Keep sharpening your medication knowledge with this free timed practice test of 10 NCLEX pharmacology questions with answers and rationales.
This set spans pediatric and oncology pharmacology, maternal-newborn medications, and safe administration — including vincristine, inhaled corticosteroids, Rho(D) immune globulin, oxytocin, fentanyl patches, and a weight-based dosage calculation.
Each question runs on a 2-minute timer to help you practice exam pacing. Select your answer, then study the rationale to connect the pharmacology to sound nursing care.
When you finish, follow the links to more pharmacology, dosage calculation, and NCLEX practice questions on NurseStudy.net.
All 10 Questions With Answers & Rationales
Prefer to review at your own pace? Every question from the timed quiz above is listed here in full. Read each one, then tap Show Answer & Rationale to check your reasoning.
Question 1: Pharmacology
A 4-year-old child with acute lymphoblastic leukemia is receiving IV vincristine. Which assessment finding is most important for the nurse to report to the primary health care provider before the next dose?
- A. Decreased appetite and mild weight loss over 1 week
- B. Complaints of tingling and weakness in the hands and feet
- C. Alopecia and scalp tenderness
- D. Occasional nausea relieved with prescribed ondansetron
Show Answer & Rationale
Answer: B. Complaints of tingling and weakness in the hands and feet
Rationale: The nurse must recognize adverse effects of high-risk medications; vincristine can cause peripheral neuropathy, so new tingling and weakness should be reported before giving additional doses.
Question 2: Pharmacology
A school-age child with persistent asthma uses an inhaled corticosteroid twice daily and albuterol as needed. The parent states, “We stopped the steroid inhaler last week because my child felt better.” What is the nurse’s best response?
- A. “That was a good choice to avoid unnecessary medication.”
- B. “Use the steroid inhaler only during an asthma flare.”
- C. “The steroid inhaler helps prevent attacks and should be taken as prescribed.”
- D. “Give extra albuterol doses instead of the steroid inhaler.”
Show Answer & Rationale
Answer: C. “The steroid inhaler helps prevent attacks and should be taken as prescribed.”
Rationale: The nurse educates about preventive medications; inhaled corticosteroids provide long-term control and should be used regularly, even when the child feels well, to reduce the risk of severe exacerbations.
Question 3: Pharmacology
A postpartum client is prescribed Rho(D) immune globulin IM. Which assessment finding indicates that this medication is appropriate?
- A. Newborn is Rh-negative and the client is Rh-positive
- B. Newborn is Rh-positive and the client is Rh-negative
- C. Both the newborn and the client are Rh-negative
- D. Both the newborn and the client are Rh-positive
Show Answer & Rationale
Answer: B. Newborn is Rh-positive and the client is Rh-negative
Rationale: The nurse evaluates orders for appropriateness; Rho(D) immune globulin is given to Rh-negative clients who deliver Rh-positive infants to prevent antibody formation and protect future pregnancies.
Question 4: Pharmacology
A client at 39 weeks’ gestation is receiving an oxytocin infusion to augment labor. Which finding requires the nurse’s priority action?
- A. Contractions every 3 minutes lasting 60 seconds, reassuring fetal heart rate
- B. Contractions every 1 minute lasting 90 seconds with minimal resting tone
- C. Mild uterine tenderness between contractions with fetal heart rate 140
- D. Client reports back discomfort with each contraction
Show Answer & Rationale
Answer: B. Contractions every 1 minute lasting 90 seconds with minimal resting tone
Rationale: The nurse must monitor IV infusions and take action based on assessment; very frequent, prolonged contractions with little uterine relaxation suggest uterine tachysystole from excessive oxytocin, increasing risk for fetal distress and uterine rupture, and require immediate intervention.
Question 5: Pharmacology
A 2-week-old newborn is prescribed oral vitamin D supplementation. Which instruction should the nurse give the parents?
- A. “Mix the full dose in a bottle of formula and save what the baby does not finish.”
- B. “Use the provided dropper to place the dose in the side of the cheek.”
- C. “Stop the supplement once the baby reaches 2 months of age.”
- D. “Give double the dose if you forget it the day before.”
Show Answer & Rationale
Answer: B. “Use the provided dropper to place the dose in the side of the cheek.”
Rationale: The nurse teaches safe medication administration to caregivers; for newborns, the correct dose should be measured with a supplied device and given into the side of the cheek to reduce the risk of aspiration and ensure accuracy.
Question 6: Pharmacology
An adolescent with cystic fibrosis is prescribed pancreatic enzyme capsules to take with meals. Which statement by the client indicates correct understanding?
- A. “I will take the enzymes only if my stools become loose.”
- B. “I will chew the capsules thoroughly to help them work faster.”
- C. “I will take the enzymes immediately before or with every meal and snack.”
