HESI RN PHARMACOLOGY MEGA TEST BANK
2025-2026 NGN REAL EXAM QUESTIONS,
ANSWERS & DETAILED RATIONALES (GRADED A+
EDITION)
This premium, question Next-Generation NCLEX (NGN)
pharmacology test bank delivers real, high-yield practice
tracking critical nursing interventions, life-saving antidotes,
and complex drug toxicities. Every multiple-choice question
features verified correct answers and dense, bolded medical
rationales designed to rapidly sharpen clinical judgment for
the HESI RN exam. It serves as an elite, comprehensive study
companion optimized to help nursing students master
pharmacology modules and confidently secure an A+ grade.
Q1. A client receiving a continuous intravenous
heparin infusion has an activated partial
thromboplastin time (aPTT) of 110 seconds. The
nurse notes petechiae and oozing from the
intravenous insertion site. Which medication
should the nurse anticipate administering?
A) Vitamin K
B) Protamine sulfate
C) Aminocaproic acid
D) Flumazenil
Answer: B) Protamine sulfate
,Rationale: Protamine sulfate is the specific
antidote used to reverse the anticoagulant effects
of heparin in the presence of severe bleeding or
severe supratherapeutic aPTT levels. Vitamin K is
the antidote for warfarin, aminocaproic acid is a
fibrinolytic inhibitor, and flumazenil is the
reversal agent for benzodiazepines.
Q2. The nurse is preparing to administer the
morning dose of digoxin 0.125 mg to a client with
heart failure. The client’s apical pulse is 52 beats
per minute. Which action should the nurse take
first?
A) Administer the medication as prescribed
B) Hold the medication and recheck the pulse in 1
hour
C) Hold the medication and notify the healthcare
provider
D) Administer the dose intravenously instead of
orally
Answer: C) Hold the medication and notify the
healthcare provider
Rationale: Digoxin is a cardiac glycoside that
decreases the heart rate (negative chronotrope).
It must be held if the apical pulse is less than 60
,beats per minute in an adult to prevent severe
bradycardia and worsening digoxin toxicity. The
provider must be notified of the bradycardic
event.
Q3. A client with type 2 diabetes mellitus is
scheduled for a computed tomography (CT) scan
with intravenous iodinated contrast media. Which
home medication must the nurse instruct the
client to withhold on the day of the procedure and
for 48 hours afterward?
A) Glyburide
B) Metformin
C) Pioglitazone
D) Sitagliptin
Answer: B) Metformin
Rationale: Metformin must be withheld prior to
and for 48 hours after procedures involving
iodinated contrast dye. The combination of
contrast dye and metformin increases the risk of
contrast-induced nephropathy and subsequent
fatal lactic acidosis. Renal function must be
verified before resuming the medication.
Q4. The nurse is monitoring a client who is
receiving an intravenous infusion of vancomycin.
, After 15 minutes, the client develops severe
flushing, erythema, and pruritus of the face, neck,
and upper torso. The client's blood pressure is
112/64 mmHg. Which action should the nurse
implement?
A) Stop the infusion permanently and prepare to
administer epinephrine
B) Slow the infusion rate to run over at least 2
hours and notify the provider
C) Increase the infusion rate to complete the
therapy faster
D) Administer intravenous furosemide to clear the
medication
Answer: B) Slow the infusion rate to run over at
least 2 hours and notify the provider
Rationale: The client is experiencing Red Man
Syndrome (or Vancomycin Flushing Syndrome),
which is a rate-dependent infusion reaction
caused by histamine release, not a true allergic
anaphylaxis. Slowing the infusion rate to run over
at least 60 to 120 minutes resolves or prevents
this reaction. Anaphylaxis would present with
airway compromise, wheezing, and profound
hypotension, requiring epinephrine.
2025-2026 NGN REAL EXAM QUESTIONS,
ANSWERS & DETAILED RATIONALES (GRADED A+
EDITION)
This premium, question Next-Generation NCLEX (NGN)
pharmacology test bank delivers real, high-yield practice
tracking critical nursing interventions, life-saving antidotes,
and complex drug toxicities. Every multiple-choice question
features verified correct answers and dense, bolded medical
rationales designed to rapidly sharpen clinical judgment for
the HESI RN exam. It serves as an elite, comprehensive study
companion optimized to help nursing students master
pharmacology modules and confidently secure an A+ grade.
Q1. A client receiving a continuous intravenous
heparin infusion has an activated partial
thromboplastin time (aPTT) of 110 seconds. The
nurse notes petechiae and oozing from the
intravenous insertion site. Which medication
should the nurse anticipate administering?
A) Vitamin K
B) Protamine sulfate
C) Aminocaproic acid
D) Flumazenil
Answer: B) Protamine sulfate
,Rationale: Protamine sulfate is the specific
antidote used to reverse the anticoagulant effects
of heparin in the presence of severe bleeding or
severe supratherapeutic aPTT levels. Vitamin K is
the antidote for warfarin, aminocaproic acid is a
fibrinolytic inhibitor, and flumazenil is the
reversal agent for benzodiazepines.
Q2. The nurse is preparing to administer the
morning dose of digoxin 0.125 mg to a client with
heart failure. The client’s apical pulse is 52 beats
per minute. Which action should the nurse take
first?
A) Administer the medication as prescribed
B) Hold the medication and recheck the pulse in 1
hour
C) Hold the medication and notify the healthcare
provider
D) Administer the dose intravenously instead of
orally
Answer: C) Hold the medication and notify the
healthcare provider
Rationale: Digoxin is a cardiac glycoside that
decreases the heart rate (negative chronotrope).
It must be held if the apical pulse is less than 60
,beats per minute in an adult to prevent severe
bradycardia and worsening digoxin toxicity. The
provider must be notified of the bradycardic
event.
Q3. A client with type 2 diabetes mellitus is
scheduled for a computed tomography (CT) scan
with intravenous iodinated contrast media. Which
home medication must the nurse instruct the
client to withhold on the day of the procedure and
for 48 hours afterward?
A) Glyburide
B) Metformin
C) Pioglitazone
D) Sitagliptin
Answer: B) Metformin
Rationale: Metformin must be withheld prior to
and for 48 hours after procedures involving
iodinated contrast dye. The combination of
contrast dye and metformin increases the risk of
contrast-induced nephropathy and subsequent
fatal lactic acidosis. Renal function must be
verified before resuming the medication.
Q4. The nurse is monitoring a client who is
receiving an intravenous infusion of vancomycin.
, After 15 minutes, the client develops severe
flushing, erythema, and pruritus of the face, neck,
and upper torso. The client's blood pressure is
112/64 mmHg. Which action should the nurse
implement?
A) Stop the infusion permanently and prepare to
administer epinephrine
B) Slow the infusion rate to run over at least 2
hours and notify the provider
C) Increase the infusion rate to complete the
therapy faster
D) Administer intravenous furosemide to clear the
medication
Answer: B) Slow the infusion rate to run over at
least 2 hours and notify the provider
Rationale: The client is experiencing Red Man
Syndrome (or Vancomycin Flushing Syndrome),
which is a rate-dependent infusion reaction
caused by histamine release, not a true allergic
anaphylaxis. Slowing the infusion rate to run over
at least 60 to 120 minutes resolves or prevents
this reaction. Anaphylaxis would present with
airway compromise, wheezing, and profound
hypotension, requiring epinephrine.
