NCLEX-PN practice test

NCLEX-PN Pharmacological Therapies Practice Test

Expected effects, side effects, PO and IM dosage math and what to report before giving a dose. Here are 8 NCLEX-PN pharmacological therapies questions, each with the answer and the reason.

Updated 2026-11-14 by the Tigertest team. Based on the NCSBN 2026 NCLEX-PN Test Plan Client Needs categories. Original questions, not affiliated with NCSBN.

1. 1.

   A client who is new to insulin asks the PN how to store the vials at home. Which instruction should the PN reinforce?

   • A.

     Keep the vial in use at room temperature for up to 28 days

   • B.

     Freeze the spare vials to keep them fresh until they are needed

   • C.

     Throw away an open vial after 3 days even if insulin is left

   • D.

     Shake the vial hard before each dose to mix the insulin

   Answer: A.

   Unopened vials stay in the refrigerator, and the vial in use can stay at room temperature for up to 28 days, which also makes injections less painful. Freezing or shaking damages insulin, and cloudy insulin is rolled gently, not shaken.

2. 2.

   A client is prescribed doxycycline for a tick bite. Which instruction should the PN reinforce?

   • A.

     Stop the capsules once the bite stops itching

   • B.

     Use sunscreen and limit time in the sun

   • C.

     Lie down right after taking the capsule

   • D.

     Take it at the same time as an iron supplement

   Answer: B.

   Doxycycline makes the skin burn easily, so sun protection is reinforced. The full course is finished even when symptoms fade, iron supplements and antacids bind the drug and block absorption so they are taken at a different time, and lying down after a dose can let the capsule lodge and burn the esophagus.

3. 3.

   Before giving digoxin to an adult client, the PN counts an apical pulse of 54/min for one full minute. Which action should the PN take?

   • A.

     Hold the dose and notify the RN

   • B.

     Give the dose and recheck the pulse in 1 hour

   • C.

     Give half the dose and document the pulse

   • D.

     Give the dose with a full glass of water

   Answer: A.

   Digoxin slows the heart, so a dose is held and reported when the apical pulse is below 60/min in an adult. Giving any part of the dose at this rate risks a dangerous bradycardia, and the PN does not change a prescribed dose.

4. 4.

   A client received regular insulin subcutaneously at 0730 before breakfast. At which time should the PN watch most closely for hypoglycemia?

   • A.

     0745

   • B.

     1000

   • C.

     1600

   • D.

     2200

   Answer: B.

   Regular insulin starts working in about 30 minutes and peaks 2 to 3 hours after the dose, so the highest hypoglycemia risk is mid-morning. 0745 is before the onset, 1600 fits the later peak of an intermediate-acting insulin such as NPH, and by 2200 the effect of a morning dose of regular insulin has worn off.

5. 5.

   A clinic client is starting a 10-day course of an oral antibiotic for a skin infection. Which statement shows the reinforced teaching was effective?

   • A.

     "I'll stop as soon as the redness is gone."

   • B.

     "I'll save any leftover pills for the next time."

   • C.

     "I'll finish the whole prescription."

   • D.

     "I'll take two pills if I miss a dose."

   Answer: C.

   Finishing the full course clears the infection and limits resistant bacteria. Stopping early, saving pills or doubling up all lead to treatment failure or side effects.

6. 6.

   A client is receiving oral oxycodone after surgery. Which finding should the PN report to the RN immediately?

   • A.

     Reports mild constipation

   • B.

     Pupils are small

   • C.

     Drowsy but wakes easily to voice

   • D.

     Respirations 8/min

   Answer: D.

   A respiratory rate of 8/min is opioid-induced respiratory depression and calls for holding the drug, stimulating the client and having naloxone given. Small pupils, mild drowsiness and constipation are expected opioid effects that are managed, not emergencies.

7. 7.

   A client takes phenytoin for a seizure disorder. Which instruction should the PN reinforce?

   • A.

     Brush and floss the teeth carefully every day

   • B.

     Take the medication only on days a seizure occurs

   • C.

     Stop the medication if drowsiness develops

   • D.

     Avoid all dairy products

   Answer: A.

   Phenytoin causes gum overgrowth, so careful daily oral hygiene and regular dental visits are reinforced. It is taken every day to keep a steady blood level, and stopping it suddenly can trigger seizures, so drowsiness is reported to the provider rather than handled by quitting the drug. Dairy products do not need to be avoided.

8. 8.

   A client who takes metformin is scheduled for a CT scan with IV contrast. Which instruction should the PN reinforce?

   • A.

     Take an extra dose the morning of the scan

   • B.

     Hold the metformin as directed around the scan

   • C.

     Take it with the contrast to prevent nausea

   • D.

     Stop the metformin permanently after the scan

   Answer: B.

   Iodinated contrast can reduce kidney function for a few days, and metformin builds up in that setting and can cause lactic acidosis, so the provider directs when to hold it and when to restart after kidney function is checked. It is resumed, not stopped for good, once the kidneys are shown to be fine.