NCLEX Pharmacology – 56 Practice Questions with
Answers and Explanations for Nursing Exam Preparation
1. The nurse is aware that the patients who are allergic to intravenous contrast media are
usually also allergic to which of the following products?
a. Eggs
b. Shellfish
c. Soy
d. acidic fruits
---Correct---Ans--- B. Some types of contrast media contain iodine as an ingredient. Shellfish
also contain significant amounts of iodine. Therefore, a patient who is allergic to iodine will
exhibit an allergic response to both iodine containing contrast media and shellfish. These
products do not contain iodine.
2. A 13-month-old child recently arrived in the United States from a foreign country with his
parents and needs childhood immunizations. His mother reports that he is allergic to eggs.
Upon further questioning, you determine that the allergy to eggs is anaphylaxis. Which of the
following vaccines should he not receive?
a. Hepatitis B
b. inactivated polio
c. diphtheria, acellular pertussis, tetanus (DTaP)
d. mumps, measles, rubella (MMR)
---Correct---Ans--- D. The measles portion of the MMR vaccine is grown in chick embryo cells.
The current MMR vaccine does not contain a significant amount of egg proteins, and even
children with dramatic egg allergies are extremely unlikely to have an anaphylactic reaction.
However, patients that do respond to egg contact with anaphylaxis should be in a medically
controlled setting where full resuscitation efforts can be administered if anaphylaxis results. The
vaccines in options a,b and c do not contain egg protein.
,3. The cell and Coombs classification system categorizes allergic reactions and is useful in
describing and classifying patient reactions to drugs. Type I reactions are immediate
hypersensitivity reactions and are mediated by:
a. immunoglobulin E (IgE).
b. immunoglobulin G (IgG).
c. immunoglobulin A (IgA).
d. immunoglobulin M (IgM).
---Correct---Ans--- A. IgE, the least common serum immunoglobulin (Ig) binds very tightly to
receptors on basophils and mast cells and is involved in allergic reactions. Binding of the
allergen to the IgE on the cells results in the release of various pharmacological mediators that
result in allergic symptoms. IgG is the major Ig (75 percent of serum Ig is IgG). Most versatile Ig
because it is capable of carrying out all of the functions of Ig molecules. IgG is the only class of
Ig that crosses the placenta. It is an opsonin, a substance that enhances phagocytosis. IgA, the
second most common serum Ig is found in secretions (tears, saliva, colostrum, and mucus). It is
important in local (mucosal) immunity. IgM, the third most common serum Ig, is the first Ig to
be made by the fetus and the first Ig to be made by a virgin B cell when it is stimulated by
antigen. IgM antibodies are very efficient in leading to the lysis of microorganisms.
4. Louie who is to receive a blood transfusion asks the nurse what is the most common type of
infection he could receive from the transfusion. The nurse teaches him that approximately 1 in
250,000 patients contract:
a. Human immunodeficiency disease (HIV).
b. Hepatitis C infection.
c. Hepatitis B infection.
d. West Nile viral disease.
---Correct---Ans--- C. Hepatitis B is the most common infection spread via blood transfusion.
Donors are screened by a questionnaire that includes symptoms. The donated blood is also
tested for infection. The risk of infection with the agents in options 2 and 3 has decreased to
approximately 1 in 2 million secondary to donor questioning and donor blood testing. The
incidence of West Nile viral transmission is unknown, but donor infection is still relatively rare.
, 5. A male patient with blood type AB, Rh factor positive needs a blood transfusion. The
Transfusion Service (blood bank) sends type O, Rh factor negative blood to the unit for the nurse
to infuse into this patient. The nurse knows that:
a. This donor blood is incompatible with the patient's blood.
b. Premedicating the patient with diphenhydramine hydrochloride (Benadryl) and
acetaminophen (Tylenol) will prevent any transfusion reactions or side effects.
c. This is a compatible match.
d. The patient is at minimal risk receiving this product since it is the first time he has been
transfused with type O, Rh negative blood.
---Correct---Ans--- C. Type O, Rh negative blood has none of the major antigens and is safely
administered to patients of all blood types. It is also known as the universal donor.
Premedicating with these agents will not prevent a major transfusion reaction if the blood type
and Rh factors of the donor blood are incompatible with the recipient's blood.
6. Dr. Rodriguez orders 250 milliliters of packed red blood cells (RBC) for a patient. This therapy
is administered for treatment of:
a. Thrombocytopenia.
b. Anemia.
c. Leukopenia.
d. Hypoalbuminemia.
---Correct---Ans--- B. A red blood cell transfusion is used to correct anemia in patients in which
the low red blood cell count must be rapidly corrected. RBC transfusion will not correct a low
platelet count. RBC transfusion will not correct a low white blood cell count. Packed RBCs
contain very little plasma and, thus, only a small amount of albumin. This amount will not
correct low albumin levels.
7. A female patient needs a whole blood transfusion. In order for transfusion services (the blood
bank) to prepare the correct product a sample of the patient's blood must be obtained for:
a. A complete blood count and differential.
b. A blood type and cross-match.
