HESI PHARMACOLOGY
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NCLEX (NGN), & Case-based Scenarios
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400+ Ques and Ans
Format Set of Multiple-choice
questions with incorporating Next Generation
NCLEX (NGN) and Case studies questions
Expert-Verified Explanations & Solutions
, Preview Questions Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any study
resources, feel free to Message me."
,─────────────────────────────────────────────────────────
QUESTION 1 (NGN-Style: Pre-Administra on Assessment)
─────────────────────────────────────────────────────────
Before administering a laxa ve to a bedfast (bedridden) client, it is
most important for the nurse to perform which assessment?
A. Observe the skin integrity of the client's rectal and sacral areas
B. Assess the client's strength in moving and turning in the bed
C. Evaluate the client's ability to recognize the urge to defecate
D. Determine the frequency and consistency of bowel movements
Answer: D
Verified Ra onale:
• Before giving a laxa ve, the nurse must ensure the client is not
already experiencing diarrhea or frequent loose stools.
• If the client’s bowel movements are already frequent or watery,
administering a laxa ve could exacerbate fluid and electrolyte
imbalances.
• While checking skin integrity, assessing strength, and evalua ng
recogni on of urge are also appropriate assessments, they are lower
priority when weighing whether or not to administer a laxa ve.
• By determining the frequency and consistency of bowel movements
first, the nurse gathers cri cal informa on to decide if giving a laxa ve
is safe or if it should be held.
─────────────────────────────────────────────────────────
QUESTION 2 (Case Study: Herbal Supplement Teaching)
,─────────────────────────────────────────────────────────
A female client with mul ple sclerosis reports having decreased
fa gue and improved memory since she began using the herbal
supplement ginkgo biloba. Which informa on is most important for
the nurse to include in the teaching plan for this client?
A. Aspirin and nonsteroidal an -inflammatory drugs interact with
ginkgo
B. Nausea and diarrhea can occur when using this supplement
C. Anxiety and headaches increase with use of ginkgo
D. Ginkgo biloba use should be limited and not taken during pregnancy
Answer: A
Verified Ra onale:
• Ginkgo biloba has blood-thinning proper es and can increase
bleeding risk, especially when combined with aspirin or NSAIDs.
• Nausea, diarrhea, anxiety, and headaches may be side effects, but the
poten al for serious bleeding poses a higher clinical priority.
• While pregnancy precau ons (D) are also relevant, the most cri cal
immediate teaching is about dangerous interac ons with
an coagulants, aspirin, or NSAIDs.
─────────────────────────────────────────────────────────
QUESTION 3 (NGN-Style: Combina on Therapy)
─────────────────────────────────────────────────────────
In explaining the benefits of the combina on an -infec ve drug co-
trimoxazole (TMP-SMZ, e.g., Bactrim) to a client receiving the
,medica on for a urinary tract infec on, which ra onale is most
accurate?
A. Each drug could cause damage to the kidneys if taken separately.
B. One drug reduces the risk of side effects caused by the other.
C. While one drug provides relief, the other fights the infec on.
D. The two drugs work together to reduce resistance of the bacterial
infec on.
Answer: D
Verified Ra onale:
• TMP and SMZ work synergis cally to inhibit bacterial growth in two
consecu ve steps of folic acid synthesis, which reduces the chance of
bacterial resistance.
• Answers A, B, and C do not accurately reflect why these two drugs are
combined.
• The synergy boosts overall effec veness and decreases the likelihood
of bacteria developing resistance.
─────────────────────────────────────────────────────────
QUESTION 4 (Case Study: Side Effects of An psycho cs)
─────────────────────────────────────────────────────────
A client being treated with haloperidol (Haldol) for schizophrenia
complains of jaw ghtness and a s ff neck. Which interven on should
the nurse implement first?
A. Give a PRN dose of diphenhydramine (Benadryl)
,B. Assess for other types of sensory hallucina ons
C. Massage the client's neck un l the muscles relax
D. Obtain a 12-lead electrocardiogram (ECG)
Answer: A
Verified Ra onale:
• Jaw ghtness and a s ff neck can be early signs of acute dystonia,
which is an extrapyramidal symptom (EPS) and can oAen be reversed
with an an cholinergic or an histamine such as Benadryl.
• Hallucina ons (B) are unrelated to the complaint of s ff neck and jaw
ghtness—these are signs of a medica on side effect rather than a
psycho c symptom.
• Massage (C) does not address the underlying dystonia.
