1
Pharmacology NCLEX Test Bank 2025–2026 | 150+ High-
Yield NCLEX-Style Questions & Rationales | Medications,
Side Effects, Nursing Interventions
Question 1:
A 72-year-old male patient with a history of atrial fibrillation and congestive heart failure is
discharged on warfarin (Coumadin) therapy. During the discharge teaching session, the nurse
reviews essential information regarding the medication. The patient is alert, oriented, and has no
signs of cognitive impairment. He verbalizes understanding about follow-up visits and expresses
confidence in managing his medications. As the nurse evaluates the patient’s understanding of
warfarin therapy, which of the following patient statements indicates the need for further
teaching?
A. "I will have my blood tested regularly to monitor my INR levels."
B. "I’ll try to avoid leafy green vegetables because they can interfere with the medication."
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C. "If I miss a dose, I can just double up the next time."
D. "I will use a soft toothbrush and electric razor to avoid bleeding."
Correct Answer: C. "If I miss a dose, I can just double up the next time."
Rationale: Doubling up on warfarin doses can result in excessive anticoagulation and increase
the risk of serious bleeding events. Warfarin has a narrow therapeutic window and requires
regular INR monitoring to maintain therapeutic levels. Patients must be instructed to never take
an extra dose if one is missed but to contact their healthcare provider for instructions. The other
statements show appropriate understanding: regular INR checks are necessary, vitamin K-rich
foods like leafy greens should be consistent in the diet, and bleeding precautions such as soft
toothbrush use are vital.
📚 Source: Saunders Comprehensive Review for the NCLEX-RN®, 10th ed., p. 431
Question 2:
A 64-year-old female patient with a history of chronic heart failure is admitted for acute
shortness of breath and bilateral lower extremity edema. The healthcare provider prescribes IV
furosemide (Lasix) 40 mg every 12 hours to manage fluid overload. After the second dose, the
nurse notes the patient’s vital signs: BP 112/78 mmHg, HR 86 bpm, RR 18/min. Lab results
reveal: sodium 138 mEq/L, potassium 2.9 mEq/L, and creatinine 1.1 mg/dL. The patient reports
feeling weak and slightly lightheaded. Which of the following findings requires immediate
nursing intervention?
,3
A. Blood pressure of 112/78 mmHg
B. Potassium level of 2.9 mEq/L
C. Weight loss of 1.5 kg in 24 hours
D. Urine output of 1,000 mL in 12 hours
Correct Answer: B. Potassium level of 2.9 mEq/L
Rationale: Furosemide is a loop diuretic that promotes potassium excretion, and a potassium
level below 3.5 mEq/L is considered hypokalemia. A value of 2.9 mEq/L is critical and may
cause cardiac arrhythmias, muscle weakness, or respiratory compromise. The patient’s weakness
may be an early sign of electrolyte imbalance. While weight loss and increased urine output are
expected outcomes of diuresis, and the blood pressure remains stable, the potassium level is
dangerously low and requires immediate intervention, such as potassium supplementation or
adjustment of diuretic therapy.
📚 Source: Lehne’s Pharmacology for Nursing Care, 10th ed., pp. 296–298
Question 3:
A 45-year-old male patient diagnosed with active tuberculosis has been prescribed isoniazid
(INH) 300 mg daily and is beginning a 6-month treatment regimen. During a routine clinic visit,
the nurse assesses his medication adherence and lifestyle habits. The patient reports taking the
medication consistently and experiencing only mild nausea. He also states, “I go out on the
weekends with friends and usually have a few beers.” He denies any numbness or tingling in his
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extremities. Which of the following statements made by the patient indicates the need for
further teaching?
A. "I sometimes drink beer on weekends."
B. "I take the medication with food to prevent nausea."
C. "I’ll report any numbness or tingling in my hands."
D. "I will avoid aluminum-containing antacids."
Correct Answer: A. "I sometimes drink beer on weekends."
Rationale: Isoniazid is hepatotoxic, and alcohol consumption significantly increases the risk of
liver damage, especially with long-term use. Patients must be counseled to avoid alcohol entirely
during treatment. The other responses reflect appropriate understanding: taking INH with food
can reduce nausea, peripheral neuropathy is a potential side effect that should be reported, and
aluminum-containing antacids interfere with absorption. Alcohol use while on INH can lead to
severe hepatotoxicity or liver failure.
