NCLEX Pharmacological and Parenteral Therapies Practice Test

Q: Is this a full-length pharmacology exam or a shorter quiz?

It’s a short 20-question set meant for focused practice, not a full exam simulation.

Q: Is the quiz timed?

No. You can take it at your own pace and focus on accuracy first.

Q: Do explanations show up while I’m taking it or only after I finish?

You get instant feedback during the quiz, so you can learn the pattern right away.

Q: What is the fastest way to improve on Pharmacological and Parenteral Therapies questions?

Focus on patterns instead of memorizing random facts. Train yourself to spot red flags in the stem (new symptoms, abnormal vitals, high-risk meds), then pick the safest first action.

Q: What kinds of medication skills does this category usually test?

Safe administration decisions, adverse effect recognition, IV and parenteral therapy basics, monitoring priorities, and what to do first when a patient’s response changes.

Q: What is the best way to approach “hold the medication” style questions?

Look for safety red flags in the stem (vitals, symptoms, allergies, lab clues, new complaints). If the stem points to harm risk, the safest choice is often to hold the medication and notify the PCP.

Q: How should I handle questions where two answers feel right?

Choose the option that prevents the most harm first. In medical questions, the correct choice is the priority intervention that protects airway, breathing, circulation, or stops a dangerous reaction before doing anything else.

Q: How do I handle questions where I do not recognize the medication name?

Use the clues you do have: the patient’s symptoms, the route (IV, IM, PO), the timing, and what is being monitored. NCLEX often rewards safe monitoring and escalation even when the drug name is unfamiliar.

Q: What are the most common “med safety” traps on this category?

Doing something routine when the stem is screaming danger. Examples include giving the next dose without checking a vital sign, ignoring allergy history, or choosing teaching when the patient needs immediate action.

Q: Will I need to enter an email to view results?

Yes. The results screen includes an email step before full results are shown.

Question 1

A nurse is caring for a patient with newly diagnosed type II diabetes mellitus who has been ordered to begin metformin. The nurse knows that the presence of which of the following in the patient’s medical history would represent a contraindication to this therapy?

Accepted Answer

renal failure. Metformin is an oral biguanide antidiabetic agent that reduces the hepatic production of glucose and increases peripheral insulin sensitivity. It is primarily eliminated by the kidney, and its use in a patient with moderate to severe renal impairment is contraindicated. Other contraindications include diabetic ketoacidosis, metabolic acidosis, and lactic acidosis. It is also not advisable to use during pregnancy. Uncontrolled hypertension and seizure disorder are not contraindications for metformin, and it may be helpful in the treatment of polycystic ovary syndrome (PCOS).

Question 2

A nurse is administering an intravenous drug to a patient for the first time. Which of these signs and/or symptoms would indicate that the patient is having an anaphylactic reaction to the medication?

Accepted Answer

tachycardia. Anaphylaxis is a severe, potentially life-threatening allergic reaction. It produces signs and symptoms of distributive shock that may occur rapidly and require immediate intervention. Severe hypotension, tachycardia, respiratory distress, erythematous wheals, diaphoresis, and swelling of the tongue/upper airway may all occur. Patients in anaphylactic shock are often anxious and may have a sense of “impending doom.” Prolonged hypoperfusion may lead to loss of consciousness and organ failure. Hypertension, fatigue, and paresthesias are not associated with anaphylaxis.

Question 3

A nurse is admitting a patient with congestive heart failure (CHF) treated with atenolol for an acute exacerbation of chronic obstructive pulmonary disease (COPD). The nurse notes a potential drug-to-drug interaction with one of the patient’s newly prescribed medications. Which of the following drugs can interfere with the patient’s current prescription?

Accepted Answer

albuterol. Albuterol should not be used. The patient takes atenolol for CHF which is a beta-blocker. Albuterol is a beta agonist that has the opposite pharmacological effect of atenolol. In a patient taking atenolol, the therapeutic capability of albuterol may be greatly decreased. Ipratropium, corticosteroids, and theophylline have no potential interaction with atenolol.

Question 4

A nurse is preparing to administer packed red blood cells to a patient. Which of these steps is the most important when administering blood and blood products to any patient?

