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Nursing Pharmacology · Nursing Pharmacology Exam Questions

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A patient taking levothyroxine has a new prescription for calcium carbonate and takes both tablets together each morning.

What teaching should the nurse provide?

A. Take both with grapefruit juice
B. Separate calcium from levothyroxine by several hours as directed because calcium can reduce absorption
C. Stop levothyroxine while taking calcium
D. Take calcium only if palpitations occur
E. Double levothyroxine on days calcium is taken

Expert Explanatory Rationale

Correct Answer: B. Separate calcium from levothyroxine by several hours as directed because calcium can reduce absorption

Calcium can interfere with levothyroxine absorption; separating administration helps maintain thyroid replacement consistency.

Question 2 of 15

Case excerpt

A patient with atrial fibrillation taking apixaban asks whether routine INR testing is needed.

Which response is accurate?

A. INR monitoring is not routinely used to dose apixaban, but kidney function, bleeding and adherence still require review
B. INR results determine whether apixaban is absorbed
C. Apixaban has no bleeding risk
D. INR is routinely used to adjust every apixaban dose
E. Skip doses before every blood test

Expert Explanatory Rationale

Correct Answer: A. INR monitoring is not routinely used to dose apixaban, but kidney function, bleeding and adherence still require review

Apixaban is a direct factor Xa inhibitor and is not titrated using INR, although clinical monitoring remains important.

Question 3 of 15

Case excerpt

A patient prescribed metronidazole asks about drinking alcohol during the course.

What should the nurse advise?

A. Drink alcohol only with the evening dose
B. There are no precautions involving alcohol
C. Avoid alcohol during treatment and for the period specified in the product guidance after the last dose
D. Alcohol improves the antibiotic's absorption
E. Take an extra dose if alcohol is consumed

Expert Explanatory Rationale

Correct Answer: C. Avoid alcohol during treatment and for the period specified in the product guidance after the last dose

Alcohol avoidance is advised during metronidazole therapy and for the recommended interval afterward because of potential adverse reactions.

Question 4 of 15

Case excerpt

A patient receiving IV insulin for diabetic ketoacidosis has a potassium level of 3.0 mEq/L.

Which concern should the nurse raise before insulin is initiated or continued?

A. Low potassium prevents insulin from lowering glucose
B. Insulin shifts potassium into cells and can worsen hypokalemia; potassium replacement and protocol guidance are needed
C. Insulin immediately raises serum potassium
D. Potassium has no relationship to insulin therapy
E. Give sodium bicarbonate instead of checking potassium

Expert Explanatory Rationale

Correct Answer: B. Insulin shifts potassium into cells and can worsen hypokalemia; potassium replacement and protocol guidance are needed

Insulin drives potassium intracellularly. Significant hypokalemia must be corrected according to protocol to reduce dysrhythmia risk.

Question 5 of 15

Case excerpt

A patient taking clozapine reports fever and sore throat.

Which action is most important?

A. Advise taking an NSAID and continuing without evaluation
B. Tell the patient to wait until the next monthly appointment
C. Arrange prompt assessment and urgent absolute neutrophil count testing according to protocol
D. Recommend doubling clozapine
E. Reassure the patient that this is always seasonal allergy

Expert Explanatory Rationale

Correct Answer: C. Arrange prompt assessment and urgent absolute neutrophil count testing according to protocol

Clozapine can cause severe neutropenia. Infection symptoms require urgent blood count evaluation and prescriber notification.

Question 6 of 15

Case excerpt

A patient receiving magnesium sulfate for severe preeclampsia has absent deep tendon reflexes and a respiratory rate of 9/min.

In the case involving a patient receiving magnesium sulfate for severe preeclampsia has absent deep tendon reflexes and a respiratory rate of 9/min, what is the nurse's best response?

A. Stop the infusion and urgently notify the provider; prepare to administer calcium gluconate as prescribed
B. Reduce environmental stimulation only
C. Encourage the patient to walk
D. Continue the infusion because seizure prevention is the priority
E. Administer another magnesium bolus

Expert Explanatory Rationale

Correct Answer: A. Stop the infusion and urgently notify the provider; prepare to administer calcium gluconate as prescribed

Loss of reflexes and respiratory depression suggest magnesium toxicity. Stop the infusion, support breathing and prepare the antidote per order.

Question 7 of 15

Case excerpt

A patient taking an oral iron supplement reports dark stools and constipation.

For the patient situation involving a patient taking an oral iron supplement reports dark stools and constipation, which teaching point is most important?

A. Crush enteric-coated iron tablets
B. Take iron with an antacid at every dose
C. Stop iron permanently without consulting the prescriber
D. Double the dose to overcome constipation
E. Dark stools can occur with iron; discuss constipation management and report tarry stools or other bleeding signs

Expert Explanatory Rationale

Correct Answer: E. Dark stools can occur with iron; discuss constipation management and report tarry stools or other bleeding signs

Iron commonly darkens stool and may cause constipation. Tarry, sticky stools with symptoms of bleeding require evaluation.

Question 8 of 15

Case excerpt

A patient with a severe infection is prescribed a broad-spectrum antibiotic. The patient says, 'I will stop it as soon as I feel better.'

Which response is best?

A. Tell the patient to share unused tablets
B. Advise doubling doses if one is missed
C. Recommend saving leftover tablets for future illness
D. Explain to take the antibiotic exactly as prescribed and contact the prescriber about adverse effects or concerns
E. Agree because symptoms indicate the infection is cured

Expert Explanatory Rationale

Correct Answer: D. Explain to take the antibiotic exactly as prescribed and contact the prescriber about adverse effects or concerns

The patient should follow the prescribed course and seek advice for adverse effects rather than stopping, sharing or self-adjusting treatment.

