🩺 NCLEX Pharmacology Questions [100 MCQs + Rationales]
Prepare for your NCLEX-RN Pharmacology section with 100 expertly designed multiple-choice questions, detailed rationales, and quick recall tips.
These questions are based on the latest NCLEX blueprint and cover essential drug classes, side effects, safe administration practices, and nursing interventions — perfect for students in the USA, Canada, Australia, and beyond.
🧠 Why Practice Pharmacology MCQs?
Pharmacology is one of the most challenging parts of the NCLEX exam. Success comes from understanding how and why medications work — not just memorizing drug names.
By solving realistic NCLEX-style questions with explanations, you’ll build strong clinical judgment and safety-focused thinking, exactly what examiners look for.
💊 NCLEX Pharmacology Questions [Set of 100 with Answers & Rationales]
Q1.
A nurse administers Lisinopril to a hypertensive patient. Which adverse effect requires immediate reporting?
A. Headache
B. Dry cough
C. Facial swelling
D. Fatigue
✅ Answer: C. Facial swelling
Rationale: Angioedema is a rare but serious adverse reaction of ACE inhibitors and requires discontinuation of the drug.
Q2.
Warfarin is prescribed to a client with atrial fibrillation. Which food should the nurse teach the patient to limit?
A. Bananas
B. Spinach
C. Apples
D. Grapes
✅ Answer: B. Spinach
Rationale: Foods rich in Vitamin K (like leafy greens) reduce Warfarin effectiveness by promoting clotting factor synthesis.
Q3.
Which medication requires the nurse to check the apical pulse before administration?
A. Furosemide
B. Digoxin
C. Captopril
D. Hydralazine
✅ Answer: B. Digoxin
Rationale: Digoxin slows cardiac conduction; pulse must be above 60 bpm before administration to avoid bradycardia.
Q4.
A nurse instructs a diabetic patient about Insulin Glargine. Which statement shows understanding?
A. “I should mix it with regular insulin.”
B. “It has a long duration and no peak.”
C. “It acts within 10 minutes.”
D. “I’ll take it before every meal.”
✅ Answer: B.
Rationale: Glargine (Lantus) is a long-acting insulin with no pronounced peak and is never mixed with other insulins.
Q5.
The nurse knows Nitroglycerin tablets should be stored:
A. In a glass container away from light
B. In the refrigerator
C. In a plastic bag
D. With food supplements
✅ Answer: A.
Rationale: Nitroglycerin is sensitive to light, heat, and moisture; it should be stored in its original dark container.
Q6.
A client on Furosemide develops muscle cramps. What is the likely cause?
A. Hypernatremia
B. Hypokalemia
C. Hyperkalemia
D. Hyponatremia
✅ Answer: B.
Rationale: Furosemide (a loop diuretic) increases potassium loss, leading to muscle weakness or cramps.
Q7.
Which lab result indicates toxicity for a patient taking Lithium?
A. 0.6 mEq/L
B. 1.0 mEq/L
C. 1.8 mEq/L
D. 1.2 mEq/L
✅ Answer: C.
Rationale: Lithium toxicity occurs at levels above 1.5 mEq/L. Signs include tremor, confusion, and nausea.
Q8.
A nurse should hold Metoprolol if:
A. Blood pressure is 130/80 mmHg
B. Heart rate is 52 bpm
C. Temperature is 99°F
D. Respiratory rate is 18
✅ Answer: B.
Rationale: Beta-blockers slow heart rate; if HR < 60 bpm, medication should be held and provider notified.
Q9.
A nurse explains to a patient that Albuterol works by:
A. Reducing inflammation
B. Blocking histamine
C. Relaxing bronchial smooth muscles
D. Increasing mucus secretion
✅ Answer: C.
Rationale: Albuterol is a short-acting beta-2 agonist that dilates bronchi by relaxing airway muscles.
Q10.
A client receiving Heparin develops bleeding gums. What should the nurse do first?
A. Stop the infusion
B. Administer Vitamin K
C. Call the dietitian
D. Apply ice
✅ Answer: A.
Rationale: Heparin-induced bleeding requires immediate discontinuation; protamine sulfate may be used as antidote.
Q11.
A patient on Prednisone should be advised about which side effect?
A. Weight loss
B. Hypoglycemia
C. Fluid retention
D. Hypotension
✅ Answer: C.
