Updated HESI RN Pharmacology 2026 with
NGN | Comprehensive Questions and Answers
Section 1: Cardiovascular Medications
1. A client taking atorvastatin develops an increased serum creatine
phosphokinase (CK) level. The nurse should assess the client for the
onset of which problem?
A. Muscle tenderness
B. Nausea and vomiting
C. Excessive bruising
D. Peripheral edema
Correct Answer: A.
Rationale: An elevated CK in a client on a statin strongly suggests
muscle injury. Statins can precipitate myopathy, which presents as
muscle pain or tenderness and, in severe cases, rhabdomyolysis. The
nurse should specifically assess for muscle symptoms to catch
complications early.
2. An increase in which serum laboratory value indicates to the nurse
that a prescription for atorvastatin is having the desired effect for a
client at risk for coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein)
,Correct Answer: C.
Rationale: The desired effect of statin therapy is to lower LDL and
triglycerides, but an especially beneficial effect is to increase levels of
HDL, which has a protective effect against coronary artery disease.
Monitoring for increased HDL confirms positive medication effects.
3. A nurse is administering digoxin to an older adult client with heart
failure. Which assessment finding requires the nurse to withhold the
medication and notify the provider?
A. Blood pressure 138/82 mmHg
B. Apical pulse 54 beats/min
C. Respiratory rate 20 breaths/min
D. Oxygen saturation 95%
Correct Answer: B.
Rationale: Digoxin can cause bradycardia. The nurse should withhold
digoxin if the apical pulse is below 60 beats/min and notify the
healthcare provider.
4. A client taking digoxin develops nausea and visual disturbances.
What is the nurse's priority action?
A. Administer the next dose with food
B. Withhold the medication and notify the provider
C. Encourage oral fluids
D. Document as expected side effects
Correct Answer: B.
Rationale: Nausea and visual changes (yellow-green halos) are classic
,signs of digoxin toxicity. The medication should be withheld
immediately and the provider notified for further evaluation.
5. A client with hypertension is prescribed lisinopril. After the first
dose, the client develops facial swelling and difficulty breathing.
Which action should the nurse take?
A. Administer the next scheduled dose
B. Place the client in Trendelenburg position
C. Stop the medication and notify the provider immediately
D. Encourage oral fluids
Correct Answer: C.
Rationale: ACE inhibitors can cause life-threatening angioedema. The
medication should be discontinued immediately and the provider
notified.
6. A client taking lisinopril reports a persistent dry cough. What is the
nurse's best action?
A. Administer an antitussive medication
B. Notify the healthcare provider
C. Instruct the client to drink more fluids
D. Document as an expected side effect
Correct Answer: B.
Rationale: ACE inhibitors commonly cause a persistent dry cough due
to bradykinin accumulation. The provider may switch the patient to an
ARB.
, 7. Which action should the nurse implement to assess the
effectiveness of the calcium channel blocker amlodipine?
A. Note the client's serum calcium levels
B. Monitor the client's serum electrolytes
C. Review the client's intake and output
D. Measure the client's blood pressure
Correct Answer: D.
Rationale: Amlodipine is primarily prescribed for hypertension. Its
direct effect is to lower blood pressure via vasodilation. Checking BP is
the best way to measure its clinical effectiveness.
8. Which assessment finding is most concerning in a client in atrial
fibrillation?
A. Atrial heart rate 250 with ventricular rate 75
B. Cold, pale lower leg
C. Irregular apical pulse
D. Shortness of breath on exertion
Correct Answer: B.
Rationale: A cold, pale lower leg may indicate an arterial
thromboembolic event, which is a serious complication of atrial
fibrillation. This finding requires immediate intervention.
9. Which laboratory value should be monitored in a patient taking
warfarin?
A. INR
B. aPTT
NGN | Comprehensive Questions and Answers
Section 1: Cardiovascular Medications
1. A client taking atorvastatin develops an increased serum creatine
phosphokinase (CK) level. The nurse should assess the client for the
onset of which problem?
A. Muscle tenderness
B. Nausea and vomiting
C. Excessive bruising
D. Peripheral edema
Correct Answer: A.
Rationale: An elevated CK in a client on a statin strongly suggests
muscle injury. Statins can precipitate myopathy, which presents as
muscle pain or tenderness and, in severe cases, rhabdomyolysis. The
nurse should specifically assess for muscle symptoms to catch
complications early.
2. An increase in which serum laboratory value indicates to the nurse
that a prescription for atorvastatin is having the desired effect for a
client at risk for coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein)
,Correct Answer: C.
Rationale: The desired effect of statin therapy is to lower LDL and
triglycerides, but an especially beneficial effect is to increase levels of
HDL, which has a protective effect against coronary artery disease.
Monitoring for increased HDL confirms positive medication effects.
3. A nurse is administering digoxin to an older adult client with heart
failure. Which assessment finding requires the nurse to withhold the
medication and notify the provider?
A. Blood pressure 138/82 mmHg
B. Apical pulse 54 beats/min
C. Respiratory rate 20 breaths/min
D. Oxygen saturation 95%
Correct Answer: B.
Rationale: Digoxin can cause bradycardia. The nurse should withhold
digoxin if the apical pulse is below 60 beats/min and notify the
healthcare provider.
4. A client taking digoxin develops nausea and visual disturbances.
What is the nurse's priority action?
A. Administer the next dose with food
B. Withhold the medication and notify the provider
C. Encourage oral fluids
D. Document as expected side effects
Correct Answer: B.
Rationale: Nausea and visual changes (yellow-green halos) are classic
,signs of digoxin toxicity. The medication should be withheld
immediately and the provider notified for further evaluation.
5. A client with hypertension is prescribed lisinopril. After the first
dose, the client develops facial swelling and difficulty breathing.
Which action should the nurse take?
A. Administer the next scheduled dose
B. Place the client in Trendelenburg position
C. Stop the medication and notify the provider immediately
D. Encourage oral fluids
Correct Answer: C.
Rationale: ACE inhibitors can cause life-threatening angioedema. The
medication should be discontinued immediately and the provider
notified.
6. A client taking lisinopril reports a persistent dry cough. What is the
nurse's best action?
A. Administer an antitussive medication
B. Notify the healthcare provider
C. Instruct the client to drink more fluids
D. Document as an expected side effect
Correct Answer: B.
Rationale: ACE inhibitors commonly cause a persistent dry cough due
to bradykinin accumulation. The provider may switch the patient to an
ARB.
, 7. Which action should the nurse implement to assess the
effectiveness of the calcium channel blocker amlodipine?
A. Note the client's serum calcium levels
B. Monitor the client's serum electrolytes
C. Review the client's intake and output
D. Measure the client's blood pressure
Correct Answer: D.
Rationale: Amlodipine is primarily prescribed for hypertension. Its
direct effect is to lower blood pressure via vasodilation. Checking BP is
the best way to measure its clinical effectiveness.
8. Which assessment finding is most concerning in a client in atrial
fibrillation?
A. Atrial heart rate 250 with ventricular rate 75
B. Cold, pale lower leg
C. Irregular apical pulse
D. Shortness of breath on exertion
Correct Answer: B.
Rationale: A cold, pale lower leg may indicate an arterial
thromboembolic event, which is a serious complication of atrial
fibrillation. This finding requires immediate intervention.
9. Which laboratory value should be monitored in a patient taking
warfarin?
A. INR
B. aPTT
