PN HESI Pharmacology Exam 2026/2027 – Complete Question Practice
Test Bank with Answers & Rationale | Practical Nursing Pharm HESI Prep |
High Yield Dosage Calculations, Cardiac, Psych, Endocrine & NCLEX-PN
Next-Gen Prep
1. A licensed practical nurse (LPN/VN) is preparing to administer prescribed digoxin to a
client with heart failure. Which assessment parameter requires the nurse to hold the
medication and notify the charge nurse?
o A) Blood pressure of 118/76 mmHg
o B) Apical pulse rate of 54 beats per minute ✔
o C) Respiratory rate of 16 breaths per minute
o D) Serum potassium level of 4.2 mEq/L Rationale: Digoxin is a cardiac glycoside
that slows heart rate while increasing contractility. An apical pulse below 60 bpm
, in an adult indicates potential toxicity or excessive bradycardia; the medication
must be held and reported.
2. A client taking oral warfarin for deep vein thrombosis (DVT) has an International
Normalized Ratio (INR) result of 4.8. What is the nurse's priority action?
o A) Hold the dose of warfarin and notify the healthcare provider ✔
o B) Administer the prescribed dose as scheduled
o C) Instruct the client to double their green leafy vegetable intake
o D) Prepare an IV bolus of unfractionated heparin Rationale: The therapeutic INR
range for DVT treatment is typically 2.0 to 3.0. An INR of 4.8 indicates an
increased risk of severe bleeding. The nurse should hold the dose and notify the
provider for antidote or dose adjustment orders.
3. What is the specific pharmacological antidote for an acute overdose of unfractionated
heparin?
o A) Vitamin K
o B) Protamine sulfate ✔
o C) Naloxone
o D) Acetylcysteine Rationale: Protamine sulfate neutralizes the anticoagulant
action of heparin. Vitamin K is the antidote for warfarin.
4. A nurse is caring for a client receiving intravenous furosemide. Which electrolyte
imbalance should the nurse monitor for most closely?
o A) Hyperkalemia
o B) Hypokalemia ✔
o C) Hypercalcemia
, o D) Hypernatremia Rationale: Furosemide is a loop diuretic that causes potassium
loss through renal excretion, placing the client at high risk for hypokalemia.
5. A client diagnosed with hypertension is prescribed lisinopril. Which common, non-life-
threatening side effect should the nurse instruct the client to expect?
o A) Facial hair growth
o B) Persistent dry cough ✔
o C) Orange-tinged urine
o D) Weight gain of 5 lbs in a day Rationale: ACE inhibitors like lisinopril prevent
the breakdown of bradykinin in the lungs, frequently causing a dry, persistent
cough.
6. A client prescribed metoprolol asks the nurse how the medication works. Which response
by the nurse is accurate?
o A) "It lowers your heart rate and blood pressure by blocking beta-1
receptors in your heart." ✔
o B) "It relaxes your blood vessels by removing excess sodium through your
kidneys."
o C) "It inhibits calcium influx into smooth muscle cells."
o D) "It directly dissolves blood clots in your coronary arteries." Rationale:
Metoprolol is a selective beta-1 blocker that decreases heart rate, myocardial
contractility, and blood pressure.
7. Prior to administering a dose of sublingual nitroglycerin to a client experiencing chest
pain, which assessment finding requires the nurse to withhold the drug?
o A) Heart rate of 88 bpm
, o B) Systolic blood pressure of 82 mmHg ✔
o C) Serum sodium level of 138 mEq/L
o D) Oxygen saturation of 96% on room air Rationale: Nitroglycerin is a potent
vasodilator. Administering it when the systolic BP is under 90 mmHg can induce
severe hypotension and compromised coronary perfusion.
8. A client receiving spironolactone should be instructed to avoid excessive intake of which
item?
o A) Dairy products
o B) Salt substitutes containing potassium chloride ✔
o C) White bread
o D) Cranberry juice Rationale: Spironolactone is a potassium-sparing diuretic.
Combining it with potassium-rich salt substitutes increases the risk of dangerous
hyperkalemia.
9. A client taking amiodarone for atrial fibrillation reports pulmonary shortness of breath
and a new dry cough. What action should the nurse take?
o A) Advise the client to use a humidifier at home
o B) Report the findings immediately to the healthcare provider due to risk of
pulmonary toxicity ✔
o C) Encourage the client to take an over-the-counter cough drop
o D) Increase the dose of amiodarone Rationale: Amiodarone can cause fatal
pulmonary toxicity (interstitial pneumonitis). Respiratory symptoms must be
evaluated promptly.
