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Nursing Pharmacology & Ward Administration (Nursing & Patient Care) Solved Questions & Notes (2026) - Apex Rankers

Medical & Health Sciences > Nursing & Patient Care > Nursing Pharmacology & Ward Administration

37 Total Solved Questions
~56 mins Estimated Reading Time
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Nursing Pharmacology & Ward Administration

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Q. 1 Nursing
Difficulty: Easy (1 Mark)
What are the traditional 'Five Rights' (now extended to Six/Eight) of medication administration that every nurse must verify?
A
Right Hospital, Right Doctor, Right Bed, Right Time, Right Chart
B
Right Patient, Right Drug, Right Dose, Right Route, Right Time, and Right Documentation
✓ Correct
C
Right Price, Right Brand, Right Ward, Right Date, Right Shelf
D
Right Room, Right Nurse, Right Diagnosis, Right Needle, Right Syringe
💡 Step-by-Step Explanation & Concept Rationale
The core rights of medication administration ensure patient safety: Right patient, drug, dose, route, time, documentation, and checking for allergies.
Q. 2 Nursing
Difficulty: Medium (1 Mark)
A physician orders 1,000 mL of 0.9% Normal Saline to be infused intravenously over 8 hours. The drop factor of the infusion set is 15 drops/mL. What is the calculated flow rate in drops per minute (gtts/min)?
A
15 gtts/min
B
31 gtts/min
✓ Correct
C
52 gtts/min
D
60 gtts/min
💡 Step-by-Step Explanation & Concept Rationale
Flow rate = (Total Volume in mL × Drop Factor) / Time in minutes. (1000 × 15) / (8 × 60) = 15000 / 480 ≈ 31.25 drops/min (31 gtts/min).
Q. 3 Nursing
Difficulty: Easy (1 Mark)
Prior to administering a prescribed dose of Digoxin, the nurse should routinely assess which vital sign and withhold the drug if it is below 60 bpm in an adult?
A
Respiratory rate
B
Apical pulse for one full minute
✓ Correct
C
Radial pulse for 10 seconds
D
Blood pressure
💡 Step-by-Step Explanation & Concept Rationale
Digoxin is a cardiac glycoside that slows AV conduction; apical pulse must be counted for 60 seconds and the drug held if heart rate < 60 bpm to prevent toxic bradycardia.
Q. 4 Nursing
Difficulty: Easy (1 Mark)
Which laboratory parameter must be closely monitored by the nurse in a patient receiving continuous intravenous unfractionated heparin therapy?
A
Prothrombin Time (PT / INR)
B
Activated Partial Thromboplastin Time (aPTT)
✓ Correct
C
Serum Creatinine
D
Serum Amylase
💡 Step-by-Step Explanation & Concept Rationale
Unfractionated heparin therapy is titrated against the aPTT (target typically 1.5 to 2.5 times the control baseline). In contrast, Warfarin is monitored with PT/INR.
Q. 5 Nursing
Difficulty: Easy (1 Mark)
When storing high-alert controlled substances such as Morphine, Pethidine, and Fentanyl in a hospital ward, what is the mandatory regulatory protocol?
A
Stored in the general open medication tray
B
Kept in a locked cupboard (double lock system) with a formal register tracking every ampoule, patient name, and wasted dose
✓ Correct
C
Kept on the nurse's desk
D
Stored with general oral vitamins
💡 Step-by-Step Explanation & Concept Rationale
Dangerous and scheduled controlled drugs require double-locked storage, dual-nurse sign-off for waste, and meticulous accountability logs according to narcotics control legislation.
Q. 6 Nursing
Difficulty: Medium (1 Mark)
Which needle gauge and length is typically selected by a nurse for an intradermal injection (such as a Mantoux tuberculin test)?
A
18 gauge, 1.5 inch
B
21 gauge, 1.0 inch
C
26 to 27 gauge, 3/8 to 1/2 inch
✓ Correct
D
14 gauge, 2.0 inch
💡 Step-by-Step Explanation & Concept Rationale
Intradermal injections require a very fine, short needle (26-27 gauge, 3/8 to 1/2 inch) inserted bevel-up at a 5-15 degree angle to create a visible wheal.
Q. 7 Nursing
Difficulty: Easy (1 Mark)
In a hospital shift handover, which standardized communication framework is widely recommended to ensure patient safety and transfer of critical clinical information?
A
SOAP format only
B
SBAR (Situation, Background, Assessment, Recommendation)
✓ Correct
C
Informal verbal chat
D
Written memo on whiteboard
💡 Step-by-Step Explanation & Concept Rationale
SBAR provides a structured, concise method for communicating patient condition between nurses and physicians, significantly reducing clinical communication errors.
Q. 8 Nursing
Difficulty: Easy (1 Mark)
The specific antidote kept readily available on the ward for rapid reversal of unfractionated Heparin overdose is:
A
Vitamin K
B
Protamine sulfate
✓ Correct
C
Calcium gluconate
D
Naloxone
💡 Step-by-Step Explanation & Concept Rationale
Protamine sulfate is a strongly basic protein that binds strongly acidic heparin to form an inactive stable salt, neutralizing its anticoagulant effects.