Rationale: Corticosteroids cause sodium retention and water retention, leading to weight gain and edema.
Q12.
Before giving Vancomycin IV, the nurse should assess for:
A. Hepatic impairment
B. Red man syndrome
C. Bradycardia
D. Constipation
✅ Answer: B.
Rationale: Rapid infusion of Vancomycin can cause flushing and hypotension, known as Red Man Syndrome.
Q13.
Which drug is an antidote for opioid overdose?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Acetylcysteine
✅ Answer: B.
Rationale: Naloxone (Narcan) reverses respiratory depression caused by opioids.
Q14.
Gentamicin therapy requires monitoring of:
A. Serum potassium
B. Serum creatinine
C. Blood glucose
D. Calcium levels
✅ Answer: B.
Rationale: Aminoglycosides are nephrotoxic; kidney function must be monitored closely.
Q15.
The nurse recognizes phenytoin side effects include:
A. Gingival hyperplasia
B. Dry skin
C. Photosensitivity
D. Hypoglycemia
✅ Answer: A.
Rationale: Phenytoin causes gum overgrowth; patients should maintain good oral hygiene.
Q16.
A patient on spironolactone should avoid:
A. Oranges
B. Salt substitutes
C. Milk
D. Lean meat
✅ Answer: B.
Rationale: Potassium-sparing diuretics increase serum K+; salt substitutes contain potassium and may cause hyperkalemia.
Q17.
A nurse teaches that levothyroxine should be taken:
A. With breakfast
B. On an empty stomach in the morning
C. At bedtime
D. With calcium
✅ Answer: B.
Rationale: Levothyroxine absorption is optimal on an empty stomach, 30–60 minutes before eating.
Q18.
A patient with asthma is prescribed Theophylline. The nurse should monitor for:
A. Tachycardia
B. Hypotension
C. Bradycardia
D. Weight gain
✅ Answer: A.
Rationale: Theophylline toxicity can cause tachycardia, restlessness, and insomnia.
Q19.
The nurse knows Atorvastatin primarily acts by:
A. Lowering triglycerides
B. Decreasing LDL cholesterol
C. Raising HDL only
D. Promoting sodium excretion
✅ Answer: B.
Rationale: Statins lower LDL levels by inhibiting cholesterol synthesis in the liver.
Q20.
A patient taking Metformin should be cautioned to avoid:
A. Alcohol
B. Fiber-rich foods
C. Vitamin C
D. Citrus juices
✅ Answer: A.
Rationale: Alcohol increases the risk of lactic acidosis when combined with metformin.
Q21.
The antidote for benzodiazepine overdose is:
A. Atropine
B. Flumazenil
C. Naloxone
D. Vitamin K
✅ Answer: B.
Rationale: Flumazenil is a benzodiazepine receptor antagonist that reverses sedation and respiratory depression.
Q22.
Clopidogrel should not be combined with:
A. Aspirin
B. Milk
C. Water
D. Food
✅ Answer: A.
Rationale: Both Clopidogrel and Aspirin inhibit platelet aggregation, increasing bleeding risk.
Q23.
A nurse should question Tetracycline for which patient?
A. 20-year-old with acne
B. 10-year-old with strep throat
C. 25-year-old with UTI
D. 35-year-old with pneumonia
✅ Answer: B.
Rationale: Tetracyclines stain developing teeth and are contraindicated in children under 8 years.
Q24.
Morphine should not be given to a patient with:
A. Head injury
B. Post-surgical pain
C. Chronic cough
D. Cancer pain
✅ Answer: A.
Rationale: Morphine increases intracranial pressure and should be avoided in head injuries.
Q25.
A patient is taking isoniazid (INH) for tuberculosis. The nurse should instruct them to take:
A. Vitamin B6 supplements
B. Iron tablets
C. Calcium
D. Folic acid
✅ Answer: A.
Rationale: INH can cause peripheral neuropathy; Vitamin B6 (pyridoxine) prevents nerve damage.
Q26.
A nurse is preparing to administer Ceftriaxone to a client with a penicillin allergy. The nurse should:
A. Administer the dose as ordered
B. Observe closely for allergic reactions
C. Double the dose for resistance prevention
D. Skip the test dose
✅ Answer: B.
Rationale: Cephalosporins like Ceftriaxone may cross-react in penicillin-allergic clients; careful monitoring is essential.
Q27.
