Pharmacology & Dosage Calculations practice test: free NCLEX-RN questions

Sample Practice Questions for Pharmacology & Dosage Calculations

1. Question 1Ref: Physiological Integrity — Pharmacological Therapies

   A client with atrial fibrillation is prescribed warfarin (Coumadin). The nurse is reviewing the medication administration record. Which laboratory value should the nurse monitor most closely?

   AInternational normalized ratio (INR)BPlatelet countCWhite blood cell countDHemoglobin
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   Correct Answer
   A. International normalized ratio (INR)

   Warfarin is an anticoagulant that requires INR monitoring to ensure therapeutic effectiveness and prevent bleeding complications. The target INR for atrial fibrillation is typically 2.0 to 3.0. Hemoglobin and platelet count are not specific to warfarin therapy, and WBC is unrelated to anticoagulation monitoring.

2. Question 2Ref: Physiological Integrity — Pharmacological Therapies

   A client with heart failure is prescribed digoxin. The nurse notes a heart rate of 58 beats per minute. What is the priority nursing action?

   AHold the medication and contact the providerBRequest an alternative medication from the providerCAdminister the digoxin as orderedDAdminister the digoxin and monitor for toxicity
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   Correct Answer
   A. Hold the medication and contact the provider

   The keyed answer is "Hold the medication and contact the provider". Digoxin should be held if the heart rate is below 60 bpm because the drug slows the heart rate further. Administering it could cause dangerous bradycardia. The nurse must hold the dose and notify the provider for further instructions.

3. Question 3Ref: Physiological Integrity — Pharmacological Therapies

   A client is prescribed metformin for type 2 diabetes. The nurse should monitor which laboratory value most closely?

   ASerum creatinineBSerum potassiumCThyroid-stimulating hormoneDHbA1c
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   Correct Answer
   A. Serum creatinine

   The keyed answer is "Serum creatinine". Metformin is contraindicated in clients with renal impairment because it can cause lactic acidosis. Serum creatinine should be monitored regularly to assess kidney function. HbA1c is monitored for diabetes control but not for metformin safety.

4. Question 4Ref: Physiological Integrity — Pharmacological Therapies

   A client is prescribed lisinopril for hypertension. Which adverse effect should the nurse teach the client to report immediately?

   AIncreased sensitivity to sunlightBDry coughCSwelling of the lips or tongueDDizziness when standing
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   Correct Answer
   C. Swelling of the lips or tongue

   The keyed answer is "Swelling of the lips or tongue". Swelling of the lips or tongue indicates angioedema, a potentially life-threatening allergic reaction to ACE inhibitors that requires immediate medical attention. A dry cough is common but not dangerous. Dizziness may require dose adjustment but is not emergent.