HESI PN PHARMACOLOGY
EXAM PACK 2025/2026
Q1: A patient is prescribed furosemide (Lasix) 40 mg PO daily. Which laboratory value should
the practical nurse (PN) monitor most closely?
● A. Blood urea nitrogen (BUN)
● B. Serum potassium [CORRECT]
● C. Serum sodium
● D. Blood glucose
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in urine,
leading to hypokalemia. Low potassium can cause life-threatening cardiac dysrhythmias. The
PN must monitor potassium levels and report values below 3.5 mEq/L. While BUN and
sodium may be affected, potassium is the priority safety concern.
Q2: [Calculation] The healthcare provider orders heparin 5,000 units subcutaneous. The vial
available is heparin 10,000 units/mL. How many mL should the PN administer?
● A. 0.25 mL
● B. 0.5 mL [CORRECT]
● C. 1.0 mL
● D. 2.0 mL
Correct Answer: B (0.5 mL)
Rationale: Desired dose (5,000 units) ÷ Available concentration (10,000 units/mL) = 0.5 mL.
Remember: Heparin is a high-alert medication requiring two nurses to verify the dose before
administration.
Q3: A patient taking digoxin (Lanoxin) reports nausea, vomiting, and states "the lights look
yellow." The PN recognizes these as signs of:
● A. Therapeutic effect of the medication
● B. Digoxin toxicity [CORRECT]
● C. Hypokalemia unrelated to medication
, ● D. Normal side effects that will resolve
Correct Answer: B
Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos, blurred vision) are
classic signs of digoxin toxicity. The PN should hold the next dose and immediately notify the
RN or healthcare provider. Toxicity risk increases with hypokalemia, renal impairment, or
advanced age.
Q4: When administering a subcutaneous injection, the PN should angle the needle at:
● A. 15 degrees
● B. 45 to 90 degrees [CORRECT]
● C. 90 degrees only
● D. 30 degrees only
Correct Answer: B
Rationale: Subcutaneous injections are given at 45 to 90 degrees depending on patient size
and needle length. A 90-degree angle is used for average adults with a short needle; 45
degrees may be used for thin patients or longer needles. The key is to deposit medication
into the fatty tissue layer, not muscle.
Q5: [Calculation] The provider orders 1,000 mL of 0.9% NaCl to infuse over 8 hours. The drip
factor is 15 gtt/mL. How many gtt/min should the PN set the IV flow rate? (Round to the
nearest whole number)
● A. 31 gtt/min [CORRECT]
● B. 42 gtt/min
● C. 28 gtt/min
● D. 125 gtt/min
Correct Answer: A (31 gtt/min)
Rationale: (Total volume × Drip factor) ÷ Total minutes = (1,000 mL × 15 gtt/mL) ÷ 480
minutes = 15,000 ÷ 480 = 31.25, rounded to 31 gtt/min. The PN must monitor IV flow rates
regularly and report any infiltration or complications immediately.
Q6: A patient with type 2 diabetes is prescribed metformin (Glucophage). The PN should
teach the patient to monitor for which adverse effect?
● A. Hypoglycemia requiring glucagon
● B. Lactic acidosis symptoms (muscle pain, difficulty breathing) [CORRECT]
● C. Weight gain and fluid retention
● D. Hyperthyroidism
, Correct Answer: B
Rationale: While metformin rarely causes hypoglycemia when used alone, the most serious
adverse effect is lactic acidosis. The PN should teach patients to report muscle pain,
weakness, trouble breathing, stomach discomfort, or feeling cold—especially if they have
kidney disease, liver disease, or drink alcohol heavily.
Q7: The "Five Rights" of medication administration include all EXCEPT:
● A. Right patient
● B. Right time
● C. Right documentation
● D. Right diagnosis [CORRECT]
Correct Answer: D
Rationale: The Five Rights are: Right patient, Right drug, Right dose, Right route, and Right
time. While documentation is essential (sometimes called the "sixth right"), the patient's
diagnosis is not one of the administration rights. The PN verifies the medication matches the
order, not the diagnosis.
Q8: [Priority Action] The PN realizes they just administered the wrong medication to a patient.
The first action is to:
● A. Complete an incident report immediately
● B. Assess the patient for adverse effects [CORRECT]
● C. Notify the healthcare provider
● D. Document the error in the medical record
Correct Answer: B
Rationale: Patient safety is the priority. The PN must immediately assess the patient for any
adverse reactions or changes in condition, then notify the RN or healthcare provider. Incident
reports and documentation follow after the patient is stabilized. Never document "medication
error" in the patient's medical record—use the facility's incident reporting system.
Q9: A patient receiving nitroglycerin sublingual for angina reports a headache. The PN should:
● A. Discontinue the medication and notify the provider
● B. Explain this is a common side effect and monitor [CORRECT]
● C. Administer a PRN opioid immediately
● D. Hold the next dose until the headache resolves
Correct Answer: B
EXAM PACK 2025/2026
Q1: A patient is prescribed furosemide (Lasix) 40 mg PO daily. Which laboratory value should
the practical nurse (PN) monitor most closely?
