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WGU D441 PROCTORED HESI PHARMACOLOGY
GHV1 EXAM QUESTIONS AND ANSWERS 2026/2027
WITH COMPLETE SOLUTIONS.
1. A client is prescribed digoxin for heart failure. Before administering
the medication, which assessment finding requires the nurse to withhold
the dose and notify the healthcare provider?
A. Apical pulse of 54 beats/minute
B. Blood pressure of 138/82 mmHg
C. Respiratory rate of 18/minute
D. Potassium level of 4.2 mEq/L
Answer: A
Solution: Digoxin can cause bradycardia. An apical pulse below the
facility's prescribed threshold, commonly 60 beats/minute in adults,
requires holding the medication and further evaluation.
2. A client taking lisinopril reports swelling of the lips and difficulty
breathing. Which action is the nurse's priority?
A. Administer the next dose with food.
B. Document the expected adverse effect.
C. Hold the medication and obtain emergency evaluation.
D. Encourage increased fluid intake.
Answer: C
Solution: Facial or lip swelling with difficulty breathing suggests
angioedema, a potentially life-threatening reaction to an ACE inhibitor.
The medication should be withheld and emergency treatment initiated.
3. A client taking warfarin has an INR of 5.8 and reports bleeding gums.
Which action is most appropriate?
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A. Administer the scheduled dose.
B. Hold the medication and notify the healthcare provider.
C. Encourage foods high in vitamin K immediately.
D. Administer aspirin for discomfort.
Answer: B
Solution: An excessively elevated INR combined with active bleeding
indicates increased hemorrhage risk. Warfarin should be held and the
provider notified for further management.
4. A client receiving heparin develops unexpected bleeding and has a
markedly elevated aPTT. Which medication is used as the antidote for
excessive heparin effects?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: B
Solution: Protamine sulfate binds to and neutralizes heparin. Vitamin K
reverses warfarin effects, while naloxone reverses opioid effects.
5. A client receiving insulin develops diaphoresis, tremors, weakness,
and confusion. Which condition should the nurse suspect?
A. Hyperglycemia
B. Hypoglycemia
C. Hyperkalemia
D. Diabetic ketoacidosis
Answer: B
Solution: Sweating, tremors, weakness, confusion, and altered mental
status are classic manifestations of hypoglycemia. Blood glucose should
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be checked promptly and treatment provided according to the client's
condition.
6. Which insulin has the most rapid onset of action?
A. Glargine
B. NPH
C. Lispro
D. Detemir
Answer: C
Solution: Lispro is a rapid-acting insulin and begins working quickly
around mealtimes. Glargine and detemir are long-acting preparations,
while NPH is intermediate-acting.
7. A client prescribed metformin is scheduled for a procedure requiring
iodinated contrast. Which action is appropriate?
A. Continue metformin regardless of the procedure.
B. Clarify the medication plan because metformin may need to be
temporarily withheld around contrast administration.
C. Double the metformin dose before the procedure.
D. Substitute insulin without provider instructions.
Answer: B
Solution: Metformin may need to be temporarily withheld in certain
patients receiving iodinated contrast because of concern for renal
impairment and the rare risk of lactic acidosis. Renal function and
current institutional guidance should be considered.
8. A client taking furosemide reports muscle weakness and palpitations.
Which electrolyte abnormality should the nurse suspect?
A. Hypernatremia
B. Hypokalemia
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C. Hypermagnesemia
D. Hypercalcemia
Answer: B
Solution: Loop diuretics such as furosemide can increase potassium
excretion. Hypokalemia can produce muscle weakness and cardiac
dysrhythmias.
9. Which laboratory value is particularly important to monitor in a client
taking spironolactone?
A. Potassium
B. Hemoglobin
C. Calcium
D. Platelets
Answer: A
Solution: Spironolactone is a potassium-sparing diuretic. It can cause
hyperkalemia, particularly in clients with renal impairment or those
taking other medications that increase potassium.
10. A client receiving morphine becomes difficult to arouse and has
respirations of 7/minute. Which medication should the nurse anticipate
administering?
A. Flumazenil
B. Protamine sulfate
C. Naloxone
D. Vitamin K
Answer: C
Solution: Naloxone is an opioid antagonist used to reverse opioid-
induced respiratory depression. The client's airway and breathing are
immediate priorities.
