2026 HESI RN PHARMACOLOGY EXAMS – NGN NURSING QUESTIONS AND ANSWERS ALREADY GRADED
A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
A patient with heart failure is prescribed digoxin. Which laboratory finding would place the patient at the
highest risk for digoxin toxicity?
A. Serum potassium of 3.2 mEq/L
B. Serum sodium of 135 mEq/L
C. Serum calcium of 10.2 mg/dL
D. Serum magnesium of 2.0 mEq/L
🟢 Correct Answer:
A. Serum potassium of 3.2 mEq/L
🔴 RATIONALE:
Hypokalemia significantly increases the risk of digoxin toxicity by enhancing the binding of digoxin to cardiac
sodium-potassium ATPase pumps. Serum potassium below 3.5 mEq/L is a major risk factor. Normal sodium,
calcium, and magnesium levels do not increase toxicity risk as significantly as hypokalemia.
Question 2
The nurse is administering intravenous furosemide to a patient with acute pulmonary edema. Which assessment
finding indicates the medication is having the desired therapeutic effect?
,A. Decreased blood pressure
B. Increased urine output and decreased dyspnea
C. Decreased heart rate
D. Increased peripheral edema
🟢 Correct Answer:
B. Increased urine output and decreased dyspnea
🔴 RATIONALE:
Furosemide is a loop diuretic used to reduce fluid volume overload. The desired therapeutic effects include
increased urine output, decreased edema, and relief of shortness of breath. Increased urine output is the most
direct indicator of effectiveness.
Question 3
A patient is prescribed warfarin (Coumadin) for atrial fibrillation. The nurse should teach the patient to avoid
which over-the-counter medication?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
🟢 Correct Answer:
B. Ibuprofen
,🔴 RATIONALE:
Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of bleeding when taken
with warfarin due to their antiplatelet effects and potential for gastrointestinal irritation. Acetaminophen is
generally safe but should be used in limited doses. Diphenhydramine and loratadine do not significantly
interact with warfarin.
Question 4
A patient is prescribed metformin for type 2 diabetes mellitus. The nurse should monitor for which serious
adverse effect?
A. Lactic acidosis
B. Hypoglycemia
C. Weight gain
D. Peripheral edema
🟢 Correct Answer:
A. Lactic acidosis
🔴 RATIONALE:
Metformin can cause lactic acidosis, a rare but serious adverse effect, especially in patients with renal
impairment, hepatic disease, or heart failure. The nurse should monitor for signs such as muscle pain, weakness,
and hyperventilation. Hypoglycemia is uncommon with metformin alone.
, Question 5
The nurse is preparing to administer a blood transfusion. Which IV solution is compatible with blood products?
A. 5% dextrose in water
B. 0.9% normal saline
C. Lactated Ringer's solution
D. 0.45% normal saline
🟢 Correct Answer:
B. 0.9% normal saline
🔴 RATIONALE:
Only 0.9% normal saline should be used with blood products. Dextrose solutions can cause hemolysis, and
lactated Ringer's contains calcium, which can cause clotting in the tubing. Normal saline maintains isotonicity
and is compatible with blood components.
Question 6
A patient with asthma is prescribed an inhaled corticosteroid. Which instruction should the nurse include in the
teaching?
A. "Rinse your mouth with water after each use."
B. "Use this medication for acute shortness of breath."
C. "Take this medication with a full glass of water."
D. "Avoid using a spacer with this medication."
A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
A patient with heart failure is prescribed digoxin. Which laboratory finding would place the patient at the
highest risk for digoxin toxicity?
A. Serum potassium of 3.2 mEq/L
B. Serum sodium of 135 mEq/L
C. Serum calcium of 10.2 mg/dL
D. Serum magnesium of 2.0 mEq/L
🟢 Correct Answer:
A. Serum potassium of 3.2 mEq/L
🔴 RATIONALE:
Hypokalemia significantly increases the risk of digoxin toxicity by enhancing the binding of digoxin to cardiac
sodium-potassium ATPase pumps. Serum potassium below 3.5 mEq/L is a major risk factor. Normal sodium,
calcium, and magnesium levels do not increase toxicity risk as significantly as hypokalemia.
Question 2
The nurse is administering intravenous furosemide to a patient with acute pulmonary edema. Which assessment
finding indicates the medication is having the desired therapeutic effect?
,A. Decreased blood pressure
B. Increased urine output and decreased dyspnea
C. Decreased heart rate
D. Increased peripheral edema
🟢 Correct Answer:
B. Increased urine output and decreased dyspnea
🔴 RATIONALE:
Furosemide is a loop diuretic used to reduce fluid volume overload. The desired therapeutic effects include
increased urine output, decreased edema, and relief of shortness of breath. Increased urine output is the most
direct indicator of effectiveness.
Question 3
A patient is prescribed warfarin (Coumadin) for atrial fibrillation. The nurse should teach the patient to avoid
which over-the-counter medication?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
🟢 Correct Answer:
B. Ibuprofen
,🔴 RATIONALE:
Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of bleeding when taken
with warfarin due to their antiplatelet effects and potential for gastrointestinal irritation. Acetaminophen is
generally safe but should be used in limited doses. Diphenhydramine and loratadine do not significantly
interact with warfarin.
Question 4
A patient is prescribed metformin for type 2 diabetes mellitus. The nurse should monitor for which serious
adverse effect?
A. Lactic acidosis
B. Hypoglycemia
C. Weight gain
D. Peripheral edema
🟢 Correct Answer:
A. Lactic acidosis
🔴 RATIONALE:
Metformin can cause lactic acidosis, a rare but serious adverse effect, especially in patients with renal
impairment, hepatic disease, or heart failure. The nurse should monitor for signs such as muscle pain, weakness,
and hyperventilation. Hypoglycemia is uncommon with metformin alone.
, Question 5
The nurse is preparing to administer a blood transfusion. Which IV solution is compatible with blood products?
A. 5% dextrose in water
B. 0.9% normal saline
C. Lactated Ringer's solution
D. 0.45% normal saline
🟢 Correct Answer:
B. 0.9% normal saline
🔴 RATIONALE:
Only 0.9% normal saline should be used with blood products. Dextrose solutions can cause hemolysis, and
lactated Ringer's contains calcium, which can cause clotting in the tubing. Normal saline maintains isotonicity
and is compatible with blood components.
Question 6
A patient with asthma is prescribed an inhaled corticosteroid. Which instruction should the nurse include in the
teaching?
A. "Rinse your mouth with water after each use."
B. "Use this medication for acute shortness of breath."
C. "Take this medication with a full glass of water."
D. "Avoid using a spacer with this medication."
