Medical-Surgical Nursing Pharmacology
Practice Questions and Rationales
100 High-Yield Questions with Complete
Rationales (2025/2026 NCLEX-RN Aligned)
SECTION A: CARDIOVASCULAR PHARMACOLOGY
(Questions 1-20)
1. A patient with heart failure is prescribed digoxin. Which
assessment finding indicates digoxin toxicity?
A. Heart rate of 60 beats/min
B. Anorexia, nausea, and vomiting
C. Blood pressure of 130/80 mmHg
D. Urine output of 50 mL/hour
Correct Answer: B
, Rationale: Anorexia, nausea, vomiting, and visual disturbances
(yellow-green halos) are early signs of digoxin toxicity.
Bradycardia may also occur but a heart rate of 60 is not
necessarily toxic. The nurse should assess the apical pulse for
one full minute before administering digoxin. The therapeutic
range for digoxin is narrow (0.8-2.0 ng/mL), and toxicity can be
life-threatening.
Incorrect Option Rationales:
• A: A heart rate of 60 bpm may be normal; bradycardia (<60
bpm) is a sign of toxicity but GI symptoms are often the earliest
indicators.
• C: Blood pressure of 130/80 mmHg is within normal limits and
not indicative of toxicity.
• D: Urine output of 50 mL/hour is normal (30-50 mL/hour
minimum) and does not indicate digoxin toxicity.
Test-Taking Tip: Early signs of digoxin toxicity include GI
symptoms (anorexia, nausea, vomiting) and visual disturbances
(yellow-green halos). Monitor serum digoxin levels and
potassium levels (hypokalemia increases toxicity risk).
, 2. A patient with hypertension is prescribed lisinopril (an
ACE inhibitor). Which adverse effect should the nurse teach
the patient to report immediately?
A. Dry cough
B. Angioedema (swelling of lips, tongue, or throat)
C. Headache
D. Dizziness
Correct Answer: B
Rationale: Angioedema is a rare but life-threatening adverse
effect of ACE inhibitors. Patients should be instructed to seek
emergency care immediately if they experience swelling of the
lips, tongue, or throat. A dry cough is a common non-emergent
side effect. Headache and dizziness may occur but are not
immediately life-threatening.
Incorrect Option Rationales:
• A: A dry cough is a common side effect of ACE inhibitors (up to
20% of patients) but is not life-threatening. It may require
switching to an ARB.
• C: Headache is a less common side effect and is not an
emergency.
, • D: Dizziness can occur due to hypotension but is not
immediately life-threatening.
Test-Taking Tip: ACE inhibitors = angioedema (emergency)
+ dry cough (common). ARBs do not cause cough.
3. A patient with heart failure is prescribed furosemide
(Lasix). Which laboratory value should the nurse monitor
most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium
wasting. Hypokalemia can predispose the patient to cardiac
dysrhythmias, especially if the patient is also on digoxin. Serum
potassium levels should be monitored closely and maintained
within normal range (3.5-5.0 mEq/L).
Practice Questions and Rationales
100 High-Yield Questions with Complete
Rationales (2025/2026 NCLEX-RN Aligned)
SECTION A: CARDIOVASCULAR PHARMACOLOGY
(Questions 1-20)
1. A patient with heart failure is prescribed digoxin. Which
assessment finding indicates digoxin toxicity?
A. Heart rate of 60 beats/min
B. Anorexia, nausea, and vomiting
C. Blood pressure of 130/80 mmHg
D. Urine output of 50 mL/hour
Correct Answer: B
, Rationale: Anorexia, nausea, vomiting, and visual disturbances
(yellow-green halos) are early signs of digoxin toxicity.
Bradycardia may also occur but a heart rate of 60 is not
necessarily toxic. The nurse should assess the apical pulse for
one full minute before administering digoxin. The therapeutic
range for digoxin is narrow (0.8-2.0 ng/mL), and toxicity can be
life-threatening.
Incorrect Option Rationales:
• A: A heart rate of 60 bpm may be normal; bradycardia (<60
bpm) is a sign of toxicity but GI symptoms are often the earliest
indicators.
• C: Blood pressure of 130/80 mmHg is within normal limits and
not indicative of toxicity.
• D: Urine output of 50 mL/hour is normal (30-50 mL/hour
minimum) and does not indicate digoxin toxicity.
Test-Taking Tip: Early signs of digoxin toxicity include GI
symptoms (anorexia, nausea, vomiting) and visual disturbances
(yellow-green halos). Monitor serum digoxin levels and
potassium levels (hypokalemia increases toxicity risk).
, 2. A patient with hypertension is prescribed lisinopril (an
ACE inhibitor). Which adverse effect should the nurse teach
the patient to report immediately?
A. Dry cough
B. Angioedema (swelling of lips, tongue, or throat)
C. Headache
D. Dizziness
Correct Answer: B
Rationale: Angioedema is a rare but life-threatening adverse
effect of ACE inhibitors. Patients should be instructed to seek
emergency care immediately if they experience swelling of the
lips, tongue, or throat. A dry cough is a common non-emergent
side effect. Headache and dizziness may occur but are not
immediately life-threatening.
Incorrect Option Rationales:
• A: A dry cough is a common side effect of ACE inhibitors (up to
20% of patients) but is not life-threatening. It may require
switching to an ARB.
• C: Headache is a less common side effect and is not an
emergency.
, • D: Dizziness can occur due to hypotension but is not
immediately life-threatening.
Test-Taking Tip: ACE inhibitors = angioedema (emergency)
+ dry cough (common). ARBs do not cause cough.
3. A patient with heart failure is prescribed furosemide
(Lasix). Which laboratory value should the nurse monitor
most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium
wasting. Hypokalemia can predispose the patient to cardiac
dysrhythmias, especially if the patient is also on digoxin. Serum
potassium levels should be monitored closely and maintained
within normal range (3.5-5.0 mEq/L).
