NCLEX Pharmacological and Parenteral Therapies Questions Answers

NCLEX Pharmacological and Parenteral Therapies Questions Answers with [Rationale]. Free practice tests for the NCLEX-RN and NCLEX-PN exams. You can download the Pharmacological and Parenteral Therapies test in PDF format.

Physiological Integrity – Pharmacological and Parenteral Therapies

Questions compose 12 to 18 percent of the exam. Content mainly addresses administering medications and pharmacological interventions. Questions may include calculations. You may encounter specific questions about pharmacological pain management, side effects and contraindications of medications, blood and blood products, parenteral/intravenous therapies, and total parenteral nutrition.

NCLEX Pharmacological and Parenteral Therapies Questions

Q1. A nurse is preparing to administer a scheduled dose of digoxin to a client with heart failure. The nurse notes the client’s apical pulse is 55 beats per minute. What is the nurse’s best action?

  • (A) Administer the medication as scheduled
  • (B) Double the dose to compensate for the slow heart rate
  • (C) Hold the medication and notify the healthcare provider
  • (D) Administer a beta-blocker with the digoxin
View Answer
Answer: (C)
Rationale: Digoxin can cause bradycardia. If the apical pulse is below 60 beats per minute, the medication should be held, and the healthcare provider should be notified.

Q2. A client is receiving morphine for severe pain. Which assessment finding requires immediate intervention?

  • (A) Respiratory rate of 8 breaths per minute
  • (B) Heart rate of 90 beats per minute
  • (C) Blood pressure of 110/70 mmHg
  • (D) Temperature of 37°C (98.6°F)
View Answer
Answer: (A)
Rationale: Morphine can cause respiratory depression. A respiratory rate of 8 breaths per minute is dangerously low and requires immediate intervention.

Q3. A nurse is administering intravenous vancomycin. Which action is most important to prevent complications?

  • (A) Administering the infusion rapidly to minimize discomfort
  • (B) Monitoring the infusion site for signs of phlebitis
  • (C) Administering the medication without dilution
  • (D) Discontinuing the infusion if the client experiences any pain
View Answer
Answer: (B)
Rationale: Monitoring the infusion site for signs of phlebitis is important because vancomycin can cause irritation and tissue damage if extravasation occurs.

Q4. A client is prescribed warfarin for anticoagulation. Which dietary instruction should the nurse include?

  • (A) Increase intake of green leafy vegetables
  • (B) Avoid foods high in vitamin K
  • (C) Consume a diet high in potassium
  • (D) Limit intake of protein-rich foods
View Answer
Answer: (B)
Rationale: Vitamin K can decrease the effectiveness of warfarin. Clients should avoid foods high in vitamin K or maintain a consistent intake to avoid fluctuations in INR levels.

Q5. A nurse is preparing to administer a unit of packed red blood cells. Which action is most important before starting the transfusion?

  • (A) Warming the blood to body temperature
  • (B) Verifying the blood type and Rh factor with another nurse
  • (C) Administering a diuretic to prevent fluid overload
  • (D) Infusing the blood rapidly to minimize discomfort
View Answer
Answer: (B)
Rationale: Verifying the blood type and Rh factor with another nurse is crucial to prevent a potentially life-threatening transfusion reaction.

Q6. A client is receiving total parenteral nutrition (TPN). Which laboratory value should the nurse monitor closely?

  • (A) Hemoglobin
  • (B) Blood glucose
  • (C) Platelet count
  • (D) White blood cell count
View Answer
Answer: (B)
Rationale: TPN solutions contain high concentrations of glucose, so it is important to monitor blood glucose levels closely to detect hyperglycemia.

Q7. A nurse is teaching a client about the side effects of furosemide. Which side effect should the client report immediately?

  • (A) Increased urine output
  • (B) Weight loss
  • (C) Muscle weakness
  • (D) Mild headache
View Answer
Answer: (C)
Rationale: Muscle weakness may indicate hypokalemia, a potential side effect of furosemide that requires prompt intervention.

