2025 – Versions 1, 2 & 3 + Bonus Practice Test |
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Pharmacology (15 Questions)
Question 1: Multiple-Choice
A nurse is caring for a client prescribed warfarin for atrial fibrillation. Which laboratory test
should the nurse monitor to assess the medication’s effectiveness?
A. Platelet count
B. INR
C. aPTT
D. Hemoglobin
Correct Answer: B
Rationale: INR (B) monitors warfarin’s anticoagulant effect, with a therapeutic range of 2–3 for
atrial fibrillation. Platelet count (A) assesses clotting risk, aPTT (C) monitors heparin, and
hemoglobin (D) evaluates anemia, per Saunders Comprehensive Review for the NCLEX-PN.
Question 2: Select-All-That-Apply
A client receiving morphine for post-operative pain reports nausea and a respiratory rate of
8/min. Which actions should the nurse take? (Select all that apply.)
A. Administer naloxone
B. Withhold the next dose
C. Notify the provider
D. Increase the dose
Correct Answers: B, C
Rationale: A respiratory rate of 8/min indicates respiratory depression, a serious morphine side
effect. Withholding the dose (B) and notifying the provider (C) are priority actions. Naloxone
(A) is for severe overdose, and increasing the dose (D) is contraindicated.
Question 3: Case Study (5 Questions)
Case Study: A 55-year-old female with peptic ulcer disease is prescribed pantoprazole. The
nurse provides medication teaching.
Question 3.1: Multiple-Choice
What adverse effect should the nurse monitor for with long-term pantoprazole use?
,A. Hyperkalemia
B. Bone fractures
C. Hypertension
D. Hypoglycemia
Correct Answer: B
Rationale: Long-term proton pump inhibitor (PPI) use, like pantoprazole, decreases calcium
absorption, increasing bone fracture risk (B). Hyperkalemia (A), hypertension (C), and
hypoglycemia (D) are not associated.
Question 3.2: Matrix
Match the medication with its monitoring parameter:
Medication Parameter
A. Bone
Pantoprazole
density
Warfarin B. INR
Digoxin C. Heart rate
Correct Answers: Pantoprazole: A, Warfarin: B, Digoxin: C
Rationale: Pantoprazole (A) requires bone density monitoring, warfarin (B)
requires INR, and digoxin (C) requires heart rate monitoring for toxicity.
Question 3.3: Select-All-That-Apply
Which teaching points should the nurse include for pantoprazole? (Select all that apply.)
A. Take 30 minutes before meals
B. Report severe diarrhea
C. Expect immediate symptom relief
D. Avoid antacids
Correct Answers: A, B
Rationale: Pantoprazole is taken 30 minutes before meals (A) for optimal absorption, and severe
diarrhea (B) may indicate C. difficile infection. Immediate relief (C) is unlikely, and antacids (D)
are generally safe unless contraindicated.
Question 3.4: Multiple-Choice
The client reports epigastric pain despite pantoprazole. What is the nurse’s first action?
A. Increase the dose
B. Notify the provider
C. Administer an antacid
D. Reassess in 24 hours
Correct Answer: B
Rationale: Persistent pain requires provider notification (B) for evaluation of treatment failure or
complications. Increasing the dose (A), giving antacids (C), or waiting (D) delays care.
Question 3.5: Multiple-Choice
Which medication may interact with pantoprazole?
A. Metformin
, B. Warfarin
C. Lisinopril
D. Albuterol
Correct Answer: B
Rationale: Pantoprazole may increase warfarin’s (B) anticoagulant effect by affecting
metabolism. Metformin (A), lisinopril (C), and albuterol (D) have minimal interactions.
Question 4: Multiple-Choice
A client is prescribed vancomycin IV for MRSA. What is the priority nursing action?
A. Monitor blood pressure
B. Check peak and trough levels
C. Assess for rash
D. Administer over 30 minutes
Correct Answer: B
Rationale: Monitoring peak and trough levels (B) ensures therapeutic vancomycin levels and
prevents toxicity. Blood pressure (A), rash (C), and infusion rate (D) are secondary.
Safety (15 Questions)
Question 5: Multiple-Choice
A nurse is assisting a client with ambulation post-surgery. What is the priority safety
intervention?
A. Ensure the client wears non-slip shoes
B. Encourage rapid ambulation
C. Allow the client to ambulate alone
D. Provide a wheelchair
Correct Answer: A
Rationale: Non-slip shoes (A) prevent falls, a priority for post-surgical clients. Rapid ambulation
(B) risks injury, ambulating alone (C) is unsafe, and a wheelchair (D) is not always needed.
Question 6: Select-All-That-Apply
Which interventions promote patient safety during medication administration? (Select all that
apply.)
A. Verify patient identity
B. Check medication label three times
C. Administer without checking allergies
D. Document immediately after administration
Correct Answers: A, B, D
Rationale: Verifying identity (A), checking the label three times (B), and documenting
immediately (D) ensure safe administration. Ignoring allergies (C) risks errors.
Question 7: Case Study (5 Questions)