Accepted Answer

patient identification. Correct patient identification is the the single most important factor that should be performed first prior to the administration of any blood or blood product. This is generally dictating by the specific policies of the facility or hospital where you work, but most will use a two-nurse verification system to match and verify the name of the patient with that on the order. Once that step is complete, the others should be completed by the two-person team as well.

Question 5

A trauma patient presents to the ER with severe hemorrhage. His blood type is O positive. Based on this information, the nurse knows that he may receive blood only from a person with which of these blood types?

Accepted Answer

Type O blood (positive or negative). A patient with type O positive blood may receive blood from another type O (negative or positive) person. While type O blood is known as the universal donor (any blood type can receive type O blood), he or she can only receive type O blood via transfusion. Additionally, this patient has a positive Rh factor, meaning that he may receive blood with or without Rh factor (i.e., positive or negative, respectively)

Question 6

A nurse is monitoring a patient during a blood transfusion. The patient acutely develops flank and chest pain accompanied by hypotension, respiratory distress, and tachycardia. The nurse notes scant brownish discolored urine in the patient’s foley bag. Which of these answer choices correctly describes both the nurse’s first action as well as the name of this patient’s transfusion reaction?

Accepted Answer

Stop the transfusion immediately due to hemolysis. The first course of action with any adverse reaction during the administration of blood produces is to immediately stop the infusion. The symptoms and signs described in this patient point to hemolysis likely due to ABO incompatibility. Allergic reactions may also present with swelling, flushing, tachycardia, and respiratory distress, but there will be no urinary changes (amount, color, etc.) present as there will be with hemolysis, which is the term for the process. This may also be called a “hemolytic reaction.”

Question 7

The nurse is preparing to administer Insulin Regular (Novolin R) to a type II diabetic client. Prior to administering the insulin, the nurse performs a glucometer test and determines the client’s blood glucose is 187 mg/dL. Following the order written below, how much insulin will the nurse administer to the client?
Administer 6 units of Regular Insulin (Novolin R) in addition to the indicated number of units based on the insulin sliding scale subcutaneously three times a day.
Adult sliding scale for insulin regular (Novolin R) based on blood glucose level:

Accepted Answer

10 units. Sliding scale dosing is a common way for insulin to be prescribed for clients. Sliding scales are used to determine how much insulin is indicated to help lower a client’s blood glucose level. There are two types of sliding scales: high blood sugar correction and carbohydrate coverage. While many patients will have just a sliding scale in place for their regular insulin administration, some will also have a base dosage required. When this is the case, the number of units in the base dose are added to the appropriate amount of insulin units determined by the sliding scale.

Question 8

The nurse is caring for a patient with a central venous access device. Which of the following are appropriate nursing actions?
Select all that apply.
A. Take blood pressure readings on the contralateral side of the central venous access device.
B. Use chlorhexidine for cleansing the insertion site and use impregnated dressing.
C. Practice sterile technique when assessing and caring for the central venous access device, including a mask for both the nurse and patient.
D. Draw invasive laboratory procedures on the same side as the central venous access device.
E. Allow the central venous line to be soaked in soap and water to cleanse the external lumens between use.

Accepted Answer

A, B, and C. The care of the central venous access device includes using sterile technique and chlorhexidine or alcohol wipes to cleanse the line’s lumens, insertion site, and surrounding skin. Many dressings are impregnated with chlorhexidine and should be used to continue to prevent infection at the insertion site. The central venous line should never be soaked in a volume of solution as this can increase the risk for infection. When needing to use the client’s arms for vital signs or lab draws, always use the contralateral side of the central line to reduce interference with the line.

Question 9

A mother calls the healthcare provider’s office regarding a prescription ordered for her child. The prescription states, “give 30 milliliters (mL) every 12 hours.” The mother tells the nurse that the only measuring device she has at home is a tablespoon. How many tablespoons of medication will the nurse instruct the mother to give?

Accepted Answer

2 tablespoons. When converting milliliters (mL) to tablespoons, one must first know that 1 tablespoon is equal to 15 mL. If the client above is administering 30 mL of medication, the nurse would instruct the mother to administer 2 tablespoons of medication.

Question 10

A 250-pound patient is prescribed a medication that comes in 750 mg tablets. His order is for 30/kg/day to be given three times daily (TID). How many tablets should the nurse should give this patient for a single dose?

