NGN HESI PHARMACOLOGY EXAM QUESTIONS
AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2027 Q&A | INSTANT
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1. A nurse is preparing to administer digoxin to a client with heart
failure. Which assessment finding requires the nurse to withhold
the medication and notify the provider?
A. Blood pressure 132/78 mm Hg
B. Respiratory rate 18/min
C. Apical pulse 54 beats/min
D. Oxygen saturation 97%
Answer: C. Apical pulse 54 beats/min
Rationale: Digoxin slows the heart rate. An apical pulse below 60
beats/min in adults is a common reason to withhold the medication
because administration may worsen bradycardia and increase the risk
of dysrhythmias. The blood pressure, respiratory rate, and oxygen
saturation are within acceptable limits and do not independently
require withholding the medication.
, 2. A client taking warfarin asks why regular blood tests are necessary.
Which laboratory value should the nurse monitor?
A. Hemoglobin A1c
B. Platelet count
C. Serum potassium
D. International Normalized Ratio (INR)
Answer: D. International Normalized Ratio (INR)
Rationale: Warfarin therapy is monitored using the INR, which measures
the effectiveness of anticoagulation. Most therapeutic INR goals range
from 2.0 to 3.0, although higher targets may be indicated for some
conditions. Platelet counts are monitored for other anticoagulants such
as heparin, while hemoglobin A1c and potassium are unrelated to
warfarin dosing.
3. Which adverse effect should the nurse monitor for in a client
receiving intravenous morphine?
A. Hypertension
B. Hyperglycemia
,C. Respiratory depression
D. Increased bowel motility
Answer: C. Respiratory depression
Rationale: Respiratory depression is the most serious adverse effect of
opioid medications and requires close monitoring of respiratory rate,
oxygenation, and level of consciousness. Morphine more commonly
causes hypotension and constipation rather than hypertension or
increased bowel motility. Hyperglycemia is not an expected opioid
effect.
4. A client is prescribed lisinopril. Which finding should the nurse
report immediately?
A. Mild fatigue
B. Swelling of the lips and tongue
C. Dry mouth
D. Heart rate of 72/min
Answer: B. Swelling of the lips and tongue
Rationale: Angioedema is a life-threatening adverse effect of ACE
inhibitors such as lisinopril. Airway obstruction may develop rapidly,
, requiring emergency treatment. Mild fatigue and dry mouth are less
urgent, while a heart rate of 72/min is normal.
5. A nurse teaches a client about nitroglycerin tablets. Which
statement indicates correct understanding?
A. Swallow the tablet with water.
B. Store tablets in the bathroom.
C. Place the tablet under the tongue at the first sign of chest pain.
D. Take one tablet every morning regardless of symptoms.
Answer: C. Place the tablet under the tongue at the first sign of chest
pain.
Rationale: Sublingual nitroglycerin provides rapid absorption during
angina. Tablets should dissolve under the tongue without swallowing.
They should be stored in their original dark container away from heat
and moisture, not in bathrooms. Routine daily administration applies to
long-acting formulations, not sublingual tablets.
6. Which electrolyte imbalance places a client taking digoxin at
greatest risk for toxicity?
AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2027 Q&A | INSTANT
DOWNLOAD PDF
1. A nurse is preparing to administer digoxin to a client with heart
failure. Which assessment finding requires the nurse to withhold
the medication and notify the provider?
A. Blood pressure 132/78 mm Hg
B. Respiratory rate 18/min
C. Apical pulse 54 beats/min
D. Oxygen saturation 97%
Answer: C. Apical pulse 54 beats/min
Rationale: Digoxin slows the heart rate. An apical pulse below 60
beats/min in adults is a common reason to withhold the medication
because administration may worsen bradycardia and increase the risk
of dysrhythmias. The blood pressure, respiratory rate, and oxygen
saturation are within acceptable limits and do not independently
require withholding the medication.
, 2. A client taking warfarin asks why regular blood tests are necessary.
Which laboratory value should the nurse monitor?
A. Hemoglobin A1c
B. Platelet count
C. Serum potassium
D. International Normalized Ratio (INR)
Answer: D. International Normalized Ratio (INR)
Rationale: Warfarin therapy is monitored using the INR, which measures
the effectiveness of anticoagulation. Most therapeutic INR goals range
from 2.0 to 3.0, although higher targets may be indicated for some
conditions. Platelet counts are monitored for other anticoagulants such
as heparin, while hemoglobin A1c and potassium are unrelated to
warfarin dosing.
3. Which adverse effect should the nurse monitor for in a client
receiving intravenous morphine?
A. Hypertension
B. Hyperglycemia
,C. Respiratory depression
D. Increased bowel motility
Answer: C. Respiratory depression
Rationale: Respiratory depression is the most serious adverse effect of
opioid medications and requires close monitoring of respiratory rate,
oxygenation, and level of consciousness. Morphine more commonly
causes hypotension and constipation rather than hypertension or
increased bowel motility. Hyperglycemia is not an expected opioid
effect.
4. A client is prescribed lisinopril. Which finding should the nurse
report immediately?
A. Mild fatigue
B. Swelling of the lips and tongue
C. Dry mouth
D. Heart rate of 72/min
Answer: B. Swelling of the lips and tongue
Rationale: Angioedema is a life-threatening adverse effect of ACE
inhibitors such as lisinopril. Airway obstruction may develop rapidly,
, requiring emergency treatment. Mild fatigue and dry mouth are less
urgent, while a heart rate of 72/min is normal.
5. A nurse teaches a client about nitroglycerin tablets. Which
statement indicates correct understanding?
A. Swallow the tablet with water.
B. Store tablets in the bathroom.
C. Place the tablet under the tongue at the first sign of chest pain.
D. Take one tablet every morning regardless of symptoms.
Answer: C. Place the tablet under the tongue at the first sign of chest
pain.
Rationale: Sublingual nitroglycerin provides rapid absorption during
angina. Tablets should dissolve under the tongue without swallowing.
They should be stored in their original dark container away from heat
and moisture, not in bathrooms. Routine daily administration applies to
long-acting formulations, not sublingual tablets.
6. Which electrolyte imbalance places a client taking digoxin at
greatest risk for toxicity?