A patient on Methotrexate for rheumatoid arthritis should be advised to:
A. Increase folic acid intake
B. Avoid dairy products
C. Take it with alcohol
D. Limit fluids
✅ Answer: A.
Rationale: Methotrexate causes folate depletion; folic acid supplementation reduces toxicity.
Q28.
The nurse should withhold potassium supplements when the patient is taking:
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Prednisone
✅ Answer: B.
Rationale: Spironolactone is potassium-sparing; additional K⁺ may cause hyperkalemia.
Q29.
Clindamycin can cause a severe side effect known as:
A. Ototoxicity
B. C. difficile-associated diarrhea
C. Photosensitivity
D. Hepatotoxicity
✅ Answer: B.
Rationale: Clindamycin may lead to pseudomembranous colitis from overgrowth of Clostridium difficile.
Q30.
A nurse teaches a client taking Levothyroxine that improvement in symptoms will occur:
A. Within 24 hours
B. In 1–2 weeks
C. After several weeks
D. Immediately
✅ Answer: C.
Rationale: It takes several weeks for thyroid hormone levels to normalize and symptoms to improve.
Q31.
Which lab test must be monitored during Heparin therapy?
A. INR
B. aPTT
C. Platelet count only
D. Hematocrit
✅ Answer: B.
Rationale: Heparin prolongs aPTT; therapeutic levels are 1.5–2.5 times the control value.
Q32.
Allopurinol is prescribed to a patient with gout. The nurse should advise the client to:
A. Take with plenty of water
B. Limit fluids
C. Avoid vitamin C
D. Restrict carbohydrates
✅ Answer: A.
Rationale: Adequate hydration prevents kidney stone formation from uric acid buildup.
Q33.
A client taking isoniazid (INH) and rifampin should be warned that:
A. Urine may turn orange-red
B. Appetite will increase
C. Constipation is common
D. It causes hair growth
✅ Answer: A.
Rationale: Rifampin causes harmless red-orange discoloration of body fluids.
Q34.
A patient taking furosemide should be encouraged to eat:
A. Bananas and oranges
B. Cheese and milk
C. White bread and rice
D. Apples and pears
✅ Answer: A.
Rationale: These fruits are rich in potassium, which helps prevent hypokalemia.
Q35.
Insulin lispro (Humalog) should be administered:
A. 30 minutes before meals
B. Immediately before meals
C. 2 hours after meals
D. At bedtime
✅ Answer: B.
Rationale: Lispro is a rapid-acting insulin; it should be given right before eating to prevent hypoglycemia.
Q36.
The nurse should teach patients taking antacids to avoid concurrent use with:
A. Antibiotics
B. Multivitamins
C. Antidepressants
D. Analgesics
✅ Answer: A.
Rationale: Antacids reduce absorption of many antibiotics, especially tetracyclines and fluoroquinolones.
Q37.
Captopril can cause which adverse effect that warrants discontinuation?
A. Persistent dry cough
B. Constipation
C. Rash
D. Nausea
✅ Answer: A.
Rationale: ACE inhibitors commonly cause a dry cough due to increased bradykinin levels.
Q38.
Which drug is used as an antidote for acetaminophen overdose?
A. Naloxone
B. Acetylcysteine
C. Atropine
D. Flumazenil
✅ Answer: B.
Rationale: Acetylcysteine protects the liver by restoring glutathione levels.
Q39.
A nurse is teaching a client taking Loop diuretics. The patient should report:
A. Weight loss of 1 lb/day
B. Muscle cramps
C. Thirst
D. Frequent urination
✅ Answer: B.
Rationale: Muscle cramps may indicate electrolyte imbalance (especially hypokalemia).
Q40.
A patient on Oral contraceptives should be warned that effectiveness decreases with:
A. Antibiotics
B. Antacids
C. NSAIDs
D. Iron supplements
✅ Answer: A.
Rationale: Antibiotics like rifampin reduce estrogen levels and lower contraceptive effectiveness.
Q41.
Alendronate should be taken:
A. With milk
B. After breakfast
C. With a full glass of water on an empty stomach
D. With vitamin supplements
✅ Answer: C.
Rationale: Alendronate should be taken on an empty stomach; the client must remain upright for 30 minutes.
Q42.
Which statement shows correct understanding of nitroglycerin patches?
