Kaplan Pharmacology Integrated Exam (Forms A, B, C, D) |
NGN Questions with Correct Answers & Rationales Questions
300+ | Latest 2026 Update | Graded A+ | Verified
1. Digoxin Administration in Infants Question: A nurse is preparing to administer digoxin to an infant. Which action
should the nurse take first? A) Administer the medication with fruit juice. B) Check the infant's blood pressure. C) Asses
the apical pulse for one full minute. D) Notify the provider if the heart rate is 100 bpm.
Correct Answer: C Clinical Rationale: The normal apical pulse for an infant is 120-160 bpm. Digoxin should be withhe
if the heart rate is less than 90-110 bpm in infants to prevent worsening of bradycardia, which is a primary sign of digox
toxicity.
2. Rifampin Side Effects Question: A patient starting Rifampin for tuberculosis expresses concern about orange-colore
urine. What is the nurse's best response? A) "This indicates a serious visual complication." B) "This is a harmless and
expected side effect of the medication." C) "We need to check your kidney function immediately." D) "You should stop
taking the medication until the color clears."
Correct Answer: B Clinical Rationale: Rifampin commonly causes a harmless orange-red discoloration of urine, sweat
saliva, and tears. Blurry vision (Option A) is associated with Ethambutol, not Rifampin.
,3. Haloperidol Adverse Effects Question: A patient taking Haloperidol exhibits involuntary tongue protrusion and lip
smacking. The nurse identifies this as: A) Akathisia B) Neuroleptic Malignant Syndrome C) Pseudoparkinsonism D)
Tardive Dyskinesia
Correct Answer: D Clinical Rationale: Involuntary tongue protrusion and lip-smacking are classic signs of Tardive
Dyskinesia, a long-term extrapyramidal side effect (EPS) of antipsychotic medications that may be irreversible.
4. Metformin Teaching (SATA) Question: Which of the following should be included in teaching for a patient prescrib
Metformin? (Select All That Apply) A) Take the medication with meals. B) You may experience a metallic taste. C)
Discontinue 48 hours before a CT scan with contrast. D) Monitor closely for frequent hypoglycemia. E) Report unusual
muscle pain or fatigue immediately.
Correct Answer: A, B, C, E Clinical Rationale: Metformin should be taken with meals (A) and can cause a metallic taste
(B). It must be held 48 hours before/after contrast to prevent kidney injury (C). Lactic acidosis is a rare but fatal risk (E)
Metformin does NOT typically cause hypoglycemia when used alone (D).
5. Heparin Monitoring Question: Which laboratory value is used to monitor the therapeutic effect of a continuous
Heparin infusion? A) Prothrombin Time (PT) B) International Normalized Ratio (INR) C) Activated Partial
Thromboplastin Time (aPTT) D) Platelet Count
Correct Answer: C Clinical Rationale: The aPTT is used to monitor the effectiveness of Heparin. PT and INR (Options A
and B) are used to monitor Warfarin therapy.
,6. Spironolactone Dietary Restrictions Question: A patient is prescribed Spironolactone. Which food choice indicates
need for further teaching? A) Apples B) Bananas C) White bread D) Grilled chicken
Correct Answer: B Clinical Rationale: Spironolactone is a potassium-sparing diuretic. Patients should avoid high-
potassium foods like bananas to prevent hyperkalemia.
7. Lisinopril Side Effects Question: A patient taking Lisinopril reports a persistent, dry cough. The nurse understands
this is caused by: A) Accumulation of bradykinin B) Pulmonary edema C) Allergic reaction to the drug binder D)
Bronchospasm
Correct Answer: A Clinical Rationale: ACE inhibitors like Lisinopril frequently cause a persistent, dry, non-productive
cough due to the accumulation of bradykinin in the lungs.
