NCLEX Pharmacology Practice Exam
1. An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and keto
rolac (Toradol) 30 mg IV q6h. Which action should the nurse implement?
A) Administer both medications according to the prescription.
Feedback: CORRECT
B) Hold the ketorolac to prevent an antagonistic effect.
Feedback: INCORRECT
C) Hold the morphine to prevent an additive drug interaction.
Feedback: INCORRECT
D) Contact the healthcare provider to clarify the prescription.
Feedback: INCORRECT
Feedback: INCORRECT
Morphine and ketorolac (Toradol) can be administered concurrently (A), and may p
roduce an additive analgesic effect, resulting in the ability to reduce the dose
of morphine, as seen in this prescription. Toradol is an antiinflammatory analg
esic, and does not have an antagonistic effect with morphine (B), like an agonis
t-antagonist medication would have. An additive analgesic effect is desirable (C
), because it allows a reduced dose of morphine. This prescription does not requ
ire any clarification, and can be administered safely as written (D).
2. The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with an
gina. Which instruction should the nurse include in this client's discharge teac
hing plan?
A) Quit taking the medication if dizziness occurs.
Feedback: INCORRECT
B) Do not get up quickly. Always rise slowly.
Feedback: CORRECT
C) Take the medication with food only.
Feedback: INCORRECT
D) Increase your intake of potassium-rich foods.
Feedback: INCORRECT
Feedback: CORRECT
An expected side effect of nitrates is orthostatic hypotension and the nurse sho
uld address how to prevent it--by rising slowly (B). Dizziness is expected, and
the client should not quit taking the medication without notifying the healthcar
e provider (A). (C and D) are not indicated when taking this medication.
3. A client who was prescribed atorvastatin (Lipitor) one month ago calls the tr
iage nurse at the clinic complaining of muscle pain and weakness in his legs. Wh
ich statement reflects the correct drug-specific teaching the nurse should provi
de to this client?
A) Increase consumption of potassium-rich foods since low potassium levels can
cause muscle spasms.
Feedback: INCORRECT
B) Have serum electrolytes checked at the next scheduled appointment to assess
hyponatremia, a cause of cramping.
,Feedback: INCORRECT
C) Make an appointment to see the healthcare provider, because muscle pain may
be an indication of a serious side effect.
Feedback: CORRECT
D) Be sure to consume a low-cholesterol diet while taking the drug to enhance t
he effectiveness of the drug.
Feedback: INCORRECT
Feedback: CORRECT
Myopathy, suggested by the leg pain and weakness, is a serious, and potentially
life-threatening, complication of Lipitor, and should be evaluated immediately b
y the healthcare provider (C). Although electrolyte imbalances such as (A or B)
can cause muscle spasms in some cases, this is not the likely cause of leg pain
in the client receiving Lipitor, and evaluation by the healthcare provider shoul
d not be delayed for any reason. A low-cholesterol diet is recommended for those
taking Lipitor since the drug is used to lower total cholesterol (D), but diet
is not related to the leg pain symptom.
4. Following heparin treatment for a pulmonary embolism, a client is being disch
arged with a prescription for warfarin (Coumadin). In conducting discharge teach
ing, the nurse advises the client to have which diagnostic test monitored regula
rly after discharge?
A) Perfusion scan.
Feedback: INCORRECT
B) Prothrombin Time (PT/INR).
Feedback: CORRECT
C) Activated partial thromboplastin (APTT).
Feedback: INCORRECT
D) Serum Coumadin level (SCL).
Feedback: INCORRECT
Feedback: CORRECT
When used for a client with pulmonary embolus, the therapeutic goal for warfarin
therapy is a PT 1½ to 2½ times greater than the control, or an INR of 2 to 3 (B). A p
erfusion might be performed to monitor lung function, but not monthly (A). APTT
is monitored for the client receiving heparin therapy (C). A blood level for Cou
madin cannot be measured (D).
5. Which nursing intervention is most important when caring for a client receivi
ng the antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
Feedback: INCORRECT
B) Assess the client for numbness and tingling of extremities.
Feedback: INCORRECT
C) Inspect the client's oral mucosa for ulcerations.
