PHARMACOLOGICAL AND PARENTERAL THERAPIES NCLEX RN ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALES 2025 UPDATED COMPLETE VERSION A nurse is providing care to a female client who is 32-weeks pregnant. The client has

PHARMACOLOGICAL AND PARENTERAL THERAPIES NCLEX RN ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALES 2025 UPDATED COMPLETE VERSION A nurse is providing care to a female client who is 32-weeks pregnant. The client has been diagnosed with hypertension and will begin prescribed pharmacological treatment. The nurse will clarify which medication if observed in the client’s record? A Spironolactone B Methyldopa C Lisinopril Correct Answer D Hydralazine Question Explanation Rationale: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension. ACE inhibitors are pregnancy risk category D and are contraindicated during the second and third trimesters of pregnancy. Spironolactone and methyldopa are pregnancy risk category B and have been used routinely and safely during pregnancy. Hydralazine is a pregnancy risk category C, but its use has been proven to be safe during pregnancy. Concepts tested NCLEX: Pharmacological and Parenteral Therapies A nurse is preparing to administer plasma to a client with a coagulation disorder. Which identification step will the nurse verify prior to initiating the transfusion? A Cross match B Expiration date C ABO compatibility Correct Answer D Hemoglobin level Question Explanation Rationale: Plasma is a blood product that needs to be typed prior to administration to avoid a reaction. Typing determines if the blood product is compatible with the client’s blood type. A cross match for antigens is only required for transfusions containing red blood cells. The expiration date is an important component to check prior to administration. However, this does not identify the client. Plasma does not contain red blood cells, so checking the hemoglobin level is not indicated and does not identify the client. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is preparing to administer newly prescribed intravenous phenytoin to a client. When reviewing the client’s medical record, which prescription should the nurse question? A Continuous infusion of dextrose 5% in 0.9% saline Correct Answer B NPH insulin 40 units before meals C Labetalol 100 mg orally twice per day Your Answer D Ketorolac 15 mg IV push as needed for pain Question Explanation Rationale: Phenytoin is not compatible with most IV fluids, especially those with dextrose. If the nurse observes a continuous infusion of a fluid that contains dextrose, they should understand that incompatibilities are likely and should not administer the medication as prescribed. Insulin, labetalol, and ketorolac do not have potential incompatibilities. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is assisting a client who is taking amlodipine with meal planning. Which fluid selected by the client would require follow up by the nurse? A Black coffee B Grapefruit juice Correct Answer C Green tea D Chocolate Milk Question Explanation Rationale: Grapefruit juice affects the metabolism of certain medications, such as amlodipine, and may cause toxicity if taken together. Clients who are taking antibiotics, such as tetracycline, should avoid consuming milk products. Clients who are taking warfarin should avoid consuming green tea. Clients who are taking stimulants should avoid consuming black coffee. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is providing teaching to the client taking metoclopramide. Serious side effects that should be reported to the provider are included in the teaching plan. Which of the following side effects is the priority? A Involuntary muscle movements Correct Answer B Report of increased fatigue C Onset of headaches D Difficulty with sleep Question Explanation Rationale: Metoclopramide is a GI stimulant that is effective in reducing headache, nausea, and vomiting. Metoclopramide can cause a serious movement disorder called tardive dyskinesia (TD). This condition is often irreversible. TD is characterized by involuntary movements of the face, tongue, or extremities. The risk of developing TD is increased with longer treatment and increased dosage. To help prevent TD, this drug shouldn’t be used for longer than 12 weeks. The more common side effects of metoclopramide can include headache, confusion, drowsiness, dizziness, restlessness, and insomnia. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is assessing a client who is taking rifampin for the treatment of tuberculosis. Which finding reported by the client should the nurse immediately report to the healthcare provider? A Blurred vision B Orange-tinged tears C Dark amber urine Correct Answer D Diarrhea Question Explanation Rationale: Rifampin causes a temporary yellow-orange discoloration of body fluids. Soft contact lenses may be permanently stained. Dark amber urine is an indication of liver dysfunction and should be reported. A major adverse effect of ethambutol, not rifampin, is optic neuritis. Diarrhea is a common side effect of antibiotics and is not the priority in this case. