LPN HESI PHARMACOLOGY 2026 COMPLETE PRACTICE EXAM –
404 QUESTIONS VERIFIED ANSWERS WITH DETAILED
CLINICAL RATIONALES REAL EXAM QUESTIONS | A+ GRADED
UPDATED 2026 EDITION
TABLE OF CONTENTS
DOMAIN 1: PAIN MANAGEMENT AND OPIOIDS Questions 1-50
DOMAIN 2: ANTIDIABETIC AGENTS Questions 51-90
DOMAIN 3: CARDIOVASCULAR MEDICATIONS Questions 91-140
DOMAIN 4: ANTIBIOTICS AND ANTI-INFECTIVES Questions 141-190
DOMAIN 5: RESPIRATORY MEDICATIONS Questions 191-230
DOMAIN 6: GASTROINTESTINAL MEDICATIONS Questions 231-260
DOMAIN 7: HEMATOLOGIC AND ANTICOAGULANT THERAPY Questions 261-290
DOMAIN 8: PSYCHIATRIC AND NEUROLOGIC MEDICATIONS Questions 291-330
DOMAIN 9: HORMONAL AND ENDOCRINE MEDICATIONS Questions 331-360
DOMAIN 10: FLUID, ELECTROLYTE, AND NUTRITIONAL THERAPY Questions 361-390
DOMAIN 11: IMMUNOLOGIC AND ONCOLOGIC MEDICATIONS Questions 391-404
DOMAIN 1: PAIN MANAGEMENT AND OPIOIDS
1. A nurse is preparing to administer morphine sulfate to a patient in pain.
Which assessment finding should cause the nurse to withhold the medication?
A. Blood pressure of 130/85 mmHg
B. Heart rate of 88 beats/min
C. Pain rating of 7/10
D. Temperature of 99.1°F
E. Respiratory rate of 10 breaths/min
Correct Answer: E
Rationale: Morphine is an opioid analgesic that causes CNS and respiratory
depression. A respiratory rate below 12 breaths/min is a contraindication to
1
,opioid administration. The nurse should withhold the drug and notify the
provider immediately. Respiratory depression is the most serious side effect of
opioid therapy.
2. A patient is prescribed metformin for type 2 diabetes. Which condition is a
contraindication for this medication?
A. Hypertension
B. Obesity
C. Renal impairment
D. Hyperlipidemia
E. Osteoporosis
Correct Answer: C
Rationale: Metformin is contraindicated in renal impairment because it can
accumulate and cause lactic acidosis, a rare but life-threatening complication.
Kidney function should be assessed before initiating therapy. The FDA
recommends
checking renal function before starting metformin and at least annually
thereafter.
3. A nurse is teaching a patient about taking oral iron supplements. Which
instruction is most important?
A. Take the medication with milk to reduce GI upset
B. Expect stools to be light-colored
C. Take the medication on an empty stomach or with vitamin C
D. Avoid physical activity after taking the medication
E. Take the medication at bedtime only
2
,Correct Answer: C
Rationale: Iron is best absorbed on an empty stomach. Vitamin C (ascorbic acid)
enhances iron absorption by converting ferric iron to ferrous iron. Milk and
antacids inhibit absorption. Dark-colored stools are expected, not light-colored
(B). Iron can cause GI upset, but taking it with food (not milk) can help.
4. Which medication requires the nurse to monitor potassium levels closely due
to its risk of hypokalemia?
A. Lisinopril
B. Spironolactone
C. Furosemide
D. Metoprolol
E. Amlodipine
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes potassium loss in the urine,
leading to hypokalemia. Spironolactone (B) is potassium-sparing and can cause
hyperkalemia. Lisinopril (A) is an ACE inhibitor that can cause hyperkalemia.
Metoprolol (D) and amlodipine (E) do not significantly affect potassium levels.
5. A patient is prescribed warfarin for atrial fibrillation. Which laboratory
value should the nurse monitor to evaluate the therapeutic effect?
A. Platelet count
B. PT/INR
C. aPTT
D. Hemoglobin
E. WBC count
3
, Correct Answer: B
Rationale: Warfarin is an anticoagulant that prolongs the prothrombin time (PT).
The INR (International Normalized Ratio) is used to monitor warfarin therapy.
The therapeutic INR for atrial fibrillation is typically 2.0-3.0. aPTT (C) is
monitored for heparin therapy. Platelet count (A) is monitored for
heparin-induced thrombocytopenia.
6. A patient is prescribed albuterol for asthma. Which side effect is most
commonly associated with this medication?
A. Bradycardia
B. Hypotension
C. Tachycardia
D. Sedation
E. Constipation
Correct Answer: C
Rationale: Albuterol is a beta-2 agonist that can cause tachycardia, palpitations,
and tremors due to beta-1 stimulation (tachycardia) and beta-2 stimulation
(tremors). It can also cause hypokalemia. Bradycardia (A) and hypotension (B)
are not typical. Sedation (D) is not a common side effect.
7. A patient is prescribed digoxin for heart failure. Which sign indicates
digoxin toxicity?