Q. 9 Nursing
Difficulty: Easy (1 Mark)
Which of the following describes the ethical nursing principle of 'Autonomy'?
A
The duty to do good and promote patient well-being
B
Respecting the patient's right to make their own informed decisions about their care
✓ Correct
C
The obligation to treat all patients fairly and equitably
D
The duty to do no harm (non-maleficence)
💡 Step-by-Step Explanation & Concept Rationale
Autonomy is the ethical principle upholding a competent patient's right to self-determination, informed consent, and refusal of treatment.
Q. 10 Nursing
Difficulty: Easy (1 Mark)
When administering an subcutaneous injection of regular insulin, which site has the fastest and most consistent rate of systemic absorption?
A
Anterior thigh
B
Abdomen (avoiding a 2-inch radius around umbilicus)
✓ Correct
C
Outer upper arm
D
Gluteal area
💡 Step-by-Step Explanation & Concept Rationale
The abdomen provides the most rapid and consistent absorption of subcutaneous insulin, followed by the arms, thighs, and buttocks.
Q. 11 Nursing
Difficulty: Easy (1 Mark)
Before administering a scheduled dose of metoprolol (a beta-blocker), the nurse should assess:
A
Pupil diameter and reflexes
B
Heart rate and blood pressure
✓ Correct
C
Blood glucose and ketones
D
Serum calcium
💡 Step-by-Step Explanation & Concept Rationale
Beta-blockers cause negative chronotropy and inotropy; doses are withheld if heart rate is < 60 bpm or systolic blood pressure < 100 mmHg.
Q. 12 Nursing
Difficulty: Easy (1 Mark)
What is the immediate action when a nurse discovers a medication administration error?
A
Inform the patient's family first
B
Assess and monitor the patient's vital signs and clinical condition immediately, then notify the physician and complete an incident report
✓ Correct
C
Keep it confidential if the patient feels fine
D
Alter the chart to match the administered drug
💡 Step-by-Step Explanation & Concept Rationale
Patient safety is the top priority; assessing the patient for adverse consequences comes first, followed by immediate physician notification and formal incident documentation.
Q. 13 Nursing
Difficulty: Easy (1 Mark)
Sublingual nitroglycerin tablets prescribed for acute angina pectoris should be instructed to:
A
Be swallowed whole with a glass of water
B
Be dissolved under the tongue without swallowing or chewing
✓ Correct
C
Be chewed before meals
D
Be dissolved in warm tea
💡 Step-by-Step Explanation & Concept Rationale
Sublingual administration bypasses extensive hepatic first-pass metabolism, allowing rapid absorption directly into systemic circulation within 1-3 minutes.
Q. 14 Nursing
Difficulty: Easy (1 Mark)
A nurse is caring for a patient on Furosemide (Lasix). Which electrolyte imbalance is the patient at greatest risk of developing?
A
Hyperkalemia
B
Hypokalemia
✓ Correct
C
Hypernatremia
D
Hypercalcemia
💡 Step-by-Step Explanation & Concept Rationale
Loop diuretics enhance potassium excretion in the urine, requiring regular serum potassium monitoring and potassium-rich diet or supplements.
Q. 15 Nursing
Difficulty: Easy (1 Mark)
What is the primary role of the triage nurse in an emergency department?
A
Admitting all patients to ward beds
B
Rapidly prioritizing patients based on the severity and urgency of their clinical presentation
✓ Correct
C
Collecting hospital admission fees
D
Dispensing pharmacy medications
💡 Step-by-Step Explanation & Concept Rationale
Emergency triage sorts incoming patients based on acuity (e.g., Resuscitation, Emergent, Urgent, Non-urgent) so that critically ill patients receive immediate intervention.
Q. 16 Nursing
Difficulty: Medium (1 Mark)
When drawing up Regular (clear) insulin and NPH (cloudy) insulin into a single syringe, what is the correct sequence?
A
Inject air into cloudy, inject air into clear, draw up clear, then draw up cloudy
✓ Correct
B
Draw up cloudy first, then draw up clear
C
Never mix two insulins in one syringe
D
Draw up whichever insulin is closest
💡 Step-by-Step Explanation & Concept Rationale
The mnemonic 'Clear before Cloudy' prevents contaminating the fast-acting clear Regular insulin vial with intermediate cloudy NPH insulin.
Q. 17 Nursing
Difficulty: Medium (1 Mark)
Which adverse effect of opioid analgesics does NOT develop tolerance over time and requires proactive nursing bowel management?
A
Sedation
B
Constipation
✓ Correct
C
Nausea
D
Euphoria
💡 Step-by-Step Explanation & Concept Rationale
Patients develop tolerance to opioid-induced sedation and nausea, but tolerance to constipation and miosis never occurs; prophylactic laxatives and hydration are mandatory.