Accepted Answer

1.5 tablets. To figure out the single dosage for this patient, first find his weight in kilograms by dividing 250 by 2.2 which is 113.6 kg. Next, multiply 113.6 by 30 to find his total dosage for the entire day which is 3,408 mg. Then, since the order specifies a TID dosing schedule, divide the day’s total dosage of 3,408 mg by 3 which is 1,136 mg in a single dose. Last, divide this single dose of 1,136 mg by 750 mg (the amount in each tablet) to find how many tablets to give in a single dose. Your answer is 1.5 tablets.

Question 11

A nurse is working in a clinic. She must give an adult patient a single intramuscular injection (IM) of penicillin G benzathine. The vial of medication states there are 600,000 units/mL. The patient’s order is for 2.4 million units given as a single dose. How many mLs of medication should the nurse draw up to give the correct dose this patient.

Accepted Answer

4 mL. To find the volume of medication to draw up for injection, take the total dose to be given 2.4 million or 2,400,000 units and divide it by the number of units in each mL of solution 600,000. This will give your answer, which is 4 mL.

Question 12

A nurse is caring for patient on IV fluids. The patient’s order states that she is to receive 500 mLs of 5% D 0.45 normal saline over a 2-hour period. The patient’s IV tubing has a drip factor of 10 gtts/ml. Approximately how many drops per minute should be administered?

Accepted Answer

42 gtts. To find the drops/minute rate of an IV solution, take the total volume that is to be given and divide it by the total of number of minutes for the infusion, then divide this number by the drip factor of the IV tubing. For this example, it would be 500 mL divided by 120 minutes, which is 4.16 mL/min that is then multiplied by 10 gtts/ml giving you the answer (rounded to the nearest whole number) of 42 gtts/minute.

Question 13

A nurse is caring for a patient with a suspected urinary tract infection (UTI). The patient’s urinalysis confirms infection and she is started on appropriate antibiotic therapy. To help with her symptoms of pain and discomfort, the physician also recommends she use over-the-counter phenazopyridine (pyridium). Which of these is an important piece of counseling the nurse should give on phenazopyridine ?

Accepted Answer

Advise the patient that she will likely have orange-colored urine while taking this drug. When educating patients on their recommended medications, it is important to include information on any likely or intended effects or unintended side effects of a medication (prescription or over-the-counter). The nurse should also review the indications for the medication, its purpose and how to properly take the drug. In this case, phenazopyridine (pyridium) is a short-term pain reliever in those with acute UTI. It should only be taken for 2 to 3 days and is not a substitute for proper antibiotic therapy. This medication will cause orange-colored urine, and this is an important expected outcome of its use. It does not reduce urine output, and patients with a UTI should be encouraged to increase their oral fluid intake, thereby increasing the total amount of urine.

Question 14

What is the intended purpose of a medication reconciliation?

Accepted Answer

To create a complete and current list of all medications and alternative therapies for review and evaluation for possible interactions. Nurses should periodically perform a medication reconciliation to create a complete and current list of all medications and alternative therapies that a patient is taking. This not only allows for evaluation for possible interactions, but also helps in reducing polypharmacy, as patients are often prescribed medications from both primary care practitioners as well as specialist for the same condition.

Question 15

Which of these is typically not an essential part of the nurse’s information review prior to administering a medication to a patient?

Accepted Answer

the patient’s family history. It is not essential to review a patient’s family history as part of the information review prior to administering a medication. A nurse should always review the “rights” of administration (patient, route, dose, etc.), pertinent data (labs, current medications, diagnoses, interactions, etc.) and the patient’s medical history for potential contraindications including any listed medication allergies.

Question 16

A nurse begins working in a pediatric clinic. She will be administering IM injections to patients who range in age from infancy to adolescence. The nurse knows that all of these muscles may be used for injection sites for all of these age groups except ____.

Accepted Answer

gluteus maximus. The gluteus maximus may not be used as a muscular site for injection until a child is of toddler age and has been walking for at least 1 year. The deltoid is another muscle that should not be used as an injection site until a child is of preschool or school age. The vastus lateralis, ventrogluteal and rectus femoris muscles may be used for IM injections for any age group.

Question 17

A nurse is caring for a patient who is receiving intravenous fluids via an infusion pump at the rate of 150 cc/hour. The infusion pump has recently been repaired and the nurse wants to double-check to ensure that it is functioning properly; however, she is called away by another patient. If the nurse notes that there is currently 600 cc in the IV bag, what is the remaining volume she should expect to find in the IV bag upon her return in 20 minutes?

