NGN HESI RN Pharmacology Exam 2026 – Complete
Actual Questions & Verified Answers | 300+ Q&A |
Graded A+ | All Versions
Batch 1: Cardiovascular, Critical Care, & Renal (Questions 1–50)
1. A patient with chronic heart failure is prescribed Digoxin 0.125 mg daily; which
physiological finding should the nurse prioritize as an indicator of potential toxicity?
A) Serum potassium level of 4.8 mEq/L
B) Visual disturbances or seeing yellow-green halos around lights
C) Heart rate of 72 beats per minute
D) Increased urinary output following medication administration
B) Visual disturbances or seeing yellow-green halos around lights
Rationale: Early signs of digitalis toxicity typically include gastrointestinal upset
followed by neurological and visual disturbances such as seeing halos.
2. A nurse is preparing to administer Spironolactone to a patient with cirrhosis; which
serum laboratory value requires immediate notification of the healthcare provider before
administration?
A) Sodium level of 136 mEq/L
B) Potassium level of 5.6 mEq/L
C) Creatinine level of 0.9 mg/dL
D) Blood urea nitrogen of 18 mg/dL
B) Potassium level of 5.6 mEq/L
Rationale: Spironolactone is a potassium-sparing diuretic; administering it to a
hyperkalaemic patient could lead to fatal cardiac arrhythmias.
3. When teaching a patient about their new prescription for Nitroglycerin sublingual
tablets, which instruction is most critical for the nurse to include regarding emergency
use?
A) Swallow the tablet with a full glass of water for faster absorption.
B) Place one tablet under the tongue and call emergency services if pain persists
after five minutes.
C) Take up to five tablets at ten-minute intervals until the chest pain resolves.
D) Discard the medication if the tablets cause a tingling sensation under the tongue.
B) Place one tablet under the tongue and call emergency services if pain persists
after five minutes.
, Rationale: Current guidelines emphasize calling emergency services if the first
dose does not resolve symptoms within five minutes.
4. A patient receiving an intravenous infusion of Heparin for a pulmonary embolism has an
activated partial thromboplastin time (aPTT) of 110 seconds; which action should the
nurse take first?
A) Increase the infusion rate to maintain therapeutic levels.
B) Stop the infusion and prepare the antagonist Protamine Sulfate.
C) Document the finding as a therapeutic response to the medication.
D) Obtain a stool sample to check for occult blood.
B) Stop the infusion and prepare the antagonist Protamine Sulfate.
Rationale: An aPTT of 110 seconds is well above the therapeutic range and poses
a high risk for spontaneous haemorrhage.
5. A nurse is monitoring a patient who has just received their first dose of Lisinopril; which
assessment finding is most representative of a common but bothersome adverse
effect?
A) Excessive hair loss
B) Development of a persistent, dry, non-productive cough
C) Bright orange discoloration of the urine
D) Severe muscle tremors in the lower extremities
B) Development of a persistent, dry, non-productive cough
Rationale: ACE inhibitors cause a buildup of bradykinin in the lungs, leading to a
chronic dry cough that often requires a change in medication.
6. A patient is receiving a continuous intravenous infusion of Nitroprusside for a
hypertensive crisis; which laboratory value must the nurse monitor to detect potential
thiocyanate toxicity?
A) Serum potassium levels
B) Serum cyanide or thiocyanate levels
C) Blood urea nitrogen
D) Serum calcium levels
B) Serum cyanide or thiocyanate levels
Rationale: Nitroprusside is metabolized into thiocyanate; prolonged infusions or
high doses can lead to toxic accumulation and metabolic acidosis.
7. A patient with atrial fibrillation is starting a new prescription for Warfarin; which specific
dietary education is essential to ensure the stability of the international normalized ratio
(INR)?
, A) Eliminate all green leafy vegetables from the diet completely.
B) Maintain a consistent intake of foods rich in Vitamin K each day.
C) Increase the consumption of citrus fruits to improve medication absorption.
