PN HESI PHARMACOLOGY EXAM REVIEW TEST
BANK 2026 Q&AS WITH DETAILED RATIONALES
COMPLETE EVOLVE HESI PN STUDY GUIDE &
A+ PACK
This comprehensive pharmacology practice test bank
features high-yield multiple-choice questions complete with
correct answers and detailed, bolded rationales specifically
tailored to the HESI PN blueprint. Designed for practical
nursing students, it provides deep review coverage of
essential medication classes, vital signs parameters, critical
drug antidotes, and patient safety nursing interventions.
Master high-alert medication concepts, maternal-child health
dosages, and critical fluid balance mechanics to secure an
A+ on your upcoming Evolve HESI PN exit examination
1. A nurse is preparing to administer digoxin to a client with
heart failure. Which clinical finding requires the nurse to hold
the medication and notify the healthcare provider?
A. Blood pressure 130/80 mmHg
B. Heart rate 52 beats per minute
C. Respiratory rate 18 breaths per minute
D. Oxygen saturation 95% on room air
• Answer: B
,• Rationale: Digoxin is a cardiac glycoside that decreases
the heart rate. The nurse must assess the apical pulse
for one full minute before administration. If the heart
rate is below 60 beats per minute in an adult (or as
prescribed by the facility), the medication must be
withheld to prevent severe bradycardia and toxicity.
2. A client is prescribed furosemide daily. Which laboratory
value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Blood urea nitrogen (BUN)
D. Serum creatinine
• Answer: B
• Rationale: Furosemide is a loop diuretic that causes the
excretion of water, sodium, and potassium. Hypokalemia
(low potassium) is a major adverse effect that can lead
to life-threatening cardiac arrhythmias. While sodium
and renal function are important, potassium tracking is
the highest priority.
3. A nurse is reinforcing teaching with a client who has a new
prescription for sublingual nitroglycerin tablets for angina.
Which instruction should the nurse include?
A. Swallow the tablet with a full glass of water.
B. Take a tablet every 15 minutes up to 4 times.
C. Place the tablet under the tongue and let it dissolve
completely.
D. Store the tablets in a clear plastic container on the
windowsill.
,• Answer: C
• Rationale: Sublingual nitroglycerin must dissolve under
the tongue to bypass gastrointestinal metabolism and
work rapidly. It should never be swallowed. The client
should take one tablet every 5 minutes up to 3 times,
and store them in their original dark, tightly sealed glass
bottle away from light and moisture.
4. A client receiving warfarin therapy has an International
Normalized Ratio (INR) of 5.2. Which medication should the
nurse anticipate administering?
A. Protamine sulfate
B. Vitamin K
C. Heparin sodium
D. Enoxaparin
• Answer: B
• Rationale: Vitamin K is the specific antidote used to
reverse the anticoagulant effects of warfarin when the
INR is dangerously elevated. Protamine sulfate is the
antidote for heparin, while enoxaparin and heparin
would further increase the risk of bleeding.
5. A nurse is caring for a client who is receiving intravenous
heparin infusion. Which laboratory test should the nurse
monitor to adjust the infusion rate?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
• Answer: C
, • Rationale: The aPTT test is specifically utilized to
monitor the therapeutic effectiveness and safety of
unfractionated heparin infusions. PT and INR are utilized
to monitor oral warfarin therapy. Platelet counts monitor
for heparin-induced thrombocytopenia but do not guide
the daily dose adjustments.
6. A client with type 1 diabetes mellitus is prescribed regular
insulin and NPH insulin injections. When mixing these
insulins in a single syringe, which action should the nurse
take first?
A. Draw up the NPH insulin first.
B. Inject air into the regular insulin vial.
C. Inject air into the NPH insulin vial.
D. Draw up the regular insulin first.
• Answer: C
• Rationale: The correct sequence for mixing insulin is to
inject air into the modified insulin vial (NPH/cloudy) first,
inject air into the unmodified insulin vial (regular/clear)
second, draw up the regular insulin third, and draw up
the NPH insulin last. This prevents contaminating the
clear regular insulin with the cloudy NPH insulin.
7. A nurse is reinforcing teaching with a client who is starting
metformin for type 2 diabetes mellitus. Which side effect
should the nurse instruct the client to expect?
