Relias RN Pharmacology Test A Updated 2026 | Comprehensive Study
Guide, Practice Exam Questions and Answers, Exam Prep Test Bank,
Medication Administration Principles, Drug Classifications Review,
Pharmacokinetics and Pharmacodynamics, Adverse Drug Reactions,
Dosage Calculation Concepts, Patient Safety Strategies, and Detailed
Rationales for Nursing Success
Question 1: Which medication is the preferred antidote for opioid overdose? A.
Flumazenil B. Naloxone C. Protamine sulfate D. Acetylcysteine CORRECT ANSWER: B.
Naloxone Rationale: Naloxone is a competitive opioid antagonist used to rapidly
reverse opioid-induced respiratory depression.
Question 2: What is the specific antidote for benzodiazepine overdose? A. Naloxone
B. Flumazenil C. Physostigmine D. Vitamin K CORRECT ANSWER: B. Flumazenil
Rationale: Flumazenil competes with benzodiazepines for receptor sites, reversing their
sedative effects.
Question 3: Which medication is used to reverse the effects of heparin? A.
Protamine sulfate B. Vitamin K C. Aminocaproic acid D. Deferoxamine CORRECT
ANSWER: A. Protamine sulfate Rationale: Protamine sulfate is a positively charged
protein that binds to negatively charged heparin to form a stable, inactive complex.
Question 4: What is the antidote for warfarin toxicity? A. Protamine sulfate B. Vitamin
K C. Idarucizumab D. Andexanet alfa CORRECT ANSWER: B. Vitamin K Rationale:
Vitamin K promotes the hepatic synthesis of clotting factors, reversing the
anticoagulant effects of warfarin.
Question 5: Which medication is the antidote for acetaminophen toxicity? A.
Acetylcysteine B. Flumazenil C. Naloxone D. Fomepizole CORRECT ANSWER: A.
Acetylcysteine Rationale: Acetylcysteine replenishes glutathione stores in the liver,
preventing hepatotoxicity from acetaminophen metabolites.
Question 6: What is the antidote for digoxin toxicity? A. Digoxin immune Fab B.
Calcium gluconate C. Glucagon D. Atropine CORRECT ANSWER: A. Digoxin immune
Fab Rationale: Digoxin immune Fab consists of antibody fragments that bind to free
digoxin, neutralizing its effects.
Question 7: Which medication is used to treat severe iron toxicity? A. Deferoxamine
B. Dimercaprol C. Penicillamine D. Succimer CORRECT ANSWER: A. Deferoxamine
Rationale: Deferoxamine chelates free iron in the bloodstream, allowing it to be
excreted in the urine.
Question 8: What is the antidote for magnesium sulfate toxicity? A. Calcium
gluconate B. Sodium bicarbonate C. Potassium chloride D. Magnesium oxide CORRECT
ANSWER: A. Calcium gluconate Rationale: Calcium gluconate antagonizes the effects
of magnesium at the neuromuscular junction, reversing toxicity.
Question 9: Which medication is used to treat severe beta-blocker toxicity? A.
Glucagon B. Calcium gluconate C. High-dose insulin D. Sodium bicarbonate CORRECT
,ANSWER: A. Glucagon Rationale: Glucagon increases intracellular cAMP
independently of beta-receptors, improving heart rate and contractility.
Question 10: What is the primary treatment for calcium channel blocker toxicity? A.
Calcium gluconate B. Glucagon C. Naloxone D. Flumazenil CORRECT ANSWER: A.
Calcium gluconate Rationale: Intravenous calcium increases serum calcium levels,
overcoming the competitive blockade at calcium channels.
Question 11: Which tuberculosis medication causes red-orange discoloration of
body fluids? A. Isoniazid B. Rifampin C. Ethambutol D. Pyrazinamide CORRECT
ANSWER: B. Rifampin Rationale: Rifampin and its metabolites are red-orange
pigments that are excreted in urine, sweat, and tears.
Question 12: Which tuberculosis medication is associated with optic neuritis? A.
Isoniazid B. Rifampin C. Ethambutol D. Streptomycin CORRECT ANSWER: C.
Ethambutol Rationale: Ethambutol can cause retrobulbar neuritis, leading to
decreased visual acuity and red-green color blindness.
Question 13: Which tuberculosis medication carries a high risk of ototoxicity? A.
Isoniazid B. Rifampin C. Ethambutol D. Streptomycin CORRECT ANSWER: D.
Streptomycin Rationale: Streptomycin is an aminoglycoside that can damage the
eighth cranial nerve, causing hearing loss and vestibular dysfunction.
