Pharmacology Master Test Bank 2025–2026 | Verified
NCLEX/ATI/HESI Q&A (Q121–140) with Rationales |
A+ Graded
1. A patient taking warfarin (Coumadin) is found to have an INR of 5.2. What
is the nurse's priority action?
A. Administer vitamin K
B. Continue the current dose
C. Hold the dose and notify the provider
D. Give protamine sulfate
Correct Answer: C
Rationale: INR >5 indicates elevated bleeding risk. The dose should be held and
the provider notified. Vitamin K may be needed if bleeding occurs.
Clinical Tip: Always assess INR and bleeding risk before administering
anticoagulants.
2. Which of the following drugs requires monitoring of peak and trough
levels?
A. Acetaminophen
B. Furosemide
C. Gentamicin
D. Lorazepam
Correct Answer: C
Rationale: Gentamicin is an aminoglycoside antibiotic that can cause
,nephrotoxicity and ototoxicity. Peak/trough monitoring ensures safe levels.
Clinical Tip: Draw peak 30 minutes after infusion; draw trough just before next
dose.
3. A client is prescribed digoxin. Which electrolyte imbalance increases the
risk of digoxin toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Low potassium enhances digoxin's effect on myocardial cells,
increasing risk of toxicity.
Watch for: Nausea, vision changes, bradycardia.
4. The nurse is administering IV potassium chloride. What is the correct
action?
A. Give IV push for fast correction
B. Dilute and infuse slowly via pump
C. Mix with dextrose and give rapidly
D. Administer intramuscularly
Correct Answer: B
Rationale: IV potassium must always be diluted and administered slowly using an
infusion pump to prevent cardiac arrest.
NEVER IV PUSH KCL.
5. Which medication should be avoided in patients with a history of
angioedema related to ACE inhibitors?
A. Lisinopril
B. Losartan
,C. Hydrochlorothiazide
D. Metoprolol
Correct Answer: A
Rationale: ACE inhibitors can trigger angioedema; avoid re-exposure in affected
patients.
Alternative: Consider ARBs (e.g., Losartan) with caution.
6. What is a serious side effect of clozapine (Clozaril)?
A. Hypertension
B. Agranulocytosis
C. Tachycardia
D. Renal failure
Correct Answer: B
Rationale: Clozapine can dangerously lower WBC count. Frequent CBC
monitoring is essential.
Signs to report: Fever, sore throat, fatigue.
7. The nurse should question which order in a child with a viral infection?
A. Acetaminophen
B. Amoxicillin
C. Aspirin
D. Ibuprofen
Correct Answer: C
Rationale: Aspirin is contraindicated in viral illnesses due to risk of Reye's
syndrome.
Safer alternatives: Acetaminophen, ibuprofen.
8. Which is an expected side effect of albuterol?
A. Bradycardia
B. Drowsiness
, C. Tremors
D. Hypoglycemia
Correct Answer: C
Rationale: Albuterol, a beta-2 agonist, can cause tremors, nervousness, and
tachycardia.
Teaching: Use spacer; monitor heart rate.
9. When giving morphine IV, what should the nurse do first?
A. Check the pain scale
B. Monitor BP and RR
C. Ask about allergies
D. Administer slowly over 1 minute
Correct Answer: B
Rationale: Opioids depress respiratory drive. Always assess RR and BP before
administration.
Hold if RR < 12/min.
10. Which medication requires avoiding grapefruit juice?
A. Lisinopril
B. Atorvastatin
C. Metformin
D. Amoxicillin
Correct Answer: B
Rationale: Grapefruit juice inhibits metabolism of statins, increasing risk of
toxicity.
Teach: Avoid grapefruit with most statins.
11. Which insulin should be given 15 minutes before meals?
A. Glargine
B. NPH
NCLEX/ATI/HESI Q&A (Q121–140) with Rationales |
A+ Graded
1. A patient taking warfarin (Coumadin) is found to have an INR of 5.2. What
is the nurse's priority action?
A. Administer vitamin K
B. Continue the current dose
C. Hold the dose and notify the provider
D. Give protamine sulfate
Correct Answer: C
Rationale: INR >5 indicates elevated bleeding risk. The dose should be held and
the provider notified. Vitamin K may be needed if bleeding occurs.
Clinical Tip: Always assess INR and bleeding risk before administering
anticoagulants.
2. Which of the following drugs requires monitoring of peak and trough
levels?
A. Acetaminophen
B. Furosemide
C. Gentamicin
D. Lorazepam
Correct Answer: C
Rationale: Gentamicin is an aminoglycoside antibiotic that can cause
,nephrotoxicity and ototoxicity. Peak/trough monitoring ensures safe levels.
Clinical Tip: Draw peak 30 minutes after infusion; draw trough just before next
dose.
3. A client is prescribed digoxin. Which electrolyte imbalance increases the
risk of digoxin toxicity?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Low potassium enhances digoxin's effect on myocardial cells,
increasing risk of toxicity.
Watch for: Nausea, vision changes, bradycardia.
4. The nurse is administering IV potassium chloride. What is the correct
action?
A. Give IV push for fast correction
B. Dilute and infuse slowly via pump
C. Mix with dextrose and give rapidly
D. Administer intramuscularly
Correct Answer: B
Rationale: IV potassium must always be diluted and administered slowly using an
infusion pump to prevent cardiac arrest.
NEVER IV PUSH KCL.
5. Which medication should be avoided in patients with a history of
angioedema related to ACE inhibitors?
A. Lisinopril
B. Losartan
,C. Hydrochlorothiazide
D. Metoprolol
Correct Answer: A
Rationale: ACE inhibitors can trigger angioedema; avoid re-exposure in affected
patients.
Alternative: Consider ARBs (e.g., Losartan) with caution.
6. What is a serious side effect of clozapine (Clozaril)?
A. Hypertension
B. Agranulocytosis
C. Tachycardia
D. Renal failure
Correct Answer: B
Rationale: Clozapine can dangerously lower WBC count. Frequent CBC
monitoring is essential.
Signs to report: Fever, sore throat, fatigue.
7. The nurse should question which order in a child with a viral infection?
A. Acetaminophen
B. Amoxicillin
C. Aspirin
D. Ibuprofen
Correct Answer: C
Rationale: Aspirin is contraindicated in viral illnesses due to risk of Reye's
syndrome.
Safer alternatives: Acetaminophen, ibuprofen.
8. Which is an expected side effect of albuterol?
A. Bradycardia
B. Drowsiness
, C. Tremors
D. Hypoglycemia
Correct Answer: C
Rationale: Albuterol, a beta-2 agonist, can cause tremors, nervousness, and
tachycardia.
Teaching: Use spacer; monitor heart rate.
9. When giving morphine IV, what should the nurse do first?
A. Check the pain scale
B. Monitor BP and RR
C. Ask about allergies
D. Administer slowly over 1 minute
Correct Answer: B
Rationale: Opioids depress respiratory drive. Always assess RR and BP before
administration.
Hold if RR < 12/min.
10. Which medication requires avoiding grapefruit juice?
A. Lisinopril
B. Atorvastatin
C. Metformin
D. Amoxicillin
Correct Answer: B
Rationale: Grapefruit juice inhibits metabolism of statins, increasing risk of
toxicity.
Teach: Avoid grapefruit with most statins.
11. Which insulin should be given 15 minutes before meals?
A. Glargine
B. NPH
