This free timed practice test delivers 10 NCLEX pharmacology questions with answers and rationales with a strong focus on pediatric medication safety — a common source of tricky NCLEX items.
You’ll review prednisone, ferrous sulfate, pediatric antibiotics, beta-agonists, controlled-substance handling, insulin teaching, vancomycin trough timing, rescue diazepam, digoxin, and filgrastim.
You’ll get 2 minutes per question on a built-in timer to build speed and accuracy. Pick your answer, then read the rationale to understand the nursing priority behind each choice.
When you’re ready for more, use the links at the end for additional 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 6-year-old child with nephrotic syndrome is receiving oral prednisone. Which parent statement indicates a need for further teaching?
- A. “We will avoid crowded places during cold and flu season.”
- B. “We will not stop the steroid suddenly; we will follow the taper schedule.”
- C. “We will check with the provider before any live vaccines are given.”
- D. “We will give an extra dose if swelling in the legs increases.”
Show Answer & Rationale
Answer: D. “We will give an extra dose if swelling in the legs increases.”
Rationale: The nurse educates caregivers about medication safety; corticosteroid doses must not be changed without provider direction, and increasing the dose independently increases the risk of serious adverse effects.
Question 2: Pharmacology
A toddler with iron-deficiency anemia is prescribed oral ferrous sulfate. Which instruction should the nurse give the parents to maximize absorption and reduce complications?
- A. “Give the iron with milk to protect the stomach.”
- B. “Mix the iron with orange juice and use a straw.”
- C. “Crush the tablet and mix it in cereal.”
- D. “Give the iron at bedtime with a full glass of water.”
Show Answer & Rationale
Answer: B. “Mix the iron with orange juice and use a straw.”
Rationale: The nurse promotes effective therapy and risk reduction; vitamin C enhances iron absorption, and using a straw helps prevent tooth staining commonly associated with liquid iron preparations.
Question 3: Pharmacology
The nurse is reviewing discharge teaching for the parent of a 3-year-old prescribed an oral liquid antibiotic for otitis media. Which statement by the parent indicates correct understanding?
- A. “If my child feels better, I can stop the medicine after a few days.”
- B. “I will use the kitchen teaspoon to measure the dose.”
- C. “If my child vomits once after a dose, I will repeat it immediately.”
- D. “I will give the medicine for the full number of days prescribed.”
Show Answer & Rationale
Answer: D. “I will give the medicine for the full number of days prescribed.”
Rationale: The nurse educates about medication adherence; completing the entire course of antibiotics helps eradicate infection and reduce the risk of resistance, even if symptoms improve.
Question 4: Pharmacology
A 5-year-old with acute asthma exacerbation is prescribed a nebulized short-acting beta agonist every 2 hours as needed. Which finding requires the nurse to contact the primary health care provider before giving another dose?
- A. Heart rate 110, slightly above baseline
- B. Mild hand tremors after the last treatment
- C. Heart rate 170 with complaints of chest discomfort
- D. Respiratory rate 26 with occasional cough
Show Answer & Rationale
Answer: C. Heart rate 170 with complaints of chest discomfort
Rationale: The nurse must review assessment data before medication administration; significant tachycardia with chest discomfort may indicate excessive beta-agonist effect and cardiac stress, so the provider should be notified before additional doses.
Question 5: Pharmacology
The nurse prepares IV morphine for a 10-year-old child after abdominal surgery. Which action best demonstrates safe management of this controlled substance?
- A. Leaving the vial at the bedside in case another dose is needed
- B. Wasting any unused portion with another licensed nurse as a witness
- C. Documenting the full vial dose even if only half was administered
- D. Asking the parent to verify the amount wasted to save staff time
Show Answer & Rationale
Answer: B. Wasting any unused portion with another licensed nurse as a witness
Rationale: The nurse must handle and administer controlled substances within regulatory guidelines; wasting unused opioid doses requires a licensed witness and appropriate documentation to prevent diversion.
Question 6: Pharmacology
A 12-year-old with type 1 diabetes uses rapid-acting insulin with meals and long-acting insulin at bedtime. Which statement by the child indicates correct understanding of insulin therapy and health promotion?
- A. “If I skip a meal, I should still take my usual rapid insulin dose.”
- B. “I need to rotate my injection sites within the same body area each week.”
- C. “I only need to check my blood sugar when I do not feel well.”
- D. “If I exercise more than usual, I should never carry snacks with me.”
Show Answer & Rationale
Answer: B. “I need to rotate my injection sites within the same body area each week.”
Rationale: The nurse educates about medication self-management; rotating injection sites within one anatomical area promotes consistent absorption and reduces lipodystrophy while maintaining predictable insulin action.
Question 7: Pharmacology
A 7-year-old receiving IV vancomycin for osteomyelitis has a new prescription for trough level monitoring. Which nursing action is most appropriate?
- A. Draw the blood sample 30 minutes after starting the infusion
- B. Draw the blood sample at the midpoint of the infusion
- C. Draw the blood sample immediately before the next scheduled dose
- D. Draw the blood sample immediately after the infusion finishes
Show Answer & Rationale
Answer: C. Draw the blood sample immediately before the next scheduled dose
Rationale: The nurse applies knowledge of pharmacokinetics and laboratory monitoring; vancomycin trough levels are obtained just before the next dose to evaluate whether the lowest serum concentration remains within therapeutic range.
Question 8: Pharmacology
A 2-year-old child with a history of seizures is prescribed rectal diazepam for home use during prolonged seizures. Which instruction should the nurse give the parents to promote safety?
- A. “Call emergency services if the seizure lasts more than 5 minutes after giving the medicine.”
- B. “Give another full dose immediately if the child remains sleepy.”
- C. “Administer the medication for every brief staring spell.”
- D. “Store the medication in the refrigerator next to the child’s drinks.”
Show Answer & Rationale
Answer: A. “Call emergency services if the seizure lasts more than 5 minutes after giving the medicine.”
Rationale: The nurse educates caregivers about emergency medication use; if seizure activity continues after rescue diazepam, emergency services must be contacted because the child is at risk for status epilepticus and respiratory compromise.
Question 9: Pharmacology
An infant with congenital heart disease is prescribed digoxin. Which finding would cause the nurse to hold the medication and notify the primary health care provider?
- A. Heart rate 140 in a calm infant
- B. Vomiting one hour after feeding and medication
- C. Heart rate 80 in a calm infant
- D. Slightly decreased appetite at one feeding
Show Answer & Rationale
Answer: C. Heart rate 80 in a calm infant
Rationale: The nurse reviews vital signs before administering high-risk medications; bradycardia relative to age is a sign of possible digoxin toxicity in infants and warrants holding the dose and notifying the provider.
Question 10: Pharmacology
A 14-year-old undergoing chemotherapy is prescribed filgrastim. The parent asks about the purpose of this medication. Which response by the nurse is most accurate and age-appropriate?
- A. “It helps prevent blood clots from forming.”
- B. “It boosts white blood cell production to help fight infection.”
- C. “It replaces red blood cells lost during treatment.”
- D. “It stops the cancer cells from dividing.”
Show Answer & Rationale
Answer: B. “It boosts white blood cell production to help fight infection.”
Rationale: The nurse educates about medications and health promotion; filgrastim is a colony-stimulating factor that increases neutrophil production, lowering the child’s risk for infection during chemotherapy-induced neutropenia.
NCLEX Pharmacology Practice Tests
Sharpen your medication knowledge with 50 free, timed pharmacology questions — complete with answers and detailed rationales. Work through all five tests to cover the drug classes the NCLEX tests most.
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.
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