UPDATED NRSG 2350 PHARMACOLOGY EXAM 2
CONCEPT BANK ACTUAL STYLE PRACTICE
QUESTIONS, VERIFIED CORRECT ANSWERS &
DETAILED RATIONALES
This high-yield, comprehensive 200-question
multiple-choice practice exam is specifically
engineered to mirror actual nursing pharmacology
exam questions for course and NCLEX preparation.
It features back-to-back integration of realistic
clinical scenarios alongside precise answers and
deeply detailed, bolded rationales for every single
item. Perfect for quick scanning, high-utility studying,
and maximizing test scores on complex cardiac,
neurological, and hematological drug modules.
Question 1
A patient is prescribed intravenous Heparin for a deep
vein thrombosis. Which laboratory value must the nurse
monitor to evaluate the therapeutic effectiveness of this
medication?
A) Prothrombin time (PT)
B) International Normalized Ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Answer: C
,Rationale: Activated partial thromboplastin time
(aPTT) is the specific blood test used to monitor the
therapeutic efficacy and safety of unfractionated
Heparin therapy. PT and INR are utilized to monitor
oral Warfarin therapy, while platelet counts track
potential Heparin-Induced Thrombocytopenia (HIT) but
do not measure therapeutic anticoagulation levels.
Question 2
The nurse is preparing to administer a scheduled dose of
Digoxin to a client with heart failure. The client’s potassium
level is reported as 3.2 mEq/L. Which action should the
nurse take first?
A) Administer the Digoxin as prescribed.
B) Hold the Digoxin and notify the healthcare provider.
C) Document the potassium level as a normal finding.
D) Administer a double dose of potassium immediately.
Answer: B
Rationale: Hypokalemia (potassium level < 3.5 mEq/L)
significantly increases the risk of digoxin toxicity
because digoxin binds to the ATPase pump more
effectively when potassium levels are low. The nurse
must hold the medication and notify the provider to
address the electrolyte imbalance.
Question 3
A patient is being discharged home with a new
prescription for Warfarin (Coumadin). Which dietary
instruction should the nurse include in the discharge
,teaching plan?
A) Eliminate all green leafy vegetables from your diet
entirely.
B) Maintain a consistent daily intake of foods high in
Vitamin K.
C) Increase your intake of red meat to boost iron
absorption.
D) Drink grape juice every morning to enhance drug
absorption.
Answer: B
Rationale: Vitamin K is the antidote for Warfarin.
Drastic changes in Vitamin K intake can alter the
drug’s effectiveness; a sudden increase can lower the
INR, while a sudden decrease can cause dangerous
bleeding. Consistency in the diet is the key to
maintaining a therapeutic INR range.
Question 4
A client presents to the emergency department with acute
chest pain. The provider prescribes sublingual
Nitroglycerin. What critical drug interaction must the nurse
rule out before administering this medication?
A) Acetaminophen within the past 4 hours
B) Phosphodiesterase inhibitors (e.g., Sildenafil) within the
past 24–48 hours
C) Beta-blockers within the past 12 hours
D) Over-the-counter daily multivitamins
Answer: B
Rationale: Concurrent use of Nitroglycerin and
, phosphodiesterase inhibitors like Sildenafil (Viagra) is
strictly contraindicated due to the risk of severe, life-
threatening hypotension caused by profound
systemic vasodilation.
Question 5
A nurse is preparing to administer a maintenance dose of
Phenytoin (Dilantin) intravenously to a patient with partial
seizures. Which solution is the only compatible fluid for
flushing and infusing this medication?
A) 5% Dextrose in Water (D5W)
B) Lactated Ringer's solution
C) 0.9% Sodium Chloride (Normal Saline)
D) 0.45% Sodium Chloride (Half Normal Saline)
Answer: C
Rationale: Phenytoin is highly unstable and will
precipitate out of solution into crystals if mixed with
any glucose-containing fluids like D5W. It must only
be administered and flushed with 0.9% Sodium
Chloride (Normal Saline).
Question 6
A patient receiving a continuous infusion of Heparin
begins to experience severe, uncontrolled epistaxis and
hematuria. Which medication should the nurse anticipate
administering as the direct antidote?
