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Nursing Pharmacology · Pharmacology Nursing Practice Quiz

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A patient taking levothyroxine asks why the tablet should be taken before breakfast.

Which explanation is best?

A. Food improves absorption, so it should be taken with breakfast
B. It works only when taken with calcium
C. It prevents all thyroid-related adverse effects
D. The timing does not affect absorption
E. Taking it consistently on an empty stomach helps maintain predictable absorption

Expert Explanatory Rationale

Correct Answer: E. Taking it consistently on an empty stomach helps maintain predictable absorption

Levothyroxine is generally taken consistently on an empty stomach, separated from food and interacting supplements such as calcium or iron.

Question 2 of 15

Case excerpt

A patient taking metformin is scheduled for a CT scan with iodinated contrast and has reduced kidney function.

In the case involving a patient taking metformin is scheduled for a ct scan with iodinated contrast and has reduced kidney function, what is the nurse's best response?

A. Administer metformin immediately before contrast
B. Check the current renal function and follow the prescribed contrast-related hold and restart protocol
C. Double the metformin dose after the scan
D. Encourage the patient to avoid fluids
E. Replace metformin with insulin without an order

Expert Explanatory Rationale

Correct Answer: B. Check the current renal function and follow the prescribed contrast-related hold and restart protocol

Metformin management around iodinated contrast depends on renal function and clinical circumstances; follow current policy and prescriber instructions.

Question 3 of 15

Case excerpt

A patient prescribed furosemide reports leg cramps and weakness. The potassium level is 2.9 mEq/L.

Which action is most appropriate?

A. Administer the medication and reassess next week
B. Restrict all oral fluids
C. Encourage a potassium-free diet
D. Report the hypokalemia and assess cardiac rhythm and replacement orders
E. Give an additional dose to remove more fluid

Expert Explanatory Rationale

Correct Answer: D. Report the hypokalemia and assess cardiac rhythm and replacement orders

Loop diuretics can cause potassium loss. Significant hypokalemia increases dysrhythmia risk and requires prompt assessment and treatment.

Question 4 of 15

Case excerpt

A patient taking phenytoin has swollen, bleeding gums and asks how to reduce this effect.

For the patient situation involving a patient taking phenytoin has swollen, bleeding gums and asks how to reduce this effect, which teaching point is most important?

A. Maintain careful oral hygiene and arrange regular dental care
B. Avoid brushing the teeth
C. Use a hard-bristled brush to massage the gums
D. Take the medication only when seizures occur
E. Stop phenytoin when gum swelling appears

Expert Explanatory Rationale

Correct Answer: A. Maintain careful oral hygiene and arrange regular dental care

Phenytoin can cause gingival hyperplasia. Good oral hygiene and regular dental assessment help reduce complications.

Question 5 of 15

Case excerpt

A patient using prednisone for several weeks plans to stop it today because symptoms have improved.

What should the nurse explain?

A. Replace prednisone with ibuprofen immediately
B. Only the first dose requires a prescription
C. Long-term corticosteroids may need gradual tapering; do not stop abruptly without instructions
D. Take a double dose every other day instead
E. Stopping suddenly prevents adrenal suppression

Expert Explanatory Rationale

Correct Answer: C. Long-term corticosteroids may need gradual tapering; do not stop abruptly without instructions

Prolonged corticosteroid therapy suppresses the hypothalamic-pituitary-adrenal axis. Abrupt withdrawal can cause adrenal insufficiency.

Question 6 of 15

Case excerpt

A patient receiving gentamicin reports new ringing in both ears.

Given the medication concern involving a patient receiving gentamicin reports new ringing in both ears, which action should the nurse take?

A. Administer the next dose early
B. Document it as unrelated to therapy
C. Report possible ototoxicity and review drug levels and renal function
D. Encourage the patient to use headphones
E. Restrict protein intake

Expert Explanatory Rationale

Correct Answer: C. Report possible ototoxicity and review drug levels and renal function

Aminoglycosides can cause ototoxicity and nephrotoxicity. New tinnitus requires prompt evaluation.

Question 7 of 15

Case excerpt

A patient prescribed nitroglycerin for angina says they took sildenafil earlier that evening.

Which instruction is essential?

A. Do not take nitroglycerin and seek urgent clinical advice because the combination can cause severe hypotension
B. Take an antacid first, then nitroglycerin
C. Use twice the nitroglycerin dose if pain persists
D. Take nitroglycerin with sildenafil to improve circulation
E. Take both medications with food

Expert Explanatory Rationale

Correct Answer: A. Do not take nitroglycerin and seek urgent clinical advice because the combination can cause severe hypotension

Combining nitrates with phosphodiesterase-5 inhibitors can cause profound hypotension and is contraindicated.

Question 8 of 15

Case excerpt

A patient taking an oral antibiotic develops widespread hives and wheezing shortly after the first dose.

What is the priority nursing response?

A. Ask the patient to take the next dose with food
B. Treat as possible anaphylaxis and activate emergency response
C. Offer a warm drink and observe
D. Wait for the prescriber to round
E. Document a mild expected reaction

Expert Explanatory Rationale

Correct Answer: B. Treat as possible anaphylaxis and activate emergency response

Hives with wheezing after medication exposure suggests anaphylaxis. Immediate emergency treatment is required.