D) Avoid all dairy products while taking this specific anticoagulant medication.
B) Maintain a consistent intake of foods rich in Vitamin K each day.
Rationale: Sudden changes in Vitamin K intake can counteract Warfarin, causing
the INR to fluctuate and increasing the risk of clots or bleeding.
8. Before administering a scheduled dose of Metoprolol, which physical assessment
finding would require the nurse to withhold the medication and notify the healthcare
provider?
A) A respiratory rate of twenty-two breaths per minute
B) A systolic blood pressure of eighty-eight mmHg or heart rate under sixty
C) A temperature of ninety-nine degrees Fahrenheit
D) An oxygen saturation of ninety-four percent on room air
B) A systolic blood pressure of eighty-eight mmHg or heart rate under sixty
Rationale: Beta-blockers lower both heart rate and blood pressure; administering
them during hypotension or bradycardia can lead to cardiogenic shock.
9. A patient is prescribed Furosemide for the management of acute pulmonary edema;
which symptom reported by the patient is most indicative of the adverse effect of
ototoxicity?
A) Increased frequency of urination during the night
B) Tinnitus or a sensation of ringing in the ears
C) A bitter metallic taste in the mouth
D) Blurred vision when looking at bright lights
B) Tinnitus or a sensation of ringing in the ears
Rationale: High-dose or rapid IV administration of loop diuretics can cause
temporary or permanent damage to the auditory nerve.
10. A nurse is caring for a patient who is taking Atorvastatin for hyperlipidemia; which
musculoskeletal symptom must the patient report immediately to the healthcare provider
for further evaluation?
A) Increased flexibility in the joints
B) Unexplained muscle pain, tenderness, or weakness (Rhabdomyolysis)
C) A slight increase in energy levels
D) Mild swelling in the ankles at night
B) Unexplained muscle pain, tenderness, or weakness (Rhabdomyolysis)
, Rationale: Statins can cause a rare but fatal breakdown of muscle tissue that can
lead to acute renal failure.
11. A patient is receiving a continuous intravenous infusion of Dopamine at a high dose for
cardiogenic shock; which assessment finding is the most critical indicator of peripheral
tissue ischemia?
A) Increased urinary output of fifty milliliters per hour
B) Pale, cool extremities with a capillary refill time of more than four seconds
C) A systolic blood pressure reading of one hundred ten mmHg
D) A heart rate increase from eighty to ninety-five beats per minute
B) Pale, cool extremities with a capillary refill time of more than four seconds
Rationale: High-dose dopamine causes intense vasoconstriction; the nurse must
monitor for "clamped down" vessels that can lead to tissue death.
12. The nurse is monitoring a patient who has received Mannitol for increased intracranial
pressure; which physiological change indicates that the medication is producing the
desired osmotic effect?
A) Increased heart rate and elevated body temperature
B) Increased urinary output and a decrease in cerebral edema symptoms
C) Increased moisture in the mucous membranes and skin
D) Decreased blood pressure and increased respiratory rate
B) Increased urinary output and a decrease in cerebral edema symptoms
Rationale: Mannitol is an osmotic diuretic that pulls fluid from the brain tissue into
the vascular space to be excreted by the kidneys.
13. Which assessment is most important for a patient who is currently receiving an
intravenous infusion of Magnesium Sulfate to prevent pre-eclamptic seizures?
A) Monitoring the patient's visual acuity for signs of double vision
B) Checking deep tendon reflexes and monitoring the respiratory rate every hour
C) Assessing the patient for increased appetite and caloric intake
D) Measuring the circumference of the patient's calves twice daily
B) Checking deep tendon reflexes and monitoring the respiratory rate every hour
Rationale: Loss of deep tendon reflexes is the first sign of magnesium toxicity,
followed by life-threatening respiratory depression.
14. A patient is prescribed Cyclosporine for the prevention of organ rejection after a heart
transplant; which beverage should the patient be told to avoid completely?
