemide?
A. Potassium
B. Hemoglobin
C. Platelets
D. Calcium only
Answer: Potassium
Rationale: Furosemide is a loop diuretic that can cause significant potassium
loss, increasing the risk for dysrhythmias.
8. A client taking spironolactone should be taught to avoid which food?
A. Apples
B. White rice
C. Bananas
D. Bread
Answer: Bananas
Rationale: Spironolactone is potassium-sparing. Excessive intake of
potassium-rich foods can increase the risk of hyperkalemia.
9. A client taking atorvastatin reports severe muscle pain and weakness.
Which laboratory test should the nurse anticipate?
A. Creatine kinase
B. INR
, C. Serum amylase
D. Troponin only
Answer: Creatine kinase
Rationale: Statins can cause myopathy and, rarely, rhabdomyolysis. An
elevated creatine kinase level supports muscle injury.
10.Which instruction is appropriate for a client taking metformin?
A. "Take the medication on an empty stomach."
B. "Avoid reporting unusual weakness or rapid breathing."
C. "Take it with meals to reduce gastrointestinal effects."
D. "Double the dose if you miss a dose."
Answer: "Take it with meals to reduce gastrointestinal effects."
Rationale: Metformin is commonly taken with meals to reduce
gastrointestinal adverse effects. Severe weakness, malaise, or rapid
breathing should be reported because they may indicate lactic acidosis.
11.A client receiving insulin develops sweating, tremors, and confusion.
What is the priority action?
A. Administer rapid-acting carbohydrate if the client can swallow
B. Administer the next insulin dose
C. Restrict fluids
D. Encourage exercise
Answer: Administer rapid-acting carbohydrate if the client can swallow
Rationale: Sweating, tremors, and confusion are manifestations of
hypoglycemia. A conscious client who can swallow should receive a rapid
source of glucose.
12.Which insulin has the most rapid onset?
A. Lispro
B. NPH
C. Glargine
D. Detemir
Answer: Lispro
Comprehensive Exam 1 100 Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026
1. A nurse is preparing to administer digoxin to an adult client. Which
assessment finding requires the nurse to withhold the medication and
notify the provider?
A. Apical pulse of 54/min
B. Blood pressure of 138/82 mm Hg
C. Respiratory rate of 18/min
D. Potassium level of 4.2 mEq/L
Answer: Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. The nurse should generally
withhold digoxin when the adult apical pulse is below 60/min and notify the
provider.
2. A client taking warfarin has an INR of 5.2. Which action should the nurse
anticipate?
A. Administer the next dose as scheduled
B. Hold warfarin and notify the provider
C. Encourage foods high in vitamin K immediately
D. Administer aspirin
Answer: Hold warfarin and notify the provider
Rationale: An INR of 5.2 indicates excessive anticoagulation and increased
bleeding risk. Warfarin should be held and the provider notified for further
management.
, 3. A client taking lisinopril reports swelling of the lips and tongue. What is
the nurse's priority action?
A. Administer the next dose with food
B. Place the client in Trendelenburg position
C. Hold the medication and assess the airway
D. Encourage oral fluids
Answer: Hold the medication and assess the airway
Rationale: Lisinopril can cause angioedema, which may rapidly compromise
the airway. The medication should be stopped and airway management
prioritized.
4. Which adverse effect is most important for the nurse to monitor in a
client receiving morphine?
A. Constipation
B. Respiratory depression
C. Mild nausea
D. Dry mouth
Answer: Respiratory depression
Rationale: Opioids suppress the respiratory center. Severe respiratory
depression is potentially life-threatening and requires immediate
intervention.
5. A client receiving IV heparin develops bleeding from the gums. Which
medication should the nurse anticipate administering if heparin toxicity
is confirmed?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: Protamine sulfate
Rationale: Protamine sulfate is the antidote for unfractionated heparin.
Vitamin K reverses warfarin, while naloxone reverses opioids.
, 6. A nurse is teaching a client who takes levothyroxine. Which statement
indicates correct understanding?
A. "I will take it at bedtime with a glass of milk."
B. "I will take it in the morning on an empty stomach."
C. "I will stop taking it when I feel better."
D. "I will take it with an iron supplement."
Answer: "I will take it in the morning on an empty stomach."
Rationale: Levothyroxine is best absorbed when taken consistently on an
empty stomach, usually 30–60 minutes before breakfast.
7. Which laboratory value is most important to monitor in a client receiving
furosemide?
A. Potassium
B. Hemoglobin
C. Platelets
D. Calcium only
Answer: Potassium
Rationale: Furosemide is a loop diuretic that can cause significant potassium
loss, increasing the risk for dysrhythmias.
8. A client taking spironolactone should be taught to avoid which food?
A. Apples
B. White rice
C. Bananas
D. Bread
Answer: Bananas
Rationale: Spironolactone is potassium-sparing. Excessive intake of
potassium-rich foods can increase the risk of hyperkalemia.
9. A client taking atorvastatin reports severe muscle pain and weakness.
Which laboratory test should the nurse anticipate?
A. Creatine kinase
B. INR
, C. Serum amylase
D. Troponin only
Answer: Creatine kinase
Rationale: Statins can cause myopathy and, rarely, rhabdomyolysis. An
elevated creatine kinase level supports muscle injury.
10.Which instruction is appropriate for a client taking metformin?
A. "Take the medication on an empty stomach."
B. "Avoid reporting unusual weakness or rapid breathing."
C. "Take it with meals to reduce gastrointestinal effects."
D. "Double the dose if you miss a dose."
Answer: "Take it with meals to reduce gastrointestinal effects."
Rationale: Metformin is commonly taken with meals to reduce
gastrointestinal adverse effects. Severe weakness, malaise, or rapid
breathing should be reported because they may indicate lactic acidosis.
11.A client receiving insulin develops sweating, tremors, and confusion.
What is the priority action?
A. Administer rapid-acting carbohydrate if the client can swallow
B. Administer the next insulin dose
C. Restrict fluids
D. Encourage exercise
Answer: Administer rapid-acting carbohydrate if the client can swallow
Rationale: Sweating, tremors, and confusion are manifestations of
hypoglycemia. A conscious client who can swallow should receive a rapid
source of glucose.
12.Which insulin has the most rapid onset?
A. Lispro
B. NPH
C. Glargine
D. Detemir
Answer: Lispro
