NCLEXRN Pharmacology Practice Questions
2025 – WGU D120 OBJECTIVE ASSESSMENT
ACTUAL EXAM STUDY GUIDE 2025/2026
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES || 100%
GUARANTEED PASS <LATEST VERSION>
NCLEX-RN Pharmacology Practice Questions & Answers
1. A client is prescribed Furosemide (Lasix) 40 mg IV push. Which action is the nurse's priority
after administration?
A. Monitor for signs of hypokalemia, such as muscle weakness.
B. Check the client's temperature for a potential febrile reaction.
C. Auscultate lung sounds to assess for pulmonary edema resolution. ✓
D. Assess for tingling in the fingers and around the mouth (circumoral paresthesia).
Rationale: While all options are relevant to Furosemide, the priority action after IV
administration is to monitor for the therapeutic effect, which is relief of fluid overload (e.g.,
resolving pulmonary edema). Hypokalemia (A) is an important side effect to monitor but is not
the immediate priority.
2. A patient taking Metoprolol (Lopressor) reports feeling dizzy and lightheaded. What is the
nurse's best initial action?
A. Administer a saline bolus as per protocol.
B. Hold the next dose of Metoprolol and notify the physician.
C. Assist the patient to a supine position and check their blood pressure. ✓
D. Instruct the patient to increase fluid intake.
Rationale: Dizziness and lightheadedness are signs of hypotension, a common side effect of
beta-blockers like Metoprolol. The nurse's first action is to ensure patient safety (prevent a fall)
and assess BP to confirm the cause before intervening or notifying the provider.
3. The nurse is preparing to administer Digoxin (Lanoxin). Prior to administration, the nurse
must assess which of the following?
A. Apical pulse for one full minute. ✓
B. Blood glucose level.
,C. Deep tendon reflexes.
D. Pupillary reaction to light.
Rationale: Digoxin can cause bradycardia. The drug must be withheld and the provider notified
if the apical pulse is below 60 bpm in an adult to prevent fatal dysrhythmias.
4. A patient on Heparin therapy has an activated partial thromboplastin time (aPTT) of 110
seconds. The therapeutic range is 60-80 seconds. What should the nurse anticipate?
A. Administering the next scheduled dose as ordered.
B. Preparing to administer Protamine Sulfate. ✓
C. Increasing the Heparin infusion rate.
D. Administering Vitamin K.
Rationale: An aPTT of 110 seconds indicates the patient is supratherapeutic and at high risk for
bleeding. Protamine Sulfate is the antidote for Heparin. Vitamin K (D) is the antidote for
Warfarin.
5. Which patient statement indicates a need for further teaching about Lisinopril (Zestril), an
ACE inhibitor?
A. "I will report any swelling of my lips or face to my doctor immediately."
B. "I will use a salt substitute to help manage my blood pressure." ✓
C. "I expect a persistent, dry cough may be a side effect of this medication."
D. "I will have my blood potassium levels checked regularly."
Rationale: Salt substitutes are often high in potassium. ACE inhibitors can cause hyperkalemia,
so using a salt substitute could dangerously elevate potassium levels. This statement indicates a
misunderstanding.
6. A client is about to receive the first dose of intravenous Penicillin. The nurse's priority is to:
A. Ensure emergency equipment and diphenhydramine are readily available. ✓
B. Administer the medication slowly over 60 minutes.
C. Check the client's white blood cell count.
D. Ask if the client has ever taken Amoxicillin.
Rationale: Penicillin can cause life-threatening anaphylaxis. The nurse's priority is to be
prepared for an allergic reaction by having emergency equipment and medications (like
diphenhydramine and epinephrine) available.
7. The nurse is caring for a patient taking Spironolactone (Aldactone). Which food should the
nurse instruct the patient to avoid?
A. Bananas ✓
B. Green leafy vegetables
C. Cranberry juice
D. Dairy products
,Rationale: Spironolactone is a potassium-sparing diuretic. Consuming high-potassium foods like
bananas can lead to dangerous hyperkalemia.