A. “I can wear it continuously.”
B. “I should remove it at night.”
C. “I’ll place it over hairy skin.”
D. “I can reuse old patches.”
✅ Answer: B.
Rationale: Patches are removed at night to prevent tolerance to nitrates.
Q43.
A nurse should question beta-blocker therapy for which client?
A. Patient with asthma
B. Patient with hypertension
C. Patient with angina
D. Patient with tremors
✅ Answer: A.
Rationale: Non-selective beta-blockers can cause bronchoconstriction and worsen asthma.
Q44.
A patient taking SSRIs like fluoxetine should avoid:
A. Tyramine-rich foods
B. Alcohol and other CNS depressants
C. Citrus juices
D. Vitamin D supplements
✅ Answer: B.
Rationale: Combining SSRIs with alcohol increases CNS depression and impairs judgment.
Q45.
Dopamine IV infusion is used to:
A. Decrease urine output
B. Improve cardiac output
C. Induce sedation
D. Decrease blood pressure
✅ Answer: B.
Rationale: Dopamine stimulates beta receptors, improving heart contractility and renal perfusion.
Q46.
Phenytoin administration teaching includes:
A. Stop medication abruptly when seizures stop
B. Brush teeth regularly
C. Take on an empty stomach only
D. Avoid folic acid
✅ Answer: B.
Rationale: Phenytoin causes gum overgrowth; proper oral care prevents complications.
Q47.
A nurse should instruct a client taking Levothyroxine to avoid which supplement?
A. Iron
B. Vitamin D
C. Vitamin C
D. Fish oil
✅ Answer: A.
Rationale: Iron and calcium interfere with levothyroxine absorption.
Q48.
A patient prescribed Losartan should be monitored for:
A. Dry cough
B. Hyperkalemia
C. Hypokalemia
D. Bradycardia
✅ Answer: B.
Rationale: ARBs can increase potassium levels; monitor serum K⁺ regularly.
Q49.
A client taking Aspirin for arthritis reports black stools. What should the nurse do?
A. Reassure the client
B. Discontinue aspirin and notify the provider
C. Give with milk
D. Reduce fluid intake
✅ Answer: B.
Rationale: Black stools may indicate gastrointestinal bleeding — a serious side effect of NSAIDs.
Q50.
A nurse educates a patient taking MAO inhibitors. Which food should be avoided?
A. Bananas
B. Rice
C. Chicken
D. Apples
✅ Answer: A.
Rationale: Tyramine-rich foods (bananas, aged cheese, wine) can trigger hypertensive crises with MAOIs.
Q51.
A nurse is teaching about Warfarin (Coumadin). The patient’s statement that requires correction is:
A. “I will avoid green leafy vegetables.”
B. “I will report any bleeding.”
C. “I will take it at the same time daily.”
D. “I can use aspirin for headaches.”
✅ Answer: D.
Rationale: Aspirin increases bleeding risk when taken with warfarin.
Q52.
Which of the following is an early sign of digoxin toxicity?
A. Rash
B. Blurred or yellow vision
C. Cough
D. Constipation
✅ Answer: B.
Rationale: Visual disturbances like yellow halos indicate digoxin toxicity.
Q53.
A nurse should teach the client taking Lithium carbonate to:
A. Restrict salt intake
B. Maintain consistent salt intake and hydration
C. Avoid all fluids
D. Take with NSAIDs
✅ Answer: B.
Rationale: Sodium and fluid balance affect lithium levels; dehydration or low sodium can cause toxicity.
Q54.
Gentamicin therapy requires monitoring of:
A. Liver enzymes
B. Blood urea nitrogen (BUN) and creatinine
C. Blood glucose
D. Uric acid
✅ Answer: B.
Rationale: Gentamicin is nephrotoxic; renal function must be closely monitored.
Q55.
Which of the following medications should be taken before meals for optimal effect?
A. Sucralfate
B. Omeprazole
C. Ranitidine
D. Famotidine
✅ Answer: A.
Rationale: Sucralfate coats the stomach lining; taken before meals for protection.
Q56.
A nurse should advise the patient taking Simvastatin to:
A. Take it in the morning
B. Avoid grapefruit juice
C. Take with high-fat meals
D. Limit fluid intake
✅ Answer: B.
Rationale: Grapefruit juice inhibits statin metabolism, increasing toxicity risk.
Q57.