Question 14: Which tuberculosis medication requires co-administration of
pyridoxine? A. Isoniazid B. Rifampin C. Ethambutol D. Pyrazinamide CORRECT
ANSWER: A. Isoniazid Rationale: Isoniazid structurally resembles pyridoxine and
increases its excretion, risking peripheral neuropathy if not supplemented.
Question 15: How can Red Man Syndrome be prevented during vancomycin
infusion? A. Administering an antihistamine B. Infusing the medication slowly C.
Diluting the medication further D. Giving a pre-dose of corticosteroids CORRECT
ANSWER: B. Infusing the medication slowly Rationale: Red Man Syndrome is a rate-
dependent infusion reaction caused by histamine release; slowing the rate prevents it.
Question 16: What is a major contraindication for tetracycline use in children under
8? A. Hepatotoxicity B. Tooth discoloration C. Nephrotoxicity D. Ototoxicity CORRECT
ANSWER: B. Tooth discoloration Rationale: Tetracyclines bind to calcium in
developing teeth and bones, causing permanent yellow-gray discoloration.
Question 17: What is a black box warning for fluoroquinolone antibiotics? A.
Hepatic failure B. Tendon rupture C. Renal failure D. Cardiac arrhythmias CORRECT
ANSWER: B. Tendon rupture Rationale: Fluoroquinolones increase the risk of tendinitis
and tendon rupture, especially in the Achilles tendon.
Question 18: Which class of antibiotics requires monitoring for both ototoxicity and
nephrotoxicity? A. Macrolides B. Aminoglycosides C. Tetracyclines D. Penicillins
CORRECT ANSWER: B. Aminoglycosides Rationale: Aminoglycosides accumulate in
the renal cortex and inner ear, causing damage to the kidneys and eighth cranial nerve.
, Question 19: What is the most serious adverse effect associated with metformin?
A. Hypoglycemia B. Lactic acidosis C. Hepatotoxicity D. Pancreatitis CORRECT
ANSWER: B. Lactic acidosis Rationale: Metformin can accumulate in patients with
renal impairment, leading to a dangerous buildup of lactic acid.
Question 20: When does regular insulin typically reach its peak effect? A. 15-30
minutes B. 2-4 hours C. 4-12 hours D. 12-24 hours CORRECT ANSWER: B. 2-4 hours
Rationale: Regular insulin has an onset of 30-60 minutes, peaks at 2-4 hours, and lasts
for 6-8 hours.
Question 21: What is the peak time for NPH insulin? A. 1-2 hours B. 2-4 hours C. 4-12
hours D. 16-24 hours CORRECT ANSWER: C. 4-12 hours Rationale: NPH is an
intermediate-acting insulin that peaks between 4 and 12 hours after subcutaneous
administration.
Question 22: Which rapid-acting insulin has an onset of 15 minutes? A. Regular B.
NPH C. Lispro D. Glargine CORRECT ANSWER: C. Lispro Rationale: Lispro is a rapid-
acting insulin analog designed to be taken just before meals to control postprandial
glucose.
Question 23: What is the initial treatment for mild hypoglycemia in a conscious
patient? A. Intravenous dextrose B. Intramuscular glucagon C. 15 grams of fast-acting
carbohydrates D. Subcutaneous epinephrine CORRECT ANSWER: C. 15 grams of fast-
acting carbohydrates Rationale: The "rule of 15" recommends 15g of simple carbs,
waiting 15 minutes, and rechecking blood glucose.
Question 24: Why must metformin be held before procedures involving iodinated
contrast dye? A. Risk of allergic reaction B. Risk of lactic acidosis C. Risk of
hypoglycemia D. Risk of renal failure CORRECT ANSWER: B. Risk of lactic acidosis
Rationale: Contrast dye can cause acute kidney injury, leading to metformin
accumulation and subsequent lactic acidosis.
Question 25: What is the primary adverse effect of sulfonylureas like glipizide? A.
Weight loss B. Hypoglycemia C. Lactic acidosis D. Gastrointestinal upset CORRECT
ANSWER: B. Hypoglycemia Rationale: Sulfonylureas stimulate pancreatic beta cells to
release insulin independently of blood glucose levels.
Question 26: How should levothyroxine be administered for optimal absorption? A.
With meals B. At bedtime with a snack C. On an empty stomach in the morning D. With
calcium supplements CORRECT ANSWER: C. On an empty stomach in the morning
Rationale: Levothyroxine absorption is significantly decreased by food, calcium, and
iron; it should be taken 30-60 minutes before breakfast.
Question 27: What is a life-threatening adverse effect of propylthiouracil (PTU) and
methimazole? A. Hepatotoxicity B. Agranulocytosis C. Nephrotoxicity D. Pulmonary
fibrosis CORRECT ANSWER: B. Agranulocytosis Rationale: These antithyroid drugs
can cause a severe drop in white blood cells, increasing the risk of life-threatening
infections.
