NGN HESI RN Pharmacology Exit Exam 2023 [Real Screenshots] 55 Questions & Verified Answers | Graded A+

NGN HESI RN Pharmacology Exit Exam 2023
[Real Screenshots] 55 Questions & Verified
Answers | Graded A+
Question 1: A client receiving morphine via PCA reports pain 8/10 and a respiratory rate of 8
breaths/min. What is the nurse’s priority action?
A) Give the next scheduled PCA dose
B) Administer naloxone 0.4 mg IV push
C) Increase the PCA basal rate


D) Encourage slow deep breathing

Correct Answer: B) Administer naloxone 0.4 mg IV push


Explanation: RR < 10 suggests opioid-induced respiratory depression; naloxone reverses excess
morphine and protects airway. Additional doses and supportive care follow.

Question 2: The nurse is teaching a client started on warfarin. Which statement by the client
indicates understanding?
A) “I will limit green leafy vegetables.”
B) “I will double the dose if I miss a pill.”
C) “I will stop taking the drug before dental work.”


D) “I will take aspirin for headaches.”

Correct Answer: A) “I will limit green leafy vegetables.”


Explanation: Vitamin K-rich foods antagonize warfarin’s effect; consistent intake maintains stable
INR. Clients should not alter dose or add ASA without approval.

Question 3: A client with heart failure is prescribed digoxin 0.25 mg PO daily. Which finding should
the nurse report immediately?
A) Serum digoxin 1.2 ng/mL
B) Heart rate 52 bpm
C) Potassium 3.8 mEq/L

,D) Creatinine 1.0 mg/dL

Correct Answer: B) Heart rate 52 bpm


Explanation: Digoxin toxicity can cause bradyarrhythmias; HR < 60 bpm warrants holding dose and
notifying provider. Therapeutic digoxin level is 0.8–2 ng/mL.

Question 4: Which lab value best reflects effective heparin therapy?
A) aPTT 2–2.5 × control
B) INR 2–3
C) Platelet count 150,000/µL


D) PT 15 seconds

Correct Answer: A) aPTT 2–2.5 × control


Explanation: Unfractionated heparin is monitored by aPTT; target is 1.5–2.5 times baseline. INR
and PT are used for warfarin; platelets monitor HIT.

Question 5: A client receiving a loop diuretic develops tinnitus. The nurse suspects:
A) Ototoxicity
B) Hypokalemia
C) Hyperglycemia


D) Hepatotoxicity

Correct Answer: A) Ototoxicity


Explanation: Rapid high-dose IV furosemide can damage the cochlea, causing reversible tinnitus
and hearing loss; slow infusion and lower doses prevent toxicity.

Question 6: A post-op client has naloxone 0.4 mg IV ordered PRN for respiratory depression. After
administration the client becomes alert and rates pain 9/10. The nurse should:
A) Give the next ordered opioid dose
B) Administer a smaller opioid dose with slower push
C) Withhold all opioids for 4 hours


D) Offer non-opioid analgesics only

Correct Answer: B) Administer a smaller opioid dose with slower push

,Explanation: Naloxone reverses analgesia; once respirations normalize, titrate smaller opioid doses
slowly to achieve pain relief without re-depressing ventilation.

Question 7: The nurse is preparing insulin aspart. Which injection timing is correct?
A) 30 min before breakfast
B) 15 min before or immediately after a meal
C) At bedtime


D) Without regard to meals

Correct Answer: B) 15 min before or immediately after a meal


Explanation: Rapid-acting aspart is given ≤ 15 min pre-meal or immediately post-meal to match
carbohydrate absorption and prevent hypoglycemia.

Question 8) A client on lithium carbonate reports new fine hand tremor. The nurse should:
A) Hold lithium and obtain level
B) Reassure client tremor is benign
C) Give propranolol PRN


D) Increase fluid intake

Correct Answer: A) Hold lithium and obtain level


Explanation: Tremor may indicate early toxicity; check lithium level (target 0.6–1.2 mEq/L) and renal
function before next dose.

Question 9) Which instruction should be included for a client starting phenytoin?
A) Take with antacids to prevent GI upset
B) Use good oral hygiene and report gum swelling
C) Double dose if seizure occurs


D) Avoid sunscreen

Correct Answer: B) Use good oral hygiene and report gum swelling


Explanation: Phenytoin causes gingival hyperplasia; brushing, flossing, and dental visits minimize
severity. Antacids decrease absorption; dose adjustments need provider orders.

, Question 10) A client receiving gentamicin has a peak level of 12 µg/mL (normal 4–10). The nurse
should:
A) Document as normal
B) Increase the dose
C) Hold next dose and notify provider


D) Give dose earlier

Correct Answer: C) Hold next dose and notify provider


Explanation: Peak > 10 µg/mL increases nephro- and ototoxicity risk; hold dose, monitor creatinine,
and await renal-dose adjustment.

Question 11) A client is prescribed sliding-scale insulin. The nurse understands this regimen:
A) Prevents hyperglycemia proactively
B) Treats hyperglycemia reactively
C) Replaces basal insulin


D) Eliminates need for finger sticks

Correct Answer: B) Treats hyperglycemia reactively


Explanation: Sliding scale only corrects existing high glucose; basal-bolus regimens provide better
glycemic control and are now preferred.

Question 12) A client on metformin is scheduled for a CT with IV contrast. The nurse should:
A) Continue metformin as usual
B) Hold metformin day of test and restart when renal function stable
C) Switch to insulin permanently


D) Give half dose

Correct Answer: B) Hold metformin day of test and restart when renal function stable


Explanation: IV contrast can cause acute kidney injury and lactic acidosis; withhold metformin 48 h
pre/post procedure until creatinine normal.

Question 13) A client receiving morphine PCA complains of constipation. The nurse should:
A) Give a stimulant laxative and increase fluids
B) Reduce morphine by 50 %