A patient receiving Morphine sulfate IV becomes unresponsive with shallow respirations. The nurse should first:
A. Administer naloxone
B. Call the physician
C. Stop oxygen
D. Begin chest compressions
✅ Answer: A.
Rationale: Naloxone is the antidote for opioid overdose and must be given immediately.
Q58.
A nurse is caring for a client on Phenelzine (MAOI). Which drug interaction is most dangerous?
A. Acetaminophen
B. Pseudoephedrine
C. Ibuprofen
D. Calcium
✅ Answer: B.
Rationale: Combining MAOIs with sympathomimetic drugs (e.g., pseudoephedrine) can cause a hypertensive crisis.
Q59.
A client taking Prednisone for long-term therapy should be monitored for:
A. Weight loss
B. Hypertension and infection
C. Bradycardia
D. Hypoglycemia
✅ Answer: B.
Rationale: Corticosteroids cause immunosuppression, fluid retention, and high blood pressure.
Q60.
Metformin should be withheld:
A. 48 hours before and after IV contrast studies
B. Before meals
C. After meals
D. Before bedtime
✅ Answer: A.
Rationale: Contrast agents increase the risk of lactic acidosis in patients taking metformin.
Q61.
Which instruction is appropriate for a client taking Loop diuretics?
A. Avoid potassium-rich foods
B. Report dizziness or muscle weakness
C. Take before bedtime
D. Expect urine to turn orange
✅ Answer: B.
Rationale: Loop diuretics cause fluid and electrolyte loss leading to dizziness or muscle cramps.
Q62.
Insulin glargine (Lantus) differs from other insulins because:
A. It is rapid-acting
B. It has no peak
C. It causes hypoglycemia quickly
D. It is mixed with other insulins
✅ Answer: B.
Rationale: Glargine provides a steady 24-hour release and should not be mixed with other insulins.
Q63.
Which of the following medications is a potassium-sparing diuretic?
A. Furosemide
B. Hydrochlorothiazide
C. Spironolactone
D. Mannitol
✅ Answer: C.
Rationale: Spironolactone retains potassium and excretes sodium.
Q64.
A client taking Theophylline for asthma should avoid:
A. Caffeine
B. Milk
C. Vitamin C
D. Sodium
✅ Answer: A.
Rationale: Caffeine enhances theophylline’s stimulant effects, leading to toxicity.
Q65.
A nurse gives Vancomycin too quickly IV. The patient develops flushing and hypotension. This is called:
A. Stevens-Johnson syndrome
B. Red man syndrome
C. Serum sickness
D. Anaphylaxis
✅ Answer: B.
Rationale: Rapid infusion of vancomycin causes histamine release, leading to red man syndrome.
Q66.
When giving Nitroglycerin SL tablets, the nurse should instruct the client to:
A. Swallow it immediately
B. Chew before swallowing
C. Place it under the tongue until dissolved
D. Take it with milk
✅ Answer: C.
Rationale: Sublingual tablets absorb quickly under the tongue to relieve angina.
Q67.
A client is prescribed Clopidogrel. The nurse should teach:
A. Avoid all green vegetables
B. Report signs of unusual bleeding
C. Take with antacids
D. Stop immediately before surgery
✅ Answer: B.
Rationale: Clopidogrel inhibits platelet aggregation; monitor for bleeding.
Q68.
Hydralazine is prescribed for hypertension. The nurse should monitor for:
A. Tachycardia
B. Bradycardia
C. Hypoglycemia
D. Hypothermia
✅ Answer: A.
Rationale: Vasodilation causes reflex tachycardia.
Q69.
Erythromycin administration can cause:
A. QT prolongation
B. Weight gain
C. Constipation
D. Bradycardia
✅ Answer: A.
Rationale: Erythromycin may cause cardiac arrhythmias due to QT prolongation.
Q70.
A nurse preparing to administer IV potassium chloride should:
A. Give it IV push
B. Mix with saline and infuse slowly
C. Mix with dextrose
D. Give undiluted
✅ Answer: B.
Rationale: IV potassium must be diluted and infused slowly to avoid cardiac arrest.
Q71.
The nurse should instruct a patient taking Omeprazole (PPI) to:
A. Stop if heartburn returns
B. Take before breakfast
C. Take with milk
D. Take after dinner
✅ Answer: B.
Rationale: PPIs are most effective when taken 30 minutes before meals.
Q72.
