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HESI RN Pharmacology Exit Exam
2025/2026 – NGN Proctored actual
Questions (55 Verified) | Already
Graded A+
1. MCQ: A client is prescribed lisinopril for hypertension. Which side effect
should the nurse monitor for?
• A) Hyperkalemia
• B) Dry cough
• C) Hypoglycemia
• D) Constipation
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry cough due to bradykinin
accumulation. Hyperkalemia is a risk, but cough is more frequent. Hypoglycemia and
constipation are not associated.
2. Cloze: A nurse is teaching a client with type 2 diabetes about metformin. The
client should take the medication with meals, monitor for lactic acidosis, and
report muscle pain or weakness to the provider.
Options:
• Type 2 diabetes, hypertension, heart failure
• Metformin, insulin, glipizide
• With meals, at bedtime, on an empty stomach
• Lactic acidosis, hypoglycemia, hyperglycemia
• Muscle pain, fever, rash
• Weakness, headache, nausea
Rationale: Metformin is taken with meals to reduce GI upset. Lactic acidosis is a rare but
serious side effect, and muscle pain or weakness may indicate this condition, requiring prompt
reporting.
3. Bowtie: A client presents with chest pain and is prescribed nitroglycerin.
Complete the bowtie diagram for angina management.
Condition: Angina
Actions:
, 2
• Administer nitroglycerin sublingually
• Instruct to rest
Parameters to Monitor:
• Blood pressure
• Chest pain relief
Potential Complications:
• Hypotension
• Headache
Rationale: Nitroglycerin relieves angina by dilating blood vessels, and rest reduces cardiac
demand. Monitor blood pressure for hypotension and pain relief for effectiveness. Hypotension
and headache are common complications.
4. Matrix/Grid: A nurse is caring for a client receiving warfarin. Indicate
whether the following findings require intervention or monitoring.
Finding Intervention Monitoring
INR 4.5 [] []
Bruising [] []
INR 2.5 [] []
Bleeding gums [ ] []
Correct Answers:
• INR 4.5: Intervention
• Bruising: Monitoring
• INR 2.5: Monitoring
• Bleeding gums: Intervention
Rationale: INR 4.5 is above therapeutic range (2–3), indicating a bleeding risk requiring
intervention. Bruising is monitored as a common side effect. INR 2.5 is therapeutic, requiring
monitoring. Bleeding gums indicate potential bleeding, needing intervention.
5. MCQ: A client is prescribed furosemide for heart failure. Which laboratory
value should the nurse monitor?
• A) Blood glucose
• B) Potassium levels
• C) Hemoglobin
• D) Sodium levels
Rationale: Furosemide, a loop diuretic, can cause hypokalemia due to potassium loss, requiring
close monitoring of potassium levels.
, 3
6. Cloze: A nurse is teaching a client with depression about fluoxetine. The client
should avoid alcohol, monitor for serotonin syndrome, and report suicidal
thoughts or agitation to the provider.
Options:
• Depression, anxiety, bipolar disorder
• Fluoxetine, sertraline, citalopram
• Avoid alcohol, avoid caffeine, avoid dairy
• Serotonin syndrome, hypoglycemia, hypertension
• Suicidal thoughts, fever, rash
• Agitation, nausea, headache
Rationale: Fluoxetine, an SSRI, requires avoiding alcohol to prevent worsening CNS effects.
Serotonin syndrome and suicidal thoughts/agitation are serious side effects requiring monitoring
and reporting.
7. Bowtie: A client presents with shortness of breath and is prescribed albuterol.
Complete the bowtie diagram for asthma exacerbation.
Condition: Asthma Exacerbation
Actions:
• Administer albuterol via inhaler
• Monitor respiratory status
Parameters to Monitor:
• Oxygen saturation
• Heart rate
Potential Complications:
• Tachycardia
• Hypokalemia
Rationale: Albuterol relieves bronchospasm, and monitoring respiratory status ensures
effectiveness. Oxygen saturation and heart rate track response, while tachycardia and
hypokalemia are potential complications.
8. Matrix/Grid: A nurse is caring for a client receiving heparin. Indicate whether
the following findings are normal or abnormal.
