PN HESI Pharmacology Exam
2026/2027
Review Test Bank with 180 Questions
and Correct Answers
Evolve HESI PN Pharmacology Exam Review
Test Bank 2026/2027
Comprehensive preparation resource for practical nursing students.
Contains 180 unique questions across 5 core pharmacology sections.
Verified answers with detailed rationales.
,SECTIONS COVERED
Section I: Fundamentals of Pharmacology and Safe Drug Administration
Weight: 20% | 36 questions
Section II: Drug Administration Routes, Medication Classes, and Nursing Interventions
Weight: 20% | 36 questions
Section III: Drug Classifications, Adverse Effects, and Contraindications
Weight: 20% | 36 questions
Section IV: Pharmacology Calculations and Dosage Determination
Weight: 20% | 36 questions
Section V: Patient Education, Monitoring, and Therapeutic Drug Management
Weight: 20% | 36 questions
Total: 180 questions with verified answers and detailed rationales.
,Section I: Fundamentals of Pharmacology and Safe Drug Administration
Weight: 20% | 36 questions
Question 1
A practical nurse is preparing to administer a newly prescribed oral medication to a 78-year-old patient. The
patient reports difficulty swallowing tablets and has a history of dysphagia following a recent stroke. Which
nursing action best ensures safe medication administration in this scenario?
A. Request the pharmacy to dispense a liquid formulation or crush the tablet if it is not enteric-coated or
extended-release.
B. Administer the tablet with a large glass of water and position the patient upright to facilitate swallowing.
C. Mix the tablet with applesauce regardless of formulation to improve swallowability and patient compliance.
D. Encourage the patient to chew the tablet thoroughly before swallowing to reduce the risk of aspiration.
Correct Answer: A
Rationale: Patients with dysphagia require alternative formulations to prevent aspiration. Enteric-coated or
extended-release tablets should never be crushed. Requesting a liquid formulation or verifying crushability is the safest
approach.
Question 2
A nursing student is reviewing the seven rights of medication administration before administering morning
medications on a busy medical-surgical unit. The preceptor emphasizes that verifying the right patient is the first
critical step. Which additional verification step is most essential to prevent medication errors in a hospital
setting?
A. Scan the patient's wristband barcode and compare it with the medication administration record before
giving any drug.
B. Ask the patient to state their date of birth and compare it to the name on the medication cup.
C. Verify the room number and bed assignment against the medication administration record before
proceeding.
D. Check the patient's diagnosis on the chart to confirm the medication is appropriate for their condition.
Correct Answer: A
Rationale: Barcode scanning at the bedside is the most reliable method for patient identification, reducing wrong-patient
errors significantly. While asking for a date of birth is helpful, barcode verification is the institutional standard.
Question 3
A practical nurse is caring for a patient with severe liver cirrhosis who is prescribed a benzodiazepine for
anxiety. The nurse knows that hepatic impairment significantly alters drug metabolism. Which concept best
explains why this patient requires a substantially reduced dose of this medication?
, A. The liver is the primary site of drug metabolism, and decreased hepatic function prolongs drug half-life and
increases toxicity risk.
B. Renal clearance compensates for liver dysfunction by increasing glomerular filtration rate to eliminate the
drug faster.
C. Cirrhosis increases plasma protein binding, which reduces the amount of free active drug available in the
bloodstream.
D. Portal hypertension enhances first-pass metabolism, leading to increased drug bioavailability and
therapeutic effect.
Correct Answer: A
Rationale: The liver metabolizes most drugs via cytochrome P450 enzymes. In cirrhosis, decreased hepatocellular function
reduces metabolism, prolonging half-life and increasing the risk of drug accumulation and toxicity.
Question 4
A patient is receiving intravenous furosemide and reports ringing in the ears and dizziness shortly after
administration. The nurse recognizes these as potential signs of ototoxicity. Which concurrent medication in the
patient's chart would most significantly increase the risk of this adverse effect?
A. Gentamicin, an aminoglycoside antibiotic, which also causes ototoxicity and potentiates the risk when
combined with loop diuretics.
B. Metoprolol, a beta-blocker, which may cause bradycardia and fatigue but does not contribute to
ototoxicity.
C. Warfarin, an anticoagulant, which increases bleeding risk but has no known effect on auditory function.
D. Omeprazole, a proton pump inhibitor, which reduces gastric acid secretion and does not affect hearing.
Correct Answer: A
Rationale: Both loop diuretics and aminoglycoside antibiotics are independently ototoxic. When administered together, they
produce synergistic damage to the inner ear hair cells, significantly increasing the risk of permanent hearing loss.
Question 5
A 4-year-old child is prescribed amoxicillin suspension for an ear infection. The medication label states the dose
is 250 mg twice daily, and the suspension concentration is 250 mg per 5 mL. The mother asks the nurse how
much to give using a household teaspoon. Which response is most accurate and safe?
A. Provide a calibrated oral syringe marked in milliliters and instruct the mother to give exactly 5 mL for each
dose to ensure accuracy.
B. Explain that one teaspoon is approximately 5 mL, so giving one teaspoon by household spoon is
acceptable for this dose.
C. Tell the mother to fill a medicine cup to the 5 mL line, which is roughly equivalent to one tablespoon of
liquid medication.
