NUR 2474 PHARMACOLOGY FINAL EXAM
NCLEX 2026 UPDATED QUESTIONS WITH
ANSWERS
The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients
who were just admitted. Which patient should the nurse assess first?
a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30
Novolin insulin
b.The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin)
c.The patient with a blood pressure of 136/92 mm Hg who complains of having a headache
d.The patient with an allergy to penicillin who is receiving an infusion of vancomycin
(Vancocin) a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20
units of 70/30 Novolin insulin
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale
and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL.
Which formulation of insulin should the nurse prepare to administer?
a.No insulin should be administered.
b.NPH
c.70/30 mix
d.Lispro (Humalog) d.Lispro (Humalog)
A patient who has erectile dysfunction asks a nurse whether sildenafil (Viagra) would be a good
medication for him to take. Which aspect of this patient's history would be of most concern?
a.Benign prostatic hypertrophy
b.Mild hypertension
c.Occasional use of nitroglycerin
d.Taking finasteride c.Occasional use of nitroglycerin
Which are contraindications for taking sildenafil (Viagra)? (Select all that apply.)
a.Patients who are taking nitroglycerin for angina pectoris
b.Patients with nonarteritic ischemic optic neuropathy (NAION) in one eye
c.Patients with BPH who are taking alpha1-adrenergic antagonists
d.Patients with a blood pressure of 100/60 mm Hg
e.Patients with a history of myocardial infarction (MI) in the past 6 months a.Patients who
are taking nitroglycerin for angina pectoris
b.Patients with nonarteritic ischemic optic neuropathy (NAION) in one eye
c.Patients with BPH who are taking alpha1-adrenergic antagonists
A pregnant patient asks the nurse if she can take antihistamines for seasonal allergies during her
1
,pregnancy. What will the nurse tell the patient?
a.Antihistamines are contraindicated during the third trimester of pregnancy.
b.Second-generation antihistamines are safer than first-generation antihistamines.
c.Antihistamines should not be taken during pregnancy, but may be taken when breast-feeding.
d.The margin of safety for antihistamines is clearly understood for pregnant patients.
a.Antihistamines are contraindicated during the third trimester of pregnancy.
A nurse is teaching a group of nursing students about antihistamines. Which statement by a
student indicates an understanding of the mechanism of action of the antihistamines?
a."Antihistamines block H1 receptors to prevent actions of histamine at these sites."
b."Antihistamines block release of histamine from mast cells and basophils."
c."H1 antagonists can bind to H1 receptors, H2 receptors, and muscarinic receptors."
d."First-generation antihistamines are more selective than second-generation antihistamines."
a."Antihistamines block H1 receptors to prevent actions of histamine at these sites."
A patient will begin taking fexofenadine (Allegra) for hay fever. The nurse teaching this patient
will tell the patient that:
a.fexofenadine should be taken with food to prevent gastrointestinal (GI) symptoms.
b.the medication may be taken once or twice daily.
c.tolerance to sedation will occur in a few weeks.
d.with renal impairment, this drug should be taken every other day. b.the medication may be
taken once or twice daily.
A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing
schedule for her. What is the recommended monitoring schedule?
a.Before each meal and before bed
b.In the morning for a fasting level and at 4 PM for the peak level
c.Six or seven times a day
d.Three times a day, along with urine glucose testing c.Six or seven times a day
An adolescent patient recently attended a health fair and had a serum glucose test. The patient
telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?"
What is the nurse's most accurate response?
a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have
diabetes."
b. "At this level, you probably have diabetes. You will need an oral glucose tolerance test this
week."
c. "This level is conclusive evidence that you have diabetes."
d. "This level is conclusive evidence that you do not have diabetes."a."Unless you were fasting
for longer than 8 hours, this does not necessarily mean you have diabetes."
Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse
administer this drug?
2
,a.Approximately 15 to 30 minutes before each meal
b.In the morning and at 4 PM
c.Once daily at bedtime
d.After meals and at bedtime c.Once daily at bedtime
A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension.
Why is the nurse concerned?
a.The beta blocker can cause insulin resistance.
b.Using the two agents together increases the risk of ketoacidosis.
c.Propranolol increases insulin requirements because of receptor blocking.
d.The beta blocker can mask the symptoms of hypoglycemia. d.The beta blocker can mask
the symptoms of hypoglycemia.
Which statement is correct about the contrast between acarbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects. a.Miglitol has not been associated with
hepatic dysfunction.