A. Tachycardia
B. Hyperkalemia
C. Yellow-green halos around lights
D. Hypotension
4
404 QUESTIONS VERIFIED ANSWERS WITH DETAILED
CLINICAL RATIONALES REAL EXAM QUESTIONS | A+ GRADED
UPDATED 2026 EDITION
TABLE OF CONTENTS
DOMAIN 1: PAIN MANAGEMENT AND OPIOIDS Questions 1-50
DOMAIN 2: ANTIDIABETIC AGENTS Questions 51-90
DOMAIN 3: CARDIOVASCULAR MEDICATIONS Questions 91-140
DOMAIN 4: ANTIBIOTICS AND ANTI-INFECTIVES Questions 141-190
DOMAIN 5: RESPIRATORY MEDICATIONS Questions 191-230
DOMAIN 6: GASTROINTESTINAL MEDICATIONS Questions 231-260
DOMAIN 7: HEMATOLOGIC AND ANTICOAGULANT THERAPY Questions 261-290
DOMAIN 8: PSYCHIATRIC AND NEUROLOGIC MEDICATIONS Questions 291-330
DOMAIN 9: HORMONAL AND ENDOCRINE MEDICATIONS Questions 331-360
DOMAIN 10: FLUID, ELECTROLYTE, AND NUTRITIONAL THERAPY Questions 361-390
DOMAIN 11: IMMUNOLOGIC AND ONCOLOGIC MEDICATIONS Questions 391-404
DOMAIN 1: PAIN MANAGEMENT AND OPIOIDS
1. A nurse is preparing to administer morphine sulfate to a patient in pain.
Which assessment finding should cause the nurse to withhold the medication?
A. Blood pressure of 130/85 mmHg
B. Heart rate of 88 beats/min
C. Pain rating of 7/10
D. Temperature of 99.1°F
E. Respiratory rate of 10 breaths/min
Correct Answer: E
Rationale: Morphine is an opioid analgesic that causes CNS and respiratory
depression. A respiratory rate below 12 breaths/min is a contraindication to
1
,opioid administration. The nurse should withhold the drug and notify the
provider immediately. Respiratory depression is the most serious side effect of
opioid therapy.
2. A patient is prescribed metformin for type 2 diabetes. Which condition is a
contraindication for this medication?
A. Hypertension
B. Obesity
C. Renal impairment
D. Hyperlipidemia
E. Osteoporosis
Correct Answer: C
Rationale: Metformin is contraindicated in renal impairment because it can
accumulate and cause lactic acidosis, a rare but life-threatening complication.
Kidney function should be assessed before initiating therapy. The FDA
recommends
checking renal function before starting metformin and at least annually
thereafter.
3. A nurse is teaching a patient about taking oral iron supplements. Which
instruction is most important?
A. Take the medication with milk to reduce GI upset
B. Expect stools to be light-colored
C. Take the medication on an empty stomach or with vitamin C
D. Avoid physical activity after taking the medication
E. Take the medication at bedtime only
2
,Correct Answer: C
Rationale: Iron is best absorbed on an empty stomach. Vitamin C (ascorbic acid)
enhances iron absorption by converting ferric iron to ferrous iron. Milk and
antacids inhibit absorption. Dark-colored stools are expected, not light-colored
(B). Iron can cause GI upset, but taking it with food (not milk) can help.
4. Which medication requires the nurse to monitor potassium levels closely due
to its risk of hypokalemia?
A. Lisinopril
B. Spironolactone
C. Furosemide
D. Metoprolol
E. Amlodipine
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes potassium loss in the urine,
leading to hypokalemia. Spironolactone (B) is potassium-sparing and can cause
hyperkalemia. Lisinopril (A) is an ACE inhibitor that can cause hyperkalemia.
Metoprolol (D) and amlodipine (E) do not significantly affect potassium levels.
5. A patient is prescribed warfarin for atrial fibrillation. Which laboratory
value should the nurse monitor to evaluate the therapeutic effect?
A. Platelet count
B. PT/INR
C. aPTT
D. Hemoglobin
E. WBC count
3
, Correct Answer: B
Rationale: Warfarin is an anticoagulant that prolongs the prothrombin time (PT).
The INR (International Normalized Ratio) is used to monitor warfarin therapy.
The therapeutic INR for atrial fibrillation is typically 2.0-3.0. aPTT (C) is
monitored for heparin therapy. Platelet count (A) is monitored for
heparin-induced thrombocytopenia.
6. A patient is prescribed albuterol for asthma. Which side effect is most
commonly associated with this medication?
A. Bradycardia
B. Hypotension
C. Tachycardia
D. Sedation
E. Constipation
Correct Answer: C
Rationale: Albuterol is a beta-2 agonist that can cause tachycardia, palpitations,
and tremors due to beta-1 stimulation (tachycardia) and beta-2 stimulation
(tremors). It can also cause hypokalemia. Bradycardia (A) and hypotension (B)
are not typical. Sedation (D) is not a common side effect.
7. A patient is prescribed digoxin for heart failure. Which sign indicates
digoxin toxicity?
A. Tachycardia
B. Hyperkalemia
C. Yellow-green halos around lights
D. Hypotension
4