Feedback: CORRECT
D) Monitor the client's urine pH for increased acidity.
Feedback: INCORRECT
, Feedback: CORRECT
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, ther
efore stomatitis and mucosal ulcerations are key signs of antimetabolite toxicit
y (C). (A, B, and D) are not typical interventions associated with the administr
ation of antimetabolites.
6. An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The
nurse knows that the purpose of this medication is to
A) decrease production of gastric secretions.
Feedback: INCORRECT
B) produce an adherent barrier over the ulcer.
Feedback: INCORRECT
C) maintain a gastric pH of 3.5 or above.
Feedback: CORRECT
D) decrease gastric motor activity.
Feedback: INCORRECT
Feedback: INCORRECT
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or a
bove (C) which is necessary for pepsinogen inactivity. (A) is the purpose of H2
receptor antagonists (cimetidine, ranitidine). (B) is the purpose of sucralfate
(Carafate). (D) is the purpose of anticholinergic drugs which are often used in
conjunction with antacids to allow the antacid to remain in the stomach longer.
7. A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Whi
ch observation by the nurse should indicate that the desired outcome of the medi
cation is being achieved?
A) Decreased blood pressure.
Feedback: INCORRECT
B) Lessening of tremors.
Feedback: CORRECT
C) Increased salivation.
Feedback: INCORRECT
D) Increased attention span.
Feedback: INCORRECT
Feedback: CORRECT
Sinemet increases the amount of levodopa to the CNS (dopamine to the brain). Inc
reased amounts of dopamine improve the symptoms of Parkinson's, such as involunt
ary movements, resting tremors (B), shuffling gait, etc. (A) is a side effect of
Sinemet. Decreased drooling would be a desired effect, not (C). Sinemet does no
t affect (D).
8. The healthcare provider prescribes naproxen (Naproxen) twice daily for a clie
nt with osteoarthritis of the hands. The client tells the nurse that the drug do
es not seem to be effective after three weeks. Which is the best response for th
e nurse to provide?
A) The frequency of the dosing is necessary to increase the effectiveness.
Feedback: INCORRECT
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
Feedback: INCORRECT
1. An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and keto
rolac (Toradol) 30 mg IV q6h. Which action should the nurse implement?
A) Administer both medications according to the prescription.
Feedback: CORRECT
B) Hold the ketorolac to prevent an antagonistic effect.
Feedback: INCORRECT
C) Hold the morphine to prevent an additive drug interaction.
Feedback: INCORRECT
D) Contact the healthcare provider to clarify the prescription.
Feedback: INCORRECT
Feedback: INCORRECT
Morphine and ketorolac (Toradol) can be administered concurrently (A), and may p
roduce an additive analgesic effect, resulting in the ability to reduce the dose
of morphine, as seen in this prescription. Toradol is an antiinflammatory analg
esic, and does not have an antagonistic effect with morphine (B), like an agonis
t-antagonist medication would have. An additive analgesic effect is desirable (C
), because it allows a reduced dose of morphine. This prescription does not requ
ire any clarification, and can be administered safely as written (D).
2. The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with an
gina. Which instruction should the nurse include in this client's discharge teac
hing plan?
A) Quit taking the medication if dizziness occurs.
Feedback: INCORRECT
B) Do not get up quickly. Always rise slowly.
Feedback: CORRECT
C) Take the medication with food only.
Feedback: INCORRECT
D) Increase your intake of potassium-rich foods.
Feedback: INCORRECT
Feedback: CORRECT
An expected side effect of nitrates is orthostatic hypotension and the nurse sho
uld address how to prevent it--by rising slowly (B). Dizziness is expected, and
the client should not quit taking the medication without notifying the healthcar
e provider (A). (C and D) are not indicated when taking this medication.
3. A client who was prescribed atorvastatin (Lipitor) one month ago calls the tr
iage nurse at the clinic complaining of muscle pain and weakness in his legs. Wh
ich statement reflects the correct drug-specific teaching the nurse should provi
de to this client?
A) Increase consumption of potassium-rich foods since low potassium levels can
cause muscle spasms.
Feedback: INCORRECT
B) Have serum electrolytes checked at the next scheduled appointment to assess
hyponatremia, a cause of cramping.
