Prophecy Relias Pharmacology
RN A Latest 2026 Actual Exam
Questions and Correct Detailed
Answers with Rationales |
Graded A+
1. A patient is prescribed Lisinopril. The nurse should prioritize assessing for which potential
side effect immediately after the first dose?
A. Hyperkalemia
B. Dry, persistent cough
C. Hypotension ✓
D. Peripheral edema
Rationale: While hyperkalemia and cough are side effects of ACE inhibitors like Lisinopril, the
most immediate risk after the first dose is "first-dose hypotension," which can cause dizziness
and syncope. The nurse should monitor the patient's blood pressure closely.
2. When teaching a patient about Warfarin (Coumadin), the nurse should instruct them to
avoid which over-the-counter medication due to the increased risk of bleeding?
A. Acetaminophen (Tylenol)
B. Ibuprofen (Advil) ✓
C. Diphenhydramine (Benadryl)
D. Docusate Sodium (Colace)
Rationale: Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can inhibit platelet
function and irritate the gastric mucosa, significantly increasing the risk of bleeding when taken
with an anticoagulant like Warfarin.
3. A patient receiving Furosemide (Lasix) complains of weakness and muscle cramping. The
nurse should suspect which electrolyte imbalance?
A. Hypernatremia
,B. Hypokalemia ✓
C. Hypercalcemia
D. Hypomagnesemia
Rationale: Furosemide is a loop diuretic that causes the loss of potassium (K+) in the urine.
Weakness and muscle cramps are classic signs of hypokalemia.
4. Which medication requires frequent monitoring of the patient's apical pulse, especially if
the rate is less than 60 bpm?
A. Levothyroxine (Synthroid)
B. Digoxin (Lanoxin) ✓
C. Metoprolol (Lopressor)
D. Atorvastatin (Lipitor)
Rationale: Digoxin is used for heart failure and atrial fibrillation. Bradycardia (heart rate <60
bpm) is a sign of digoxin toxicity and must be assessed before administration.
5. The nurse is caring for a patient on Insulin Glargine (Lantus). Which statement by the
patient indicates a correct understanding of this medication?
A. "I will take this insulin 15 minutes before each meal."
B. "This is a clear insulin that I take once a day, at the same time every day." ✓
C. "I need to shake the vial vigorously before drawing it up."
D. "This insulin has a peak effect in 2-4 hours."
Rationale: Insulin Glargine is a long-acting, clear insulin that is peakless and provides a basal
level of insulin for about 24 hours. It is given once daily at a consistent time and should not be
shaken, as this can alter its absorption profile.
6. A patient is started on Clopidogrel (Plavix). The nurse understands this medication works
by:
A. Inhibiting vitamin K-dependent clotting factors.
B. Preventing the conversion of fibrinogen to fibrin.
C. Inhibiting platelet aggregation. ✓
D. Dissolving existing clots.
Rationale: Clopidogrel is an antiplatelet agent that works by inhibiting the P2Y12 ADP receptor
on platelets, preventing them from aggregating and forming a thrombus.
7. Which laboratory value is most critical to monitor for a patient receiving Heparin?
A. Prothrombin Time (PT)
B. Activated Partial Thromboplastin Time (aPTT) ✓
C. International Normalized Ratio (INR)
D. Platelet count
, Rationale: The aPTT is the standard test used to monitor the therapeutic effect of
unfractionated heparin. INR is used for Warfarin.
8. A patient taking Metformin (Glucophage) is scheduled for a cardiac catheterization with
contrast dye. The most appropriate action by the nurse is to:
A. Admin the Metformin as scheduled with a small sip of water.
B. Hold the Metformin the day of and after the procedure as ordered. ✓
C. Double the Metformin dose the night before to ensure glycemic control.
D. Encourage a high-carbohydrate meal before taking the Metformin.
Rationale: Metformin must be held before and after procedures involving iodinated contrast
dye due to the high risk of contrast-induced nephropathy and subsequent lactic acidosis, a rare
but serious complication of Metformin.
9. The nurse administers a stat dose of Albuterol via nebulizer for acute asthma. What is the
expected therapeutic outcome?
A. Reduced inflammation in the airways.
B. Bronchodilation. ✓
C. Decreased respiratory secretions.
D. Suppression of the cough reflex.
Rationale: Albuterol is a short-acting beta-agonist (SABA). Its primary therapeutic effect is rapid
bronchodilation by relaxing the smooth muscles in the airways.
10. A patient with Parkinson's disease is taking Carbidopa/Levodopa. The nurse should teach
the patient to avoid taking the medication with:
A. A full glass of water.
B. A low-protein snack.
C. A high-protein meal. ✓
D. An antacid.
Rationale: High-protein meals can compete with the absorption of Levodopa in the small
intestine, significantly reducing its effectiveness and leading to "on-off" phenomena.
11. Which medication is an antidote for Heparin overdose?
A. Vitamin K
B. Protamine Sulfate ✓
C. Naloxone (Narcan)
D. Flumazenil (Romazicon)
Rationale: Protamine Sulfate is a specific antidote that binds to and neutralizes Heparin.
Vitamin K is the antidote for Warfarin.
