NCLEX RN Pharmacology
Comprehensive Exam 2 100 Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026
1. 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 a supine position
C. Hold lisinopril and notify the healthcare provider immediately
D. Encourage increased fluid intake
Answer: Hold lisinopril and notify the healthcare provider immediately
Rationale: Angioedema is a potentially life-threatening adverse effect of ACE
inhibitors and can obstruct the airway. The medication should be
discontinued and emergency treatment initiated.
2. Which assessment finding is most important for a client receiving
digoxin?
A. Blood pressure of 138/82 mmHg
B. Respiratory rate of 18/min
C. Apical pulse of 54/min
D. Temperature of 37.1°C (98.8°F)
Answer: Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. The nurse should generally
withhold the medication and notify the provider when the adult apical pulse
is below 60/min.
3. A client receiving warfarin has an INR of 5.8 and no active bleeding.
Which action should the nurse anticipate?
,A. Administer the scheduled dose
B. Hold warfarin and notify the healthcare provider
C. Encourage foods high in vitamin K immediately
D. Administer protamine sulfate
Answer: Hold warfarin and notify the healthcare provider
Rationale: An INR of 5.8 indicates excessive anticoagulation and increased
bleeding risk. Warfarin should be withheld and further treatment determined
by the provider.
4. Which medication is the antidote for opioid-induced respiratory
depression?
A. Flumazenil
B. Acetylcysteine
C. Vitamin K
D. Naloxone
Answer: Naloxone
Rationale: Naloxone is an opioid antagonist that rapidly reverses opioid-
induced respiratory and central nervous system depression.
5. A client taking furosemide is at greatest risk for which electrolyte
imbalance?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary potassium
excretion, placing the client at risk for hypokalemia.
6. Which statement by a client taking levothyroxine indicates correct
understanding?
A. “I will take it with my calcium supplement.”
B. “I can stop it once my symptoms improve.”
,C. “I will take it in the morning on an empty stomach.”
D. “I should take it only when I feel tired.”
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. Calcium and iron
can decrease absorption.
7. Which adverse effect should the nurse monitor for in a client receiving
gentamicin?
A. Constipation
B. Ototoxicity and nephrotoxicity
C. Hypoglycemia
D. Photosensitivity
Answer: Ototoxicity and nephrotoxicity
Rationale: Aminoglycosides such as gentamicin can cause kidney injury and
damage to the auditory and vestibular systems. Renal function and hearing
should be monitored.
8. A client receiving vancomycin develops flushing and hypotension during
the infusion. What should the nurse suspect?
A. Stevens-Johnson syndrome
B. Serotonin syndrome
C. Infusion-related “red man” syndrome
D. Neuroleptic malignant syndrome
Answer: Infusion-related “red man” syndrome
Rationale: Rapid IV administration of vancomycin can cause flushing,
hypotension, and erythema, commonly called vancomycin infusion reaction
or “red man” syndrome.
9. Which instruction is most important for a client taking metformin?
A. Take the medication on an empty stomach
B. Avoid all carbohydrates
, C. Notify the provider if scheduled for iodinated contrast studies
D. Take an extra dose if blood glucose increases
Answer: Notify the provider if scheduled for iodinated contrast studies
Rationale: Metformin may need to be temporarily withheld around certain
iodinated contrast procedures because of the risk of lactic acidosis,
particularly in clients with impaired renal function.
10.Which medication is commonly used as a rescue medication for acute
asthma symptoms?
A. Fluticasone
B. Montelukast
C. Albuterol
D. Salmeterol
Answer: Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist used for rapid
relief of acute bronchospasm.
11.A client taking phenytoin should receive which teaching?
A. “Stop the medication when seizures stop.”
B. “Maintain good oral hygiene and regular dental care.”
C. “Take antacids at the same time as the medication.”
D. “Double the next dose if one is missed.”
Answer: “Maintain good oral hygiene and regular dental care.”
Rationale: Phenytoin can cause gingival hyperplasia. Meticulous oral hygiene
and regular dental examinations help reduce this complication.
12.Which laboratory test is especially important for a client receiving
heparin therapy?
