PHARM KAPLAN INTEGRATED TEST
2026 WITH QUESTIONS AND VERIFIED
CORRECT ANSWERS | MCQs | GRADED
A+ | GUARANTEED PASS | PHARM
KAPLAN LATEST EXAM
Question 1
A nurse administers enalapril to a patient with heart failure. Which finding requires immediate
intervention?
A. Dry cough
B. Serum potassium 5.8 mEq/L
C. Blood pressure 110/70 mm Hg
D. Dizziness when standing
Correct Answer: B
Rationale: Enalapril (ACE inhibitor) can cause hyperkalemia. Potassium >5.5 mEq/L increases
risk of arrhythmias. Dry cough is common but not emergent. BP 110/70 is acceptable. Dizziness
may indicate hypotension but is not immediately life-threatening.
Question 2
A patient on warfarin has an INR of 4.5. Which action is most appropriate?
A. Administer vitamin K
B. Hold the next dose and notify provider
C. Increase the next warfarin dose
D. Give protamine sulfate
Correct Answer: B
Rationale: INR goal is typically 2–3. INR 4.5 is elevated but not critical (<5 without bleeding).
Hold dose and notify provider. Vitamin K is for >5 or bleeding. Protamine is for heparin.
Question 3
Which medication is contraindicated in a patient with acute narrow-angle glaucoma?
A. Atropine
,B. Pilocarpine
C. Timolol
D. Latanoprost
Correct Answer: A
Rationale: Atropine (anticholinergic) causes pupillary dilation, worsening angle closure.
Pilocarpine (miotic), timolol (beta-blocker), and latanoprost (prostaglandin analog) lower IOP.
Question 4
A nurse administers furosemide. Which lab value should be monitored most closely?
A. Sodium
B. Calcium
C. Potassium
D. Chloride
Correct Answer: C
Rationale: Furosemide is a loop diuretic causing significant potassium wasting → hypokalemia
(arrhythmia risk). Monitor potassium and replace as needed.
Question 5
A patient is started on lithium. Which instruction is most important?
A. Take with high-sodium foods
B. Maintain consistent fluid intake
C. Avoid grapefruit juice
D. Take on an empty stomach
Correct Answer: B
Rationale: Lithium toxicity risk increases with dehydration or low sodium. Consistent fluid
intake (2–3 L/day) maintains stable serum levels.
Question 6
Which drug requires a 7-day washout before starting a monoamine oxidase inhibitor (MAOI)?
A. Sertraline
B. Fluoxetine
C. Venlafaxine
D. Bupropion
,Correct Answer: B
Rationale: Fluoxetine (SSRI) has a long half-life (4–6 days for active metabolite). Requires 5–7
week washout, but at minimum 7 days. Sertraline: 14 days. Venlafaxine and bupropion: shorter.
Question 7
A patient receiving IV morphine has a respiratory rate of 8/min. Which medication should be
available?
A. Flumazenil
B. Naloxone
C. Activated charcoal
D. Acetylcysteine
Correct Answer: B
Rationale: Naloxone is an opioid antagonist that reverses respiratory depression. Flumazenil for
benzodiazepines. Acetylcysteine for acetaminophen.
Question 8
Which antibiotic causes red man syndrome if infused too rapidly?
A. Ciprofloxacin
B. Vancomycin
C. Gentamicin
D. Doxycycline
Correct Answer: B
Rationale: Vancomycin rapid infusion causes histamine release → flushing, hypotension (red
man syndrome). Infuse over ≥60 min.
Question 9
A patient on metformin is scheduled for IV contrast. What action is essential?
A. Hold metformin for 48 hours post-contrast
B. Increase metformin dose
C. Administer metformin with food
D. Monitor for hyperglycemia
Correct Answer: A
Rationale: IV contrast can cause acute kidney injury, leading to metformin accumulation and
lactic acidosis. Hold metformin 48h post-contrast and restart only if renal function normal.
, Question 10
Digoxin toxicity is associated with which electrolyte imbalance?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Correct Answer: B
Rationale: Hypokalemia increases digoxin binding to sodium-potassium ATPase → toxicity risk
(nausea, visual changes, arrhythmias). Monitor potassium closely.
Question 11
A patient on spironolactone should avoid which supplement?
A. Magnesium
B. Potassium
C. Calcium
D. Zinc
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. Added potassium can cause life-
threatening hyperkalemia.
Question 12
The antidote for heparin overdose is:
A. Vitamin K
B. Protamine sulfate
C. Phytonadione
D. Andexanet alfa
Correct Answer: B
Rationale: Protamine sulfate reverses heparin. Vitamin K reverses warfarin. Andexanet reverses
rivaroxaban/apixaban.