8. A patient with Parkinson's disease is taking Levodopa-Carbidopa (Sinemet). Which finding
indicates the medication is effective?
A. Decreased tremors and improved mobility. ✓
B. Increased appetite and weight gain.
C. Resolution of urinary incontinence.
D. Improved short-term memory.
Rationale: The goal of Sinemet is to reduce the symptoms of Parkinson's disease, such as
tremors, rigidity, and bradykinesia (slowed movement).
9. When teaching a client about Warfarin (Coumadin), which statement by the client
demonstrates understanding?
A. "I can take Aspirin for my occasional headaches."
B. "I will use an electric razor for shaving." ✓
C. "I should eat more green leafy vegetables like spinach."
D. "I will stop the medication if I see any bruising."
Rationale: Using an electric razor minimizes the risk of cuts and bleeding, which is crucial for a
patient on anticoagulants. Aspirin (A) increases bleeding risk. Green leafy vegetables (C) are
high in Vitamin K, which antagonizes Warfarin. Stopping the medication (D) without consulting a
provider is dangerous.
10. The nurse administers Morphine Sulfate 4 mg IV to a post-operative patient. What is the
nurse's priority assessment?
A. Pain level on a 0-10 scale.
B. Respiratory rate. ✓
C. Bowel sounds.
D. Urinary output.
Rationale: Respiratory depression is the most serious and life-threatening side effect of opioid
analgesics like Morphine. Assessing respiratory rate is the priority before and after
administration.
11. A diabetic patient is started on Metformin (Glucophage). The nurse should teach the
patient to monitor for which adverse effect?
A. Hypoglycemia
B. Lactic Acidosis ✓
C. Renal calculi
D. Hepatotoxicity
Rationale: Metformin carries a risk of lactic acidosis, especially in patients with renal
, impairment, dehydration, or sepsis. Symptoms include malaise, myalgia, respiratory distress,
and abdominal pain.
12. Which lab value is most critical to monitor for a patient receiving Amphotericin B?
A. Serum creatinine and BUN. ✓
B. Serum sodium.
C. Platelet count.
D. Serum amylase.
Rationale: Amphotericin B is highly nephrotoxic. Monitoring renal function (creatinine and BUN)
is essential to detect and manage kidney damage.
13. A patient taking Sertraline (Zoloft) for 2 weeks reports, "I don't feel any better." The
nurse's best response is:
A. "The medication may need 4-6 weeks to achieve its full therapeutic effect." ✓
B. "I will notify your doctor to increase the dosage immediately."
C. "You should stop taking it since it's not working."
D. "Let's discuss other medication options with your provider."
Rationale: SSRIs like Sertraline typically take 2-4 weeks to begin working and 4-6 weeks for full
effect. Providing this education manages patient expectations and promotes adherence.
14. Prior to administering a stat dose of Nitroglycerin sublingually, the nurse should assess for
what key contraindication?
A. Use of Phosphodiesterase-5 (PDE5) inhibitors (e.g., Sildenafil/Viagra) in the last 24-48 hours.
✓
B. A history of asthma.
C. A heart rate below 60 bpm.
D. A history of peptic ulcer disease.
Rationale: The combination of Nitroglycerin and PDE5 inhibitors can cause a severe and
potentially fatal drop in blood pressure. This is a critical safety check.
15. A client with myasthenia gravis is receiving Neostigmine. Which assessment finding
indicates a cholinergic crisis?
A. Improved muscle strength and ability to swallow.
B. Tachycardia and hypertension.
C. Increased salivation, bradycardia, and muscle weakness. ✓
D. Hyperglycemia and diaphoresis.
Rationale: A cholinergic crisis is a result of medication toxicity and presents with symptoms of
excessive muscarinic stimulation (SLUDGE: Salivation, Lacrimation, Urination, Defecation, GI
upset, Emesis) and muscle weakness. This is a medical emergency.