A nurse counsels a patient with diabetes who is starting therapy with an alpha-glucosidase
inhibitor. The patient should be educated about the potential for which adverse reactions? (Select
all that apply.)
a.Hypoglycemia
b.Flatulence
c.Elevated iron levels in the blood
d.Fluid retention
e. Diarrhea b.Flatulence
e.Diarrhea
The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient
tells the nurse she does not want to take medications while she is pregnant. What will the nurse
explain to this patient?
a.Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
b.Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c.No danger to the fetus exists until the third trimester.
d.Treatment is required only if the patient is experiencing symptoms. b.Neuropsychologic
deficits in the fetus can occur if the condition is not treated.
A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine
(Synthroid). Which statement by the patient indicates a need for further teaching?
3
, a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d. "If I take calcium supplements, I may need to decrease my dose of Synthroid." d."If I take
calcium supplements, I may need to decrease my dose of Synthroid."
A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses
the patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a
temperature of 97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the
provider to request an order for which drug?
a.Beta blocker
b.Increased dose of PO levothyroxine
c.Intravenous levothyroxine
d.Methimazole (Tapazole) c.Intravenous levothyroxine
A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse
learns that the patient also takes warfarin (Coumadin). The nurse will notify the provider to
discuss the dose.
a.reducing levothyroxine
b.reducing warfarin
c.increasing levothyroxine
d.increasing warfarin b.reducing; warfarin
An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL,
and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine (Levothroid) 100
mcg/day PO. What will the nurse do?
a.Administer the medication as ordered.
b.Contact the provider to discuss giving the levothyroxine IV.
c.Request an order to give desiccated thyroid (Armour Thyroid).
d.Suggest that the provider lower the dose. d.Suggest that the provider lower the dose.
A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine (Synthroid).
The child comes to the clinic for a well-child check up. The nurse will expect the provider to:
a.change the dose of levothyroxine to 6 mcg/kg/day.
b.discontinue the drug if the child's physical and mental development is normal.
c.increase the dose to accommodate the child's increased growth.
d.stop the drug for 4 weeks and check the child's TSH level. a.change the dose of
levothyroxine to 6 mcg/kg/day.
A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of
pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site
and along the vein. What is the nurse's priority action?
4
NCLEX 2026 UPDATED QUESTIONS WITH
ANSWERS
The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients
who were just admitted. Which patient should the nurse assess first?
a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30
Novolin insulin
b.The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin)
c.The patient with a blood pressure of 136/92 mm Hg who complains of having a headache
d.The patient with an allergy to penicillin who is receiving an infusion of vancomycin
(Vancocin) a.The NPO patient with a blood glucose level of 80 mg/dL who just received 20
units of 70/30 Novolin insulin
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale
and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL.
Which formulation of insulin should the nurse prepare to administer?
a.No insulin should be administered.
b.NPH
c.70/30 mix
d.Lispro (Humalog) d.Lispro (Humalog)
A patient who has erectile dysfunction asks a nurse whether sildenafil (Viagra) would be a good
medication for him to take. Which aspect of this patient's history would be of most concern?
a.Benign prostatic hypertrophy
b.Mild hypertension
c.Occasional use of nitroglycerin
d.Taking finasteride c.Occasional use of nitroglycerin
Which are contraindications for taking sildenafil (Viagra)? (Select all that apply.)
a.Patients who are taking nitroglycerin for angina pectoris
b.Patients with nonarteritic ischemic optic neuropathy (NAION) in one eye
c.Patients with BPH who are taking alpha1-adrenergic antagonists
d.Patients with a blood pressure of 100/60 mm Hg
e.Patients with a history of myocardial infarction (MI) in the past 6 months a.Patients who
are taking nitroglycerin for angina pectoris
b.Patients with nonarteritic ischemic optic neuropathy (NAION) in one eye
c.Patients with BPH who are taking alpha1-adrenergic antagonists
A pregnant patient asks the nurse if she can take antihistamines for seasonal allergies during her
1
,pregnancy. What will the nurse tell the patient?
a.Antihistamines are contraindicated during the third trimester of pregnancy.
b.Second-generation antihistamines are safer than first-generation antihistamines.
c.Antihistamines should not be taken during pregnancy, but may be taken when breast-feeding.
d.The margin of safety for antihistamines is clearly understood for pregnant patients.
a.Antihistamines are contraindicated during the third trimester of pregnancy.