A. INR
B. Serum sodium
C. aPTT
D. Hemoglobin A1c
Answer: aPTT
Comprehensive Exam 2 100 Questions
And Correct Answers (Verified
Answers) Plus Rationales 2026
1. 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 a supine position
C. Hold lisinopril and notify the healthcare provider immediately
D. Encourage increased fluid intake
Answer: Hold lisinopril and notify the healthcare provider immediately
Rationale: Angioedema is a potentially life-threatening adverse effect of ACE
inhibitors and can obstruct the airway. The medication should be
discontinued and emergency treatment initiated.
2. Which assessment finding is most important for a client receiving
digoxin?
A. Blood pressure of 138/82 mmHg
B. Respiratory rate of 18/min
C. Apical pulse of 54/min
D. Temperature of 37.1°C (98.8°F)
Answer: Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. The nurse should generally
withhold the medication and notify the provider when the adult apical pulse
is below 60/min.
3. A client receiving warfarin has an INR of 5.8 and no active bleeding.
Which action should the nurse anticipate?
,A. Administer the scheduled dose
B. Hold warfarin and notify the healthcare provider
C. Encourage foods high in vitamin K immediately
D. Administer protamine sulfate
Answer: Hold warfarin and notify the healthcare provider
Rationale: An INR of 5.8 indicates excessive anticoagulation and increased
bleeding risk. Warfarin should be withheld and further treatment determined
by the provider.
4. Which medication is the antidote for opioid-induced respiratory
depression?
A. Flumazenil
B. Acetylcysteine
C. Vitamin K
D. Naloxone
Answer: Naloxone
Rationale: Naloxone is an opioid antagonist that rapidly reverses opioid-
induced respiratory and central nervous system depression.
5. A client taking furosemide is at greatest risk for which electrolyte
imbalance?
A. Hypernatremia
B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary potassium
excretion, placing the client at risk for hypokalemia.
6. Which statement by a client taking levothyroxine indicates correct
understanding?
A. “I will take it with my calcium supplement.”
B. “I can stop it once my symptoms improve.”
,C. “I will take it in the morning on an empty stomach.”
D. “I should take it only when I feel tired.”
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. Calcium and iron
can decrease absorption.
7. Which adverse effect should the nurse monitor for in a client receiving
gentamicin?
A. Constipation
B. Ototoxicity and nephrotoxicity
C. Hypoglycemia
D. Photosensitivity
Answer: Ototoxicity and nephrotoxicity
Rationale: Aminoglycosides such as gentamicin can cause kidney injury and
damage to the auditory and vestibular systems. Renal function and hearing
should be monitored.
8. A client receiving vancomycin develops flushing and hypotension during
the infusion. What should the nurse suspect?
A. Stevens-Johnson syndrome
B. Serotonin syndrome
C. Infusion-related “red man” syndrome
D. Neuroleptic malignant syndrome
Answer: Infusion-related “red man” syndrome
Rationale: Rapid IV administration of vancomycin can cause flushing,
hypotension, and erythema, commonly called vancomycin infusion reaction
or “red man” syndrome.
9. Which instruction is most important for a client taking metformin?
A. Take the medication on an empty stomach
B. Avoid all carbohydrates
, C. Notify the provider if scheduled for iodinated contrast studies
D. Take an extra dose if blood glucose increases
Answer: Notify the provider if scheduled for iodinated contrast studies
Rationale: Metformin may need to be temporarily withheld around certain
iodinated contrast procedures because of the risk of lactic acidosis,
particularly in clients with impaired renal function.
10.Which medication is commonly used as a rescue medication for acute
asthma symptoms?
A. Fluticasone
B. Montelukast
C. Albuterol
D. Salmeterol
Answer: Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist used for rapid
relief of acute bronchospasm.
11.A client taking phenytoin should receive which teaching?
A. “Stop the medication when seizures stop.”
B. “Maintain good oral hygiene and regular dental care.”
C. “Take antacids at the same time as the medication.”
D. “Double the next dose if one is missed.”
Answer: “Maintain good oral hygiene and regular dental care.”
Rationale: Phenytoin can cause gingival hyperplasia. Meticulous oral hygiene
and regular dental examinations help reduce this complication.
12.Which laboratory test is especially important for a client receiving
heparin therapy?
A. INR
B. Serum sodium
C. aPTT
D. Hemoglobin A1c
Answer: aPTT
