PN HESI Pharmacology Exam
Review 2026/2027 – Practical
Nursing Questions & Answers
with Detailed Rationales
Guaranteed Pass (GRADED A+)
Question 1
A practical nurse is administering digoxin to a client with heart
failure. Which assessment finding should cause the nurse to hold
the medication and notify the healthcare provider?
A. Apical pulse of 54 beats/min
B. Respiratory rate of 18/min
C. Blood pressure of 128/76 mm Hg
D. Temperature of 98.6°F (37°C)
Answer: A. Apical pulse of 54 beats/min
Rationale: Digoxin can cause bradycardia. The nurse should
assess the apical pulse before administration and generally
withhold digoxin when the adult apical pulse is below the
prescribed safe threshold, commonly 60 beats/min, and notify
the provider according to agency policy.
Question 2
,A client receiving furosemide is at greatest risk for which
electrolyte imbalance?
A. Hypercalcemia
B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary
excretion of sodium and potassium. The nurse should monitor
serum potassium and assess for weakness, muscle cramps, and
dysrhythmias.
Question 3
A client prescribed warfarin should be instructed to maintain a
consistent intake of which food?
A. Spinach
B. Apples
C. White rice
D. Chicken
_Answer: A. Spinach
Rationale: Spinach and other dark green leafy vegetables
contain vitamin K, which can reduce the anticoagulant effect of
warfarin. Clients do not necessarily need to eliminate these
foods but should maintain a consistent intake and follow
monitoring instructions.
Question 4
,Which medication is commonly used as an antidote for opioid-
induced respiratory depression?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Vitamin K
_Answer: A. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse
opioid-induced respiratory and central nervous system
depression. Respiratory status must be monitored because the
duration of action of some opioids can exceed that of naloxone.
Question 5
A client taking lisinopril reports swelling of the lips and tongue.
What is the nurse's priority action?
A. Administer the next dose with food
B. Encourage increased oral fluids
C. Hold the medication and seek immediate medical attention
D. Document the finding as an expected adverse effect
_Answer: C. Hold the medication and seek immediate
medical attention
Rationale: Facial, lip, or tongue swelling can indicate
angioedema, a potentially life-threatening reaction associated
with ACE inhibitors. Airway assessment and emergency
intervention are priorities.
Question 6
, Which instruction is most appropriate for a client taking
metformin?
A. Take the medication only when blood glucose is elevated.
B. Take the medication as prescribed, commonly with meals.
C. Stop the medication whenever appetite decreases.
D. Double the next dose if one dose is missed.
_Answer: B. Take the medication as prescribed, commonly
with meals.
Rationale: Metformin is commonly taken with meals to reduce
gastrointestinal adverse effects. Clients should take it
consistently as prescribed and should not independently double
doses.
Question 7
A client receiving insulin develops sweating, tremors, and
confusion. Which condition should the nurse suspect?
A. Hypercalcemia
B. Hypoglycemia
C. Hypernatremia
D. Fluid overload
_Answer: B. Hypoglycemia
Rationale: Sweating, tremors, confusion, weakness, and
palpitations are common manifestations of hypoglycemia. The
nurse should check the blood glucose level and provide
appropriate rapid-acting carbohydrate if the client is conscious
and able to swallow.
Review 2026/2027 – Practical
Nursing Questions & Answers
with Detailed Rationales
Guaranteed Pass (GRADED A+)
Question 1
A practical nurse is administering digoxin to a client with heart
failure. Which assessment finding should cause the nurse to hold
the medication and notify the healthcare provider?
A. Apical pulse of 54 beats/min
B. Respiratory rate of 18/min
C. Blood pressure of 128/76 mm Hg
D. Temperature of 98.6°F (37°C)
Answer: A. Apical pulse of 54 beats/min
Rationale: Digoxin can cause bradycardia. The nurse should
assess the apical pulse before administration and generally
withhold digoxin when the adult apical pulse is below the
prescribed safe threshold, commonly 60 beats/min, and notify
the provider according to agency policy.
Question 2
,A client receiving furosemide is at greatest risk for which
electrolyte imbalance?
A. Hypercalcemia
B. Hyperkalemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary
excretion of sodium and potassium. The nurse should monitor
serum potassium and assess for weakness, muscle cramps, and
dysrhythmias.
Question 3
A client prescribed warfarin should be instructed to maintain a
consistent intake of which food?
A. Spinach
B. Apples
C. White rice
D. Chicken
_Answer: A. Spinach
Rationale: Spinach and other dark green leafy vegetables
contain vitamin K, which can reduce the anticoagulant effect of
warfarin. Clients do not necessarily need to eliminate these
foods but should maintain a consistent intake and follow
monitoring instructions.
Question 4
,Which medication is commonly used as an antidote for opioid-
induced respiratory depression?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Vitamin K
_Answer: A. Naloxone
Rationale: Naloxone is an opioid antagonist used to reverse
opioid-induced respiratory and central nervous system
depression. Respiratory status must be monitored because the
duration of action of some opioids can exceed that of naloxone.
Question 5
A client taking lisinopril reports swelling of the lips and tongue.
What is the nurse's priority action?
A. Administer the next dose with food
B. Encourage increased oral fluids
C. Hold the medication and seek immediate medical attention
D. Document the finding as an expected adverse effect
_Answer: C. Hold the medication and seek immediate
medical attention
Rationale: Facial, lip, or tongue swelling can indicate
angioedema, a potentially life-threatening reaction associated
with ACE inhibitors. Airway assessment and emergency
intervention are priorities.
Question 6
, Which instruction is most appropriate for a client taking
metformin?
A. Take the medication only when blood glucose is elevated.
B. Take the medication as prescribed, commonly with meals.
C. Stop the medication whenever appetite decreases.
D. Double the next dose if one dose is missed.
_Answer: B. Take the medication as prescribed, commonly
with meals.
Rationale: Metformin is commonly taken with meals to reduce
gastrointestinal adverse effects. Clients should take it
consistently as prescribed and should not independently double
doses.
Question 7
A client receiving insulin develops sweating, tremors, and
confusion. Which condition should the nurse suspect?
A. Hypercalcemia
B. Hypoglycemia
C. Hypernatremia
D. Fluid overload
_Answer: B. Hypoglycemia
Rationale: Sweating, tremors, confusion, weakness, and
palpitations are common manifestations of hypoglycemia. The
nurse should check the blood glucose level and provide
appropriate rapid-acting carbohydrate if the client is conscious
and able to swallow.