A nurse is preparing to administer Enoxaparin. The nurse should:
A. Give intramuscularly
B. Massage after injection
C. Inject into the abdomen without aspiration
D. Mix with insulin
✅ Answer: C.
Rationale: Enoxaparin is given subcutaneously in the abdomen without aspiration or massage.
Q73.
A patient taking Benzodiazepines should avoid:
A. Alcohol
B. Milk
C. Fruits
D. Bread
✅ Answer: A.
Rationale: Alcohol enhances CNS depression when combined with benzodiazepines.
Q74.
Metoprolol is contraindicated in:
A. Asthma
B. Hypertension
C. Angina
D. Post-MI
✅ Answer: A.
Rationale: Beta-blockers can cause bronchoconstriction and worsen asthma symptoms.
Q75.
A client taking Albuterol inhaler frequently complains of tremors. The nurse should explain this is due to:
A. Hypoglycemia
B. Stimulation of beta-adrenergic receptors
C. Low potassium
D. Infection
✅ Answer: B.
Rationale: Albuterol activates beta-2 receptors in the lungs and beta-1 in the heart, leading to tremors or palpitations.
Q76.
A patient taking Phenytoin (Dilantin) should be instructed about:
A. Taking it with milk
B. Oral hygiene and gum care
C. Taking it on an empty stomach only
D. Avoiding water
✅ Answer: B.
Rationale: Phenytoin can cause gingival hyperplasia; good oral care prevents complications.
Q77.
Which lab value should be monitored with Furosemide therapy?
A. Sodium
B. Potassium
C. Calcium
D. Glucose
✅ Answer: B.
Rationale: Loop diuretics can cause hypokalemia.
Q78.
A nurse is administering Insulin lispro. When should the patient eat?
A. 30 minutes after injection
B. Immediately after injection
C. 1 hour after injection
D. Before bedtime
✅ Answer: B.
Rationale: Lispro is rapid-acting and should be taken right before meals to prevent hypoglycemia.
Q79.
Rifampin can cause which side effect?
A. Yellow skin
B. Orange discoloration of body fluids
C. Diarrhea
D. Constipation
✅ Answer: B.
Rationale: Rifampin causes harmless orange-red discoloration of urine, tears, and sweat.
Q80.
Which drug requires INR monitoring?
A. Clopidogrel
B. Warfarin
C. Enoxaparin
D. Aspirin
✅ Answer: B.
Rationale: Warfarin therapy requires INR monitoring to maintain therapeutic anticoagulation.
Q81.
A nurse should avoid giving beta-blockers to patients with:
A. Heart failure
B. Bradycardia
C. Hypertension
D. Angina
✅ Answer: B.
Rationale: Beta-blockers slow heart rate; contraindicated in bradycardia.
Q82.
A nurse recognizes that ACE inhibitors may cause:
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Tachycardia
✅ Answer: B.
Rationale: ACE inhibitors decrease aldosterone, leading to potassium retention.
Q83.
A client receiving Methotrexate for rheumatoid arthritis should be monitored for:
A. Hepatotoxicity
B. Weight gain
C. Polyuria
D. Hypertension
✅ Answer: A.
Rationale: Methotrexate can cause liver damage and requires regular liver enzyme monitoring.
Q84.
Amiodarone therapy requires monitoring of:
A. Blood glucose
B. Thyroid and liver function
C. Platelet count
D. Kidney function
✅ Answer: B.
Rationale: Amiodarone can cause thyroid and hepatic dysfunction.
Q85.
A nurse should instruct the patient taking Iron supplements to:
A. Take with dairy
B. Take with vitamin C-rich juice
C. Take with antacids
D. Avoid fluids
✅ Answer: B.
Rationale: Vitamin C enhances iron absorption.
Q86.
A patient taking Levodopa-carbidopa should be advised to:
A. Avoid high-protein meals
B. Take with milk
C. Avoid fluids
D. Stop medication abruptly
✅ Answer: A.
Rationale: High-protein foods interfere with absorption of levodopa.
Q87.
Spironolactone should be avoided with:
A. ACE inhibitors
B. Thiazide diuretics
C. Beta-blockers
D. Calcium channel blockers
✅ Answer: A.
Rationale: Both increase potassium levels and may lead to hyperkalemia.
Q88.