,Feedback: INCORRECT
C) Make an appointment to see the healthcare provider, because muscle pain may
be an indication of a serious side effect.
Feedback: CORRECT
D) Be sure to consume a low-cholesterol diet while taking the drug to enhance t
he effectiveness of the drug.
Feedback: INCORRECT
Feedback: CORRECT
Myopathy, suggested by the leg pain and weakness, is a serious, and potentially
life-threatening, complication of Lipitor, and should be evaluated immediately b
y the healthcare provider (C). Although electrolyte imbalances such as (A or B)
can cause muscle spasms in some cases, this is not the likely cause of leg pain
in the client receiving Lipitor, and evaluation by the healthcare provider shoul
d not be delayed for any reason. A low-cholesterol diet is recommended for those
taking Lipitor since the drug is used to lower total cholesterol (D), but diet
is not related to the leg pain symptom.
4. Following heparin treatment for a pulmonary embolism, a client is being disch
arged with a prescription for warfarin (Coumadin). In conducting discharge teach
ing, the nurse advises the client to have which diagnostic test monitored regula
rly after discharge?
A) Perfusion scan.
Feedback: INCORRECT
B) Prothrombin Time (PT/INR).
Feedback: CORRECT
C) Activated partial thromboplastin (APTT).
Feedback: INCORRECT
D) Serum Coumadin level (SCL).
Feedback: INCORRECT
Feedback: CORRECT
When used for a client with pulmonary embolus, the therapeutic goal for warfarin
therapy is a PT 1½ to 2½ times greater than the control, or an INR of 2 to 3 (B). A p
erfusion might be performed to monitor lung function, but not monthly (A). APTT
is monitored for the client receiving heparin therapy (C). A blood level for Cou
madin cannot be measured (D).
5. Which nursing intervention is most important when caring for a client receivi
ng the antimetabolite cytosine arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
Feedback: INCORRECT
B) Assess the client for numbness and tingling of extremities.
Feedback: INCORRECT
C) Inspect the client's oral mucosa for ulcerations.
Feedback: CORRECT
D) Monitor the client's urine pH for increased acidity.
Feedback: INCORRECT
, Feedback: CORRECT
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, ther
efore stomatitis and mucosal ulcerations are key signs of antimetabolite toxicit
y (C). (A, B, and D) are not typical interventions associated with the administr
ation of antimetabolites.
6. An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The
nurse knows that the purpose of this medication is to
A) decrease production of gastric secretions.
Feedback: INCORRECT
B) produce an adherent barrier over the ulcer.
Feedback: INCORRECT
C) maintain a gastric pH of 3.5 or above.
Feedback: CORRECT
D) decrease gastric motor activity.
Feedback: INCORRECT
Feedback: INCORRECT
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or a
bove (C) which is necessary for pepsinogen inactivity. (A) is the purpose of H2
receptor antagonists (cimetidine, ranitidine). (B) is the purpose of sucralfate
(Carafate). (D) is the purpose of anticholinergic drugs which are often used in
conjunction with antacids to allow the antacid to remain in the stomach longer.
7. A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Whi
ch observation by the nurse should indicate that the desired outcome of the medi
cation is being achieved?
A) Decreased blood pressure.
Feedback: INCORRECT
B) Lessening of tremors.
Feedback: CORRECT
C) Increased salivation.
Feedback: INCORRECT
D) Increased attention span.
Feedback: INCORRECT
Feedback: CORRECT
Sinemet increases the amount of levodopa to the CNS (dopamine to the brain). Inc
reased amounts of dopamine improve the symptoms of Parkinson's, such as involunt
ary movements, resting tremors (B), shuffling gait, etc. (A) is a side effect of
Sinemet. Decreased drooling would be a desired effect, not (C). Sinemet does no
t affect (D).
8. The healthcare provider prescribes naproxen (Naproxen) twice daily for a clie
nt with osteoarthritis of the hands. The client tells the nurse that the drug do
es not seem to be effective after three weeks. Which is the best response for th
e nurse to provide?
A) The frequency of the dosing is necessary to increase the effectiveness.
Feedback: INCORRECT
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
Feedback: INCORRECT
