Free Pharmacology Practice Questions

Safe medication administration, dosage calculations, drug interactions, and patient teaching — heavily weighted on every nursing licensure exam.

Question 1

A client on warfarin therapy has an INR of 5.2. Which action should the nurse take FIRST?

AAdminister the scheduled warfarin dose.
BHold the next dose and notify the provider.
CGive vitamin K 10 mg IV push.
DAdminister fresh frozen plasma.

Correct answer: B. Hold the next dose and notify the provider.

The therapeutic INR range for most indications is 2.0–3.0 (up to 3.5 for mechanical valves). An INR of 5.2 indicates over-anticoagulation and bleeding risk. The first nursing action is to hold the dose and notify the provider, who will determine whether vitamin K or FFP is needed based on bleeding status.

Key concept: Therapeutic INR is 2.0–3.0. An INR > 5 without bleeding = hold dose and call provider.

Question 2

A nurse administers regular insulin at 0700. The nurse should monitor the client most closely for hypoglycemia at:

A0730–0800.
B0900–1100.
C1300–1500.
D1700–1900.

Correct answer: B. 0900–1100.

Regular insulin onset is 30 minutes, peaks at 2–4 hours, and lasts 6–8 hours. Hypoglycemia is most likely at the peak — 2 to 4 hours after a 0700 dose, which is 0900–1100.

Key concept: Regular insulin peaks at 2–4 h. NPH peaks at 4–12 h. Rapid (lispro/aspart) peaks at 1 h.

Question 3

Before administering digoxin to an adult client, the nurse should:

ACheck blood pressure and hold if systolic < 100 mm Hg.
BMeasure the apical pulse for 60 seconds and hold if < 60 bpm.
CCheck the most recent potassium and hold if > 5.0.
DAuscultate lung sounds for crackles.

Correct answer: B. Measure the apical pulse for 60 seconds and hold if < 60 bpm.

Digoxin should be held in adults if the apical heart rate is < 60 bpm (children < 90–110 depending on age). Always assess for signs of toxicity: nausea, vomiting, visual changes (yellow halos), and arrhythmias. Hypokalemia potentiates toxicity, so check the potassium too — but the bedside action is the apical pulse.

Key concept: Digoxin: hold for HR < 60 in adults. Watch for toxicity, especially with hypokalemia.

Question 4

Which action by the nurse demonstrates safe practice of the "rights" of medication administration?

AAsking the client their name and verifying with one identifier.
BChecking the medication against the MAR three times before administration.
CAdministering the medication first and documenting at the end of the shift.
DBorrowing a dose from another client when pharmacy is closed.

Correct answer: B. Checking the medication against the MAR three times before administration.

Best practice is to verify the medication against the MAR three times: when retrieving from storage, when preparing, and at the bedside. Two patient identifiers are required (not one). Documentation must be done immediately after administration, and never borrow medications between clients.

Key concept: Three checks, two identifiers, document immediately, never borrow.

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