A) Orange juice fortified with extra calcium
B) Grapefruit juice because it can significantly increase the drug's toxic levels
Actual Questions & Verified Answers | 300+ Q&A |
Graded A+ | All Versions
Batch 1: Cardiovascular, Critical Care, & Renal (Questions 1–50)
1. A patient with chronic heart failure is prescribed Digoxin 0.125 mg daily; which
physiological finding should the nurse prioritize as an indicator of potential toxicity?
A) Serum potassium level of 4.8 mEq/L
B) Visual disturbances or seeing yellow-green halos around lights
C) Heart rate of 72 beats per minute
D) Increased urinary output following medication administration
B) Visual disturbances or seeing yellow-green halos around lights
Rationale: Early signs of digitalis toxicity typically include gastrointestinal upset
followed by neurological and visual disturbances such as seeing halos.
2. A nurse is preparing to administer Spironolactone to a patient with cirrhosis; which
serum laboratory value requires immediate notification of the healthcare provider before
administration?
A) Sodium level of 136 mEq/L
B) Potassium level of 5.6 mEq/L
C) Creatinine level of 0.9 mg/dL
D) Blood urea nitrogen of 18 mg/dL
B) Potassium level of 5.6 mEq/L
Rationale: Spironolactone is a potassium-sparing diuretic; administering it to a
hyperkalaemic patient could lead to fatal cardiac arrhythmias.
3. When teaching a patient about their new prescription for Nitroglycerin sublingual
tablets, which instruction is most critical for the nurse to include regarding emergency
use?
A) Swallow the tablet with a full glass of water for faster absorption.
B) Place one tablet under the tongue and call emergency services if pain persists
after five minutes.
C) Take up to five tablets at ten-minute intervals until the chest pain resolves.
D) Discard the medication if the tablets cause a tingling sensation under the tongue.
B) Place one tablet under the tongue and call emergency services if pain persists
after five minutes.
, Rationale: Current guidelines emphasize calling emergency services if the first
dose does not resolve symptoms within five minutes.
4. A patient receiving an intravenous infusion of Heparin for a pulmonary embolism has an
activated partial thromboplastin time (aPTT) of 110 seconds; which action should the
nurse take first?
A) Increase the infusion rate to maintain therapeutic levels.
B) Stop the infusion and prepare the antagonist Protamine Sulfate.
C) Document the finding as a therapeutic response to the medication.
D) Obtain a stool sample to check for occult blood.
B) Stop the infusion and prepare the antagonist Protamine Sulfate.
Rationale: An aPTT of 110 seconds is well above the therapeutic range and poses
a high risk for spontaneous haemorrhage.
5. A nurse is monitoring a patient who has just received their first dose of Lisinopril; which
assessment finding is most representative of a common but bothersome adverse
effect?
A) Excessive hair loss
B) Development of a persistent, dry, non-productive cough
C) Bright orange discoloration of the urine
D) Severe muscle tremors in the lower extremities
B) Development of a persistent, dry, non-productive cough
Rationale: ACE inhibitors cause a buildup of bradykinin in the lungs, leading to a
chronic dry cough that often requires a change in medication.
6. A patient is receiving a continuous intravenous infusion of Nitroprusside for a
hypertensive crisis; which laboratory value must the nurse monitor to detect potential
thiocyanate toxicity?
A) Serum potassium levels
B) Serum cyanide or thiocyanate levels
C) Blood urea nitrogen
D) Serum calcium levels
B) Serum cyanide or thiocyanate levels
Rationale: Nitroprusside is metabolized into thiocyanate; prolonged infusions or
high doses can lead to toxic accumulation and metabolic acidosis.
7. A patient with atrial fibrillation is starting a new prescription for Warfarin; which specific
dietary education is essential to ensure the stability of the international normalized ratio
(INR)?
, A) Eliminate all green leafy vegetables from the diet completely.
B) Maintain a consistent intake of foods rich in Vitamin K each day.
C) Increase the consumption of citrus fruits to improve medication absorption.
D) Avoid all dairy products while taking this specific anticoagulant medication.
