Giving medications safely, dosage math, adverse effects, and blood products. Try 8 free questions below, each with the answer, a rationale, and the source it was checked against.
13–19% of the NCLEX-RN182 questions in NCLEXSimReviewed October 2026
Pharmacological and Parenteral Therapies is one of the eight client needs categories in the NCSBN NCLEX-RN test plan. Expect questions on Dosage calculation, High-alert drugs, Antidotes, IV therapy, Adverse effects, and Transfusions.
A client who started haloperidol yesterday has a sudden painful spasm that twists the neck to one side. Which medication should the nurse expect to give?
Correct answer: D
Acute dystonia is treated with an anticholinergic such as benztropine or with diphenhydramine, given IM or IV for rapid relief. Dantrolene is used for NMS.
Source: Lehne's Pharmacology for Nursing Care, 12th ed. (antipsychotic EPS)
A client is receiving IV acyclovir. Which nursing action helps prevent kidney injury?
Correct answer: A
Acyclovir can crystallize in the renal tubules. Adequate hydration and infusing over at least 1 hour reduce the risk.
Source: FDA label: Acyclovir sodium injection, DailyMed
A child is starting methylphenidate for ADHD. What should the nurse teach the parents?
Correct answer: A
Stimulants are given early in the day to avoid insomnia. They can decrease appetite and slow growth, so weight and height are monitored.
Source: FDA label: Ritalin (methylphenidate), DailyMed
Which instructions should the nurse include for a client starting warfarin? Select all that apply.
Correct answers: C, D, E
Consistent vitamin K intake keeps INR stable, black stools may signal GI bleeding, and soft toothbrushes reduce gum bleeding. Aspirin increases bleeding risk, and missed doses are never doubled.
Source: FDA label: Coumadin (warfarin), DailyMed (patient counseling)
Which instruction should the nurse give a client taking lithium?
Correct answer: C
Lithium is excreted like sodium. Low sodium or dehydration (sweating, vomiting, diarrhea) increases lithium levels and toxicity risk. Consistent salt and fluid intake (usually 2 to 3 L/day) keeps levels stable.
Source: FDA label: Lithium carbonate, DailyMed; Varcarolis, 9th ed.
A client is starting linezolid. What should the nurse teach?
Correct answer: C
Linezolid is a weak MAO inhibitor. Large amounts of tyramine can raise blood pressure, and combining it with serotonergic drugs can cause serotonin syndrome.
Source: FDA label: Zyvox (linezolid), DailyMed
Heparin 5,000 units subcutaneously is prescribed. The vial contains 10,000 units/mL. How many mL should the nurse give?
Answer: 0.5 mL
5,000 units ÷ 10,000 units/mL = 0.5 mL.
Source: Pickar. Dosage Calculations; ISMP High-Alert Medications
A client has a tonic-clonic seizure lasting more than 5 minutes. Which medication should the nurse expect to give first?
Correct answer: C
Status epilepticus is a seizure lasting 5 minutes or longer. A benzodiazepine (IV lorazepam, IM midazolam, or IV diazepam) is first-line, followed by a second-line agent such as fosphenytoin or levetiracetam.
Source: American Epilepsy Society. Guideline: Treatment of Convulsive Status Epilepticus (2016)
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