Finding Normal Abnormal
aPTT 70 seconds [ ] []
Bruising [] []
aPTT 30 seconds [ ] []
Hematuria [] []
HESI RN Pharmacology Exit Exam
2025/2026 – NGN Proctored actual
Questions (55 Verified) | Already
Graded A+
1. MCQ: A client is prescribed lisinopril for hypertension. Which side effect
should the nurse monitor for?
• A) Hyperkalemia
• B) Dry cough
• C) Hypoglycemia
• D) Constipation
Rationale: Lisinopril, an ACE inhibitor, commonly causes a dry cough due to bradykinin
accumulation. Hyperkalemia is a risk, but cough is more frequent. Hypoglycemia and
constipation are not associated.
2. Cloze: A nurse is teaching a client with type 2 diabetes about metformin. The
client should take the medication with meals, monitor for lactic acidosis, and
report muscle pain or weakness to the provider.
Options:
• Type 2 diabetes, hypertension, heart failure
• Metformin, insulin, glipizide
• With meals, at bedtime, on an empty stomach
• Lactic acidosis, hypoglycemia, hyperglycemia
• Muscle pain, fever, rash
• Weakness, headache, nausea
Rationale: Metformin is taken with meals to reduce GI upset. Lactic acidosis is a rare but
serious side effect, and muscle pain or weakness may indicate this condition, requiring prompt
reporting.
3. Bowtie: A client presents with chest pain and is prescribed nitroglycerin.
Complete the bowtie diagram for angina management.
Condition: Angina
Actions:
, 2
• Administer nitroglycerin sublingually
• Instruct to rest
Parameters to Monitor:
• Blood pressure
• Chest pain relief
Potential Complications:
• Hypotension
• Headache
Rationale: Nitroglycerin relieves angina by dilating blood vessels, and rest reduces cardiac
demand. Monitor blood pressure for hypotension and pain relief for effectiveness. Hypotension
and headache are common complications.
4. Matrix/Grid: A nurse is caring for a client receiving warfarin. Indicate
whether the following findings require intervention or monitoring.
Finding Intervention Monitoring
INR 4.5 [] []
Bruising [] []
INR 2.5 [] []
Bleeding gums [ ] []
Correct Answers:
• INR 4.5: Intervention
• Bruising: Monitoring
• INR 2.5: Monitoring
• Bleeding gums: Intervention
Rationale: INR 4.5 is above therapeutic range (2–3), indicating a bleeding risk requiring
intervention. Bruising is monitored as a common side effect. INR 2.5 is therapeutic, requiring
monitoring. Bleeding gums indicate potential bleeding, needing intervention.
5. MCQ: A client is prescribed furosemide for heart failure. Which laboratory
value should the nurse monitor?
• A) Blood glucose
• B) Potassium levels
• C) Hemoglobin
• D) Sodium levels
Rationale: Furosemide, a loop diuretic, can cause hypokalemia due to potassium loss, requiring
close monitoring of potassium levels.
, 3
6. Cloze: A nurse is teaching a client with depression about fluoxetine. The client
should avoid alcohol, monitor for serotonin syndrome, and report suicidal
thoughts or agitation to the provider.
Options:
• Depression, anxiety, bipolar disorder
• Fluoxetine, sertraline, citalopram
• Avoid alcohol, avoid caffeine, avoid dairy
• Serotonin syndrome, hypoglycemia, hypertension
• Suicidal thoughts, fever, rash
• Agitation, nausea, headache
Rationale: Fluoxetine, an SSRI, requires avoiding alcohol to prevent worsening CNS effects.
Serotonin syndrome and suicidal thoughts/agitation are serious side effects requiring monitoring
and reporting.
7. Bowtie: A client presents with shortness of breath and is prescribed albuterol.
Complete the bowtie diagram for asthma exacerbation.
Condition: Asthma Exacerbation
Actions:
• Administer albuterol via inhaler
• Monitor respiratory status
Parameters to Monitor:
• Oxygen saturation
• Heart rate
Potential Complications:
• Tachycardia
• Hypokalemia
Rationale: Albuterol relieves bronchospasm, and monitoring respiratory status ensures
effectiveness. Oxygen saturation and heart rate track response, while tachycardia and
hypokalemia are potential complications.
8. Matrix/Grid: A nurse is caring for a client receiving heparin. Indicate whether
the following findings are normal or abnormal.
Finding Normal Abnormal
aPTT 70 seconds [ ] []
Bruising [] []
aPTT 30 seconds [ ] []
Hematuria [] []
