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KAPLAN PHARMACOLOGY INTEGRATED
EXAM 2026 | FORMS A, B, C, D | 375+ NGN
QUESTIONS WITH CORRECT ANSWERS &
RATIONALES | A+ GRADE GUIDE
## Table of Contents
| Section | Form | Topic Area | Number of Questions |
|---------|------|----------------------------|----------------------|
| 1 | Form A | Cardiovascular & Renal Pharmacology | 40 |
| 2 | Form A | Neurologic & Psychiatric Pharmacology | 35 |
| 3 | Form A | Endocrine & Reproductive Pharmacology | 35 |
| 4 | Form B | Anti-infectives & Immunosuppressants | 40 |
| 5 | Form B | Respiratory & GI Pharmacology | 35 |
| 6 | Form B | Pain & Inflammation Management | 35 |
| 7 | Form C | Chemotherapy & Biologic Agents | 40 |
| 8 | Form C | Critical Care & Emergency Pharmacology | 35 |
| 9 | Form C | Antidotes & Toxicology | 35 |
| 10 | Form D | NGN Case Studies (6 cases with 6-8 questions each) | 45 |
| **Total** | **All Forms** | | **~375 Questions** |
---
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# Form A: Cardiovascular, Neurologic, Endocrine Pharmacology
## Section 1: Cardiovascular & Renal Pharmacology (Form A, Q1-40)
**1.** A patient with heart failure (HFrEF) is prescribed
**sacubitril/valsartan**. Which laboratory value requires immediate
notification of the provider before the first dose?
A) Serum potassium 4.0 mEq/L
B) Serum creatinine 0.9 mg/dL
C) Serum potassium 5.8 mEq/L
D) BNP 500 pg/mL
**Answer: C** – Hyperkalemia (K+ >5.4) is a contraindication;
sacubitril/valsartan can further increase potassium.
**2.** A patient on **digoxin** presents with nausea, vomiting, yellow
vision, and heart rate 42 bpm. Which medication should the nurse
anticipate?
A) Digoxin immune Fab (Digibind)
B) Atropine
C) Lidocaine
D) Amiodarone
**Answer: A** – Digoxin toxicity with bradycardia and visual changes
requires Digibind.
,3|Page
**3.** **NGN Bow-Tie Question:** A patient on **furosemide** 80
mg BID develops muscle cramps and weakness.
- **Condition:** Select the most likely electrolyte imbalance →
Hypokalemia
- **Treatment:** Select the most appropriate intervention → IV
potassium replacement
- **Monitoring:** Select the parameter to monitor → Telemetry for
arrhythmias
**4.** A patient with **atrial fibrillation** is on **apixaban**. Which
instruction is most important?
A) Take with food to reduce GI upset
B) Do not double the dose if missed
C) Monitor INR weekly
D) Use a soft toothbrush
**Answer: B** – Apixaban has a short half-life; double dose increases
bleeding risk.
**5.** A patient on **metoprolol succinate** reports dizziness and
fatigue. Which action is correct?
A) Increase dose gradually
B) Check blood pressure and heart rate
C) Switch to metoprolol tartrate
D) Stop medication immediately
, 4|Page
**Answer: B** – Assess for bradycardia or hypotension; never stop
beta-blockers abruptly.
**6.** Which medication requires the nurse to hold the dose if the
apical heart rate is <60 bpm?
A) Lisinopril
B) Digoxin
C) Furosemide
D) Spironolactone
**Answer: B** – Digoxin toxicity risk increases with bradycardia.
**7.** A patient is started on **spironolactone** for heart failure.
Which finding requires discontinuation?
A) Serum potassium 5.0 mEq/L
B) Gynecomastia
C) Blood pressure 110/70
D) Urine output 40 mL/hr
**Answer: B** – Spironolactone causes gynecomastia due to
antiandrogen effects; may require switch to eplerenone.