2025 – WGU D120 OBJECTIVE ASSESSMENT
ACTUAL EXAM STUDY GUIDE 2025/2026
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES || 100%
GUARANTEED PASS <LATEST VERSION>
NCLEX-RN Pharmacology Practice Questions & Answers
1. A client is prescribed Furosemide (Lasix) 40 mg IV push. Which action is the nurse's priority
after administration?
A. Monitor for signs of hypokalemia, such as muscle weakness.
B. Check the client's temperature for a potential febrile reaction.
C. Auscultate lung sounds to assess for pulmonary edema resolution. ✓
D. Assess for tingling in the fingers and around the mouth (circumoral paresthesia).
Rationale: While all options are relevant to Furosemide, the priority action after IV
administration is to monitor for the therapeutic effect, which is relief of fluid overload (e.g.,
resolving pulmonary edema). Hypokalemia (A) is an important side effect to monitor but is not
the immediate priority.
2. A patient taking Metoprolol (Lopressor) reports feeling dizzy and lightheaded. What is the
nurse's best initial action?
A. Administer a saline bolus as per protocol.
B. Hold the next dose of Metoprolol and notify the physician.
C. Assist the patient to a supine position and check their blood pressure. ✓
D. Instruct the patient to increase fluid intake.
Rationale: Dizziness and lightheadedness are signs of hypotension, a common side effect of
beta-blockers like Metoprolol. The nurse's first action is to ensure patient safety (prevent a fall)
and assess BP to confirm the cause before intervening or notifying the provider.
3. The nurse is preparing to administer Digoxin (Lanoxin). Prior to administration, the nurse
must assess which of the following?
A. Apical pulse for one full minute. ✓
B. Blood glucose level.
,C. Deep tendon reflexes.
D. Pupillary reaction to light.
Rationale: Digoxin can cause bradycardia. The drug must be withheld and the provider notified
if the apical pulse is below 60 bpm in an adult to prevent fatal dysrhythmias.
4. A patient on Heparin therapy has an activated partial thromboplastin time (aPTT) of 110
seconds. The therapeutic range is 60-80 seconds. What should the nurse anticipate?
A. Administering the next scheduled dose as ordered.
B. Preparing to administer Protamine Sulfate. ✓
C. Increasing the Heparin infusion rate.
D. Administering Vitamin K.
Rationale: An aPTT of 110 seconds indicates the patient is supratherapeutic and at high risk for
bleeding. Protamine Sulfate is the antidote for Heparin. Vitamin K (D) is the antidote for
Warfarin.
5. Which patient statement indicates a need for further teaching about Lisinopril (Zestril), an
ACE inhibitor?
A. "I will report any swelling of my lips or face to my doctor immediately."
B. "I will use a salt substitute to help manage my blood pressure." ✓
C. "I expect a persistent, dry cough may be a side effect of this medication."
D. "I will have my blood potassium levels checked regularly."
Rationale: Salt substitutes are often high in potassium. ACE inhibitors can cause hyperkalemia,
so using a salt substitute could dangerously elevate potassium levels. This statement indicates a
misunderstanding.
6. A client is about to receive the first dose of intravenous Penicillin. The nurse's priority is to:
A. Ensure emergency equipment and diphenhydramine are readily available. ✓
B. Administer the medication slowly over 60 minutes.
C. Check the client's white blood cell count.
D. Ask if the client has ever taken Amoxicillin.
Rationale: Penicillin can cause life-threatening anaphylaxis. The nurse's priority is to be
prepared for an allergic reaction by having emergency equipment and medications (like
diphenhydramine and epinephrine) available.
7. The nurse is caring for a patient taking Spironolactone (Aldactone). Which food should the
nurse instruct the patient to avoid?
A. Bananas ✓
B. Green leafy vegetables
C. Cranberry juice
D. Dairy products
,Rationale: Spironolactone is a potassium-sparing diuretic. Consuming high-potassium foods like
bananas can lead to dangerous hyperkalemia.