Answers and Explanations for Nursing Exam Preparation
1. The nurse is aware that the patients who are allergic to intravenous contrast media are
usually also allergic to which of the following products?
a. Eggs
b. Shellfish
c. Soy
d. acidic fruits
---Correct---Ans--- B. Some types of contrast media contain iodine as an ingredient. Shellfish
also contain significant amounts of iodine. Therefore, a patient who is allergic to iodine will
exhibit an allergic response to both iodine containing contrast media and shellfish. These
products do not contain iodine.
2. A 13-month-old child recently arrived in the United States from a foreign country with his
parents and needs childhood immunizations. His mother reports that he is allergic to eggs.
Upon further questioning, you determine that the allergy to eggs is anaphylaxis. Which of the
following vaccines should he not receive?
a. Hepatitis B
b. inactivated polio
c. diphtheria, acellular pertussis, tetanus (DTaP)
d. mumps, measles, rubella (MMR)
---Correct---Ans--- D. The measles portion of the MMR vaccine is grown in chick embryo cells.
The current MMR vaccine does not contain a significant amount of egg proteins, and even
children with dramatic egg allergies are extremely unlikely to have an anaphylactic reaction.
However, patients that do respond to egg contact with anaphylaxis should be in a medically
controlled setting where full resuscitation efforts can be administered if anaphylaxis results. The
vaccines in options a,b and c do not contain egg protein.
,3. The cell and Coombs classification system categorizes allergic reactions and is useful in
describing and classifying patient reactions to drugs. Type I reactions are immediate
hypersensitivity reactions and are mediated by:
a. immunoglobulin E (IgE).
b. immunoglobulin G (IgG).
c. immunoglobulin A (IgA).
d. immunoglobulin M (IgM).
---Correct---Ans--- A. IgE, the least common serum immunoglobulin (Ig) binds very tightly to
receptors on basophils and mast cells and is involved in allergic reactions. Binding of the
allergen to the IgE on the cells results in the release of various pharmacological mediators that
result in allergic symptoms. IgG is the major Ig (75 percent of serum Ig is IgG). Most versatile Ig
because it is capable of carrying out all of the functions of Ig molecules. IgG is the only class of
Ig that crosses the placenta. It is an opsonin, a substance that enhances phagocytosis. IgA, the
second most common serum Ig is found in secretions (tears, saliva, colostrum, and mucus). It is
important in local (mucosal) immunity. IgM, the third most common serum Ig, is the first Ig to
be made by the fetus and the first Ig to be made by a virgin B cell when it is stimulated by
antigen. IgM antibodies are very efficient in leading to the lysis of microorganisms.
4. Louie who is to receive a blood transfusion asks the nurse what is the most common type of
infection he could receive from the transfusion. The nurse teaches him that approximately 1 in
250,000 patients contract:
a. Human immunodeficiency disease (HIV).
b. Hepatitis C infection.
c. Hepatitis B infection.
d. West Nile viral disease.
---Correct---Ans--- C. Hepatitis B is the most common infection spread via blood transfusion.
Donors are screened by a questionnaire that includes symptoms. The donated blood is also
tested for infection. The risk of infection with the agents in options 2 and 3 has decreased to
approximately 1 in 2 million secondary to donor questioning and donor blood testing. The
incidence of West Nile viral transmission is unknown, but donor infection is still relatively rare.
, 5. A male patient with blood type AB, Rh factor positive needs a blood transfusion. The
Transfusion Service (blood bank) sends type O, Rh factor negative blood to the unit for the nurse
to infuse into this patient. The nurse knows that:
a. This donor blood is incompatible with the patient's blood.
b. Premedicating the patient with diphenhydramine hydrochloride (Benadryl) and
acetaminophen (Tylenol) will prevent any transfusion reactions or side effects.
c. This is a compatible match.
d. The patient is at minimal risk receiving this product since it is the first time he has been
transfused with type O, Rh negative blood.
---Correct---Ans--- C. Type O, Rh negative blood has none of the major antigens and is safely
administered to patients of all blood types. It is also known as the universal donor.
Premedicating with these agents will not prevent a major transfusion reaction if the blood type
and Rh factors of the donor blood are incompatible with the recipient's blood.
6. Dr. Rodriguez orders 250 milliliters of packed red blood cells (RBC) for a patient. This therapy
is administered for treatment of:
a. Thrombocytopenia.
b. Anemia.
c. Leukopenia.
d. Hypoalbuminemia.
---Correct---Ans--- B. A red blood cell transfusion is used to correct anemia in patients in which
the low red blood cell count must be rapidly corrected. RBC transfusion will not correct a low
platelet count. RBC transfusion will not correct a low white blood cell count. Packed RBCs
contain very little plasma and, thus, only a small amount of albumin. This amount will not
correct low albumin levels.
7. A female patient needs a whole blood transfusion. In order for transfusion services (the blood
bank) to prepare the correct product a sample of the patient's blood must be obtained for:
a. A complete blood count and differential.
b. A blood type and cross-match.