A. Weight gain
B. Hypoglycemia
C. Gastrointestinal distress
D. Blurred vision
BANK 2026 Q&AS WITH DETAILED RATIONALES
COMPLETE EVOLVE HESI PN STUDY GUIDE &
A+ PACK
This comprehensive pharmacology practice test bank
features high-yield multiple-choice questions complete with
correct answers and detailed, bolded rationales specifically
tailored to the HESI PN blueprint. Designed for practical
nursing students, it provides deep review coverage of
essential medication classes, vital signs parameters, critical
drug antidotes, and patient safety nursing interventions.
Master high-alert medication concepts, maternal-child health
dosages, and critical fluid balance mechanics to secure an
A+ on your upcoming Evolve HESI PN exit examination
1. A nurse is preparing to administer digoxin to a client with
heart failure. Which clinical finding requires the nurse to hold
the medication and notify the healthcare provider?
A. Blood pressure 130/80 mmHg
B. Heart rate 52 beats per minute
C. Respiratory rate 18 breaths per minute
D. Oxygen saturation 95% on room air
• Answer: B
,• Rationale: Digoxin is a cardiac glycoside that decreases
the heart rate. The nurse must assess the apical pulse
for one full minute before administration. If the heart
rate is below 60 beats per minute in an adult (or as
prescribed by the facility), the medication must be
withheld to prevent severe bradycardia and toxicity.
2. A client is prescribed furosemide daily. Which laboratory
value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Blood urea nitrogen (BUN)
D. Serum creatinine
• Answer: B
• Rationale: Furosemide is a loop diuretic that causes the
excretion of water, sodium, and potassium. Hypokalemia
(low potassium) is a major adverse effect that can lead
to life-threatening cardiac arrhythmias. While sodium
and renal function are important, potassium tracking is
the highest priority.
3. A nurse is reinforcing teaching with a client who has a new
prescription for sublingual nitroglycerin tablets for angina.
Which instruction should the nurse include?
A. Swallow the tablet with a full glass of water.
B. Take a tablet every 15 minutes up to 4 times.
C. Place the tablet under the tongue and let it dissolve
completely.
D. Store the tablets in a clear plastic container on the
windowsill.
,• Answer: C
• Rationale: Sublingual nitroglycerin must dissolve under
the tongue to bypass gastrointestinal metabolism and
work rapidly. It should never be swallowed. The client
should take one tablet every 5 minutes up to 3 times,
and store them in their original dark, tightly sealed glass
bottle away from light and moisture.
4. A client receiving warfarin therapy has an International
Normalized Ratio (INR) of 5.2. Which medication should the
nurse anticipate administering?
A. Protamine sulfate
B. Vitamin K
C. Heparin sodium
D. Enoxaparin
• Answer: B
• Rationale: Vitamin K is the specific antidote used to
reverse the anticoagulant effects of warfarin when the
INR is dangerously elevated. Protamine sulfate is the
antidote for heparin, while enoxaparin and heparin
would further increase the risk of bleeding.
5. A nurse is caring for a client who is receiving intravenous
heparin infusion. Which laboratory test should the nurse
monitor to adjust the infusion rate?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
• Answer: C
, • Rationale: The aPTT test is specifically utilized to
monitor the therapeutic effectiveness and safety of
unfractionated heparin infusions. PT and INR are utilized
to monitor oral warfarin therapy. Platelet counts monitor
for heparin-induced thrombocytopenia but do not guide
the daily dose adjustments.
6. A client with type 1 diabetes mellitus is prescribed regular
insulin and NPH insulin injections. When mixing these
insulins in a single syringe, which action should the nurse
take first?
A. Draw up the NPH insulin first.
B. Inject air into the regular insulin vial.
C. Inject air into the NPH insulin vial.
D. Draw up the regular insulin first.
• Answer: C
• Rationale: The correct sequence for mixing insulin is to
inject air into the modified insulin vial (NPH/cloudy) first,
inject air into the unmodified insulin vial (regular/clear)
second, draw up the regular insulin third, and draw up
the NPH insulin last. This prevents contaminating the
clear regular insulin with the cloudy NPH insulin.
7. A nurse is reinforcing teaching with a client who is starting
metformin for type 2 diabetes mellitus. Which side effect
should the nurse instruct the client to expect?
A. Weight gain
B. Hypoglycemia
C. Gastrointestinal distress
D. Blurred vision