- D. “I should stop taking the enzymes if I gain too much weight.”
Show Answer & Rationale
Answer: C. “I will take the enzymes immediately before or with every meal and snack.”
Rationale: The nurse educates about chronic medication use; pancreatic enzymes must be taken just before or with all meals and snacks to improve digestion and nutrient absorption in clients with cystic fibrosis.
Question 7: Pharmacology
A client with newly diagnosed breast cancer is starting IV doxorubicin. The nurse reviews the client’s past medical history. Which condition requires further discussion with the primary health care provider before beginning therapy?
- A. Controlled hypothyroidism
- B. History of myocardial infarction 2 years ago
- C. Seasonal allergic rhinitis
- D. Osteoarthritis of the knees
Show Answer & Rationale
Answer: B. History of myocardial infarction 2 years ago
Rationale: The nurse reviews pertinent data before administering high-risk medications; doxorubicin is cardiotoxic, so a history of significant heart disease warrants careful evaluation, baseline cardiac testing, and possible regimen adjustment.
Question 8: Pharmacology
A client with tuberculosis is prescribed isoniazid and rifampin. Which teaching point is most important for the nurse to include to support health promotion and adherence?
- A. “You can stop the medications once you feel better.”
- B. “Take both medications as prescribed for the entire treatment period.”
- C. “Avoid all fruits while you are taking these medications.”
- D. “If your urine changes color, stop taking the medications immediately.”
Show Answer & Rationale
Answer: B. “Take both medications as prescribed for the entire treatment period.”
Rationale: The nurse promotes disease control and prevents resistance; combination therapy for tuberculosis must be taken consistently for the full duration prescribed, even when symptoms improve.
Question 9: Pharmacology
A frail older adult with chronic pain is prescribed a new transdermal fentanyl patch. Which instruction is most important for the nurse to give the caregiver?
- A. “Cut the patch in half if the client seems too sleepy.”
- B. “Apply the patch to a hairy area for better absorption.”
- C. “Dispose of used patches by folding them in half and placing them in a secure container.”
- D. “Change the patch every day at the same time.”
Show Answer & Rationale
Answer: C. “Dispose of used patches by folding them in half and placing them in a secure container.”
Rationale: The nurse must handle and dispose of controlled substances safely; used fentanyl patches still contain medication and should be folded adhesive sides together and discarded securely to prevent accidental or intentional misuse.
Question 10: Pharmacology
A 9-month-old infant weighing 9 kg is prescribed cefazolin 225 mg IM every 8 hours. The medication is available as 100 mg/mL. How many milliliters should the nurse prepare for one dose?
- A. 1.25 mL
- B. 2.0 mL
- C. 2.25 mL
- D. 3.0 mL
Show Answer & Rationale
Answer: C. 2.25 mL
Rationale: The nurse performs dosage calculations for safe medication administration; 225 mg divided by 100 mg/mL equals 2.25 mL.
Pharmacology Practice Tests
Free, timed NCLEX pharmacology questions with answers and full rationales: high-alert drugs, adverse effects, safe administration and client teaching, now organized by drug class. New tests are added to this series regularly.
Core Adult Pharmacology
Safe medication administration, adverse effects, and patient teaching basics.
High-Alert Medications
Anticoagulants, insulin, antiepileptics, opioids, and patient safety.
Pediatric, Oncology & OB
Chemotherapy agents, Rh immune globulin, oxytocin, and weight-based dosing.
Pediatric Meds & Controlled Substances
Insulin teaching, digoxin, vancomycin troughs, and safe controlled-substance handling.
Maternity & OB Pharmacology
Magnesium sulfate, epidurals, nifedipine, nalbuphine, and postpartum medications.
Cardiac Medications
Beta blockers, sacubitril/valsartan, amiodarone, nitrates, calcium channel blockers, adenosine, statins and clonidine.
Antibiotics and Antimicrobials
Fluoroquinolones, doxycycline, metronidazole, C. difficile, sulfonamides, linezolid, nystatin, acyclovir, nitrofurantoin and azithromycin.
Psychiatric Medications
Clozapine, NMS, acute dystonia, MAOIs, bupropion, benzodiazepines, valproate, olanzapine, ADHD stimulants and disulfiram.
Endocrine and Insulin
Levothyroxine, PTU, glucagon, SGLT2 inhibitors, GLP-1 agonists, insulin glargine and storage, adrenal insufficiency and desmopressin.
Anticoagulants
Warfarin, heparin and enoxaparin, DOACs, reversal agents, clopidogrel after a stent, alteplase and anticoagulant safety teaching.
Respiratory and GI Medications
Montelukast, tiotropium, LABA combination inhalers, theophylline, benzonatate, PPIs, sucralfate, metoclopramide, ondansetron and misoprostol.
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