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is collecting the health history for a client who reports a sudden onset of generalized weakness and fatigue. The nurse notes the client has a new prescription for spironolactone. Which action should the nurse take first? A Review the drug formulary for side effects Correct Answer B Request the health care provider to stop the medication Your Answer C Notify the pharmacist of the findings D Document the findings Question Explanation Rationale: During medication administration, it is important for the nurse to assess knowledge of drugs, including adverse effects and physiologic factors that affect drug action. Information about specific drugs is available in pharmacology texts and drug reference books. Calling the health care provider may be an option after reviewing the drug formulary. The nurse should notify the pharmacist if the medication is the cause of the symptoms. The nurse will document the findings, but the priority is to review the formulary. Concepts tested NCLEX: Pharmacological and Parenteral Therapies A nurse is assessing a client who started taking prescribed olmesartan 2 weeks ago. Which finding indicates an expected response to the medication? A Heart rate of 85 beats/min B Urinary output of 45 ml/hr C Blood pressure of 125/79 mmHg Correct Answer D Respiratory rate of 20 breaths/min Question Explanation Rationale: Olmesartan is an angiotensin II receptor antagonist used in the treatment of hypertension. The expected outcome is to maintain the blood pressure within normal limits. Although within normal limits, the heart rate, urinary output, and respiratory rate are not used to evaluate the efficacy of olmesartan. Concepts tested NCLEX: Pharmacological and Parenteral Therapies A nurse is providing dietary instructions to a client who is taking prescribed amiloride. Which information will the nurse include in the teaching? A “Avoid eating foods that are rich in potassium such as bananas.” Correct Answer B “It is important to control high-sodium foods such as canned soups.” Your Answer C “Eat plenty of foods that contain calcium such as milk.” D “Choose foods that are high in iron content such as shellfish.” Question Explanation Rationale: Amiloride is a potassium-sparing diuretic used in the treatment of edema, hypertension, and potassium loss caused by other diuretic medications. Amiloride may cause hyperkalemia, so the client should be informed to limit their potassium intake. Sodium, calcium, and iron are not affected by the use of amiloride. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is educating a client with preeclampsia about magnesium sulfate. Which statement should the nurse include in the teaching? A “This medication is used to reduce your risk of seizures.” Correct Answer B “This medication will raise your blood pressure.” C “This medication might make you urinate more frequently.” D “This medication will be discontinued once your headache subsides.” Question Explanation Rationale: Magnesium sulfate is a medication that is used to prevent seizures for clients with preeclampsia. The medication will not raise blood pressure and has no effect on urination. Magnesium is given continuously and will not be discontinued if the client’s headache subsides. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is providing medication teaching for a client prescribed famotidine for the treatment of gastroesophageal reflux disease (GERD). Which statement by the client indicates an understanding of the teaching? A “I will take this medication once a day in the morning.” B “I will no longer have discomfort at night once I begin this medication.” C “This medication will both prevent and treat heartburn.” Correct Answer D “My treatment will be done in one week.” Question Explanation Rationale: H2 receptor blockers (antagonists) are used to prevent and treat conditions caused by too much acid being produced in the stomach. These conditions include gastric ulcers, duodenal ulcers, and GERD. Famotidine may be prescribed to take twice a day, in the morning and evening, or just once daily in the evening. Duration of treatment varies but is at a minimum two weeks. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is educating a client on self-administration of a fluticasone inhaler. What statement indicates an understanding of the teaching? A “I will rinse my mouth with water after using the inhaler.” Correct Answer B “Disinfectant wipes can be used to clean the spacer.” C “I need to wait 15 minutes between puffs.” D “This inhaler should be used before the others.” Question Explanation Rationale: To prevent thrush, the client should rinse his or her mouth with water and spit it out. The spacer should be washed with warm water and dish detergent. The client may need two puffs but does not have to wait 15 minutes between. Bronchodilators should be used before corticosteroids. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is caring for a female client who is requesting hormonal contraceptives. Which of the following questions should the nurse ask to assess for contraindications? A “Have you ever had a blood clot?” Correct Answer B “How many children do you have?” C “Do you drink alcohol?” D “Did you experience acne in adolescence?” Question Explanation Rationale: A history of thromboembolic disorders is a contraindication to hormonal contraceptives; therefore, any history of thrombus should be assessed. The number of children/pregnancies and use of alcohol are probable history questions but are not contraindications to this method. Acne is a side effect of oral contraceptives but not a contraindication. Concepts tested NCLEX: Pharmacological and Parenteral Therapies The nurse is preparing to administer a client’s oral medications. Which action should the nurse take prior to administration? A Assess the client’s swallowing ability Correct Answer B Place the client in the supine position C Remove any oxygen delivery devices D