8. A patient with Parkinson's disease is taking Levodopa-Carbidopa (Sinemet). Which finding
indicates the medication is effective?
A. Decreased tremors and improved mobility. ✓
B. Increased appetite and weight gain.
C. Resolution of urinary incontinence.
D. Improved short-term memory.
Rationale: The goal of Sinemet is to reduce the symptoms of Parkinson's disease, such as
tremors, rigidity, and bradykinesia (slowed movement).
9. When teaching a client about Warfarin (Coumadin), which statement by the client
demonstrates understanding?
A. "I can take Aspirin for my occasional headaches."
B. "I will use an electric razor for shaving." ✓
C. "I should eat more green leafy vegetables like spinach."
D. "I will stop the medication if I see any bruising."
Rationale: Using an electric razor minimizes the risk of cuts and bleeding, which is crucial for a
patient on anticoagulants. Aspirin (A) increases bleeding risk. Green leafy vegetables (C) are
high in Vitamin K, which antagonizes Warfarin. Stopping the medication (D) without consulting a
provider is dangerous.
10. The nurse administers Morphine Sulfate 4 mg IV to a post-operative patient. What is the
nurse's priority assessment?
A. Pain level on a 0-10 scale.
B. Respiratory rate. ✓
C. Bowel sounds.
D. Urinary output.
Rationale: Respiratory depression is the most serious and life-threatening side effect of opioid
analgesics like Morphine. Assessing respiratory rate is the priority before and after
administration.
11. A diabetic patient is started on Metformin (Glucophage). The nurse should teach the
patient to monitor for which adverse effect?
A. Hypoglycemia
B. Lactic Acidosis ✓
C. Renal calculi
D. Hepatotoxicity
Rationale: Metformin carries a risk of lactic acidosis, especially in patients with renal
, impairment, dehydration, or sepsis. Symptoms include malaise, myalgia, respiratory distress,
and abdominal pain.
12. Which lab value is most critical to monitor for a patient receiving Amphotericin B?
A. Serum creatinine and BUN. ✓
B. Serum sodium.
C. Platelet count.
D. Serum amylase.
Rationale: Amphotericin B is highly nephrotoxic. Monitoring renal function (creatinine and BUN)
is essential to detect and manage kidney damage.
13. A patient taking Sertraline (Zoloft) for 2 weeks reports, "I don't feel any better." The
nurse's best response is:
A. "The medication may need 4-6 weeks to achieve its full therapeutic effect." ✓
B. "I will notify your doctor to increase the dosage immediately."
C. "You should stop taking it since it's not working."
D. "Let's discuss other medication options with your provider."
Rationale: SSRIs like Sertraline typically take 2-4 weeks to begin working and 4-6 weeks for full
effect. Providing this education manages patient expectations and promotes adherence.
14. Prior to administering a stat dose of Nitroglycerin sublingually, the nurse should assess for
what key contraindication?
A. Use of Phosphodiesterase-5 (PDE5) inhibitors (e.g., Sildenafil/Viagra) in the last 24-48 hours.
✓
B. A history of asthma.
C. A heart rate below 60 bpm.
D. A history of peptic ulcer disease.
Rationale: The combination of Nitroglycerin and PDE5 inhibitors can cause a severe and
potentially fatal drop in blood pressure. This is a critical safety check.
15. A client with myasthenia gravis is receiving Neostigmine. Which assessment finding
indicates a cholinergic crisis?
A. Improved muscle strength and ability to swallow.
B. Tachycardia and hypertension.
C. Increased salivation, bradycardia, and muscle weakness. ✓
D. Hyperglycemia and diaphoresis.
Rationale: A cholinergic crisis is a result of medication toxicity and presents with symptoms of
excessive muscarinic stimulation (SLUDGE: Salivation, Lacrimation, Urination, Defecation, GI
upset, Emesis) and muscle weakness. This is a medical emergency.