8. Dosage Calculation: Gentamicin Question: A child weighing 22 lbs is prescribed Gentamicin 2.5 mg/kg. The
medication is available as 10 mg/mL. How many mL should be administered? A) 1.5 mL B) 2.0 mL C) 2.5 mL D) 5.0 mL
Correct Answer: 2.5 mL Clinical Rationale:
• Convert lbs to kg: 22 lbs / 2.2 = 10 kg.
• Calculate mg: 10 kg × 2.5 mg/kg = 25 mg.
• Calculate mL: 25 mg / 10 mg/mL = 2.5 mL.
, 9. Opioid Overdose Antidote Question: A patient presents with respiratory depression following an oxycodone
overdose. Which medication should the nurse prepare? A) Flumazenil B) Naloxone C) Atropine D) Protamine Sulfate
Correct Answer: B Clinical Rationale: Naloxone is the specific opioid antagonist used to reverse respiratory depressio
Flumazenil (A) is for benzodiazepines; Atropine (C) is for bradycardia; Protamine (D) is for Heparin.
10. Vancomycin Administration (SATA) Question: Which nursing interventions are appropriate for Vancomycin
administration? (Select All That Apply) A) Infuse over at least 60 minutes. B) Monitor for flushing of the face and neck. C
Assess the IV site for patency and phlebitis. D) Obtain a trough level before the next dose. E) Inform the patient their uri
will turn orange.
Correct Answer: A, B, C, D Clinical Rationale: Vancomycin must be infused slowly (A) to prevent Red Man Syndrome
(B). It is a vesicant (C). Trough levels (D) are critical for safety. Orange urine (E) is Rifampin, not Vancomycin.
11. Lithium and Sodium Balance Question: A patient on Lithium therapy is at increased risk for toxicity if they develo
which condition? A) Hypernatremia B) Hyponatremia C) Hypocalcemia D) Hyperkalemia
Correct Answer: B Clinical Rationale: Lithium is a salt. If sodium levels are low (hyponatremia), the kidneys retain
lithium, leading to toxic levels. Patients must maintain consistent sodium and fluid intake.
NGN Questions with Correct Answers & Rationales Questions
300+ | Latest 2026 Update | Graded A+ | Verified
1. Digoxin Administration in Infants Question: A nurse is preparing to administer digoxin to an infant. Which action
should the nurse take first? A) Administer the medication with fruit juice. B) Check the infant's blood pressure. C) Asses
the apical pulse for one full minute. D) Notify the provider if the heart rate is 100 bpm.
Correct Answer: C Clinical Rationale: The normal apical pulse for an infant is 120-160 bpm. Digoxin should be withhe
if the heart rate is less than 90-110 bpm in infants to prevent worsening of bradycardia, which is a primary sign of digox
toxicity.
2. Rifampin Side Effects Question: A patient starting Rifampin for tuberculosis expresses concern about orange-colore
urine. What is the nurse's best response? A) "This indicates a serious visual complication." B) "This is a harmless and
expected side effect of the medication." C) "We need to check your kidney function immediately." D) "You should stop
taking the medication until the color clears."
Correct Answer: B Clinical Rationale: Rifampin commonly causes a harmless orange-red discoloration of urine, sweat
saliva, and tears. Blurry vision (Option A) is associated with Ethambutol, not Rifampin.
,3. Haloperidol Adverse Effects Question: A patient taking Haloperidol exhibits involuntary tongue protrusion and lip
smacking. The nurse identifies this as: A) Akathisia B) Neuroleptic Malignant Syndrome C) Pseudoparkinsonism D)
Tardive Dyskinesia
Correct Answer: D Clinical Rationale: Involuntary tongue protrusion and lip-smacking are classic signs of Tardive
Dyskinesia, a long-term extrapyramidal side effect (EPS) of antipsychotic medications that may be irreversible.
