Pharmacology NCLEX Predictor
Exam: Most Tested Topics (2026
Update)|| Questions And Answers
With Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Total Questions: 85
Time Limit: 150 minutes (simulates NCLEX pacing)
Format: Multiple choice, select all that apply (SATA), ordered response, and NGN
case study.
Focus Areas: Cardiovascular, Antibiotics, Anticoagulants, Insulins, Psychiatric
Meds, Toxicity Antidotes, Patient Education, High-Alert Meds.
Section 1: Cardiovascular Medications (15 Questions)
1. A nurse is administering digoxin 0.125 mg PO. Which finding requires
immediate action?
A. Apical pulse 62 BPM
B. Serum potassium 3.2 mEq/L
C. Serum digoxin level 2.4 ng/mL
D. Patient reports nausea
Rationale: Therapeutic digoxin level is 0.8–2.0 ng/mL. >2.0 indicates toxicity.
Hypokalemia (3.2) potentiates toxicity, but the level itself is critical. Nausea is
early toxicity sign.
2. A patient on furosemide and lisinopril develops angioedema. Priority
action?
A. Administer epinephrine
B. Hold lisinopril and notify provider
,C. Increase furosemide dose
D. Give diphenhydramine
Rationale: Angioedema from ACE inhibitors (lisinopril) is life-threatening – stop
the drug. Epinephrine if airway compromise.
3. SATA: Which are adverse effects of amiodarone?
A. Pulmonary fibrosis
B. Blue-gray skin discoloration
C. Hyperthyroidism
D. Bradycardia
E. Corneal microdeposits
Rationale: Amiodarone causes pulmonary toxicity, thyroid dysfunction (hypo or
hyper), skin discoloration, bradycardia, and corneal deposits.
4. A patient on warfarin has INR 4.5 without bleeding. The nurse expects:
A. Vitamin K 10 mg IM
B. Hold warfarin and monitor
C. Protamine sulfate
D. Fresh frozen plasma
Rationale: INR 4.5 (therapeutic 2-3) – hold warfarin. Vitamin K if >5 or bleeding.
Protamine for heparin.
5. Beta-blocker contraindication in:
A. Hypertension
B. Asthma
C. Heart failure
D. Migraine
Rationale: Non-selective beta-blockers cause bronchospasm – contraindicated in
asthma.
6. Patient on clopidogrel for stent. Which drug interaction increases bleeding
risk?
A. Omeprazole
B. Acetaminophen
C. Metformin
D. Levothyroxine
, Rationale: Omeprazole inhibits CYP2C19, reducing clopidogrel activation and
increasing bleeding? Actually omeprazole reduces antiplatelet effect – but also GI
bleeding risk. Correct interaction: PPIs decrease efficacy, but concurrent NSAIDs
increase bleeding. However, omeprazole + clopidogrel = reduced efficacy, not
bleeding. Wait – question asks "increases bleeding risk" – answer should
be NSAIDs or anticoagulants. But here omeprazole is wrong. Correct answer not
listed? Let’s adjust: In real NCLEX: Warfarin or NSAIDs. But among options,
omeprazole is a distractor. Best answer: None – but if forced, choose omeprazole
for interaction awareness. Actually NCLEX says Proton pump inhibitors (except
pantoprazole) reduce efficacy, not bleeding. So correct answer for
bleeding: Aspirin. Since not an option, I'll replace question:
Corrected 6: Patient on clopidogrel. Which drug increases risk of bleeding?
A. Aspirin
7. Atorvastatin teaching: Which statement indicates understanding?
A. “I can take grapefruit juice daily”
B. “I will report muscle pain or dark urine”
C. “Liver enzymes don’t need monitoring”
D. “Statins are safe in pregnancy”
Rationale: Statins cause myopathy/rhabdomyolysis – report muscle pain.
Grapefruit increases toxicity.
8. IV heparin infusion: aPTT 110 seconds (control 30). Action?
A. Increase rate
B. Bolus 5000 units
C. Stop infusion and notify provider
D. Draw stat aPTT
Rationale: aPTT >100 seconds = high bleeding risk. Stop heparin.
9. Milrinone is prescribed. The nurse knows this drug:
A. Increases preload
B. Increases contractility and vasodilates
C. Beta-1 antagonist
D. Increases afterload
Rationale: Milrinone = phosphodiesterase inhibitor – inotropic (increase
contractility) and vasodilator (decrease preload/afterload).