A nurse is teaching a group of nursing students about antihistamines. Which statement by a
student indicates an understanding of the mechanism of action of the antihistamines?
a."Antihistamines block H1 receptors to prevent actions of histamine at these sites."
b."Antihistamines block release of histamine from mast cells and basophils."
c."H1 antagonists can bind to H1 receptors, H2 receptors, and muscarinic receptors."
d."First-generation antihistamines are more selective than second-generation antihistamines."
a."Antihistamines block H1 receptors to prevent actions of histamine at these sites."
A patient will begin taking fexofenadine (Allegra) for hay fever. The nurse teaching this patient
will tell the patient that:
a.fexofenadine should be taken with food to prevent gastrointestinal (GI) symptoms.
b.the medication may be taken once or twice daily.
c.tolerance to sedation will occur in a few weeks.
d.with renal impairment, this drug should be taken every other day. b.the medication may be
taken once or twice daily.
A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing
schedule for her. What is the recommended monitoring schedule?
a.Before each meal and before bed
b.In the morning for a fasting level and at 4 PM for the peak level
c.Six or seven times a day
d.Three times a day, along with urine glucose testing c.Six or seven times a day
An adolescent patient recently attended a health fair and had a serum glucose test. The patient
telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?"
What is the nurse's most accurate response?
a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have
diabetes."
b. "At this level, you probably have diabetes. You will need an oral glucose tolerance test this
week."
c. "This level is conclusive evidence that you have diabetes."
d. "This level is conclusive evidence that you do not have diabetes."a."Unless you were fasting
for longer than 8 hours, this does not necessarily mean you have diabetes."
Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse
administer this drug?
2
,a.Approximately 15 to 30 minutes before each meal
b.In the morning and at 4 PM
c.Once daily at bedtime
d.After meals and at bedtime c.Once daily at bedtime
A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension.
Why is the nurse concerned?
a.The beta blocker can cause insulin resistance.
b.Using the two agents together increases the risk of ketoacidosis.
c.Propranolol increases insulin requirements because of receptor blocking.
d.The beta blocker can mask the symptoms of hypoglycemia. d.The beta blocker can mask
the symptoms of hypoglycemia.
Which statement is correct about the contrast between acarbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects. a.Miglitol has not been associated with
hepatic dysfunction.
A nurse counsels a patient with diabetes who is starting therapy with an alpha-glucosidase
inhibitor. The patient should be educated about the potential for which adverse reactions? (Select
all that apply.)
a.Hypoglycemia
b.Flatulence
c.Elevated iron levels in the blood
d.Fluid retention
e. Diarrhea b.Flatulence
e.Diarrhea
The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient
tells the nurse she does not want to take medications while she is pregnant. What will the nurse
explain to this patient?
a.Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
b.Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c.No danger to the fetus exists until the third trimester.
d.Treatment is required only if the patient is experiencing symptoms. b.Neuropsychologic
deficits in the fetus can occur if the condition is not treated.
A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine
(Synthroid). Which statement by the patient indicates a need for further teaching?
3
, a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d. "If I take calcium supplements, I may need to decrease my dose of Synthroid." d."If I take
calcium supplements, I may need to decrease my dose of Synthroid."
A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses
the patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a
temperature of 97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the
provider to request an order for which drug?
a.Beta blocker
b.Increased dose of PO levothyroxine
c.Intravenous levothyroxine
d.Methimazole (Tapazole) c.Intravenous levothyroxine
A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse
learns that the patient also takes warfarin (Coumadin). The nurse will notify the provider to
discuss the dose.
a.reducing levothyroxine
b.reducing warfarin
c.increasing levothyroxine
d.increasing warfarin b.reducing; warfarin
An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL,
and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine (Levothroid) 100
mcg/day PO. What will the nurse do?
a.Administer the medication as ordered.
b.Contact the provider to discuss giving the levothyroxine IV.
c.Request an order to give desiccated thyroid (Armour Thyroid).
d.Suggest that the provider lower the dose. d.Suggest that the provider lower the dose.
A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine (Synthroid).
The child comes to the clinic for a well-child check up. The nurse will expect the provider to:
a.change the dose of levothyroxine to 6 mcg/kg/day.
b.discontinue the drug if the child's physical and mental development is normal.
c.increase the dose to accommodate the child's increased growth.
d.stop the drug for 4 weeks and check the child's TSH level. a.change the dose of
levothyroxine to 6 mcg/kg/day.
A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of
pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site
and along the vein. What is the nurse's priority action?
4