A) Vitamin K
B) Protamine sulfate
C) Flumazenil
CONCEPT BANK ACTUAL STYLE PRACTICE
QUESTIONS, VERIFIED CORRECT ANSWERS &
DETAILED RATIONALES
This high-yield, comprehensive 200-question
multiple-choice practice exam is specifically
engineered to mirror actual nursing pharmacology
exam questions for course and NCLEX preparation.
It features back-to-back integration of realistic
clinical scenarios alongside precise answers and
deeply detailed, bolded rationales for every single
item. Perfect for quick scanning, high-utility studying,
and maximizing test scores on complex cardiac,
neurological, and hematological drug modules.
Question 1
A patient is prescribed intravenous Heparin for a deep
vein thrombosis. Which laboratory value must the nurse
monitor to evaluate the therapeutic effectiveness of this
medication?
A) Prothrombin time (PT)
B) International Normalized Ratio (INR)
C) Activated partial thromboplastin time (aPTT)
D) Platelet count
Answer: C
,Rationale: Activated partial thromboplastin time
(aPTT) is the specific blood test used to monitor the
therapeutic efficacy and safety of unfractionated
Heparin therapy. PT and INR are utilized to monitor
oral Warfarin therapy, while platelet counts track
potential Heparin-Induced Thrombocytopenia (HIT) but
do not measure therapeutic anticoagulation levels.
Question 2
The nurse is preparing to administer a scheduled dose of
Digoxin to a client with heart failure. The client’s potassium
level is reported as 3.2 mEq/L. Which action should the
nurse take first?
A) Administer the Digoxin as prescribed.
B) Hold the Digoxin and notify the healthcare provider.
C) Document the potassium level as a normal finding.
D) Administer a double dose of potassium immediately.
Answer: B
Rationale: Hypokalemia (potassium level < 3.5 mEq/L)
significantly increases the risk of digoxin toxicity
because digoxin binds to the ATPase pump more
effectively when potassium levels are low. The nurse
must hold the medication and notify the provider to
address the electrolyte imbalance.
Question 3
A patient is being discharged home with a new
prescription for Warfarin (Coumadin). Which dietary
instruction should the nurse include in the discharge
,teaching plan?
A) Eliminate all green leafy vegetables from your diet
entirely.
B) Maintain a consistent daily intake of foods high in
Vitamin K.
C) Increase your intake of red meat to boost iron
absorption.
D) Drink grape juice every morning to enhance drug
absorption.
Answer: B
Rationale: Vitamin K is the antidote for Warfarin.
Drastic changes in Vitamin K intake can alter the
drug’s effectiveness; a sudden increase can lower the
INR, while a sudden decrease can cause dangerous
bleeding. Consistency in the diet is the key to
maintaining a therapeutic INR range.
Question 4
A client presents to the emergency department with acute
chest pain. The provider prescribes sublingual
Nitroglycerin. What critical drug interaction must the nurse
rule out before administering this medication?
A) Acetaminophen within the past 4 hours
B) Phosphodiesterase inhibitors (e.g., Sildenafil) within the
past 24–48 hours
C) Beta-blockers within the past 12 hours
D) Over-the-counter daily multivitamins
Answer: B
Rationale: Concurrent use of Nitroglycerin and
, phosphodiesterase inhibitors like Sildenafil (Viagra) is
strictly contraindicated due to the risk of severe, life-
threatening hypotension caused by profound
systemic vasodilation.
Question 5
A nurse is preparing to administer a maintenance dose of
Phenytoin (Dilantin) intravenously to a patient with partial
seizures. Which solution is the only compatible fluid for
flushing and infusing this medication?
A) 5% Dextrose in Water (D5W)
B) Lactated Ringer's solution
C) 0.9% Sodium Chloride (Normal Saline)
D) 0.45% Sodium Chloride (Half Normal Saline)
Answer: C
Rationale: Phenytoin is highly unstable and will
precipitate out of solution into crystals if mixed with
any glucose-containing fluids like D5W. It must only
be administered and flushed with 0.9% Sodium
Chloride (Normal Saline).
Question 6
A patient receiving a continuous infusion of Heparin
begins to experience severe, uncontrolled epistaxis and
hematuria. Which medication should the nurse anticipate
administering as the direct antidote?
A) Vitamin K
B) Protamine sulfate
C) Flumazenil
