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Nursing Pharmacology · Pharmacology Nursing Practice Test

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Showing all 15 practice questions with expert explanatory rationales.

Question 1 of 15

Case excerpt

A patient with a history of peptic ulcer disease is prescribed naproxen for chronic joint pain.

Which teaching should the nurse prioritize?

A. Report black stools or vomiting blood and use the medication only as directed
B. Use aspirin routinely with naproxen
C. Take extra doses on days with more pain
D. Combine naproxen with another NSAID for stronger relief
E. Ignore persistent stomach pain

Expert Explanatory Rationale

Correct Answer: A. Report black stools or vomiting blood and use the medication only as directed

NSAIDs can cause gastrointestinal ulceration and bleeding. The patient should recognize warning signs and avoid duplicate NSAID use.

Question 2 of 15

Case excerpt

A patient receiving IV potassium chloride has a burning sensation at the infusion site.

In the case involving a patient receiving iv potassium chloride has a burning sensation at the infusion site, what is the nurse's best response?

A. Assess the IV site and infusion rate; potassium must never be given by IV push
B. Flush rapidly with concentrated potassium
C. Stop cardiac monitoring
D. Add potassium directly to the IV tubing
E. Increase the rate to finish the infusion

Expert Explanatory Rationale

Correct Answer: A. Assess the IV site and infusion rate; potassium must never be given by IV push

IV potassium can irritate veins and cause dangerous dysrhythmias if infused too rapidly. It must be diluted and administered by controlled infusion, never IV push.

Question 3 of 15

Case excerpt

A patient taking an oral contraceptive is prescribed an enzyme-inducing antiseizure medication.

What should the nurse discuss?

A. The combination always increases contraceptive effectiveness
B. The antiseizure medication may reduce contraceptive effectiveness; discuss additional or alternative contraception with the prescriber
C. Use two contraceptive tablets after every dose
D. No interaction is possible with oral medications
E. Skip contraceptive tablets on antiseizure medication days

Expert Explanatory Rationale

Correct Answer: B. The antiseizure medication may reduce contraceptive effectiveness; discuss additional or alternative contraception with the prescriber

Some enzyme-inducing antiseizure drugs lower hormonal contraceptive concentrations and can reduce effectiveness.

Question 4 of 15

Case excerpt

A patient receiving insulin glargine asks whether it can be mixed in the same syringe with regular insulin.

Which answer is correct?

A. It should be mixed with regular insulin to reduce injections
B. It must be shaken vigorously before use
C. It is used only to correct sudden hyperglycemia
D. It should be injected intravenously
E. It should not be mixed with other insulins in the same syringe

Expert Explanatory Rationale

Correct Answer: E. It should not be mixed with other insulins in the same syringe

Insulin glargine is a long-acting basal insulin and should not be mixed with other insulins.

Question 5 of 15

Case excerpt

A patient taking an opioid analgesic after surgery has not had a bowel movement for three days.

Which plan should the nurse anticipate?

A. Restrict fiber permanently
B. Wait until vomiting develops
C. Assess bowel status and implement the prescribed bowel regimen, fluids and mobility as appropriate
D. Encourage the patient to take extra opioid doses
E. Stop all fluids

Expert Explanatory Rationale

Correct Answer: C. Assess bowel status and implement the prescribed bowel regimen, fluids and mobility as appropriate

Opioids slow gastrointestinal motility. Prevention and treatment often include a bowel regimen, hydration and activity as appropriate.

Question 6 of 15

Case excerpt

A patient receiving chemotherapy has an absolute neutrophil count of 400/mm³ and a temperature of 38.3°C (100.9°F).

Which action is most urgent?

A. Wait for the next scheduled blood count
B. Give a live vaccine
C. Treat as febrile neutropenia and initiate urgent evaluation and prescribed antimicrobial pathway
D. Administer an antipyretic and reassess tomorrow
E. Encourage fresh flowers in the room

Expert Explanatory Rationale

Correct Answer: C. Treat as febrile neutropenia and initiate urgent evaluation and prescribed antimicrobial pathway

Fever with severe neutropenia is an emergency because infection can progress rapidly; prompt evaluation and antimicrobial treatment are time-critical.

Question 7 of 15

Case excerpt

A patient taking spironolactone has a potassium level of 5.8 mEq/L.

Which food choice should the nurse advise the patient to discuss limiting?

A. Blueberries
B. Banana smoothie
C. Plain pasta
D. White rice
E. Applesauce

Expert Explanatory Rationale

Correct Answer: B. Banana smoothie

Spironolactone is potassium-sparing. A high-potassium food such as banana may contribute to hyperkalemia; dietary advice should be individualized.

Question 8 of 15

Case excerpt

A patient using a transdermal fentanyl patch is scheduled for MRI.

Given the medication concern involving a patient using a transdermal fentanyl patch is scheduled for mri, which action should the nurse take?

A. Ignore the patch because it is not metal
B. Place a second patch before transport
C. Cut the patch in half
D. Follow MRI safety policy and remove the patch before scanning if required, with a plan for safe analgesia
E. Apply a heating pad over the patch

Expert Explanatory Rationale

Correct Answer: D. Follow MRI safety policy and remove the patch before scanning if required, with a plan for safe analgesia

Some transdermal patches contain metallic components and may heat during MRI. Follow device and facility guidance and ensure safe analgesia.