2026/2027
Review Test Bank with 180 Questions
and Correct Answers
Evolve HESI PN Pharmacology Exam Review
Test Bank 2026/2027
Comprehensive preparation resource for practical nursing students.
Contains 180 unique questions across 5 core pharmacology sections.
Verified answers with detailed rationales.
,SECTIONS COVERED
Section I: Fundamentals of Pharmacology and Safe Drug Administration
Weight: 20% | 36 questions
Section II: Drug Administration Routes, Medication Classes, and Nursing Interventions
Weight: 20% | 36 questions
Section III: Drug Classifications, Adverse Effects, and Contraindications
Weight: 20% | 36 questions
Section IV: Pharmacology Calculations and Dosage Determination
Weight: 20% | 36 questions
Section V: Patient Education, Monitoring, and Therapeutic Drug Management
Weight: 20% | 36 questions
Total: 180 questions with verified answers and detailed rationales.
,Section I: Fundamentals of Pharmacology and Safe Drug Administration
Weight: 20% | 36 questions
Question 1
A practical nurse is preparing to administer a newly prescribed oral medication to a 78-year-old patient. The
patient reports difficulty swallowing tablets and has a history of dysphagia following a recent stroke. Which
nursing action best ensures safe medication administration in this scenario?
A. Request the pharmacy to dispense a liquid formulation or crush the tablet if it is not enteric-coated or
extended-release.
B. Administer the tablet with a large glass of water and position the patient upright to facilitate swallowing.
C. Mix the tablet with applesauce regardless of formulation to improve swallowability and patient compliance.
D. Encourage the patient to chew the tablet thoroughly before swallowing to reduce the risk of aspiration.
Correct Answer: A
Rationale: Patients with dysphagia require alternative formulations to prevent aspiration. Enteric-coated or
extended-release tablets should never be crushed. Requesting a liquid formulation or verifying crushability is the safest
approach.
Question 2
A nursing student is reviewing the seven rights of medication administration before administering morning
medications on a busy medical-surgical unit. The preceptor emphasizes that verifying the right patient is the first
critical step. Which additional verification step is most essential to prevent medication errors in a hospital
setting?
A. Scan the patient's wristband barcode and compare it with the medication administration record before
giving any drug.
B. Ask the patient to state their date of birth and compare it to the name on the medication cup.
C. Verify the room number and bed assignment against the medication administration record before
proceeding.
D. Check the patient's diagnosis on the chart to confirm the medication is appropriate for their condition.
Correct Answer: A
Rationale: Barcode scanning at the bedside is the most reliable method for patient identification, reducing wrong-patient
errors significantly. While asking for a date of birth is helpful, barcode verification is the institutional standard.
Question 3
A practical nurse is caring for a patient with severe liver cirrhosis who is prescribed a benzodiazepine for
anxiety. The nurse knows that hepatic impairment significantly alters drug metabolism. Which concept best
explains why this patient requires a substantially reduced dose of this medication?
, A. The liver is the primary site of drug metabolism, and decreased hepatic function prolongs drug half-life and
increases toxicity risk.
B. Renal clearance compensates for liver dysfunction by increasing glomerular filtration rate to eliminate the
drug faster.
C. Cirrhosis increases plasma protein binding, which reduces the amount of free active drug available in the
bloodstream.
D. Portal hypertension enhances first-pass metabolism, leading to increased drug bioavailability and
therapeutic effect.
Correct Answer: A
Rationale: The liver metabolizes most drugs via cytochrome P450 enzymes. In cirrhosis, decreased hepatocellular function
reduces metabolism, prolonging half-life and increasing the risk of drug accumulation and toxicity.
Question 4
A patient is receiving intravenous furosemide and reports ringing in the ears and dizziness shortly after
administration. The nurse recognizes these as potential signs of ototoxicity. Which concurrent medication in the
patient's chart would most significantly increase the risk of this adverse effect?
A. Gentamicin, an aminoglycoside antibiotic, which also causes ototoxicity and potentiates the risk when
combined with loop diuretics.
B. Metoprolol, a beta-blocker, which may cause bradycardia and fatigue but does not contribute to
ototoxicity.
C. Warfarin, an anticoagulant, which increases bleeding risk but has no known effect on auditory function.
D. Omeprazole, a proton pump inhibitor, which reduces gastric acid secretion and does not affect hearing.
Correct Answer: A
Rationale: Both loop diuretics and aminoglycoside antibiotics are independently ototoxic. When administered together, they
produce synergistic damage to the inner ear hair cells, significantly increasing the risk of permanent hearing loss.
Question 5
A 4-year-old child is prescribed amoxicillin suspension for an ear infection. The medication label states the dose
is 250 mg twice daily, and the suspension concentration is 250 mg per 5 mL. The mother asks the nurse how
much to give using a household teaspoon. Which response is most accurate and safe?
A. Provide a calibrated oral syringe marked in milliliters and instruct the mother to give exactly 5 mL for each
dose to ensure accuracy.
B. Explain that one teaspoon is approximately 5 mL, so giving one teaspoon by household spoon is
acceptable for this dose.
C. Tell the mother to fill a medicine cup to the 5 mL line, which is roughly equivalent to one tablespoon of
liquid medication.