**8.** **NGN Multiple Response:** A patient is prescribed
**amiodarone**. Which adverse effects require monitoring? (Select all
that apply)
A) Pulmonary fibrosis
KAPLAN PHARMACOLOGY INTEGRATED
EXAM 2026 | FORMS A, B, C, D | 375+ NGN
QUESTIONS WITH CORRECT ANSWERS &
RATIONALES | A+ GRADE GUIDE
## Table of Contents
| Section | Form | Topic Area | Number of Questions |
|---------|------|----------------------------|----------------------|
| 1 | Form A | Cardiovascular & Renal Pharmacology | 40 |
| 2 | Form A | Neurologic & Psychiatric Pharmacology | 35 |
| 3 | Form A | Endocrine & Reproductive Pharmacology | 35 |
| 4 | Form B | Anti-infectives & Immunosuppressants | 40 |
| 5 | Form B | Respiratory & GI Pharmacology | 35 |
| 6 | Form B | Pain & Inflammation Management | 35 |
| 7 | Form C | Chemotherapy & Biologic Agents | 40 |
| 8 | Form C | Critical Care & Emergency Pharmacology | 35 |
| 9 | Form C | Antidotes & Toxicology | 35 |
| 10 | Form D | NGN Case Studies (6 cases with 6-8 questions each) | 45 |
| **Total** | **All Forms** | | **~375 Questions** |
---
,2|Page
# Form A: Cardiovascular, Neurologic, Endocrine Pharmacology
## Section 1: Cardiovascular & Renal Pharmacology (Form A, Q1-40)
**1.** A patient with heart failure (HFrEF) is prescribed
**sacubitril/valsartan**. Which laboratory value requires immediate
notification of the provider before the first dose?
A) Serum potassium 4.0 mEq/L
B) Serum creatinine 0.9 mg/dL
C) Serum potassium 5.8 mEq/L
D) BNP 500 pg/mL
**Answer: C** – Hyperkalemia (K+ >5.4) is a contraindication;
sacubitril/valsartan can further increase potassium.
**2.** A patient on **digoxin** presents with nausea, vomiting, yellow
vision, and heart rate 42 bpm. Which medication should the nurse
anticipate?
A) Digoxin immune Fab (Digibind)
B) Atropine
C) Lidocaine
D) Amiodarone
**Answer: A** – Digoxin toxicity with bradycardia and visual changes
requires Digibind.
,3|Page
**3.** **NGN Bow-Tie Question:** A patient on **furosemide** 80
mg BID develops muscle cramps and weakness.
- **Condition:** Select the most likely electrolyte imbalance →
Hypokalemia
- **Treatment:** Select the most appropriate intervention → IV
potassium replacement
- **Monitoring:** Select the parameter to monitor → Telemetry for
arrhythmias
**4.** A patient with **atrial fibrillation** is on **apixaban**. Which
instruction is most important?
A) Take with food to reduce GI upset
B) Do not double the dose if missed
C) Monitor INR weekly
D) Use a soft toothbrush
**Answer: B** – Apixaban has a short half-life; double dose increases
bleeding risk.
**5.** A patient on **metoprolol succinate** reports dizziness and
fatigue. Which action is correct?
A) Increase dose gradually
B) Check blood pressure and heart rate
C) Switch to metoprolol tartrate
D) Stop medication immediately
, 4|Page
**Answer: B** – Assess for bradycardia or hypotension; never stop
beta-blockers abruptly.
**6.** Which medication requires the nurse to hold the dose if the
apical heart rate is <60 bpm?
A) Lisinopril
B) Digoxin
C) Furosemide
D) Spironolactone
**Answer: B** – Digoxin toxicity risk increases with bradycardia.
**7.** A patient is started on **spironolactone** for heart failure.
Which finding requires discontinuation?
A) Serum potassium 5.0 mEq/L
B) Gynecomastia
C) Blood pressure 110/70
D) Urine output 40 mL/hr
**Answer: B** – Spironolactone causes gynecomastia due to
antiandrogen effects; may require switch to eplerenone.
**8.** **NGN Multiple Response:** A patient is prescribed
**amiodarone**. Which adverse effects require monitoring? (Select all
that apply)
A) Pulmonary fibrosis
