NCLEX-RN Pharmacology version 2/NCLEX RN Pharmacology Test Bank 2 Actual Exam Newest With Complete Questions And Correct Detailed Answers| Brand New Version!

NCLEX-RN Pharmacology version
2/NCLEX RN Pharmacology Test Bank 2
Actual Exam Newest With Complete
Questions And Correct Detailed Answers|
Brand New Version!



Section 1: Cardiovascular Pharmacology

Question 1
A nurse is preparing to administer furosemide (Lasix) to a patient with heart failure.
Which laboratory value is most important to review before administration?

 A. Serum sodium
 B. Serum potassium
 C. Serum calcium
 D. Serum magnesium

Answer: B. Serum potassium
Rationale: Furosemide is a loop diuretic that acts on the ascending loop of Henle to
inhibit sodium and chloride reabsorption. This action also causes significant potassium
loss (hypokalemia). Hypokalemia can precipitate life-threatening cardiac dysrhythmias,
especially in patients with heart failure who may also be on digoxin. Assessing
potassium levels before administration is a critical safety measure .




Question 2
A patient taking metoprolol (Lopressor), a beta-blocker, should be taught to monitor for
which effect?

 A. Hyperglycemia

, B. Tachycardia
 C. Dry, non-productive cough
 D. Weight loss

Answer: B. Tachycardia
Rationale: Beta-blockers like metoprolol work by blocking the effects of epinephrine
(adrenaline) on beta-1 adrenergic receptors in the heart. This action decreases heart
rate (causing bradycardia, not tachycardia), reduces myocardial contractility, and lowers
blood pressure. Patients should be taught to take their pulse daily and report if it falls
below 60 beats per minute .




Question 3
Which medication should the nurse hold and contact the provider if the patient's apical
pulse is 54 beats per minute?

 A. Lisinopril (Prinivil)
 B. Digoxin (Lanoxin)
 C. Furosemide (Lasix)
 D. Atorvastatin (Lipitor)

Answer: B. Digoxin (Lanoxin)
Rationale: Digoxin is a cardiac glycoside that increases the force of myocardial
contraction and decreases heart rate by inhibiting the sodium-potassium ATPase pump.
A common adverse effect is bradycardia. A holding parameter (e.g., withhold if apical
pulse <60 bpm in an adult) is a standard safety protocol to prevent toxicity .




Question 4
A client with a deep vein thrombosis (DVT) is started on a continuous intravenous
heparin infusion. The nurse understands that the primary purpose of this medication is
to:

 A. Dissolve the existing clot.
 B. Prevent the formation of new clots.
 C. Inhibit platelet aggregation.
 D. Activate vitamin K-dependent clotting factors.

, Answer: B. Prevent the formation of new clots.
Rationale: Heparin is an anticoagulant that works by activating antithrombin III, which
in turn inactivates thrombin and factor Xa. This prevents the extension of existing
clots and the formation of new clots, but it does not dissolve clots that have already
formed. Thrombolytics (like tPA) are used for clot dissolution .




Question 5
The nurse is providing discharge teaching to a patient prescribed warfarin (Coumadin).
Which statement by the patient indicates a need for further teaching?

 A. "I will use an electric razor when shaving."
 B. "I will report any unusual bleeding or bruising to my doctor."
 C. "I can continue to eat large salads with spinach every day."
 D. "I will inform my dentist about this medication before any procedures."

Answer: C. "I can continue to eat large salads with spinach every day."
Rationale: Warfarin exerts its anticoagulant effect by inhibiting vitamin K-dependent
clotting factors. Consistent intake of vitamin K is necessary to maintain a stable INR.
Suddenly increasing intake of vitamin K-rich foods like spinach, kale, and broccoli
can decrease the effectiveness of warfarin and increase the risk of clot formation.
Patients should be taught to maintain a consistent intake of vitamin K foods .




Question 6
A client is receiving alteplase (tPA) for an acute myocardial infarction. The nurse's
priority assessment during the infusion is monitoring for:

 A. Bleeding
 B. Hypotension
 C. Dysrhythmias
 D. Allergic reaction

Answer: A. Bleeding
Rationale: Alteplase is a thrombolytic (or "clot-buster") that works by converting
plasminogen to plasmin, which actively breaks down fibrin clots. Its major and most
dangerous adverse effect is bleeding, including intracranial hemorrhage. The nurse

, must monitor for any signs of bleeding (e.g., gums, injection sites, neurological
changes) .




Section 2: Respiratory and Allergy Medications

Question 7
A patient using an albuterol (ProAir, Ventolin) metered-dose inhaler reports feeling
shaky, nervous, and has a rapid heartbeat after each use. What is the nurse's best
response?

 A. "These are common side effects of the medication and should decrease with
continued use."
 B. "Stop taking the medication immediately and call your provider."
 C. "You are likely using the inhaler incorrectly."
 D. "This is a sign of a severe allergic reaction."

Answer: A. "These are common side effects of the medication and should decrease
with continued use."
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that is relatively selective
for beta-2 receptors in the lungs. However, at higher doses, it can also stimulate beta-1
receptors in the heart, leading to tremors, nervousness, and palpitations. Patients should
be reassured that these effects are common and often diminish as tolerance develops .




Question 8
A patient arrives in the emergency department with an acute asthma exacerbation and
is in severe respiratory distress. Which medication should the nurse anticipate
administering first?

 A. Montelukast (Singulair)
 B. Salmeterol (Serevent)
 C. Albuterol (ProAir, Ventolin)
 D. Fluticasone (Flovent)

Answer: C. Albuterol (ProAir, Ventolin)
Rationale: For an acute asthma attack, the priority is to quickly relieve