Question 9 of 15

Case excerpt

A patient is prescribed an inhaled anticholinergic bronchodilator for COPD.

Which teaching is appropriate? Select all that apply.

A. Understand that it is not intended to replace a rescue plan for sudden severe symptoms unless specifically prescribed
B. Review dry mouth management
C. Use the device with the prescribed technique
D. Stop all maintenance inhalers when breathing improves
E. Report difficulty urinating or eye pain after accidental eye exposure
F. Avoid spraying the medication into the eyes

Expert Explanatory Rationale

Correct Answer: A. Understand that it is not intended to replace a rescue plan for sudden severe symptoms unless specifically prescribed; B. Review dry mouth management; C. Use the device with the prescribed technique; E. Report difficulty urinating or eye pain after accidental eye exposure; F. Avoid spraying the medication into the eyes

Inhaled anticholinergics can cause dry mouth and, with eye exposure, ocular effects; correct device use is important.

Question 10 of 15

Case excerpt

A patient taking an oral antibiotic develops watery diarrhea several times a day with abdominal cramping.

Considering the medication-safety situation involving a patient taking an oral antibiotic develops watery diarrhea several times a day with abdominal cramping, which nursing actions are appropriate? Select all that apply.

A. Follow infection-control precautions if indicated
B. Report concern for antibiotic-associated colitis
C. Do not recommend antidiarrheal treatment without clinical assessment
D. Assess severity, hydration and associated symptoms
E. Review recent antibiotic exposure
F. Encourage the patient to take leftover antibiotics

Expert Explanatory Rationale

Correct Answer: A. Follow infection-control precautions if indicated; B. Report concern for antibiotic-associated colitis; C. Do not recommend antidiarrheal treatment without clinical assessment; D. Assess severity, hydration and associated symptoms; E. Review recent antibiotic exposure

Significant diarrhea after antibiotics may indicate C. difficile infection and requires clinical assessment and appropriate precautions.

Question 11 of 15

Case excerpt

A patient receiving an IV medication develops sudden wheezing, facial swelling and hypotension.

Which actions should the nurse take? Select all that apply.

A. Restart the infusion at a slower rate
B. Stop the suspected medication infusion
C. Activate emergency response
D. Support airway and circulation
E. Document the event after immediate stabilization
F. Prepare to administer epinephrine as prescribed or per emergency protocol

Expert Explanatory Rationale

Correct Answer: B. Stop the suspected medication infusion; C. Activate emergency response; D. Support airway and circulation; E. Document the event after immediate stabilization; F. Prepare to administer epinephrine as prescribed or per emergency protocol

The presentation is consistent with anaphylaxis; immediate emergency treatment takes priority over documentation.

Question 12 of 15

Case excerpt

A patient taking an oral iron preparation asks how to improve absorption.

Which advice is appropriate? Select all that apply.

A. Keep iron away from children
B. Take with vitamin C or a vitamin-C-containing drink if tolerated
C. Discuss constipation if it becomes troublesome
D. Expect possible dark stools
E. Separate from calcium supplements and antacids as directed
F. Take with tea to improve absorption

Expert Explanatory Rationale

Correct Answer: A. Keep iron away from children; B. Take with vitamin C or a vitamin-C-containing drink if tolerated; C. Discuss constipation if it becomes troublesome; D. Expect possible dark stools; E. Separate from calcium supplements and antacids as directed

Vitamin C may improve absorption; calcium, antacids and some beverages reduce it. Iron overdose is dangerous to children.

Question 13 of 15

Case excerpt

A patient is prescribed a beta blocker after myocardial infarction.

Which assessment findings should prompt review before administration? Select all that apply.

A. New wheezing in a patient with reactive airway disease
B. Heart rate within the prescribed parameter and no symptoms
C. Signs of acute decompensated heart failure
D. New dizziness with near-syncope
E. Marked bradycardia
F. Symptomatic hypotension

Expert Explanatory Rationale

Correct Answer: A. New wheezing in a patient with reactive airway disease; C. Signs of acute decompensated heart failure; D. New dizziness with near-syncope; E. Marked bradycardia; F. Symptomatic hypotension

Beta blockers can worsen bradycardia, hypotension, bronchospasm in susceptible patients and acute decompensated heart failure.

Question 14 of 15

Case excerpt

A patient is prescribed 15 units of insulin. The pen delivers doses in 1-unit increments.

How many units should be dialed into the pen?

Expert Explanatory Rationale

Correct Answer: 15

The prescribed dose is 15 units; dial 15 units and verify the product and dose.

Question 15 of 15

Case excerpt

A patient receiving lithium develops coarse tremor and ataxia after a gastrointestinal illness.

Arrange the appropriate nursing response in order.

A. Continue monitoring and follow the revised treatment plan
B. Assess neurologic status, hydration and vital signs
C. Hold the next lithium dose and promptly contact the prescriber
D. Obtain ordered lithium level, renal function and electrolyte tests

Expert Explanatory Rationale

Correct Answer: B. Assess neurologic status, hydration and vital signs; C. Hold the next lithium dose and promptly contact the prescriber; D. Obtain ordered lithium level, renal function and electrolyte tests; A. Continue monitoring and follow the revised treatment plan

Assess the patient, prevent another dose while toxicity is suspected, obtain ordered tests and monitor under the revised plan.

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