1
HESI RN Pharmacology NGN Exam
2025 – 4 Full Versions with 300+
Actual Questions & Verified Correct
Answers + Clinical Rationales
Version 1: HESI RN Pharmacology NGN Exam 2025
(Questions 1–75)
Question 1
A client with hypertension is prescribed lisinopril 10 mg daily. Which assessment finding should
the nurse prioritize?
A) Heart rate
B) Blood pressure
C) Respiratory rate
D) Blood glucose
Rationale: Lisinopril, an ACE inhibitor, lowers blood pressure by inhibiting angiotensin II
formation. Monitoring blood pressure is critical to evaluate therapeutic effectiveness and detect
hypotension. [Ref: ATI Pharmacology, ACE Inhibitors]
Question 2
A client is prescribed warfarin for atrial fibrillation. Which laboratory value should the nurse
monitor?
A) Platelet count
B) INR
C) Hemoglobin
D) Serum creatinine
Rationale: Warfarin, an anticoagulant, requires INR monitoring (therapeutic range: 2–3 for atrial
fibrillation) to assess clotting risk and prevent bleeding or thrombosis. [Ref: ATI Pharmacology,
Anticoagulants]
Question 3 (SATA)
A client is prescribed sertraline for depression. Which side effects should the nurse teach the
client to report? (Select all that apply.)
A) Suicidal thoughts
B) Constipation
, 2
C) Agitation
D) Sexual dysfunction
Rationale: Sertraline, an SSRI, carries a black box warning for suicidal thoughts, especially
initially. Agitation and sexual dysfunction are common side effects requiring provider
notification. Constipation is less common. [Ref: ATI Pharmacology, SSRIs]
Question 4
Case Study: A 65-year-old client with type 2 diabetes is prescribed metformin 500 mg twice
daily. The client reports nausea and diarrhea.
Question: What is the nurse’s best action?
A) Stop the medication
B) Advise taking with food
C) Increase the dose
D) Switch to insulin
Rationale: Metformin commonly causes gastrointestinal upset, which can be minimized by
taking it with food. Stopping or switching is inappropriate without provider consultation. [Ref:
ATI Pharmacology, Antidiabetics]
Question 5
A client on heparin develops a platelet count of 90,000/mm³. What is the nurse’s priority action?
A) Continue the infusion
B) Notify the provider
C) Administer vitamin K
D) Monitor vital signs
Rationale: A platelet count below 100,000/mm³ suggests heparin-induced thrombocytopenia
(HIT), a serious complication requiring immediate provider notification to discontinue heparin.
[Ref: ATI Pharmacology, Anticoagulants]
Question 6
A client with schizophrenia is prescribed risperidone. Which side effect should the nurse
monitor?
A) Hypertension
B) Akathisia
C) Hypoglycemia
D) Bradycardia
Rationale: Risperidone, an atypical antipsychotic, commonly causes akathisia (restlessness) due
to dopamine receptor antagonism. Other options are less common. [Ref: ATI Pharmacology,
Antipsychotics]
Question 7
Prioritization: A nurse is caring for four clients receiving medications. Which client should the
nurse assess first?
, 3
A) Client on lisinopril with a cough
B) Client on warfarin with an INR of 2.5
C) Client on clozapine with a fever
D) Client on metformin with nausea
Rationale: Fever in a client on clozapine may indicate agranulocytosis, a life-threatening side
effect requiring immediate WBC monitoring. Other findings are less urgent. [Ref: ATI
Pharmacology, Antipsychotics]
Question 8
A client is prescribed furosemide 40 mg IV for heart failure. Which electrolyte should the nurse
monitor?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Rationale: Furosemide, a loop diuretic, causes potassium loss, risking hypokalemia, which can
lead to arrhythmias in heart failure. [Ref: ATI Pharmacology, Diuretics]
Question 9
A client with asthma is prescribed albuterol via inhaler. What should the nurse teach?
A) Use daily for prevention
B) Use as needed for wheezing
C) Take with food
D) Avoid during exercise
Rationale: Albuterol, a short-acting beta-agonist, is used as a rescue inhaler for acute asthma
symptoms like wheezing, not for daily prevention. [Ref: ATI Pharmacology, Bronchodilators]
Question 10
A client on digoxin reports nausea and visual halos. What is the nurse’s priority action?