Guide, Practice Exam Questions and Answers, Exam Prep Test Bank,
Medication Administration Principles, Drug Classifications Review,
Pharmacokinetics and Pharmacodynamics, Adverse Drug Reactions,
Dosage Calculation Concepts, Patient Safety Strategies, and Detailed
Rationales for Nursing Success
Question 1: Which medication is the preferred antidote for opioid overdose? A.
Flumazenil B. Naloxone C. Protamine sulfate D. Acetylcysteine CORRECT ANSWER: B.
Naloxone Rationale: Naloxone is a competitive opioid antagonist used to rapidly
reverse opioid-induced respiratory depression.
Question 2: What is the specific antidote for benzodiazepine overdose? A. Naloxone
B. Flumazenil C. Physostigmine D. Vitamin K CORRECT ANSWER: B. Flumazenil
Rationale: Flumazenil competes with benzodiazepines for receptor sites, reversing their
sedative effects.
Question 3: Which medication is used to reverse the effects of heparin? A.
Protamine sulfate B. Vitamin K C. Aminocaproic acid D. Deferoxamine CORRECT
ANSWER: A. Protamine sulfate Rationale: Protamine sulfate is a positively charged
protein that binds to negatively charged heparin to form a stable, inactive complex.
Question 4: What is the antidote for warfarin toxicity? A. Protamine sulfate B. Vitamin
K C. Idarucizumab D. Andexanet alfa CORRECT ANSWER: B. Vitamin K Rationale:
Vitamin K promotes the hepatic synthesis of clotting factors, reversing the
anticoagulant effects of warfarin.
Question 5: Which medication is the antidote for acetaminophen toxicity? A.
Acetylcysteine B. Flumazenil C. Naloxone D. Fomepizole CORRECT ANSWER: A.
Acetylcysteine Rationale: Acetylcysteine replenishes glutathione stores in the liver,
preventing hepatotoxicity from acetaminophen metabolites.
Question 6: What is the antidote for digoxin toxicity? A. Digoxin immune Fab B.
Calcium gluconate C. Glucagon D. Atropine CORRECT ANSWER: A. Digoxin immune
Fab Rationale: Digoxin immune Fab consists of antibody fragments that bind to free
digoxin, neutralizing its effects.
Question 7: Which medication is used to treat severe iron toxicity? A. Deferoxamine
B. Dimercaprol C. Penicillamine D. Succimer CORRECT ANSWER: A. Deferoxamine
Rationale: Deferoxamine chelates free iron in the bloodstream, allowing it to be
excreted in the urine.
Question 8: What is the antidote for magnesium sulfate toxicity? A. Calcium
gluconate B. Sodium bicarbonate C. Potassium chloride D. Magnesium oxide CORRECT
ANSWER: A. Calcium gluconate Rationale: Calcium gluconate antagonizes the effects
of magnesium at the neuromuscular junction, reversing toxicity.
Question 9: Which medication is used to treat severe beta-blocker toxicity? A.
Glucagon B. Calcium gluconate C. High-dose insulin D. Sodium bicarbonate CORRECT
,ANSWER: A. Glucagon Rationale: Glucagon increases intracellular cAMP
independently of beta-receptors, improving heart rate and contractility.
Question 10: What is the primary treatment for calcium channel blocker toxicity? A.
Calcium gluconate B. Glucagon C. Naloxone D. Flumazenil CORRECT ANSWER: A.
Calcium gluconate Rationale: Intravenous calcium increases serum calcium levels,
overcoming the competitive blockade at calcium channels.
Question 11: Which tuberculosis medication causes red-orange discoloration of
body fluids? A. Isoniazid B. Rifampin C. Ethambutol D. Pyrazinamide CORRECT
ANSWER: B. Rifampin Rationale: Rifampin and its metabolites are red-orange
pigments that are excreted in urine, sweat, and tears.
Question 12: Which tuberculosis medication is associated with optic neuritis? A.
Isoniazid B. Rifampin C. Ethambutol D. Streptomycin CORRECT ANSWER: C.
Ethambutol Rationale: Ethambutol can cause retrobulbar neuritis, leading to
decreased visual acuity and red-green color blindness.
Question 13: Which tuberculosis medication carries a high risk of ototoxicity? A.
Isoniazid B. Rifampin C. Ethambutol D. Streptomycin CORRECT ANSWER: D.
Streptomycin Rationale: Streptomycin is an aminoglycoside that can damage the
eighth cranial nerve, causing hearing loss and vestibular dysfunction.
Question 14: Which tuberculosis medication requires co-administration of
pyridoxine? A. Isoniazid B. Rifampin C. Ethambutol D. Pyrazinamide CORRECT
ANSWER: A. Isoniazid Rationale: Isoniazid structurally resembles pyridoxine and
increases its excretion, risking peripheral neuropathy if not supplemented.