WGU D441 PROCTORED HESI PHARMACOLOGY
GHV1 EXAM QUESTIONS AND ANSWERS 2026/2027
WITH COMPLETE SOLUTIONS.
1. A client is prescribed digoxin for heart failure. Before administering
the medication, which assessment finding requires the nurse to withhold
the dose and notify the healthcare provider?
A. Apical pulse of 54 beats/minute
B. Blood pressure of 138/82 mmHg
C. Respiratory rate of 18/minute
D. Potassium level of 4.2 mEq/L
Answer: A
Solution: Digoxin can cause bradycardia. An apical pulse below the
facility's prescribed threshold, commonly 60 beats/minute in adults,
requires holding the medication and further evaluation.
2. A client taking lisinopril reports swelling of the lips and difficulty
breathing. Which action is the nurse's priority?
A. Administer the next dose with food.
B. Document the expected adverse effect.
C. Hold the medication and obtain emergency evaluation.
D. Encourage increased fluid intake.
Answer: C
Solution: Facial or lip swelling with difficulty breathing suggests
angioedema, a potentially life-threatening reaction to an ACE inhibitor.
The medication should be withheld and emergency treatment initiated.
3. A client taking warfarin has an INR of 5.8 and reports bleeding gums.
Which action is most appropriate?
,2|Page
A. Administer the scheduled dose.
B. Hold the medication and notify the healthcare provider.
C. Encourage foods high in vitamin K immediately.
D. Administer aspirin for discomfort.
Answer: B
Solution: An excessively elevated INR combined with active bleeding
indicates increased hemorrhage risk. Warfarin should be held and the
provider notified for further management.
4. A client receiving heparin develops unexpected bleeding and has a
markedly elevated aPTT. Which medication is used as the antidote for
excessive heparin effects?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: B
Solution: Protamine sulfate binds to and neutralizes heparin. Vitamin K
reverses warfarin effects, while naloxone reverses opioid effects.
5. A client receiving insulin develops diaphoresis, tremors, weakness,
and confusion. Which condition should the nurse suspect?
A. Hyperglycemia
B. Hypoglycemia
C. Hyperkalemia
D. Diabetic ketoacidosis
Answer: B
Solution: Sweating, tremors, weakness, confusion, and altered mental
status are classic manifestations of hypoglycemia. Blood glucose should
,3|Page
be checked promptly and treatment provided according to the client's
condition.
6. Which insulin has the most rapid onset of action?
A. Glargine
B. NPH
C. Lispro
D. Detemir
Answer: C
Solution: Lispro is a rapid-acting insulin and begins working quickly
around mealtimes. Glargine and detemir are long-acting preparations,
while NPH is intermediate-acting.
7. A client prescribed metformin is scheduled for a procedure requiring
iodinated contrast. Which action is appropriate?
A. Continue metformin regardless of the procedure.
B. Clarify the medication plan because metformin may need to be
temporarily withheld around contrast administration.
C. Double the metformin dose before the procedure.
D. Substitute insulin without provider instructions.
Answer: B
Solution: Metformin may need to be temporarily withheld in certain
patients receiving iodinated contrast because of concern for renal
impairment and the rare risk of lactic acidosis. Renal function and
current institutional guidance should be considered.
8. A client taking furosemide reports muscle weakness and palpitations.
Which electrolyte abnormality should the nurse suspect?
A. Hypernatremia
B. Hypokalemia
, 4|Page
C. Hypermagnesemia
D. Hypercalcemia
Answer: B
Solution: Loop diuretics such as furosemide can increase potassium
excretion. Hypokalemia can produce muscle weakness and cardiac
dysrhythmias.
9. Which laboratory value is particularly important to monitor in a client
taking spironolactone?
A. Potassium
B. Hemoglobin
C. Calcium
D. Platelets
Answer: A
Solution: Spironolactone is a potassium-sparing diuretic. It can cause
hyperkalemia, particularly in clients with renal impairment or those
taking other medications that increase potassium.
10. A client receiving morphine becomes difficult to arouse and has
respirations of 7/minute. Which medication should the nurse anticipate
administering?
A. Flumazenil
B. Protamine sulfate
C. Naloxone
D. Vitamin K
Answer: C
Solution: Naloxone is an opioid antagonist used to reverse opioid-
induced respiratory depression. The client's airway and breathing are
immediate priorities.
