Kaplan Pharmacology Integrated Exam (Forms A, B,
C, D) | NGN Questions with Correct Answers &
RationalesQuestions 300+ | Latest 2026 Update |
Graded A+ | Verified
Section 1: Cardiovascular Pharmacology (Questions 1-50)
1. A client with heart failure is prescribed digoxin 0.25 mg daily. Which
finding indicates the client is experiencing digoxin toxicity?
A) Heart rate of 72 beats per minute
B) Blood pressure of 120/80 mm Hg
C) Yellow-green halos around lights
D) Serum digoxin level of 1.0 ng/mL
Answer: C – Yellow-green halos (xanthopsia) are a classic visual disturbance
of digoxin toxicity. Therapeutic range is 0.5-2.0 ng/mL (D is therapeutic).
Bradycardia (not a heart rate of 72) is also a sign of toxicity.
2. A client is prescribed warfarin for atrial fibrillation. Which statement by
the client indicates a need for further teaching?
A) "I will use a soft toothbrush to prevent gum bleeding."
B) "I will avoid eating large amounts of spinach and kale."
C) "I will take ibuprofen for my headaches."
D) "I will report any unusual bruising to my provider."
Answer: C – Ibuprofen (NSAID) increases bleeding risk when taken with
warfarin and should be avoided. Acetaminophen is a safer alternative. Soft
toothbrush (A), consistent vitamin K intake (B), and reporting bruising (D)
are correct.
,3. A client receiving IV heparin has an aPTT of 110 seconds (control 30
seconds). What is the priority nursing action?
A) Continue the infusion at the same rate
B) Increase the infusion rate
C) Stop the infusion and notify the provider
D) Decrease the infusion rate
Answer: C – Therapeutic aPTT is 1.5-2.5 times control (45-75 seconds). An
aPTT of 110 seconds (3.7 times control) indicates excessive anticoagulation
and bleeding risk. The infusion should be stopped and the provider notified.
4. A client is prescribed lisinopril for hypertension. Which finding requires
immediate intervention?
A) Dry, hacking cough
B) Blood pressure of 130/80 mm Hg
C) Swelling of the tongue and lips
D) Serum potassium of 4.0 mEq/L
Answer: C – Swelling of the tongue and lips indicates angioedema, a life-
threatening allergic reaction to ACE inhibitors requiring immediate airway
assessment and intervention. Dry cough (A) is a common side effect but not
an emergency.
5. A client with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is effective?
A) Weight gain of 2 kg in 24 hours
B) Jugular venous distension
C) Weight loss of 2 kg in 24 hours
D) Crackles in the lung bases
,Answer: C – A weight loss of 1 kg (2.2 lbs) corresponds to approximately 1
liter of fluid loss. Weight loss indicates effective diuresis. Weight gain (A),
JVD (B), and crackles (D) indicate fluid overload.
6. A client is prescribed atorvastatin. Which instruction should the nurse
include in discharge teaching?
A) "Take this medication in the morning with breakfast."
B) "Report any muscle pain or weakness to your provider."
C) "You can stop this medication once your cholesterol is normal."
D) "Grapefruit juice has no effect on this medication."
Answer: B – Statins can cause myopathy and rhabdomyolysis. Muscle pain,
weakness, or dark urine should be reported immediately. Statins are most
effective when taken in the evening (A) because cholesterol synthesis peaks
at night. Therapy is typically lifelong (C). Grapefruit juice increases statin
levels (D).
7. A client is prescribed nitroglycerin sublingual for angina. The client takes
one tablet every 5 minutes for three doses with no relief. What should the
client do?
A) Take two more tablets
B) Go to bed and rest
C) Call 911 immediately
D) Schedule an appointment with the provider
Answer: C – Unrelieved chest pain after 3 nitroglycerin tablets (over 15
minutes) is a medical emergency indicating possible myocardial infarction.
The client must call 911 immediately.
8. A client is prescribed metoprolol for heart failure. Which finding requires
the nurse to hold the medication?
A) Blood pressure of 110/70 mm Hg
, B) Apical pulse of 52 beats per minute
C) Respiratory rate of 16 breaths per minute
D) Weight gain of 1 pound in 24 hours
Answer: B – Beta-blockers should be held if the apical pulse is below 60 beats
per minute to prevent symptomatic bradycardia. BP of 110/70 (A) is
acceptable. RR of 16 (C) is normal.
9. A client is prescribed clopidogrel following a drug-eluting stent
placement. The nurse should teach the client to report which finding?
A) Easy bruising
B) Headache
C) Black, tarry stools
D) Nausea
Answer: C – Black, tarry stools (melena) indicate gastrointestinal bleeding, a
serious complication of antiplatelet therapy. Easy bruising (A) is expected
but should be monitored. Headache (B) and nausea (D) are common but not
emergencies.
10. A client is prescribed amiodarone for atrial fibrillation. Which adverse
effect requires long-term monitoring?
A) Ototoxicity
B) Pulmonary fibrosis
C) Nephrotoxicity
D) Hepatotoxicity
Answer: B – Amiodarone can cause life-threatening pulmonary fibrosis.
Baseline and periodic pulmonary function tests and chest X-rays are
recommended. Ototoxicity (A) is associated with aminoglycosides and loop
diuretics.