A) Administer an antiemetic
B) Check digoxin levels
C) Monitor blood pressure
D) Encourage fluid intake
Rationale: Nausea and visual halos suggest digoxin toxicity (therapeutic range: 0.5–2 ng/mL),
requiring immediate level checks to prevent arrhythmias. [Ref: ATI Pharmacology, Cardiac
Glycosides]
Question 11
A client is prescribed levothyroxine for hypothyroidism. When should the nurse teach the client
to take it?
A) At bedtime
B) In the morning on an empty stomach
, 4
C) With meals
D) Every 12 hours
Rationale: Levothyroxine is best absorbed on an empty stomach in the morning to avoid food
interference and maintain consistent thyroid levels. [Ref: ATI Pharmacology, Thyroid
Medications]
Question 12
A client on atorvastatin develops muscle tenderness. What should the nurse assess?
A) Blood pressure
B) Creatine kinase (CK)
C) Blood glucose
D) Platelet count
Rationale: Muscle tenderness with statins like atorvastatin may indicate rhabdomyolysis,
requiring CK level monitoring to assess muscle damage. [Ref: ATI Pharmacology, Statins]
Question 13 (SATA)
A client is prescribed prednisone for rheumatoid arthritis. Which adverse effects should the nurse
monitor? (Select all that apply.)
A) Weight gain
B) Hyperglycemia
C) Hypotension
D) Osteoporosis
Rationale: Prednisone, a corticosteroid, causes weight gain, hyperglycemia, and osteoporosis
due to its metabolic and bone effects. Hypotension is not typical; hypertension is more common.
[Ref: ATI Pharmacology, Corticosteroids]
Question 14
Case Study: A client with epilepsy is prescribed phenytoin 100 mg three times daily. The client
reports gingival hyperplasia.
Question: What should the nurse do?
A) Increase the dose
B) Educate on oral hygiene
C) Stop the medication
D) Administer a sedative
Rationale: Gingival hyperplasia is a common side effect of phenytoin. Good oral hygiene can
mitigate it; stopping the medication requires provider consultation. [Ref: ATI Pharmacology,
Anticonvulsants]
Question 15
A client is prescribed morphine IV for pain. Which assessment is the nurse’s priority?
A) Blood pressure
B) Respiratory rate
HESI RN Pharmacology NGN Exam
2025 – 4 Full Versions with 300+
Actual Questions & Verified Correct
Answers + Clinical Rationales
Version 1: HESI RN Pharmacology NGN Exam 2025
(Questions 1–75)
Question 1
A client with hypertension is prescribed lisinopril 10 mg daily. Which assessment finding should
the nurse prioritize?
A) Heart rate
B) Blood pressure
C) Respiratory rate
D) Blood glucose
Rationale: Lisinopril, an ACE inhibitor, lowers blood pressure by inhibiting angiotensin II
formation. Monitoring blood pressure is critical to evaluate therapeutic effectiveness and detect
hypotension. [Ref: ATI Pharmacology, ACE Inhibitors]
Question 2
A client is prescribed warfarin for atrial fibrillation. Which laboratory value should the nurse
monitor?
A) Platelet count
B) INR
C) Hemoglobin
D) Serum creatinine
Rationale: Warfarin, an anticoagulant, requires INR monitoring (therapeutic range: 2–3 for atrial
fibrillation) to assess clotting risk and prevent bleeding or thrombosis. [Ref: ATI Pharmacology,
Anticoagulants]
Question 3 (SATA)
A client is prescribed sertraline for depression. Which side effects should the nurse teach the
client to report? (Select all that apply.)
A) Suicidal thoughts
B) Constipation
, 2
C) Agitation
D) Sexual dysfunction
Rationale: Sertraline, an SSRI, carries a black box warning for suicidal thoughts, especially
initially. Agitation and sexual dysfunction are common side effects requiring provider
notification. Constipation is less common. [Ref: ATI Pharmacology, SSRIs]
Question 4
Case Study: A 65-year-old client with type 2 diabetes is prescribed metformin 500 mg twice
daily. The client reports nausea and diarrhea.
Question: What is the nurse’s best action?
A) Stop the medication
B) Advise taking with food
C) Increase the dose
D) Switch to insulin
Rationale: Metformin commonly causes gastrointestinal upset, which can be minimized by
taking it with food. Stopping or switching is inappropriate without provider consultation. [Ref:
ATI Pharmacology, Antidiabetics]
Question 5
A client on heparin develops a platelet count of 90,000/mm³. What is the nurse’s priority action?