Question 15: How can Red Man Syndrome be prevented during vancomycin
infusion? A. Administering an antihistamine B. Infusing the medication slowly C.
Diluting the medication further D. Giving a pre-dose of corticosteroids CORRECT
ANSWER: B. Infusing the medication slowly Rationale: Red Man Syndrome is a rate-
dependent infusion reaction caused by histamine release; slowing the rate prevents it.
Question 16: What is a major contraindication for tetracycline use in children under
8? A. Hepatotoxicity B. Tooth discoloration C. Nephrotoxicity D. Ototoxicity CORRECT
ANSWER: B. Tooth discoloration Rationale: Tetracyclines bind to calcium in
developing teeth and bones, causing permanent yellow-gray discoloration.
Question 17: What is a black box warning for fluoroquinolone antibiotics? A.
Hepatic failure B. Tendon rupture C. Renal failure D. Cardiac arrhythmias CORRECT
ANSWER: B. Tendon rupture Rationale: Fluoroquinolones increase the risk of tendinitis
and tendon rupture, especially in the Achilles tendon.
Question 18: Which class of antibiotics requires monitoring for both ototoxicity and
nephrotoxicity? A. Macrolides B. Aminoglycosides C. Tetracyclines D. Penicillins
CORRECT ANSWER: B. Aminoglycosides Rationale: Aminoglycosides accumulate in
the renal cortex and inner ear, causing damage to the kidneys and eighth cranial nerve.
, Question 19: What is the most serious adverse effect associated with metformin?
A. Hypoglycemia B. Lactic acidosis C. Hepatotoxicity D. Pancreatitis CORRECT
ANSWER: B. Lactic acidosis Rationale: Metformin can accumulate in patients with
renal impairment, leading to a dangerous buildup of lactic acid.
Question 20: When does regular insulin typically reach its peak effect? A. 15-30
minutes B. 2-4 hours C. 4-12 hours D. 12-24 hours CORRECT ANSWER: B. 2-4 hours
Rationale: Regular insulin has an onset of 30-60 minutes, peaks at 2-4 hours, and lasts
for 6-8 hours.
Question 21: What is the peak time for NPH insulin? A. 1-2 hours B. 2-4 hours C. 4-12
hours D. 16-24 hours CORRECT ANSWER: C. 4-12 hours Rationale: NPH is an
intermediate-acting insulin that peaks between 4 and 12 hours after subcutaneous
administration.
Question 22: Which rapid-acting insulin has an onset of 15 minutes? A. Regular B.
NPH C. Lispro D. Glargine CORRECT ANSWER: C. Lispro Rationale: Lispro is a rapid-
acting insulin analog designed to be taken just before meals to control postprandial
glucose.
Question 23: What is the initial treatment for mild hypoglycemia in a conscious
patient? A. Intravenous dextrose B. Intramuscular glucagon C. 15 grams of fast-acting
carbohydrates D. Subcutaneous epinephrine CORRECT ANSWER: C. 15 grams of fast-
acting carbohydrates Rationale: The "rule of 15" recommends 15g of simple carbs,
waiting 15 minutes, and rechecking blood glucose.
Question 24: Why must metformin be held before procedures involving iodinated
contrast dye? A. Risk of allergic reaction B. Risk of lactic acidosis C. Risk of
hypoglycemia D. Risk of renal failure CORRECT ANSWER: B. Risk of lactic acidosis
Rationale: Contrast dye can cause acute kidney injury, leading to metformin
accumulation and subsequent lactic acidosis.
Question 25: What is the primary adverse effect of sulfonylureas like glipizide? A.
Weight loss B. Hypoglycemia C. Lactic acidosis D. Gastrointestinal upset CORRECT
ANSWER: B. Hypoglycemia Rationale: Sulfonylureas stimulate pancreatic beta cells to
release insulin independently of blood glucose levels.
Question 26: How should levothyroxine be administered for optimal absorption? A.
With meals B. At bedtime with a snack C. On an empty stomach in the morning D. With
calcium supplements CORRECT ANSWER: C. On an empty stomach in the morning
Rationale: Levothyroxine absorption is significantly decreased by food, calcium, and
iron; it should be taken 30-60 minutes before breakfast.
Question 27: What is a life-threatening adverse effect of propylthiouracil (PTU) and
methimazole? A. Hepatotoxicity B. Agranulocytosis C. Nephrotoxicity D. Pulmonary
fibrosis CORRECT ANSWER: B. Agranulocytosis Rationale: These antithyroid drugs
can cause a severe drop in white blood cells, increasing the risk of life-threatening
infections.