Test Bank with Answers & Rationale | Practical Nursing Pharm HESI Prep |
High Yield Dosage Calculations, Cardiac, Psych, Endocrine & NCLEX-PN
Next-Gen Prep
1. A licensed practical nurse (LPN/VN) is preparing to administer prescribed digoxin to a
client with heart failure. Which assessment parameter requires the nurse to hold the
medication and notify the charge nurse?
o A) Blood pressure of 118/76 mmHg
o B) Apical pulse rate of 54 beats per minute ✔
o C) Respiratory rate of 16 breaths per minute
o D) Serum potassium level of 4.2 mEq/L Rationale: Digoxin is a cardiac glycoside
that slows heart rate while increasing contractility. An apical pulse below 60 bpm
, in an adult indicates potential toxicity or excessive bradycardia; the medication
must be held and reported.
2. A client taking oral warfarin for deep vein thrombosis (DVT) has an International
Normalized Ratio (INR) result of 4.8. What is the nurse's priority action?
o A) Hold the dose of warfarin and notify the healthcare provider ✔
o B) Administer the prescribed dose as scheduled
o C) Instruct the client to double their green leafy vegetable intake
o D) Prepare an IV bolus of unfractionated heparin Rationale: The therapeutic INR
range for DVT treatment is typically 2.0 to 3.0. An INR of 4.8 indicates an
increased risk of severe bleeding. The nurse should hold the dose and notify the
provider for antidote or dose adjustment orders.
3. What is the specific pharmacological antidote for an acute overdose of unfractionated
heparin?
o A) Vitamin K
o B) Protamine sulfate ✔
o C) Naloxone
o D) Acetylcysteine Rationale: Protamine sulfate neutralizes the anticoagulant
action of heparin. Vitamin K is the antidote for warfarin.
4. A nurse is caring for a client receiving intravenous furosemide. Which electrolyte
imbalance should the nurse monitor for most closely?
o A) Hyperkalemia
o B) Hypokalemia ✔
o C) Hypercalcemia
, o D) Hypernatremia Rationale: Furosemide is a loop diuretic that causes potassium
loss through renal excretion, placing the client at high risk for hypokalemia.
5. A client diagnosed with hypertension is prescribed lisinopril. Which common, non-life-
threatening side effect should the nurse instruct the client to expect?
o A) Facial hair growth
o B) Persistent dry cough ✔
o C) Orange-tinged urine
o D) Weight gain of 5 lbs in a day Rationale: ACE inhibitors like lisinopril prevent
the breakdown of bradykinin in the lungs, frequently causing a dry, persistent
cough.
6. A client prescribed metoprolol asks the nurse how the medication works. Which response
by the nurse is accurate?
o A) "It lowers your heart rate and blood pressure by blocking beta-1
receptors in your heart." ✔
o B) "It relaxes your blood vessels by removing excess sodium through your
kidneys."
o C) "It inhibits calcium influx into smooth muscle cells."
o D) "It directly dissolves blood clots in your coronary arteries." Rationale:
Metoprolol is a selective beta-1 blocker that decreases heart rate, myocardial
contractility, and blood pressure.
7. Prior to administering a dose of sublingual nitroglycerin to a client experiencing chest
pain, which assessment finding requires the nurse to withhold the drug?
o A) Heart rate of 88 bpm
, o B) Systolic blood pressure of 82 mmHg ✔
o C) Serum sodium level of 138 mEq/L
o D) Oxygen saturation of 96% on room air Rationale: Nitroglycerin is a potent
vasodilator. Administering it when the systolic BP is under 90 mmHg can induce
severe hypotension and compromised coronary perfusion.
8. A client receiving spironolactone should be instructed to avoid excessive intake of which
item?
o A) Dairy products
o B) Salt substitutes containing potassium chloride ✔
o C) White bread
o D) Cranberry juice Rationale: Spironolactone is a potassium-sparing diuretic.
Combining it with potassium-rich salt substitutes increases the risk of dangerous
hyperkalemia.
9. A client taking amiodarone for atrial fibrillation reports pulmonary shortness of breath
and a new dry cough. What action should the nurse take?
o A) Advise the client to use a humidifier at home
o B) Report the findings immediately to the healthcare provider due to risk of
pulmonary toxicity ✔
o C) Encourage the client to take an over-the-counter cough drop
o D) Increase the dose of amiodarone Rationale: Amiodarone can cause fatal
pulmonary toxicity (interstitial pneumonitis). Respiratory symptoms must be
evaluated promptly.
