Pharmacology Mastery Test Bank: Medications & Dosages
1) A 68-year-old man with a history of chronic heart failure is
receiving lisinopril 10 mg PO daily. He complains of a new,
persistent dry cough. Which action by the nurse is most
appropriate?
A. Administer the lisinopril and document the cough as an
expected side effect.
B. Hold the lisinopril and notify the provider about the cough.
C. Suggest the patient take an over-the-counter cough
suppressant and continue lisinopril.
D. Instruct the patient to stop lisinopril permanently and start
an OTC herbal remedy.
Correct answer: B
Rationale:
Lisinopril (an ACE inhibitor) commonly causes a persistent dry
cough due to increased bradykinin. The appropriate action is to
hold the medication and notify the provider so an alternative
(usually an ARB) can be considered. This addresses patient
safety and preserves renal/cardiac management under
prescriber direction.
Distractors: A is incorrect because while cough is a known side
effect, it is not simply “expected” to be left unmanaged — it
may necessitate stopping the drug. C is incorrect because
,treating symptomatically without involving the prescriber risks
ongoing adverse effects and nonadherence. D is incorrect and
unsafe — instructing a patient to stop a prescribed ACE
inhibitor permanently without provider guidance and substitute
an OTC herbal remedy is inappropriate.
Clinical safety/teaching tip: Teach patients to report a
persistent dry cough, angioedema (facial swelling), or dizziness
with ACE inhibitors; document onset and severity and advise
contacting the prescriber for medication substitution.
Difficulty: Moderate
Bloom’s taxonomy: Application
NCLEX client need category + subcategory: Physiological
Integrity — Pharmacological and Parenteral Therapies
2) A 24-year-old female presents with a 7-day history of fever
and dysuria and is prescribed nitrofurantoin 100 mg PO twice
daily for 7 days. She asks whether she can take the medication
with food. What is the best response?
A. “No — nitrofurantoin must be taken on an empty stomach.”
B. “Yes — taking it with food helps absorption and reduces GI
upset.”
C. “Only take it with dairy products for better effect.”
D. “Take it with fruit juice; it increases urine acidity and
effectiveness.”
Correct answer: B
,Rationale:
Nitrofurantoin is best taken with food to improve absorption
and decrease gastrointestinal upset. Answer B is correct and
promotes adherence and effectiveness while minimizing
adverse GI effects.
Distractors: A is incorrect — nitrofurantoin does not require an
empty stomach. C is incorrect — dairy is not specifically
required and may interfere with some antibiotics. D is incorrect
— fruit juice guidance is unnecessary and may interact with
other medications; altering urine pH as a strategy is not advised
here.
Clinical safety/teaching tip: Instruct patients to complete the
full course, expect possible brownish urine discoloration
(harmless), and report signs of pulmonary symptoms or
peripheral neuropathy.
Difficulty: Easy
Bloom’s taxonomy: Recall
NCLEX client need category + subcategory: Physiological
Integrity — Pharmacological and Parenteral Therapies
3) A postoperative patient is receiving morphine IV PCA. The
patient becomes somnolent with a respiratory rate of 8
breaths/min and SpO₂ 86%. What is the nurse’s priority action?
A. Administer naloxone IV per standing protocol.
B. Increase the PCA basal rate because the patient is in pain.
C. Stimulate the patient and assess airway and breathing;
, prepare naloxone.
D. Place the patient in Trendelenburg position.
Correct answer: C
Rationale:
The priority is Airway/Breathing/Circulation. First, stimulate the
patient and assess airway and respirations and provide
supplemental oxygen and support ventilation if needed;
prepare and administer naloxone per protocol if respiratory
depression persists. C reflects the correct sequence: assess and
intervene to secure airway and breathing before automatic
antagonist administration.
Distractors: A is premature — naloxone is indicated for opioid-
induced respiratory depression, but immediate assessment and
basic airway/oxygen measures should occur first (and naloxone
prepared). B is dangerous — increasing opioid dose worsens
respiratory depression. D is not indicated for opioid overdose
and does not address hypoventilation.
Clinical safety/teaching tip: For patients on opioids, monitor
sedation scores and respiratory rate frequently; have naloxone
readily available and ensure staff can support ventilation (bag-
valve mask).
