Saunders Comprehensive Review for the NCLEX-
PN® Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
Nursing Pharmacology (Advanced — Drug
Administration, Dosage & Categories). TEST BANK
Question 1 — Rights of Medication Administration (Single-
best-answer)
A nurse is preparing to give a new prescription of lisinopril 10
mg PO daily to a patient. Which action best demonstrates
adherence to the “right patient” and reduces medication-error
risk?
A. Scan the medication barcode and then ask the patient if their
name is John.
B. Check the patient’s armband and compare the armband
name to the MAR, then ask the patient to state their full name
and date of birth.
C. Ask the patient’s roommate to verify the patient’s name
while confirming the MAR.
D. Ask the patient to nod when the nurse states the medication
name and dose.
,Correct answer: B.
Rationale — Correct (B):
• Checking the armband against the MAR and then asking
the patient to state two identifiers (name + DOB) uses two
patient identifiers per standard safety practice, reducing
misidentification. This is consistent with the rights of
medication administration and error prevention.
Rationale — Incorrect:
• A: Scanning is good, but asking a yes/no question (“is your
name John?”) is not reliable — the patient could be
confused or answer incorrectly; should use two identifiers.
• C: A roommate is not an acceptable identifier; privacy and
reliability issues.
• D: A nod is not a reliable confirmation; verbalization of
identifiers is required.
Question 2 — ACE Inhibitor: Contraindication (Single-best-
answer)
A 62-year-old woman with hypertension is prescribed lisinopril.
Which finding in her history is most important to report to the
prescriber before giving the first dose?
A. History of a persistent dry cough with seasonal allergies.
B. Current pregnancy (first trimester).
,C. Allergy to sulfonamide antibiotics.
D. History of GERD treated with omeprazole.
Correct answer: B.
Rationale — Correct (B):
• ACE inhibitors (like lisinopril) are teratogenic and
contraindicated during pregnancy due to fetal renal
damage and death risk. Pregnancy is an absolute
contraindication; must withhold and notify prescriber.
Rationale — Incorrect:
• A: ACE inhibitors commonly cause a dry cough (due to
bradykinin) but a history of seasonal cough is not an
absolute contraindication—still warrants caution and
monitoring.
• C: Sulfonamide allergy is unrelated to ACE inhibitors.
• D: GERD/omeprazole is not a contraindication; however,
drug-drug interactions are minimal.
Question 3 — IV Infusion Rate (Calculation)
Order: Infuse 1,000 mL normal saline over 8 hours using an
infusion pump. What rate (mL/hr) should the nurse program?
Show step-by-step calculation and final answer.
Calculation (step-by-step):
1. Total volume = 1,000 mL.
, 2. Total time = 8 hours.
3. Rate (mL/hr) = Total volume ÷ Time = 1,000 ÷ 8.
o 1,000 ÷ 8 = 125 (because 8 × 125 = 1,000).
Answer: 125 mL/hr.
Rationale:
• Use infusion pump; calculation straightforward. Always
verify pump setting and double-check orders and IV
patency before initiating.
Question 4 — IV Drops per Minute (Calculation)
Order: 500 mL D5W to infuse over 4 hours. Manual tubing
delivers 20 gtt/mL. What is the infusion rate in drops per minute
(gtt/min)? Show work.
Calculation (step-by-step):
1. Total volume = 500 mL.
2. Total time = 4 hours = 4 × 60 = 240 minutes.
3. Flow rate (mL/min) = 500 ÷ 240.
o 500 ÷ 240 = 2.083333... mL/min.
4. Tubing = 20 gtt/mL → gtt/min = 2.083333... × 20.
o 2.083333... × 20 = 41.666666... gtt/min.
5. Round per facility policy — usually to the nearest whole
drop: 42 gtt/min.
PN® Examination
9th Edition
• Author(s)Linda Anne Silvestri; Angela Silvestri
Nursing Pharmacology (Advanced — Drug
Administration, Dosage & Categories). TEST BANK
Question 1 — Rights of Medication Administration (Single-
best-answer)
A nurse is preparing to give a new prescription of lisinopril 10
mg PO daily to a patient. Which action best demonstrates
adherence to the “right patient” and reduces medication-error
risk?
A. Scan the medication barcode and then ask the patient if their
name is John.
B. Check the patient’s armband and compare the armband
name to the MAR, then ask the patient to state their full name
and date of birth.
C. Ask the patient’s roommate to verify the patient’s name
while confirming the MAR.
D. Ask the patient to nod when the nurse states the medication
name and dose.
,Correct answer: B.
Rationale — Correct (B):
• Checking the armband against the MAR and then asking
the patient to state two identifiers (name + DOB) uses two
patient identifiers per standard safety practice, reducing
misidentification. This is consistent with the rights of
medication administration and error prevention.
Rationale — Incorrect:
• A: Scanning is good, but asking a yes/no question (“is your
name John?”) is not reliable — the patient could be
confused or answer incorrectly; should use two identifiers.
• C: A roommate is not an acceptable identifier; privacy and
reliability issues.
• D: A nod is not a reliable confirmation; verbalization of
identifiers is required.
Question 2 — ACE Inhibitor: Contraindication (Single-best-
answer)
A 62-year-old woman with hypertension is prescribed lisinopril.
Which finding in her history is most important to report to the
prescriber before giving the first dose?
A. History of a persistent dry cough with seasonal allergies.
B. Current pregnancy (first trimester).
,C. Allergy to sulfonamide antibiotics.
D. History of GERD treated with omeprazole.
Correct answer: B.
Rationale — Correct (B):
• ACE inhibitors (like lisinopril) are teratogenic and
contraindicated during pregnancy due to fetal renal
damage and death risk. Pregnancy is an absolute
contraindication; must withhold and notify prescriber.
Rationale — Incorrect:
• A: ACE inhibitors commonly cause a dry cough (due to
bradykinin) but a history of seasonal cough is not an
absolute contraindication—still warrants caution and
monitoring.
• C: Sulfonamide allergy is unrelated to ACE inhibitors.
• D: GERD/omeprazole is not a contraindication; however,
drug-drug interactions are minimal.
Question 3 — IV Infusion Rate (Calculation)
Order: Infuse 1,000 mL normal saline over 8 hours using an
infusion pump. What rate (mL/hr) should the nurse program?
Show step-by-step calculation and final answer.
Calculation (step-by-step):
1. Total volume = 1,000 mL.
, 2. Total time = 8 hours.
3. Rate (mL/hr) = Total volume ÷ Time = 1,000 ÷ 8.
o 1,000 ÷ 8 = 125 (because 8 × 125 = 1,000).
Answer: 125 mL/hr.
Rationale:
• Use infusion pump; calculation straightforward. Always
verify pump setting and double-check orders and IV
patency before initiating.
Question 4 — IV Drops per Minute (Calculation)
Order: 500 mL D5W to infuse over 4 hours. Manual tubing
delivers 20 gtt/mL. What is the infusion rate in drops per minute
(gtt/min)? Show work.
Calculation (step-by-step):
1. Total volume = 500 mL.
2. Total time = 4 hours = 4 × 60 = 240 minutes.
3. Flow rate (mL/min) = 500 ÷ 240.
o 500 ÷ 240 = 2.083333... mL/min.
4. Tubing = 20 gtt/mL → gtt/min = 2.083333... × 20.
o 2.083333... × 20 = 41.666666... gtt/min.
5. Round per facility policy — usually to the nearest whole
drop: 42 gtt/min.