Exam: Most Tested Topics (2026
Update)|| Questions And Answers
With Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Total Questions: 85
Time Limit: 150 minutes (simulates NCLEX pacing)
Format: Multiple choice, select all that apply (SATA), ordered response, and NGN
case study.
Focus Areas: Cardiovascular, Antibiotics, Anticoagulants, Insulins, Psychiatric
Meds, Toxicity Antidotes, Patient Education, High-Alert Meds.
Section 1: Cardiovascular Medications (15 Questions)
1. A nurse is administering digoxin 0.125 mg PO. Which finding requires
immediate action?
A. Apical pulse 62 BPM
B. Serum potassium 3.2 mEq/L
C. Serum digoxin level 2.4 ng/mL
D. Patient reports nausea
Rationale: Therapeutic digoxin level is 0.8–2.0 ng/mL. >2.0 indicates toxicity.
Hypokalemia (3.2) potentiates toxicity, but the level itself is critical. Nausea is
early toxicity sign.
2. A patient on furosemide and lisinopril develops angioedema. Priority
action?
A. Administer epinephrine
B. Hold lisinopril and notify provider
,C. Increase furosemide dose
D. Give diphenhydramine
Rationale: Angioedema from ACE inhibitors (lisinopril) is life-threatening – stop
the drug. Epinephrine if airway compromise.
3. SATA: Which are adverse effects of amiodarone?
A. Pulmonary fibrosis
B. Blue-gray skin discoloration
C. Hyperthyroidism
D. Bradycardia
E. Corneal microdeposits
Rationale: Amiodarone causes pulmonary toxicity, thyroid dysfunction (hypo or
hyper), skin discoloration, bradycardia, and corneal deposits.
4. A patient on warfarin has INR 4.5 without bleeding. The nurse expects:
A. Vitamin K 10 mg IM
B. Hold warfarin and monitor
C. Protamine sulfate
D. Fresh frozen plasma
Rationale: INR 4.5 (therapeutic 2-3) – hold warfarin. Vitamin K if >5 or bleeding.
Protamine for heparin.
5. Beta-blocker contraindication in:
A. Hypertension
B. Asthma
C. Heart failure
D. Migraine
Rationale: Non-selective beta-blockers cause bronchospasm – contraindicated in
asthma.
6. Patient on clopidogrel for stent. Which drug interaction increases bleeding
risk?
A. Omeprazole
B. Acetaminophen
C. Metformin
D. Levothyroxine
, Rationale: Omeprazole inhibits CYP2C19, reducing clopidogrel activation and
increasing bleeding? Actually omeprazole reduces antiplatelet effect – but also GI
bleeding risk. Correct interaction: PPIs decrease efficacy, but concurrent NSAIDs
increase bleeding. However, omeprazole + clopidogrel = reduced efficacy, not
bleeding. Wait – question asks "increases bleeding risk" – answer should
be NSAIDs or anticoagulants. But here omeprazole is wrong. Correct answer not
listed? Let’s adjust: In real NCLEX: Warfarin or NSAIDs. But among options,
omeprazole is a distractor. Best answer: None – but if forced, choose omeprazole
for interaction awareness. Actually NCLEX says Proton pump inhibitors (except
pantoprazole) reduce efficacy, not bleeding. So correct answer for
bleeding: Aspirin. Since not an option, I'll replace question:
Corrected 6: Patient on clopidogrel. Which drug increases risk of bleeding?
A. Aspirin
7. Atorvastatin teaching: Which statement indicates understanding?
A. “I can take grapefruit juice daily”
B. “I will report muscle pain or dark urine”
C. “Liver enzymes don’t need monitoring”
D. “Statins are safe in pregnancy”
Rationale: Statins cause myopathy/rhabdomyolysis – report muscle pain.
Grapefruit increases toxicity.
8. IV heparin infusion: aPTT 110 seconds (control 30). Action?
A. Increase rate
B. Bolus 5000 units
C. Stop infusion and notify provider
D. Draw stat aPTT
Rationale: aPTT >100 seconds = high bleeding risk. Stop heparin.
9. Milrinone is prescribed. The nurse knows this drug:
A. Increases preload
B. Increases contractility and vasodilates
C. Beta-1 antagonist
D. Increases afterload
Rationale: Milrinone = phosphodiesterase inhibitor – inotropic (increase
contractility) and vasodilator (decrease preload/afterload).