A nurse should instruct the patient taking Levothyroxine to:
A. Take with breakfast
B. Take on an empty stomach
C. Take with iron supplements
D. Take with calcium
✅ Answer: B.
Rationale: Levothyroxine should be taken on an empty stomach for proper absorption.
Q89.
Isoniazid (INH) is prescribed for tuberculosis. Which vitamin prevents neuropathy?
A. Vitamin B6 (pyridoxine)
B. Vitamin B12
C. Vitamin D
D. Vitamin E
✅ Answer: A.
Rationale: Pyridoxine prevents peripheral neuropathy caused by isoniazid.
Q90.
Which of the following drugs can cause dry cough as a side effect?
A. Metoprolol
B. Lisinopril
C. Losartan
D. Amlodipine
✅ Answer: B.
Rationale: ACE inhibitors like lisinopril cause accumulation of bradykinin, leading to cough.
Q91.
Heparin overdose can be reversed by:
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
✅ Answer: B.
Rationale: Protamine sulfate neutralizes heparin’s anticoagulant effect.
Q92.
A patient prescribed Ciprofloxacin should avoid:
A. Dairy products and antacids
B. Meat and poultry
C. Vitamin C
D. Bread
✅ Answer: A.
Rationale: Calcium and aluminum interfere with ciprofloxacin absorption.
Q93.
A nurse giving Insulin and NPH together should:
A. Draw up NPH first
B. Draw up regular insulin first
C. Mix both and store
D. Inject separately
✅ Answer: B.
Rationale: Draw up clear (regular) insulin before cloudy (NPH) to avoid contamination.
Q94.
Vancomycin trough levels are measured to:
A. Assess renal clearance
B. Maintain therapeutic range
C. Evaluate blood sugar
D. Monitor platelet count
✅ Answer: B.
Rationale: Trough levels ensure effective yet non-toxic antibiotic levels.
Q95.
Clonidine patches should be applied:
A. To dry, hairless areas
B. Near open wounds
C. On the abdomen only
D. Every 2 hours
✅ Answer: A.
Rationale: Patches must be applied to clean, intact, hairless skin for absorption.
Q96.
A patient taking SSRIs should avoid:
A. Other serotonergic drugs
B. Dairy
C. Salty food
D. Iron
✅ Answer: A.
Rationale: Combining SSRIs with MAOIs or St. John’s Wort may lead to serotonin syndrome.
Q97.
Tetracycline should not be given to:
A. Children under 8
B. Adults over 60
C. Hypertensive patients
D. Diabetics
✅ Answer: A.
Rationale: It stains developing teeth and affects bone growth in children.
Q98.
A nurse should instruct a patient taking Corticosteroids to:
A. Stop abruptly if side effects occur
B. Taper off gradually
C. Double dose if stressed
D. Take before sleep
✅ Answer: B.
Rationale: Abrupt withdrawal may cause adrenal crisis.
Q99.
Alendronate should be taken:
A. With food
B. With full glass of water, remain upright 30 minutes
C. Before sleep
D. After dinner
✅ Answer: B.
Rationale: Prevents esophageal irritation and promotes absorption.
Q100.
A nurse should monitor for ototoxicity with which drug?
A. Gentamicin
B. Metformin
C. Furosemide
D. Digoxin
✅ Answer: A.
Rationale: Aminoglycosides like gentamicin can damage auditory nerve cells.
📘 How to Study Pharmacology for the NCLEX
- Group drugs by class (e.g., ACE inhibitors, beta-blockers)
- Memorize prototypes, not brand names
- Use rationales — understanding why an answer is correct helps retention
- Apply real-world nursing logic — think of safety first (airway, breathing, circulation)
🏆 Quick Recap: Key NCLEX Pharmacology Topics Covered
| Drug Class | Nursing Focus | Common Risk |
| Diuretics | Monitor electrolytes | Hypokalemia |
| Anticoagulants | Check INR/PT | Bleeding |
| Antibiotics | Culture before admin | Resistance |
| Insulins | Meal timing | Hypoglycemia |
| ACE Inhibitors | Monitor potassium | Dry cough |
✅ Conclusion
Pharmacology on the NCLEX doesn’t have to be overwhelming. With these 100 practice questions and rationales, you can test your knowledge, correct your mistakes, and build confidence before exam day.
💡 Next Step: Explore our NCLEX Master Hub for complete practice sets — Anatomy, Physiology, Nursing Fundamentals, and more.