NCLEX-RN Pharmacology Practice Test
High-alert drugs, IV therapy, blood products and dosage math. Here are 5 NCLEX-RN pharmacology questions, each with the answer and the reason.
Updated by the Tigertest team. Based on the NCSBN 2026 NCLEX-RN Test Plan Client Needs categories. Original questions, not affiliated with NCSBN.
- 1.
A postoperative client receiving IV morphine is difficult to arouse and has a respiratory rate of 7/min. Which medication should the nurse prepare to give?
- A.
Atropine
- B.
Naloxone
- C.
Flumazenil
- D.
Acetylcysteine
Answer: B.Naloxone is the opioid antagonist that reverses opioid-induced respiratory depression. Flumazenil reverses benzodiazepines, not opioids.
- A.
- 2.
Fifteen minutes into a unit of packed red blood cells, a client reports chills and low back pain. Temperature has risen from 98.8 F to 101.2 F (38.4 C). Which action should the nurse take first?
- A.
Slow the transfusion rate
- B.
Notify the blood bank
- C.
Stop the transfusion
- D.
Give the PRN acetaminophen
Answer: C.Chills, fever and back pain early in a transfusion suggest an acute hemolytic reaction, so the transfusion is stopped at once, then the line is kept open with 0.9% saline at a new tubing set. Notifying the blood bank is required, but only after the infusion is stopped.
- A.
- 3.
Total parenteral nutrition is prescribed at 83 mL/hr. At the start of the shift, the nurse finds the bag is 300 mL behind schedule. Which action should the nurse take?
- A.
Keep the rate at 83 mL/hr
- B.
Spread the 300 mL over the shift
- C.
Increase the rate to catch up
- D.
Stop the bag and hang a new one
Answer: A.TPN is never sped up to make up lost volume, because a rapid dextrose load can cause hyperglycemia and fluid overload; the nurse keeps the prescribed rate and reports the shortfall. Spreading the missed volume over the shift is still a catch-up increase.
- A.
- 4.
During an IV vancomycin infusion, a client develops flushing and a red rash on the face, neck, and upper chest. BP is 118/76 mm Hg, and the lungs are clear with no stridor. Which action should the nurse take first?
- A.
Apply cool compresses to rash
- B.
Give epinephrine 0.3 mg IM
- C.
Draw a vancomycin trough level
- D.
Stop the vancomycin infusion
Answer: D.Flushing and an upper-body rash during infusion with stable vital signs is vancomycin infusion reaction, usually from running it too fast; the infusion is stopped, and it is later resumed more slowly, often after an antihistamine. Epinephrine is for anaphylaxis, which this stable client without airway signs does not show.
- A.
- 5.
A client's peripheral IV of 0.9% sodium chloride is running. The site is cool, pale, and swollen. Which action should the nurse take first?
- A.
Apply a warm compress
- B.
Elevate the arm on a pillow
- C.
Flush the line to test it
- D.
Stop the infusion
Answer: D.Cool, pale, swollen tissue signals infiltration, so the infusion is stopped first and the catheter then removed. Elevating the arm and applying a compress come after, and flushing pushes more fluid into the tissue.
- A.
Drill every pharmacology question in the NCLEX-RN Pharmacology drill: questions you miss come back until you have mastered them. Then take a timed practice test with the NCLEX-RN section in it.
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