B) Maintain a consistent intake of foods rich in Vitamin K each day.
Rationale: Sudden changes in Vitamin K intake can counteract Warfarin, causing
the INR to fluctuate and increasing the risk of clots or bleeding.
8. Before administering a scheduled dose of Metoprolol, which physical assessment
finding would require the nurse to withhold the medication and notify the healthcare
provider?
A) A respiratory rate of twenty-two breaths per minute
B) A systolic blood pressure of eighty-eight mmHg or heart rate under sixty
C) A temperature of ninety-nine degrees Fahrenheit
D) An oxygen saturation of ninety-four percent on room air
B) A systolic blood pressure of eighty-eight mmHg or heart rate under sixty
Rationale: Beta-blockers lower both heart rate and blood pressure; administering
them during hypotension or bradycardia can lead to cardiogenic shock.
9. A patient is prescribed Furosemide for the management of acute pulmonary edema;
which symptom reported by the patient is most indicative of the adverse effect of
ototoxicity?
A) Increased frequency of urination during the night
B) Tinnitus or a sensation of ringing in the ears
C) A bitter metallic taste in the mouth
D) Blurred vision when looking at bright lights
B) Tinnitus or a sensation of ringing in the ears
Rationale: High-dose or rapid IV administration of loop diuretics can cause
temporary or permanent damage to the auditory nerve.
10. A nurse is caring for a patient who is taking Atorvastatin for hyperlipidemia; which
musculoskeletal symptom must the patient report immediately to the healthcare provider
for further evaluation?
A) Increased flexibility in the joints
B) Unexplained muscle pain, tenderness, or weakness (Rhabdomyolysis)
C) A slight increase in energy levels
D) Mild swelling in the ankles at night
B) Unexplained muscle pain, tenderness, or weakness (Rhabdomyolysis)
, Rationale: Statins can cause a rare but fatal breakdown of muscle tissue that can
lead to acute renal failure.
11. A patient is receiving a continuous intravenous infusion of Dopamine at a high dose for
cardiogenic shock; which assessment finding is the most critical indicator of peripheral
tissue ischemia?
A) Increased urinary output of fifty milliliters per hour
B) Pale, cool extremities with a capillary refill time of more than four seconds
C) A systolic blood pressure reading of one hundred ten mmHg
D) A heart rate increase from eighty to ninety-five beats per minute
B) Pale, cool extremities with a capillary refill time of more than four seconds
Rationale: High-dose dopamine causes intense vasoconstriction; the nurse must
monitor for "clamped down" vessels that can lead to tissue death.
12. The nurse is monitoring a patient who has received Mannitol for increased intracranial
pressure; which physiological change indicates that the medication is producing the
desired osmotic effect?
A) Increased heart rate and elevated body temperature
B) Increased urinary output and a decrease in cerebral edema symptoms
C) Increased moisture in the mucous membranes and skin
D) Decreased blood pressure and increased respiratory rate
B) Increased urinary output and a decrease in cerebral edema symptoms
Rationale: Mannitol is an osmotic diuretic that pulls fluid from the brain tissue into
the vascular space to be excreted by the kidneys.
13. Which assessment is most important for a patient who is currently receiving an
intravenous infusion of Magnesium Sulfate to prevent pre-eclamptic seizures?
A) Monitoring the patient's visual acuity for signs of double vision
B) Checking deep tendon reflexes and monitoring the respiratory rate every hour
C) Assessing the patient for increased appetite and caloric intake
D) Measuring the circumference of the patient's calves twice daily
B) Checking deep tendon reflexes and monitoring the respiratory rate every hour
Rationale: Loss of deep tendon reflexes is the first sign of magnesium toxicity,
followed by life-threatening respiratory depression.
14. A patient is prescribed Cyclosporine for the prevention of organ rejection after a heart
transplant; which beverage should the patient be told to avoid completely?
A) Orange juice fortified with extra calcium
B) Grapefruit juice because it can significantly increase the drug's toxic levels