A) Continue the infusion
B) Notify the provider
C) Administer vitamin K
D) Monitor vital signs
Rationale: A platelet count below 100,000/mm³ suggests heparin-induced thrombocytopenia
(HIT), a serious complication requiring immediate provider notification to discontinue heparin.
[Ref: ATI Pharmacology, Anticoagulants]
Question 6
A client with schizophrenia is prescribed risperidone. Which side effect should the nurse
monitor?
A) Hypertension
B) Akathisia
C) Hypoglycemia
D) Bradycardia
Rationale: Risperidone, an atypical antipsychotic, commonly causes akathisia (restlessness) due
to dopamine receptor antagonism. Other options are less common. [Ref: ATI Pharmacology,
Antipsychotics]
Question 7
Prioritization: A nurse is caring for four clients receiving medications. Which client should the
nurse assess first?
, 3
A) Client on lisinopril with a cough
B) Client on warfarin with an INR of 2.5
C) Client on clozapine with a fever
D) Client on metformin with nausea
Rationale: Fever in a client on clozapine may indicate agranulocytosis, a life-threatening side
effect requiring immediate WBC monitoring. Other findings are less urgent. [Ref: ATI
Pharmacology, Antipsychotics]
Question 8
A client is prescribed furosemide 40 mg IV for heart failure. Which electrolyte should the nurse
monitor?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
Rationale: Furosemide, a loop diuretic, causes potassium loss, risking hypokalemia, which can
lead to arrhythmias in heart failure. [Ref: ATI Pharmacology, Diuretics]
Question 9
A client with asthma is prescribed albuterol via inhaler. What should the nurse teach?
A) Use daily for prevention
B) Use as needed for wheezing
C) Take with food
D) Avoid during exercise
Rationale: Albuterol, a short-acting beta-agonist, is used as a rescue inhaler for acute asthma
symptoms like wheezing, not for daily prevention. [Ref: ATI Pharmacology, Bronchodilators]
Question 10
A client on digoxin reports nausea and visual halos. What is the nurse’s priority action?
A) Administer an antiemetic
B) Check digoxin levels
C) Monitor blood pressure
D) Encourage fluid intake
Rationale: Nausea and visual halos suggest digoxin toxicity (therapeutic range: 0.5–2 ng/mL),
requiring immediate level checks to prevent arrhythmias. [Ref: ATI Pharmacology, Cardiac
Glycosides]
Question 11
A client is prescribed levothyroxine for hypothyroidism. When should the nurse teach the client
to take it?
A) At bedtime
B) In the morning on an empty stomach
, 4
C) With meals
D) Every 12 hours
Rationale: Levothyroxine is best absorbed on an empty stomach in the morning to avoid food
interference and maintain consistent thyroid levels. [Ref: ATI Pharmacology, Thyroid
Medications]
Question 12
A client on atorvastatin develops muscle tenderness. What should the nurse assess?
A) Blood pressure
B) Creatine kinase (CK)
C) Blood glucose
D) Platelet count
Rationale: Muscle tenderness with statins like atorvastatin may indicate rhabdomyolysis,
requiring CK level monitoring to assess muscle damage. [Ref: ATI Pharmacology, Statins]
Question 13 (SATA)
A client is prescribed prednisone for rheumatoid arthritis. Which adverse effects should the nurse
monitor? (Select all that apply.)
A) Weight gain
B) Hyperglycemia
C) Hypotension
D) Osteoporosis
Rationale: Prednisone, a corticosteroid, causes weight gain, hyperglycemia, and osteoporosis
due to its metabolic and bone effects. Hypotension is not typical; hypertension is more common.
[Ref: ATI Pharmacology, Corticosteroids]
Question 14
Case Study: A client with epilepsy is prescribed phenytoin 100 mg three times daily. The client
reports gingival hyperplasia.
Question: What should the nurse do?
A) Increase the dose
B) Educate on oral hygiene
C) Stop the medication
D) Administer a sedative
Rationale: Gingival hyperplasia is a common side effect of phenytoin. Good oral hygiene can
mitigate it; stopping the medication requires provider consultation. [Ref: ATI Pharmacology,
Anticonvulsants]
Question 15
A client is prescribed morphine IV for pain. Which assessment is the nurse’s priority?
A) Blood pressure
B) Respiratory rate