C, D) | NGN Questions with Correct Answers &
RationalesQuestions 300+ | Latest 2026 Update |
Graded A+ | Verified
Section 1: Cardiovascular Pharmacology (Questions 1-50)
1. A client with heart failure is prescribed digoxin 0.25 mg daily. Which
finding indicates the client is experiencing digoxin toxicity?
A) Heart rate of 72 beats per minute
B) Blood pressure of 120/80 mm Hg
C) Yellow-green halos around lights
D) Serum digoxin level of 1.0 ng/mL
Answer: C – Yellow-green halos (xanthopsia) are a classic visual disturbance
of digoxin toxicity. Therapeutic range is 0.5-2.0 ng/mL (D is therapeutic).
Bradycardia (not a heart rate of 72) is also a sign of toxicity.
2. A client is prescribed warfarin for atrial fibrillation. Which statement by
the client indicates a need for further teaching?
A) "I will use a soft toothbrush to prevent gum bleeding."
B) "I will avoid eating large amounts of spinach and kale."
C) "I will take ibuprofen for my headaches."
D) "I will report any unusual bruising to my provider."
Answer: C – Ibuprofen (NSAID) increases bleeding risk when taken with
warfarin and should be avoided. Acetaminophen is a safer alternative. Soft
toothbrush (A), consistent vitamin K intake (B), and reporting bruising (D)
are correct.
,3. A client receiving IV heparin has an aPTT of 110 seconds (control 30
seconds). What is the priority nursing action?
A) Continue the infusion at the same rate
B) Increase the infusion rate
C) Stop the infusion and notify the provider
D) Decrease the infusion rate
Answer: C – Therapeutic aPTT is 1.5-2.5 times control (45-75 seconds). An
aPTT of 110 seconds (3.7 times control) indicates excessive anticoagulation
and bleeding risk. The infusion should be stopped and the provider notified.
4. A client is prescribed lisinopril for hypertension. Which finding requires
immediate intervention?
A) Dry, hacking cough
B) Blood pressure of 130/80 mm Hg
C) Swelling of the tongue and lips
D) Serum potassium of 4.0 mEq/L
Answer: C – Swelling of the tongue and lips indicates angioedema, a life-
threatening allergic reaction to ACE inhibitors requiring immediate airway
assessment and intervention. Dry cough (A) is a common side effect but not
an emergency.
5. A client with heart failure is prescribed furosemide. Which assessment
finding indicates the medication is effective?
A) Weight gain of 2 kg in 24 hours
B) Jugular venous distension
C) Weight loss of 2 kg in 24 hours
D) Crackles in the lung bases
,Answer: C – A weight loss of 1 kg (2.2 lbs) corresponds to approximately 1
liter of fluid loss. Weight loss indicates effective diuresis. Weight gain (A),
JVD (B), and crackles (D) indicate fluid overload.
6. A client is prescribed atorvastatin. Which instruction should the nurse
include in discharge teaching?
A) "Take this medication in the morning with breakfast."
B) "Report any muscle pain or weakness to your provider."
C) "You can stop this medication once your cholesterol is normal."
D) "Grapefruit juice has no effect on this medication."
Answer: B – Statins can cause myopathy and rhabdomyolysis. Muscle pain,
weakness, or dark urine should be reported immediately. Statins are most
effective when taken in the evening (A) because cholesterol synthesis peaks
at night. Therapy is typically lifelong (C). Grapefruit juice increases statin
levels (D).
7. A client is prescribed nitroglycerin sublingual for angina. The client takes
one tablet every 5 minutes for three doses with no relief. What should the
client do?
A) Take two more tablets
B) Go to bed and rest
C) Call 911 immediately
D) Schedule an appointment with the provider
Answer: C – Unrelieved chest pain after 3 nitroglycerin tablets (over 15
minutes) is a medical emergency indicating possible myocardial infarction.
The client must call 911 immediately.
8. A client is prescribed metoprolol for heart failure. Which finding requires
the nurse to hold the medication?
A) Blood pressure of 110/70 mm Hg
, B) Apical pulse of 52 beats per minute
C) Respiratory rate of 16 breaths per minute
D) Weight gain of 1 pound in 24 hours
Answer: B – Beta-blockers should be held if the apical pulse is below 60 beats
per minute to prevent symptomatic bradycardia. BP of 110/70 (A) is
acceptable. RR of 16 (C) is normal.
9. A client is prescribed clopidogrel following a drug-eluting stent
placement. The nurse should teach the client to report which finding?
A) Easy bruising
B) Headache
C) Black, tarry stools
D) Nausea
Answer: C – Black, tarry stools (melena) indicate gastrointestinal bleeding, a
serious complication of antiplatelet therapy. Easy bruising (A) is expected
but should be monitored. Headache (B) and nausea (D) are common but not
emergencies.
10. A client is prescribed amiodarone for atrial fibrillation. Which adverse
effect requires long-term monitoring?
A) Ototoxicity
B) Pulmonary fibrosis
C) Nephrotoxicity
D) Hepatotoxicity
Answer: B – Amiodarone can cause life-threatening pulmonary fibrosis.
Baseline and periodic pulmonary function tests and chest X-rays are
recommended. Ototoxicity (A) is associated with aminoglycosides and loop
diuretics.