Question 13
2026 WITH QUESTIONS AND VERIFIED
CORRECT ANSWERS | MCQs | GRADED
A+ | GUARANTEED PASS | PHARM
KAPLAN LATEST EXAM
Question 1
A nurse administers enalapril to a patient with heart failure. Which finding requires immediate
intervention?
A. Dry cough
B. Serum potassium 5.8 mEq/L
C. Blood pressure 110/70 mm Hg
D. Dizziness when standing
Correct Answer: B
Rationale: Enalapril (ACE inhibitor) can cause hyperkalemia. Potassium >5.5 mEq/L increases
risk of arrhythmias. Dry cough is common but not emergent. BP 110/70 is acceptable. Dizziness
may indicate hypotension but is not immediately life-threatening.
Question 2
A patient on warfarin has an INR of 4.5. Which action is most appropriate?
A. Administer vitamin K
B. Hold the next dose and notify provider
C. Increase the next warfarin dose
D. Give protamine sulfate
Correct Answer: B
Rationale: INR goal is typically 2–3. INR 4.5 is elevated but not critical (<5 without bleeding).
Hold dose and notify provider. Vitamin K is for >5 or bleeding. Protamine is for heparin.
Question 3
Which medication is contraindicated in a patient with acute narrow-angle glaucoma?
A. Atropine
,B. Pilocarpine
C. Timolol
D. Latanoprost
Correct Answer: A
Rationale: Atropine (anticholinergic) causes pupillary dilation, worsening angle closure.
Pilocarpine (miotic), timolol (beta-blocker), and latanoprost (prostaglandin analog) lower IOP.
Question 4
A nurse administers furosemide. Which lab value should be monitored most closely?
A. Sodium
B. Calcium
C. Potassium
D. Chloride
Correct Answer: C
Rationale: Furosemide is a loop diuretic causing significant potassium wasting → hypokalemia
(arrhythmia risk). Monitor potassium and replace as needed.
Question 5
A patient is started on lithium. Which instruction is most important?
A. Take with high-sodium foods
B. Maintain consistent fluid intake
C. Avoid grapefruit juice
D. Take on an empty stomach
Correct Answer: B
Rationale: Lithium toxicity risk increases with dehydration or low sodium. Consistent fluid
intake (2–3 L/day) maintains stable serum levels.
Question 6
Which drug requires a 7-day washout before starting a monoamine oxidase inhibitor (MAOI)?
A. Sertraline
B. Fluoxetine
C. Venlafaxine
D. Bupropion
,Correct Answer: B
Rationale: Fluoxetine (SSRI) has a long half-life (4–6 days for active metabolite). Requires 5–7
week washout, but at minimum 7 days. Sertraline: 14 days. Venlafaxine and bupropion: shorter.
Question 7
A patient receiving IV morphine has a respiratory rate of 8/min. Which medication should be
available?
A. Flumazenil
B. Naloxone
C. Activated charcoal
D. Acetylcysteine
Correct Answer: B
Rationale: Naloxone is an opioid antagonist that reverses respiratory depression. Flumazenil for
benzodiazepines. Acetylcysteine for acetaminophen.
Question 8
Which antibiotic causes red man syndrome if infused too rapidly?
A. Ciprofloxacin
B. Vancomycin
C. Gentamicin
D. Doxycycline
Correct Answer: B
Rationale: Vancomycin rapid infusion causes histamine release → flushing, hypotension (red
man syndrome). Infuse over ≥60 min.
Question 9
A patient on metformin is scheduled for IV contrast. What action is essential?
A. Hold metformin for 48 hours post-contrast
B. Increase metformin dose
C. Administer metformin with food
D. Monitor for hyperglycemia
Correct Answer: A
Rationale: IV contrast can cause acute kidney injury, leading to metformin accumulation and
lactic acidosis. Hold metformin 48h post-contrast and restart only if renal function normal.
, Question 10
Digoxin toxicity is associated with which electrolyte imbalance?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Correct Answer: B
Rationale: Hypokalemia increases digoxin binding to sodium-potassium ATPase → toxicity risk
(nausea, visual changes, arrhythmias). Monitor potassium closely.
Question 11
A patient on spironolactone should avoid which supplement?
A. Magnesium
B. Potassium
C. Calcium
D. Zinc
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. Added potassium can cause life-
threatening hyperkalemia.
Question 12
The antidote for heparin overdose is:
A. Vitamin K
B. Protamine sulfate
C. Phytonadione
D. Andexanet alfa
Correct Answer: B
Rationale: Protamine sulfate reverses heparin. Vitamin K reverses warfarin. Andexanet reverses
rivaroxaban/apixaban.
Question 13