Difficulty: Moderate
Bloom’s taxonomy: Application
NCLEX client need category + subcategory: Physiological
Integrity — Pharmacological and Parenteral Therapies
1) A 68-year-old man with a history of chronic heart failure is
receiving lisinopril 10 mg PO daily. He complains of a new,
persistent dry cough. Which action by the nurse is most
appropriate?
A. Administer the lisinopril and document the cough as an
expected side effect.
B. Hold the lisinopril and notify the provider about the cough.
C. Suggest the patient take an over-the-counter cough
suppressant and continue lisinopril.
D. Instruct the patient to stop lisinopril permanently and start
an OTC herbal remedy.
Correct answer: B
Rationale:
Lisinopril (an ACE inhibitor) commonly causes a persistent dry
cough due to increased bradykinin. The appropriate action is to
hold the medication and notify the provider so an alternative
(usually an ARB) can be considered. This addresses patient
safety and preserves renal/cardiac management under
prescriber direction.
Distractors: A is incorrect because while cough is a known side
effect, it is not simply “expected” to be left unmanaged — it
may necessitate stopping the drug. C is incorrect because
,treating symptomatically without involving the prescriber risks
ongoing adverse effects and nonadherence. D is incorrect and
unsafe — instructing a patient to stop a prescribed ACE
inhibitor permanently without provider guidance and substitute
an OTC herbal remedy is inappropriate.
Clinical safety/teaching tip: Teach patients to report a
persistent dry cough, angioedema (facial swelling), or dizziness
with ACE inhibitors; document onset and severity and advise
contacting the prescriber for medication substitution.
Difficulty: Moderate
Bloom’s taxonomy: Application
NCLEX client need category + subcategory: Physiological
Integrity — Pharmacological and Parenteral Therapies
2) A 24-year-old female presents with a 7-day history of fever
and dysuria and is prescribed nitrofurantoin 100 mg PO twice
daily for 7 days. She asks whether she can take the medication
with food. What is the best response?
A. “No — nitrofurantoin must be taken on an empty stomach.”
B. “Yes — taking it with food helps absorption and reduces GI
upset.”
C. “Only take it with dairy products for better effect.”
D. “Take it with fruit juice; it increases urine acidity and
effectiveness.”
Correct answer: B
,Rationale:
Nitrofurantoin is best taken with food to improve absorption
and decrease gastrointestinal upset. Answer B is correct and
promotes adherence and effectiveness while minimizing
adverse GI effects.
Distractors: A is incorrect — nitrofurantoin does not require an
empty stomach. C is incorrect — dairy is not specifically
required and may interfere with some antibiotics. D is incorrect
— fruit juice guidance is unnecessary and may interact with
other medications; altering urine pH as a strategy is not advised
here.
Clinical safety/teaching tip: Instruct patients to complete the
full course, expect possible brownish urine discoloration
(harmless), and report signs of pulmonary symptoms or
peripheral neuropathy.
Difficulty: Easy
Bloom’s taxonomy: Recall
NCLEX client need category + subcategory: Physiological
Integrity — Pharmacological and Parenteral Therapies
3) A postoperative patient is receiving morphine IV PCA. The
patient becomes somnolent with a respiratory rate of 8
breaths/min and SpO₂ 86%. What is the nurse’s priority action?
A. Administer naloxone IV per standing protocol.
B. Increase the PCA basal rate because the patient is in pain.
C. Stimulate the patient and assess airway and breathing;
, prepare naloxone.
D. Place the patient in Trendelenburg position.
Correct answer: C
Rationale:
The priority is Airway/Breathing/Circulation. First, stimulate the
patient and assess airway and respirations and provide
supplemental oxygen and support ventilation if needed;
prepare and administer naloxone per protocol if respiratory
depression persists. C reflects the correct sequence: assess and
intervene to secure airway and breathing before automatic
antagonist administration.
Distractors: A is premature — naloxone is indicated for opioid-
induced respiratory depression, but immediate assessment and
basic airway/oxygen measures should occur first (and naloxone
prepared). B is dangerous — increasing opioid dose worsens
respiratory depression. D is not indicated for opioid overdose
and does not address hypoventilation.
Clinical safety/teaching tip: For patients on opioids, monitor
sedation scores and respiratory rate frequently; have naloxone
readily available and ensure staff can support ventilation (bag-
valve mask).
Difficulty: Moderate
Bloom’s taxonomy: Application
NCLEX client need category + subcategory: Physiological
Integrity — Pharmacological and Parenteral Therapies