📚 Source: Lilley’s Pharmacology and the Nursing Process, 10th ed., pp. 675–676
Question 4:
A 58-year-old female patient with hypertension is prescribed lisinopril 20 mg daily during a
follow-up visit. Two weeks later, she returns complaining of a persistent dry cough that has been
present for the last 10 days. She denies chest pain, wheezing, or shortness of breath. The nurse
notes that vital signs are stable and lung sounds are clear. The patient expresses frustration,
Pharmacology NCLEX Test Bank 2025–2026 | 150+ High-
Yield NCLEX-Style Questions & Rationales | Medications,
Side Effects, Nursing Interventions
Question 1:
A 72-year-old male patient with a history of atrial fibrillation and congestive heart failure is
discharged on warfarin (Coumadin) therapy. During the discharge teaching session, the nurse
reviews essential information regarding the medication. The patient is alert, oriented, and has no
signs of cognitive impairment. He verbalizes understanding about follow-up visits and expresses
confidence in managing his medications. As the nurse evaluates the patient’s understanding of
warfarin therapy, which of the following patient statements indicates the need for further
teaching?
A. "I will have my blood tested regularly to monitor my INR levels."
B. "I’ll try to avoid leafy green vegetables because they can interfere with the medication."
,2
C. "If I miss a dose, I can just double up the next time."
D. "I will use a soft toothbrush and electric razor to avoid bleeding."
Correct Answer: C. "If I miss a dose, I can just double up the next time."
Rationale: Doubling up on warfarin doses can result in excessive anticoagulation and increase
the risk of serious bleeding events. Warfarin has a narrow therapeutic window and requires
regular INR monitoring to maintain therapeutic levels. Patients must be instructed to never take
an extra dose if one is missed but to contact their healthcare provider for instructions. The other
statements show appropriate understanding: regular INR checks are necessary, vitamin K-rich
foods like leafy greens should be consistent in the diet, and bleeding precautions such as soft
toothbrush use are vital.
📚 Source: Saunders Comprehensive Review for the NCLEX-RN®, 10th ed., p. 431
Question 2:
A 64-year-old female patient with a history of chronic heart failure is admitted for acute
shortness of breath and bilateral lower extremity edema. The healthcare provider prescribes IV
furosemide (Lasix) 40 mg every 12 hours to manage fluid overload. After the second dose, the
nurse notes the patient’s vital signs: BP 112/78 mmHg, HR 86 bpm, RR 18/min. Lab results
reveal: sodium 138 mEq/L, potassium 2.9 mEq/L, and creatinine 1.1 mg/dL. The patient reports
feeling weak and slightly lightheaded. Which of the following findings requires immediate
nursing intervention?
,3
A. Blood pressure of 112/78 mmHg
B. Potassium level of 2.9 mEq/L
C. Weight loss of 1.5 kg in 24 hours
D. Urine output of 1,000 mL in 12 hours
Correct Answer: B. Potassium level of 2.9 mEq/L
Rationale: Furosemide is a loop diuretic that promotes potassium excretion, and a potassium
level below 3.5 mEq/L is considered hypokalemia. A value of 2.9 mEq/L is critical and may
cause cardiac arrhythmias, muscle weakness, or respiratory compromise. The patient’s weakness
may be an early sign of electrolyte imbalance. While weight loss and increased urine output are
expected outcomes of diuresis, and the blood pressure remains stable, the potassium level is
dangerously low and requires immediate intervention, such as potassium supplementation or
adjustment of diuretic therapy.
📚 Source: Lehne’s Pharmacology for Nursing Care, 10th ed., pp. 296–298
Question 3:
A 45-year-old male patient diagnosed with active tuberculosis has been prescribed isoniazid
(INH) 300 mg daily and is beginning a 6-month treatment regimen. During a routine clinic visit,
the nurse assesses his medication adherence and lifestyle habits. The patient reports taking the
medication consistently and experiencing only mild nausea. He also states, “I go out on the
weekends with friends and usually have a few beers.” He denies any numbness or tingling in his
, 4
extremities. Which of the following statements made by the patient indicates the need for
further teaching?
A. "I sometimes drink beer on weekends."
B. "I take the medication with food to prevent nausea."
C. "I’ll report any numbness or tingling in my hands."
D. "I will avoid aluminum-containing antacids."
Correct Answer: A. "I sometimes drink beer on weekends."
Rationale: Isoniazid is hepatotoxic, and alcohol consumption significantly increases the risk of
liver damage, especially with long-term use. Patients must be counseled to avoid alcohol entirely
during treatment. The other responses reflect appropriate understanding: taking INH with food
can reduce nausea, peripheral neuropathy is a potential side effect that should be reported, and
aluminum-containing antacids interfere with absorption. Alcohol use while on INH can lead to
severe hepatotoxicity or liver failure.
📚 Source: Lilley’s Pharmacology and the Nursing Process, 10th ed., pp. 675–676
Question 4:
A 58-year-old female patient with hypertension is prescribed lisinopril 20 mg daily during a
follow-up visit. Two weeks later, she returns complaining of a persistent dry cough that has been
present for the last 10 days. She denies chest pain, wheezing, or shortness of breath. The nurse
notes that vital signs are stable and lung sounds are clear. The patient expresses frustration,