Accepted Answer

550 cc. An infusion pump may be checked for accuracy in one of two ways. The nurse can count the drops per minute given to a patient over a 1-minute period and check this figure with a manual calculation of the drops per minute the patient should receive. Or the nurse can allow the IV solution to infuse over a period of time and calculate the expected volume of solution to be given over that period of time and compare that to the volume in the IV bag as is demonstrated in this scenario. The calculations are as follows: at a rate of 150 cc/hour, a total volume of 50 cc should infuse in a 20-minute period (20 divided by 60 is 0.333 multiplied by 150 is 50). If 600 cc is the initial volume, then the nurse should expect to find 550 cc remaining after 20 minutes.

Question 18

Which of these is a correct statement regarding the diagnosis of phlebitis?

Accepted Answer

Phlebitis may present as fever; redness, swelling, and pain at the IV site; slowing of intravenous flow; and a visible red streak extending from the catheter insertion site. Phlebitis usually presents with fever; redness, swelling, and pain at the IV site; slowing of intravenous flow; and a visible red streak extending from the catheter insertion site. Treatment of phlebitis should begin with the cessation of intravenous therapy and then with warm compresses and elevation of the affected limb. While analgesics for pain and antipyretics may be given, oral antibiotics are generally not indicated in the treatment of phlebitis. Pain, swelling in the area around the catheter insertion site, coolness and paleness of the area around the catheter insertion site, and a slowing of intravenous flow are symptoms of an infiltration, not phlebitis.

Question 19

A nurse is caring for a patient with a prn order for an opioid pain medication. The nurse utilizes a pain assessment scale and determines the patient would benefit from the administration of the drug. After administration, which of these should the nurse assess for as a side effect of this class of medication?

Accepted Answer

pruritus. Narcotic, opioid pain medications are indicated for moderate to severe pain. Common side effects of this class of drugs include constipation, sedation, nausea, dizziness, and pruritus. More severe side effects include respiratory depression and arrest, hepatic damage, anaphylactic reaction, circulatory collapse, and cardiac arrest. Indigestion is a common side effect of non-opioid analgesics in the non-steroidal anti-inflammatory (NSAID) class of medications. Dry mouth can occur with the use of centrally acting non-opioid analgesics, such as clonidine. Diarrhea is typically not a side effect of either opioid or non-opioid analgesics.

Question 20

A patient admitted to the ICU with an order for complete bowel rest is started on total parenteral nutrition (TPN). On the second day, the nurse notes that the patient has developed hypertension. The physical assessment demonstrates mild peripheral edema, neck vein distension and the presence of mild crackles and rales on auscultation of the lungs bilaterally. Which of these complications of TPN is this patient likely experiencing?

Accepted Answer

fluid overload. This patient has signs consistent with fluid overload. Just as with any other intravenous administration of fluids, TPN that is given too quickly will produce these clinical signs. Additionally, the patient may complain of shortness of breath or dyspnea. Hypoglycemia typically presents with the complaint of headache, the presence of a tremor or “shakiness,” cool and clammy skin, diaphoresis, blurry vision, and loss of consciousness with or without seizures. Lab values will demonstrate a very low glucose level. Infection presents with fever, chills, diaphoresis with/without pain, redness and swelling at the catheter insertion site. Pneumothorax is a complication due to placement of the central venous access line prior to the onset of TPN feedings and will likely be clinically apparent during or shortly after the procedure with the main clinical findings of abrupt onset of chest pain and shortness of breath accompanied by tachycardia and tachypnea with hypotension and hypoxia if severe.

NCLEX Pharmacological and Parenteral Therapies Practice Test

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Molly W.

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Common Practice Set Question with Their Answers

Is this a full-length pharmacology exam or a shorter quiz?

Is the quiz timed?

Do explanations show up while I’m taking it or only after I finish?

What is the fastest way to improve on Pharmacological and Parenteral Therapies questions?

What kinds of medication skills does this category usually test?

What is the best way to approach “hold the medication” style questions?

How should I handle questions where two answers feel right?

How do I handle questions where I do not recognize the medication name?

What are the most common “med safety” traps on this category?

Will I need to enter an email to view results?

What should I do if the quiz content does not load correctly?