RN Pharmacology 2026

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Sample questions from RN Pharmacology 2026

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

1. 1.A 68-year-old client in the emergency department is receiving an IV heparin infusion for a pulmonary embolism. The aPTT is 118 seconds, and the client has new bleeding from the gums. Which action should the nurse take first?

   • A.Stop the heparin infusion and notify the provider
   • B.Decrease the infusion rate by 10% and recheck the aPTT in 6 hours
   • C.Administer the next scheduled dose of warfarin
   • D.Apply firm pressure to the gums and continue the infusion

   Rationale: The elevated aPTT and active bleeding indicate excessive anticoagulation, so stop the infusion and promptly notify the provider. Merely reducing the rate delays action despite active bleeding. Warfarin does not rapidly reverse heparin, and pressure alone does not address the cause while the infusion continues.

2. 2.A 74-year-old client on a medical unit takes digoxin and furosemide for heart failure. The client reports nausea and seeing yellow halos; the apical pulse is 52/min and potassium is 2.9 mEq/L. What should the nurse do?

   • A.Hold digoxin and notify the provider
   • B.Give digoxin with food to reduce nausea
   • C.Administer the scheduled furosemide and recheck potassium tomorrow
   • D.Encourage the client to walk to improve the heart rate

   Rationale: Bradycardia, visual changes, nausea, and hypokalemia suggest digoxin toxicity, so hold the dose and notify the provider. Food will not correct toxicity, and giving more furosemide may worsen potassium loss. Ambulation is unsafe with bradycardia and possible dysrhythmia.

3. 3.A 58-year-old client with type 1 diabetes is admitted to the hospital with glucose 286 mg/dL and potassium 4.2 mEq/L. The client is prescribed insulin glargine and insulin lispro. Which action is appropriate?

   • A.Administer glargine at the scheduled time and lispro with the meal
   • B.Mix glargine and lispro in the same syringe to reduce injections
   • C.Hold glargine if the client does not eat breakfast
   • D.Give lispro 2 hours before the meal

   Rationale: Glargine provides basal insulin and is generally continued at its scheduled time, while lispro is timed with food. Glargine should not be mixed with other insulin. Holding basal insulin in type 1 diabetes risks ketosis, and lispro given 2 hours before a meal may cause hypoglycemia.

4. 4.A 62-year-old client on a medical unit has an order for metformin and is scheduled for a contrast-enhanced CT scan. The eGFR is 38 mL/min/1.73 m2. Which action should the nurse take?

   • A.Hold metformin according to protocol and clarify when it should be restarted
   • B.Give metformin with a full glass of water before the scan
   • C.Double the metformin dose after the scan to prevent hyperglycemia
   • D.Substitute an extra dose of insulin without a prescription

   Answer and rationale are in the full material.

5. 5.A 45-year-old client with asthma arrives at urgent care with audible wheezing, respiratory rate 30/min, and oxygen saturation 90% on room air. Which medication should the nurse administer first from the prescribed regimen?

   • A.Albuterol by inhalation
   • B.Salmeterol by inhalation
   • C.Montelukast orally
   • D.Fluticasone by inhalation

   Answer and rationale are in the full material.