RN A Latest 2026 Actual Exam
Questions and Correct Detailed
Answers with Rationales |
Graded A+
1. A patient is prescribed Lisinopril. The nurse should prioritize assessing for which potential
side effect immediately after the first dose?
A. Hyperkalemia
B. Dry, persistent cough
C. Hypotension ✓
D. Peripheral edema
Rationale: While hyperkalemia and cough are side effects of ACE inhibitors like Lisinopril, the
most immediate risk after the first dose is "first-dose hypotension," which can cause dizziness
and syncope. The nurse should monitor the patient's blood pressure closely.
2. When teaching a patient about Warfarin (Coumadin), the nurse should instruct them to
avoid which over-the-counter medication due to the increased risk of bleeding?
A. Acetaminophen (Tylenol)
B. Ibuprofen (Advil) ✓
C. Diphenhydramine (Benadryl)
D. Docusate Sodium (Colace)
Rationale: Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can inhibit platelet
function and irritate the gastric mucosa, significantly increasing the risk of bleeding when taken
with an anticoagulant like Warfarin.
3. A patient receiving Furosemide (Lasix) complains of weakness and muscle cramping. The
nurse should suspect which electrolyte imbalance?
A. Hypernatremia
,B. Hypokalemia ✓
C. Hypercalcemia
D. Hypomagnesemia
Rationale: Furosemide is a loop diuretic that causes the loss of potassium (K+) in the urine.
Weakness and muscle cramps are classic signs of hypokalemia.
4. Which medication requires frequent monitoring of the patient's apical pulse, especially if
the rate is less than 60 bpm?
A. Levothyroxine (Synthroid)
B. Digoxin (Lanoxin) ✓
C. Metoprolol (Lopressor)
D. Atorvastatin (Lipitor)
Rationale: Digoxin is used for heart failure and atrial fibrillation. Bradycardia (heart rate <60
bpm) is a sign of digoxin toxicity and must be assessed before administration.
5. The nurse is caring for a patient on Insulin Glargine (Lantus). Which statement by the
patient indicates a correct understanding of this medication?
A. "I will take this insulin 15 minutes before each meal."
B. "This is a clear insulin that I take once a day, at the same time every day." ✓
C. "I need to shake the vial vigorously before drawing it up."
D. "This insulin has a peak effect in 2-4 hours."
Rationale: Insulin Glargine is a long-acting, clear insulin that is peakless and provides a basal
level of insulin for about 24 hours. It is given once daily at a consistent time and should not be
shaken, as this can alter its absorption profile.
6. A patient is started on Clopidogrel (Plavix). The nurse understands this medication works
by:
A. Inhibiting vitamin K-dependent clotting factors.
B. Preventing the conversion of fibrinogen to fibrin.
C. Inhibiting platelet aggregation. ✓
D. Dissolving existing clots.
Rationale: Clopidogrel is an antiplatelet agent that works by inhibiting the P2Y12 ADP receptor
on platelets, preventing them from aggregating and forming a thrombus.
7. Which laboratory value is most critical to monitor for a patient receiving Heparin?
A. Prothrombin Time (PT)
B. Activated Partial Thromboplastin Time (aPTT) ✓
C. International Normalized Ratio (INR)
D. Platelet count
, Rationale: The aPTT is the standard test used to monitor the therapeutic effect of
unfractionated heparin. INR is used for Warfarin.
8. A patient taking Metformin (Glucophage) is scheduled for a cardiac catheterization with
contrast dye. The most appropriate action by the nurse is to:
A. Admin the Metformin as scheduled with a small sip of water.
B. Hold the Metformin the day of and after the procedure as ordered. ✓
C. Double the Metformin dose the night before to ensure glycemic control.
D. Encourage a high-carbohydrate meal before taking the Metformin.
Rationale: Metformin must be held before and after procedures involving iodinated contrast
dye due to the high risk of contrast-induced nephropathy and subsequent lactic acidosis, a rare
but serious complication of Metformin.
9. The nurse administers a stat dose of Albuterol via nebulizer for acute asthma. What is the
expected therapeutic outcome?
A. Reduced inflammation in the airways.
B. Bronchodilation. ✓
C. Decreased respiratory secretions.
D. Suppression of the cough reflex.
Rationale: Albuterol is a short-acting beta-agonist (SABA). Its primary therapeutic effect is rapid
bronchodilation by relaxing the smooth muscles in the airways.
10. A patient with Parkinson's disease is taking Carbidopa/Levodopa. The nurse should teach
the patient to avoid taking the medication with:
A. A full glass of water.
B. A low-protein snack.
C. A high-protein meal. ✓
D. An antacid.
Rationale: High-protein meals can compete with the absorption of Levodopa in the small
intestine, significantly reducing its effectiveness and leading to "on-off" phenomena.
11. Which medication is an antidote for Heparin overdose?
A. Vitamin K
B. Protamine Sulfate ✓
C. Naloxone (Narcan)
D. Flumazenil (Romazicon)
Rationale: Protamine Sulfate is a specific antidote that binds to and neutralizes Heparin.
Vitamin K is the antidote for Warfarin.