Q. 18 Nursing
Difficulty: Easy (1 Mark)
In preparing a sterile tray on the ward, which portion of the sterile field is considered non-sterile (contaminated)?
A
The center of the sterile drape
B
The outer 1-inch (2.5 cm) margin around the perimeter of the drape
✓ Correct
C
Any surface above the waist
D
Instruments placed inside the field
💡 Step-by-Step Explanation & Concept Rationale
The 1-inch border along the outer edges of a sterile drape is considered unsterile because it is vulnerable to contact with unsterile surroundings.
Q. 19 Nursing
Difficulty: Easy (1 Mark)
What is the primary antidote administered to reverse the toxic respiratory depression caused by benzodiazepines (e.g., Diazepam, Midazolam)?
A
Naloxone
B
Flumazenil
✓ Correct
C
N-acetylcysteine
D
Atropine
💡 Step-by-Step Explanation & Concept Rationale
Flumazenil is a competitive antagonist at the central GABA-benzodiazepine receptor complex, reversing benzodiazepine sedation.
Q. 20 Nursing
Difficulty: Easy (1 Mark)
The primary purpose of applying a tourniquet on a limb during venous blood collection is to:
A
Stop arterial blood flow
B
Distend and engorge the veins by impeding superficial venous return
✓ Correct
C
Anesthetize the puncture site
D
Sterilize the skin
💡 Step-by-Step Explanation & Concept Rationale
A tourniquet obstructs venous return while permitting arterial inflow, dilating peripheral veins for easier venipuncture; it should not remain on for > 1 minute.
Q. 21 Nursing
Difficulty: Medium (1 Mark)
Clinical Scenario 4: In managing a specialized nursing procedure for Nursing Pharmacology & Ward Administration, which clinical standard ensures optimal patient safety and outcome?
A
Adhere strictly to aseptic technique, continuous vital signs monitoring, and documentation of patient tolerance
✓ Correct
B
Bypass safety checklists to expedite bedside care
C
Delegate patient assessment to non-clinical orderlies
D
Administer medication without checking physician orders
💡 Step-by-Step Explanation & Concept Rationale
Adherence to institutional aseptic guidelines, rigorous monitoring of patient physiological responses, and precise charting constitute the gold standard of professional nursing accountability.
Q. 22 Nursing
Difficulty: Medium (1 Mark)
Clinical Scenario 8: In managing a specialized nursing procedure for Nursing Pharmacology & Ward Administration, which clinical standard ensures optimal patient safety and outcome?
A
Adhere strictly to aseptic technique, continuous vital signs monitoring, and documentation of patient tolerance
✓ Correct
B
Bypass safety checklists to expedite bedside care
C
Delegate patient assessment to non-clinical orderlies
D
Administer medication without checking physician orders
💡 Step-by-Step Explanation & Concept Rationale
Adherence to institutional aseptic guidelines, rigorous monitoring of patient physiological responses, and precise charting constitute the gold standard of professional nursing accountability.
Q. 23 Nursing
Difficulty: Medium (1 Mark)
Clinical Scenario 12: In managing a specialized nursing procedure for Nursing Pharmacology & Ward Administration, which clinical standard ensures optimal patient safety and outcome?
A
Adhere strictly to aseptic technique, continuous vital signs monitoring, and documentation of patient tolerance
✓ Correct
B
Bypass safety checklists to expedite bedside care
C
Delegate patient assessment to non-clinical orderlies
D
Administer medication without checking physician orders
💡 Step-by-Step Explanation & Concept Rationale
Adherence to institutional aseptic guidelines, rigorous monitoring of patient physiological responses, and precise charting constitute the gold standard of professional nursing accountability.
Q. 24 Nursing
Difficulty: Medium (1 Mark)
Clinical Scenario 16: In managing a specialized nursing procedure for Nursing Pharmacology & Ward Administration, which clinical standard ensures optimal patient safety and outcome?
A
Adhere strictly to aseptic technique, continuous vital signs monitoring, and documentation of patient tolerance
✓ Correct
B
Bypass safety checklists to expedite bedside care
C
Delegate patient assessment to non-clinical orderlies
D
Administer medication without checking physician orders
💡 Step-by-Step Explanation & Concept Rationale
Adherence to institutional aseptic guidelines, rigorous monitoring of patient physiological responses, and precise charting constitute the gold standard of professional nursing accountability.
Q. 25 Nursing
Difficulty: Medium (1 Mark)
Clinical Scenario 20: In managing a specialized nursing procedure for Nursing Pharmacology & Ward Administration, which clinical standard ensures optimal patient safety and outcome?
A
Adhere strictly to aseptic technique, continuous vital signs monitoring, and documentation of patient tolerance
✓ Correct
B
Bypass safety checklists to expedite bedside care
C
Delegate patient assessment to non-clinical orderlies
D
Administer medication without checking physician orders
💡 Step-by-Step Explanation & Concept Rationale
Adherence to institutional aseptic guidelines, rigorous monitoring of patient physiological responses, and precise charting constitute the gold standard of professional nursing accountability.
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