● A. Blood urea nitrogen (BUN)
● B. Serum potassium [CORRECT]
● C. Serum sodium
● D. Blood glucose
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss in urine,
leading to hypokalemia. Low potassium can cause life-threatening cardiac dysrhythmias. The
PN must monitor potassium levels and report values below 3.5 mEq/L. While BUN and
sodium may be affected, potassium is the priority safety concern.
Q2: [Calculation] The healthcare provider orders heparin 5,000 units subcutaneous. The vial
available is heparin 10,000 units/mL. How many mL should the PN administer?
● A. 0.25 mL
● B. 0.5 mL [CORRECT]
● C. 1.0 mL
● D. 2.0 mL
Correct Answer: B (0.5 mL)
Rationale: Desired dose (5,000 units) ÷ Available concentration (10,000 units/mL) = 0.5 mL.
Remember: Heparin is a high-alert medication requiring two nurses to verify the dose before
administration.
Q3: A patient taking digoxin (Lanoxin) reports nausea, vomiting, and states "the lights look
yellow." The PN recognizes these as signs of:
● A. Therapeutic effect of the medication
● B. Digoxin toxicity [CORRECT]
● C. Hypokalemia unrelated to medication
, ● D. Normal side effects that will resolve
Correct Answer: B
Rationale: Nausea, vomiting, and visual disturbances (yellow-green halos, blurred vision) are
classic signs of digoxin toxicity. The PN should hold the next dose and immediately notify the
RN or healthcare provider. Toxicity risk increases with hypokalemia, renal impairment, or
advanced age.
Q4: When administering a subcutaneous injection, the PN should angle the needle at:
● A. 15 degrees
● B. 45 to 90 degrees [CORRECT]
● C. 90 degrees only
● D. 30 degrees only
Correct Answer: B
Rationale: Subcutaneous injections are given at 45 to 90 degrees depending on patient size
and needle length. A 90-degree angle is used for average adults with a short needle; 45
degrees may be used for thin patients or longer needles. The key is to deposit medication
into the fatty tissue layer, not muscle.
Q5: [Calculation] The provider orders 1,000 mL of 0.9% NaCl to infuse over 8 hours. The drip
factor is 15 gtt/mL. How many gtt/min should the PN set the IV flow rate? (Round to the
nearest whole number)
● A. 31 gtt/min [CORRECT]
● B. 42 gtt/min
● C. 28 gtt/min
● D. 125 gtt/min
Correct Answer: A (31 gtt/min)
Rationale: (Total volume × Drip factor) ÷ Total minutes = (1,000 mL × 15 gtt/mL) ÷ 480
minutes = 15,000 ÷ 480 = 31.25, rounded to 31 gtt/min. The PN must monitor IV flow rates
regularly and report any infiltration or complications immediately.
Q6: A patient with type 2 diabetes is prescribed metformin (Glucophage). The PN should
teach the patient to monitor for which adverse effect?
● A. Hypoglycemia requiring glucagon
● B. Lactic acidosis symptoms (muscle pain, difficulty breathing) [CORRECT]
● C. Weight gain and fluid retention
● D. Hyperthyroidism
, Correct Answer: B
Rationale: While metformin rarely causes hypoglycemia when used alone, the most serious
adverse effect is lactic acidosis. The PN should teach patients to report muscle pain,
weakness, trouble breathing, stomach discomfort, or feeling cold—especially if they have
kidney disease, liver disease, or drink alcohol heavily.
Q7: The "Five Rights" of medication administration include all EXCEPT:
● A. Right patient
● B. Right time
● C. Right documentation
● D. Right diagnosis [CORRECT]
Correct Answer: D
Rationale: The Five Rights are: Right patient, Right drug, Right dose, Right route, and Right
time. While documentation is essential (sometimes called the "sixth right"), the patient's
diagnosis is not one of the administration rights. The PN verifies the medication matches the
order, not the diagnosis.
Q8: [Priority Action] The PN realizes they just administered the wrong medication to a patient.
The first action is to:
● A. Complete an incident report immediately
● B. Assess the patient for adverse effects [CORRECT]
● C. Notify the healthcare provider
● D. Document the error in the medical record
Correct Answer: B
Rationale: Patient safety is the priority. The PN must immediately assess the patient for any
adverse reactions or changes in condition, then notify the RN or healthcare provider. Incident
reports and documentation follow after the patient is stabilized. Never document "medication
error" in the patient's medical record—use the facility's incident reporting system.
Q9: A patient receiving nitroglycerin sublingual for angina reports a headache. The PN should:
● A. Discontinue the medication and notify the provider
● B. Explain this is a common side effect and monitor [CORRECT]
● C. Administer a PRN opioid immediately
● D. Hold the next dose until the headache resolves
Correct Answer: B