Q8. A client with chronic pain is prescribed a fentanyl transdermal patch. What instruction should the nurse provide?

  • (A) Apply the patch to the same site each time
  • (B) Avoid exposing the patch to heat sources
  • (C) Change the patch every 24 hours
  • (D) Cut the patch to adjust the dose if needed
View Answer
Answer: (B)
Rationale: Heat can increase the absorption of fentanyl, leading to a potential overdose. Clients should avoid exposing the patch to heat sources.

Q9. A nurse is preparing to administer heparin subcutaneously. Which site is most appropriate for the injection?

  • (A) Deltoid muscle
  • (B) Anterior thigh
  • (C) Abdomen
  • (D) Gluteal muscle
View Answer
Answer: (C)
Rationale: The abdomen is the preferred site for subcutaneous heparin injections due to better absorption and fewer complications.

Q10. A nurse is calculating the dosage for a medication. The order is for 250 mg, and the available concentration is 500 mg/2 mL. How many mL should the nurse administer?

  • (A) 0.5 mL
  • (B) 1 mL
  • (C) 1.5 mL
  • (D) 2 mL
View Answer
Answer: (B)
Rationale: The calculation is (250 mg / 500 mg) x 2 mL = 1 mL.

Q11. A client is prescribed lithium for bipolar disorder. Which dietary recommendation is important to prevent lithium toxicity?

  • (A) Increase sodium intake
  • (B) Limit fluid intake
  • (C) Maintain consistent sodium intake
  • (D) Avoid foods high in potassium
View Answer
Answer: (C)
Rationale: Maintaining consistent sodium intake is important because fluctuations in sodium levels can affect lithium excretion and increase the risk of toxicity.

Q12. A nurse is administering an intramuscular injection. Which technique is most appropriate to reduce discomfort?

  • (A) Using a large-gauge needle
  • (B) Injecting the medication slowly
  • (C) Massaging the injection site immediately after
  • (D) Inserting the needle at a 45-degree angle
View Answer
Answer: (B)
Rationale: Injecting the medication slowly can reduce discomfort and minimize tissue damage.

Q13. A client is receiving methotrexate for rheumatoid arthritis. Which adverse effect should the nurse monitor for?

  • (A) Hypotension
  • (B) Nephrotoxicity
  • (C) Bone marrow suppression
  • (D) Hyperglycemia
View Answer
Answer: (C)
Rationale: Methotrexate can cause bone marrow suppression, leading to anemia, leukopenia, and thrombocytopenia.

Q14. A nurse is preparing to administer a medication via a peripheral intravenous (IV) line. Which action is most important to ensure safe administration?

  • (A) Checking the IV site for signs of infiltration or phlebitis
  • (B) Administering the medication rapidly to ensure effectiveness
  • (C) Using the smallest gauge needle possible
  • (D) Elevating the client’s arm above heart level during administration
View Answer
Answer: (A)
Rationale: Checking the IV site for signs of infiltration or phlebitis ensures the medication is administered safely and prevents complications.

Q15. A nurse is administering total parenteral nutrition (TPN) through a central line. Which complication should the nurse monitor for?

  • (A) Hyperkalemia
  • (B) Hypoglycemia
  • (C) Infection
  • (D) Hypercalcemia
View Answer
Answer: (C)
Rationale: Infection is a common complication associated with central lines due to the risk of introducing pathogens during insertion and maintenance.

Q16. A client is receiving enoxaparin (Lovenox) for deep vein thrombosis prophylaxis. Which instruction should the nurse provide?

  • (A) “Administer the injection into the muscle.”
  • (B) “Rotate injection sites between the abdomen and thigh.”
  • (C) “Massage the injection site after administration.”
  • (D) “Avoid injecting into the same site within 24 hours.”
View Answer
Answer: (D)
Rationale: Avoiding injection into the same site within 24 hours helps prevent tissue damage and irritation.

Q17. A nurse is administering an IV bolus of a high-alert medication. What is the most important step to prevent medication errors?

