13–19% of the NCLEX-RN

Pharmacology NCLEX practice questions

Adverse effects and interactions, blood products, dosage calculation, expected actions, medication administration, parenteral and IV therapies, and pain management.

13–19%of scored items on the 2026 test plan
185Pharmacology questions in the Aegis bank
6free samples below
Question 1 Multiple choice hard

A client with new-onset A-fib is started on apixaban. Which client teaching is most important?

  1. A.Take with food only
  2. B.Report any signs of bleeding (gums, urine, stool, bruising)
  3. C.INR will be checked weekly
  4. D.Avoid all leafy green vegetables
Show answer and rationale

Correct answer: B · DOAC anticoagulation

Apixaban (Eliquis) is a DOAC — no routine INR monitoring needed and no dietary restrictions. Bleeding precautions are essential. Vitamin K restriction is for warfarin.

Question 2 Multiple choice hard

A client takes prednisone 40 mg daily for 3 months and now needs to discontinue. The nurse should:

  1. A.Stop abruptly
  2. B.Taper gradually to allow adrenal recovery
  3. C.Switch to IV
  4. D.Double the dose first
Show answer and rationale

Correct answer: B · Steroid tapering

Long-term steroids suppress HPA axis. Abrupt cessation → adrenal crisis. Always taper gradually. Stress doses needed for surgery/illness during taper.

Question 3 Multiple choice hard

A client takes spironolactone for heart failure. Which lab finding requires the nurse to notify the provider?

  1. A.Sodium 138
  2. B.Potassium 5.8 mEq/L
  3. C.Glucose 110
  4. D.Creatinine 1.0
Show answer and rationale

Correct answer: B · Spironolactone — hyperkalemia

Spironolactone is a potassium-sparing diuretic — risk of hyperkalemia, especially with ACE inhibitors/ARBs. K+ > 5.0 needs attention; > 5.5 → consider dose change, > 6.0 → urgent.

Question 4 Multiple choice hard

A client has been receiving long-term opioid therapy and is being switched to a new opioid. The nurse should be aware of:

  1. A.Opioid switching has no risk
  2. B.Use opioid equianalgesic table; reduce calculated dose by 25-50% to account for incomplete cross-tolerance
  3. C.Give equivalent dose without adjustment
  4. D.Double the calculated dose
Show answer and rationale

Correct answer: B · Opioid rotation safety

Opioid rotation: equianalgesic table calculates equivalent dose; reduce 25-50% (incomplete cross-tolerance, individual variability). Closely monitor for sedation, RR.

Question 5 Select all that apply hard

A client with TB is starting RIPE therapy (rifampin, isoniazid, pyrazinamide, ethambutol). Which teaching points are correct? Select all that apply.

  1. A.Rifampin will turn body fluids orange
  2. B.Take vitamin B6 (pyridoxine) to prevent isoniazid neuropathy
  3. C.Discontinue medications when symptoms improve
  4. D.Avoid alcohol
  5. E.Get baseline and periodic vision testing for ethambutol
Show answer and rationale

Correct answer: A, B, D, E · TB pharmacology

Rifampin = orange fluids. INH causes peripheral neuropathy (B6 prevents). Alcohol increases hepatotoxicity. Ethambutol can cause optic neuritis. Therapy is 6+ months — never stop early.

Question 6 Select 3 hard

A 70-year-old client receiving IV vancomycin develops sudden upper body flushing, itching, and BP drop from 132/80 to 98/60 during the infusion. Which actions are appropriate? Select 3.

  1. A.Stop the infusion temporarily
  2. B.Administer diphenhydramine and slow the infusion rate when restarted
  3. C.Notify the provider
  4. D.Administer epinephrine immediately as for anaphylaxis
  5. E.Discontinue vancomycin permanently
Show answer and rationale

Correct answer: A, B, C · Vancomycin red man response

"Red man syndrome" = histamine release from rapid vancomycin infusion. Stop, antihistamine, slow rate when restarted, notify provider. NOT a true allergy. Anaphylaxis would require epinephrine.

What Pharmacology tests

  • Adverse effects and interactions
  • Dosage calculation
  • Medication administration
  • IV therapy and central venous access
  • Blood and blood products
  • Pharmacological pain management

How to study it

Drill this category in the app until your accuracy holds above 70%, then move it into mixed practice. Aegis tracks Pharmacology separately in your coverage map and will surface it as "today's best move" when it is the weakest link in your readiness score.

Back to all categories · See the 4-week study plan

Pharmacology FAQ

What percentage of the NCLEX-RN is Pharmacological and Parenteral Therapies?

Pharmacological and Parenteral Therapies makes up 13–19% of scored items on the 2026 NCSBN NCLEX-RN Test Plan, effective April 1, 2026.

What topics does Pharmacology cover?

Adverse effects and interactions, blood products, dosage calculation, expected actions, medication administration, parenteral and IV therapies, and pain management. Key content areas include adverse effects and interactions, dosage calculation, medication administration, iv therapy and central venous access, and more.

How many Pharmacology questions are in Aegis?

185 standalone questions, plus related sub-questions inside the 100 NGN case studies. The free tier gives you 25 questions a day across any category.

Other categories

15–21%

Management of Care

10–16%

Safety & Infection Control

6–12%

Health Promotion

6–12%

Psychosocial Integrity

6–12%

Basic Care & Comfort

9–15%

Risk Reduction

11–17%

Physiological Adaptation

Practice 185 Pharmacology questions in the app.

25 questions a day, 3 NGN case studies, and a full mock exam are free. No account, no sign-up.

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