Question 9 of 15

Case excerpt

A patient is prescribed nitroglycerin sublingual tablets for episodic angina.

Which instructions should the nurse include? Select all that apply.

A. Seek emergency help for chest pain that persists according to the action plan
B. Store tablets in the original container as directed
C. Expect possible headache or dizziness
D. Avoid concurrent phosphodiesterase-5 inhibitors
E. Sit down before taking a dose if possible
F. Swallow the tablet whole with a full meal

Expert Explanatory Rationale

Correct Answer: A. Seek emergency help for chest pain that persists according to the action plan; B. Store tablets in the original container as directed; C. Expect possible headache or dizziness; D. Avoid concurrent phosphodiesterase-5 inhibitors; E. Sit down before taking a dose if possible

Sublingual nitroglycerin can cause hypotension and headache; correct storage and emergency instructions are essential.

Question 10 of 15

Case excerpt

A patient is prescribed an oral corticosteroid for an inflammatory condition.

Which teaching points should be included for a prolonged course? Select all that apply.

A. Avoid all vaccines permanently
B. Report signs of infection
C. Monitor glucose if at risk or instructed
D. Take with food if directed to reduce stomach upset
E. Discuss bone protection and other long-term risks with the prescriber
F. Do not stop suddenly without a tapering plan when one is required

Expert Explanatory Rationale

Correct Answer: B. Report signs of infection; C. Monitor glucose if at risk or instructed; D. Take with food if directed to reduce stomach upset; E. Discuss bone protection and other long-term risks with the prescriber; F. Do not stop suddenly without a tapering plan when one is required

Long-term corticosteroids can suppress immunity, raise glucose and affect bone health; tapering may be required.

Question 11 of 15

Case excerpt

A patient taking an anticoagulant is scheduled for dental extraction.

Considering the medication-safety situation involving a patient taking an anticoagulant is scheduled for dental extraction, which nursing actions are appropriate? Select all that apply.

A. Do not stop the medication independently
B. Take an extra anticoagulant dose to prevent clots
C. Report unusual bleeding after the procedure
D. Review the planned procedure and bleeding risk with the treating team
E. Tell the dentist and prescriber about the anticoagulant
F. Follow individualized instructions for any interruption or local hemostasis

Expert Explanatory Rationale

Correct Answer: A. Do not stop the medication independently; C. Report unusual bleeding after the procedure; D. Review the planned procedure and bleeding risk with the treating team; E. Tell the dentist and prescriber about the anticoagulant; F. Follow individualized instructions for any interruption or local hemostasis

Periprocedural anticoagulation decisions depend on thrombotic and bleeding risk and must be coordinated by the treating team.

Question 12 of 15

Case excerpt

A patient taking an antipsychotic reports muscle rigidity, high fever and confusion.

Considering the medication-safety situation involving a patient taking an antipsychotic reports muscle rigidity, high fever and confusion, which nursing actions are appropriate? Select all that apply.

A. Suspect neuroleptic malignant syndrome
B. Arrange emergency medical assessment
C. Reassure the patient that this is a harmless expected effect
D. Monitor vital signs and muscle rigidity
E. Notify the prescriber immediately
F. Hold further antipsychotic doses pending urgent clinical direction

Expert Explanatory Rationale

Correct Answer: A. Suspect neuroleptic malignant syndrome; B. Arrange emergency medical assessment; D. Monitor vital signs and muscle rigidity; E. Notify the prescriber immediately; F. Hold further antipsychotic doses pending urgent clinical direction

Fever, rigidity and altered mental status may indicate neuroleptic malignant syndrome, a life-threatening emergency.

Question 13 of 15

Case excerpt

A patient with heart failure is prescribed spironolactone.

Which findings should the nurse monitor? Select all that apply.

A. Concurrent use of potassium supplements or salt substitutes
B. Blood pressure
C. Renal function
D. Signs of hyperkalemia such as weakness or dysrhythmia
E. Serum potassium loss as the expected primary effect
F. Serum potassium

Expert Explanatory Rationale

Correct Answer: A. Concurrent use of potassium supplements or salt substitutes; B. Blood pressure; C. Renal function; D. Signs of hyperkalemia such as weakness or dysrhythmia; F. Serum potassium

Spironolactone can cause hyperkalemia and worsen renal function; potassium sources and blood pressure also require review.

Question 14 of 15

Case excerpt

An IV infusion contains 1,000 mL and is prescribed to run over 8 hours.

What is the infusion rate in mL/hr?

Expert Explanatory Rationale

Correct Answer: 125

1,000 mL divided by 8 hours equals 125 mL/hr.

Question 15 of 15

Case excerpt

A patient taking warfarin reports a new episode of vomiting blood.

Arrange the nurse's immediate actions in order.

A. Hold further warfarin pending urgent clinical direction
B. Assess vital signs and signs of hemodynamic compromise
C. Document findings and interventions after immediate care
D. Notify the prescriber or emergency team and prepare for urgent evaluation

Expert Explanatory Rationale

Correct Answer: B. Assess vital signs and signs of hemodynamic compromise; A. Hold further warfarin pending urgent clinical direction; D. Notify the prescriber or emergency team and prepare for urgent evaluation; C. Document findings and interventions after immediate care

Assess and stabilize first, withhold further anticoagulant pending direction, escalate urgently and document.

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