Question 9 of 15

Case excerpt

A patient is prescribed furosemide for heart failure.

Which assessments are important during therapy? Select all that apply.

A. Serum potassium and renal function
B. Daily weight and fluid balance
C. Blood pressure and orthostatic symptoms
D. Serum glucose only once in a lifetime
E. Signs of dehydration
F. Hearing changes with high-dose or IV therapy

Expert Explanatory Rationale

Correct Answer: A. Serum potassium and renal function; B. Daily weight and fluid balance; C. Blood pressure and orthostatic symptoms; E. Signs of dehydration; F. Hearing changes with high-dose or IV therapy

Furosemide can cause volume depletion, hypotension, electrolyte changes and, particularly with high-dose IV therapy, ototoxicity.

Question 10 of 15

Case excerpt

A patient is taking lithium maintenance therapy.

Which instructions reduce the risk of toxicity? Select all that apply.

A. Report worsening tremor, confusion or unsteady gait
B. Report vomiting, diarrhea or heavy sweating
C. Start NSAIDs regularly without consulting the prescriber
D. Avoid sudden major changes in dietary sodium
E. Attend ordered serum lithium and renal monitoring
F. Maintain consistent fluid intake

Expert Explanatory Rationale

Correct Answer: A. Report worsening tremor, confusion or unsteady gait; B. Report vomiting, diarrhea or heavy sweating; D. Avoid sudden major changes in dietary sodium; E. Attend ordered serum lithium and renal monitoring; F. Maintain consistent fluid intake

Fluid and sodium changes, interacting medicines and dehydration can raise lithium levels; monitoring and early reporting are essential.

Question 11 of 15

Case excerpt

A patient is prescribed an aminoglycoside antibiotic.

Which monitoring priorities are appropriate? Select all that apply.

A. Hearing and balance symptoms
B. Routine visual acuity as the only safety check
C. New tinnitus or vertigo
D. Urine output
E. Renal function
F. Ordered serum drug concentrations when indicated

Expert Explanatory Rationale

Correct Answer: A. Hearing and balance symptoms; C. New tinnitus or vertigo; D. Urine output; E. Renal function; F. Ordered serum drug concentrations when indicated

Aminoglycosides can cause nephrotoxicity and ototoxicity, so renal, auditory and drug-level monitoring may be needed.

Question 12 of 15

Case excerpt

A patient is prescribed a long-term proton pump inhibitor.

Which counseling points are appropriate? Select all that apply.

A. Report persistent diarrhea or severe abdominal symptoms
B. Discuss the need for ongoing therapy at follow-up
C. Do not independently increase the dose for every episode of heartburn
D. Assume it prevents every cause of gastrointestinal bleeding
E. Take the medicine according to the product-specific instructions
F. Review possible long-term risks when prolonged therapy is planned

Expert Explanatory Rationale

Correct Answer: A. Report persistent diarrhea or severe abdominal symptoms; B. Discuss the need for ongoing therapy at follow-up; C. Do not independently increase the dose for every episode of heartburn; E. Take the medicine according to the product-specific instructions; F. Review possible long-term risks when prolonged therapy is planned

Use the lowest effective regimen for an appropriate indication, follow administration guidance and review ongoing need and adverse effects.

Question 13 of 15

Case excerpt

A patient is receiving a heparin infusion for pulmonary embolism.

Considering the medication-safety situation involving a patient is receiving a heparin infusion for pulmonary embolism, which nursing actions are appropriate? Select all that apply.

A. Administer IM injections routinely to reduce bruising
B. Use the prescribed reversal plan if serious bleeding occurs
C. Assess for bleeding
D. Monitor platelet trends for possible HIT
E. Use an infusion pump and verify the prescribed rate
F. Monitor aPTT or anti-Xa according to the institutional protocol

Expert Explanatory Rationale

Correct Answer: B. Use the prescribed reversal plan if serious bleeding occurs; C. Assess for bleeding; D. Monitor platelet trends for possible HIT; E. Use an infusion pump and verify the prescribed rate; F. Monitor aPTT or anti-Xa according to the institutional protocol

Heparin requires protocol-based coagulation monitoring, bleeding surveillance, platelet monitoring and controlled infusion delivery.

Question 14 of 15

Case excerpt

A prescription reads 0.6 mg of a medication. Available tablets contain 0.2 mg each.

How many tablets are needed for one dose?

Expert Explanatory Rationale

Correct Answer: 3

0.6 mg ÷ 0.2 mg per tablet = 3 tablets.

Question 15 of 15

Case excerpt

A patient develops signs of a severe allergic reaction during an IV antibiotic infusion.

Arrange the initial response actions in order.

A. Administer emergency medication according to protocol and reassess
B. Stop the suspected infusion
C. Assess airway, breathing and circulation
D. Activate emergency response and obtain assistance

Expert Explanatory Rationale

Correct Answer: BCDA

Remove the suspected trigger, rapidly assess the patient, summon emergency support and treat according to protocol.

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