RN Pharmacology Proctored B Test

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Sample questions from RN Pharmacology Proctored B Test

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In the neonatal unit, a 3-day-old newborn weighing 2.4 kg is prescribed an oral medication at 5 mg/kg/day divided every 12 hours. The available solution contains 2 mg/mL. How many milliliters should the nurse administer per dose?

   • A.3 mL
   • B.1.5 mL
   • C.12 mL
   • D.6 mL

   Rationale: The total daily dose is 2.4 kg x 5 mg/kg/day = 12 mg/day, so each of two doses is 6 mg. At 2 mg/mL, 6 mg requires 3 mL, not 1.5 mL; therefore, the correct answer is 3 mL.

2. 2.A client states, "I feel fine, so I stopped taking my sustained-release antiseizure medication twice a day and take both tablets at bedtime." Which response is the nurse's best action?

   • A.Instruct the client to resume the prescribed schedule and not double doses to compensate.
   • B.Recommend crushing the tablets so the medication is absorbed more quickly.
   • C.Tell the client to take an extra dose the next morning if a seizure occurs overnight.
   • D.Explain that taking both tablets at bedtime maintains the prescribed daily dose.

   Rationale: Sustained-release formulations are designed to release medication over time, and taking doses together can produce excessive peak concentrations and adverse effects. The client should return to the prescribed schedule and seek prescriber guidance about missed doses rather than doubling up. Crushing a sustained-release tablet can disrupt its release mechanism, and taking an extra dose after a seizure is not a safe substitute for following the schedule.

3. 3.Refer to the client's chart. Which actions should the nurse take before administering the next dose of gentamicin? Select all that apply.

   • A.Review urine output and renal function before any further doses.
   • B.Increase the infusion rate so the medication reaches its peak more quickly.
   • C.Verify that the trough specimen was collected immediately before the scheduled dose.
   • D.Hold the dose and contact the prescriber about the rising creatinine and elevated trough.
   • E.Administer the dose as scheduled because the temperature is improving.
   • F.Ask the client about new tinnitus, hearing changes, or dizziness.

   Rationale: The creatinine has risen from 0.7 to 1.4 mg/dL and the trough of 2.8 mcg/mL is above the stated reference range, so the nurse should hold the dose and promptly clarify the regimen. Confirming that the trough was drawn immediately before the dose helps determine whether the result is interpretable, and reviewing urine output and renal function helps assess drug clearance. Asking about tinnitus, hearing changes, and dizziness screens for aminoglycoside ototoxicity; an improving temperature does not make an elevated trough safe, and increasing the infusion rate does not correct accumulation and may increase harm.

4. 4.At change of shift, the nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client using a transdermal nicotine patch who reports mild skin itching under the patch
   • B.A client taking an oral antibiotic who reports a metallic taste
   • C.A client taking lithium who reports new coarse hand tremors, nausea, and difficulty walking
   • D.A client taking levothyroxine who reports mild fatigue after missing one dose

   Answer and rationale are in the full material.

5. 5.A client with atrial fibrillation has taken warfarin for 6 days. The INR is 5.6, and the client reports bleeding gums when brushing but has no other visible bleeding. Which action should the nurse take first?

   • A.Give the client a high-vitamin-K meal and repeat the INR in one week.
   • B.Administer the scheduled warfarin because the client has atrial fibrillation.
   • C.Encourage vigorous brushing to remove blood from the gums.
   • D.Hold the warfarin and notify the prescriber of the INR and bleeding.

   Answer and rationale are in the full material.