  • (A) Double-checking the medication with another nurse
  • (B) Administering the medication over 5 minutes
  • (C) Using a smaller gauge needle
  • (D) Flushing the IV line before and after administration
View Answer
Answer: (A)
Rationale: Double-checking the medication with another nurse ensures the correct medication and dose are administered, preventing errors.

Q18. A client with chronic kidney disease is prescribed epoetin alfa. What is the primary purpose of this medication?

  • (A) To lower blood pressure
  • (B) To increase red blood cell production
  • (C) To reduce proteinuria
  • (D) To manage hyperkalemia
View Answer
Answer: (B)
Rationale: Epoetin alfa stimulates red blood cell production, which is often needed in clients with chronic kidney disease due to anemia.

Q19. A nurse is administering a potassium chloride infusion. Which precaution is most important?

  • (A) Diluting the potassium chloride in 100 mL of fluid
  • (B) Administering the infusion through a central line
  • (C) Monitoring the client’s cardiac rhythm
  • (D) Infusing the potassium chloride rapidly
View Answer
Answer: (C)
Rationale: Monitoring the client’s cardiac rhythm is crucial because potassium chloride can cause cardiac arrhythmias if administered too rapidly or in excessive doses.

Q20. A nurse is providing education to a client prescribed a new antihypertensive medication. Which side effect should the client report immediately?

  • (A) Dizziness when standing up
  • (B) Mild headache
  • (C) Persistent cough
  • (D) Swelling of the face and lips
View Answer
Answer: (D)
Rationale: Swelling of the face and lips may indicate angioedema, a serious and potentially life-threatening side effect that requires immediate medical attention.

Q21. A client is receiving continuous IV infusion of heparin. Which laboratory test is most important to monitor?

  • (A) International normalized ratio (INR)
  • (B) Complete blood count (CBC)
  • (C) Activated partial thromboplastin time (aPTT)
  • (D) Prothrombin time (PT)
View Answer
Answer: (C)
Rationale: Activated partial thromboplastin time (aPTT) is the most important laboratory test to monitor for clients receiving continuous IV heparin to maintain therapeutic levels and adjust dosage as needed.

Q22. A nurse is administering a medication that requires reconstitution. Which step should the nurse take first?

  • (A) Drawing up the diluent into the syringe
  • (B) Adding the diluent to the powder
  • (C) Rolling the vial to mix the medication
  • (D) Checking the expiration date on the vial
View Answer
Answer: (D)
Rationale: Checking the expiration date on the vial ensures the medication is safe and effective for use before reconstitution.

Q23. A client is prescribed an oral corticosteroid for asthma. Which instruction should the nurse include to prevent a common side effect?

  • (A) “Take the medication on an empty stomach.”
  • (B) “Avoid taking the medication with dairy products.”
  • (C) “Rinse your mouth after each dose.”
  • (D) “Limit fluid intake while on this medication.”
View Answer
Answer: (C)
Rationale: Rinsing the mouth after each dose of oral corticosteroids helps prevent oral thrush, a common side effect.

Q24. A nurse is administering a nitroglycerin patch to a client. Which instruction is most appropriate?

  • (A) “Apply the patch to the same site each day.”
  • (B) “Remove the patch at night to prevent tolerance.”
  • (C) “Cover the patch with a heating pad for better absorption.”
  • (D) “Apply the patch directly over the heart.”
View Answer
Answer: (B)
Rationale: Removing the patch at night helps prevent tolerance to the medication, ensuring it remains effective.

Q25. A nurse is administering insulin to a client with diabetes mellitus. Which injection site is most appropriate for rapid absorption?

  • (A) Abdomen
  • (B) Deltoid muscle
  • (C) Thigh
  • (D) Gluteal muscle
View Answer
Answer: (A)
Rationale: The abdomen is the most appropriate injection site for rapid absorption of insulin.

See also:

Safe and Effective Care Environment

Health Promotion and Maintenance

Psychosocial Integrity