4. Metformin Teaching (SATA) Question: Which of the following should be included in teaching for a patient prescrib
Metformin? (Select All That Apply) A) Take the medication with meals. B) You may experience a metallic taste. C)
Discontinue 48 hours before a CT scan with contrast. D) Monitor closely for frequent hypoglycemia. E) Report unusual
muscle pain or fatigue immediately.
Correct Answer: A, B, C, E Clinical Rationale: Metformin should be taken with meals (A) and can cause a metallic taste
(B). It must be held 48 hours before/after contrast to prevent kidney injury (C). Lactic acidosis is a rare but fatal risk (E)
Metformin does NOT typically cause hypoglycemia when used alone (D).
5. Heparin Monitoring Question: Which laboratory value is used to monitor the therapeutic effect of a continuous
Heparin infusion? A) Prothrombin Time (PT) B) International Normalized Ratio (INR) C) Activated Partial
Thromboplastin Time (aPTT) D) Platelet Count
Correct Answer: C Clinical Rationale: The aPTT is used to monitor the effectiveness of Heparin. PT and INR (Options A
and B) are used to monitor Warfarin therapy.
,6. Spironolactone Dietary Restrictions Question: A patient is prescribed Spironolactone. Which food choice indicates
need for further teaching? A) Apples B) Bananas C) White bread D) Grilled chicken
Correct Answer: B Clinical Rationale: Spironolactone is a potassium-sparing diuretic. Patients should avoid high-
potassium foods like bananas to prevent hyperkalemia.
7. Lisinopril Side Effects Question: A patient taking Lisinopril reports a persistent, dry cough. The nurse understands
this is caused by: A) Accumulation of bradykinin B) Pulmonary edema C) Allergic reaction to the drug binder D)
Bronchospasm
Correct Answer: A Clinical Rationale: ACE inhibitors like Lisinopril frequently cause a persistent, dry, non-productive
cough due to the accumulation of bradykinin in the lungs.
8. Dosage Calculation: Gentamicin Question: A child weighing 22 lbs is prescribed Gentamicin 2.5 mg/kg. The
medication is available as 10 mg/mL. How many mL should be administered? A) 1.5 mL B) 2.0 mL C) 2.5 mL D) 5.0 mL
Correct Answer: 2.5 mL Clinical Rationale:
• Convert lbs to kg: 22 lbs / 2.2 = 10 kg.
• Calculate mg: 10 kg × 2.5 mg/kg = 25 mg.
• Calculate mL: 25 mg / 10 mg/mL = 2.5 mL.
, 9. Opioid Overdose Antidote Question: A patient presents with respiratory depression following an oxycodone
overdose. Which medication should the nurse prepare? A) Flumazenil B) Naloxone C) Atropine D) Protamine Sulfate
Correct Answer: B Clinical Rationale: Naloxone is the specific opioid antagonist used to reverse respiratory depressio
Flumazenil (A) is for benzodiazepines; Atropine (C) is for bradycardia; Protamine (D) is for Heparin.
10. Vancomycin Administration (SATA) Question: Which nursing interventions are appropriate for Vancomycin
administration? (Select All That Apply) A) Infuse over at least 60 minutes. B) Monitor for flushing of the face and neck. C
Assess the IV site for patency and phlebitis. D) Obtain a trough level before the next dose. E) Inform the patient their uri
will turn orange.
Correct Answer: A, B, C, D Clinical Rationale: Vancomycin must be infused slowly (A) to prevent Red Man Syndrome
(B). It is a vesicant (C). Trough levels (D) are critical for safety. Orange urine (E) is Rifampin, not Vancomycin.
11. Lithium and Sodium Balance Question: A patient on Lithium therapy is at increased risk for toxicity if they develo
which condition? A) Hypernatremia B) Hyponatremia C) Hypocalcemia D) Hyperkalemia
Correct Answer: B Clinical Rationale: Lithium is a salt. If sodium levels are low (hyponatremia), the kidneys retain
lithium, leading to toxic levels. Patients must maintain consistent sodium and fluid intake.