• An ECG (D) is not indicated at this moment because the presenta on
is not sugges ve of cardiac e ology.
─────────────────────────────────────────────────────────
QUESTION 5 (NGN-Style: Insulin Administra on Safety)
─────────────────────────────────────────────────────────
Which interven on is most important for the nurse to implement for a
client who is receiving lispro (Humalog) insulin?
A. Check blood glucose levels every six hours
B. Provide meals at the same me that insulin is given
C. Assess for hypoglycemia between meals
D. Keep an oral glucose solu on at the bedside
,Answer: B
Verified Ra onale:
• Lispro (Humalog) is a rapid-ac ng insulin that begins working within
about 15 minutes. Therefore, the client’s meal or snack should be ready
and available to prevent hypoglycemia.
• Checking blood glucose (A) regularly is correct in principle but not the
most cri cal immediate ac on with rapid-ac ng insulin.
• Monitoring for hypoglycemia (C) and having a glucose source (D) are
important for any insulin therapy, but ensuring the pa ent has a meal
immediately available (B) is the top priority to avoid rapid
hypoglycemia.
─────────────────────────────────────────────────────────
QUESTION 6 (Case Study: NSAID Use & Anemia)
─────────────────────────────────────────────────────────
A client who takes NSAIDs daily for rheumatoid arthri s is being
treated for anemia. Which interven on is most important for the
nurse to include in the plan of care?
A. Observe for gastrointes nal bleeding
B. Monitor liver func on test results
C. Protect the skin from bruising
D. Provide and encourage high-iron dietary selec ons
Answer: A
Verified Ra onale:
,• Chronic NSAID use can cause GI bleeding, which may manifest as
anemia.
• New-onset anemia in a client taking NSAIDs makes GI blood loss
highly suspect and the highest priority.
• Monitoring liver func on (B) is important but not as immediate.
• Although preven ng skin trauma (C) and promo ng iron intake (D) are
beneficial, iden fying GI bleeding is paramount.
─────────────────────────────────────────────────────────
QUESTION 7 (Case Study: Vancomycin and Hospital-Acquired Infec ons)
─────────────────────────────────────────────────────────
When trea ng a pa ent with a hospital-acquired infec on (HAI) using
vancomycin, what is the priority nursing ac on?
A. Report the HAI to Medicare
B. Assess the pa ent’s response
C. Obtain a WBC count
D. Ensure to obtain a peak and trough
Answer: D
Verified Ra onale:
• Monitoring vancomycin levels (peak and trough) is essen al to ensure
therapeu c dosing and to minimize nephrotoxicity and ototoxicity.
• While assessing response (B) and obtaining labs (C) are important, the
precise measurement of peak and trough remains the cri cal ac on to
guide safe and effec ve dosing.
,─────────────────────────────────────────────────────────
QUESTION 8 (Basic Dosage Calcula on)
─────────────────────────────────────────────────────────
The healthcare provider orders 1000 mL of D5W to infuse over 12
hours. At how many mL/hour will you set the IV pump?
A. 75 mL/hr
B. 83 mL/hr
C. 100 mL/hr
D. 125 mL/hr
Answer: B (83 mL/hr)
Verified Ra onale:
• Calcula on: 1000 mL ÷ 12 hours = 83.3 mL/hr (rounded to 83 mL/hr).
─────────────────────────────────────────────────────────
QUESTION 9 (Teaching Reinforcement: Rifampin)
─────────────────────────────────────────────────────────
What further teaching is needed when rifampin (Rifadin) is given for
TB?
A. “Rifampin can reduce the effec veness of oral contracep ves.”
B. “Rifampin can cause discolora on of body fluids, such as sweat and
urine.”
C. “I should expect my urine and saliva to turn red–orange.”
D. “I can keep wearing my contact lenses without any staining issues.”
, Answer: D indicates further teaching is needed.
Verified Ra onale:
• Rifampin can stain contact lenses and bodily fluids (tears, sweat,
urine) can turn orange, red, or brown. This can ruin contact lenses
permanently.
• The other statements are correct instruc ons.
─────────────────────────────────────────────────────────
QUESTION 10 (NGN-Style: Priority Assessment in ED Client)
─────────────────────────────────────────────────────────
A client with erec le dysfunc on reports conges on, dizziness, and
nausea. Which nursing assessment takes priority?
A. Muscle and back pain
B. Breath sounds
C. Palpate for abdominal disten on
D. Measure blood pressure standing and lying down
Answer: D
Verified Ra onale:
• Many erec le dysfunc on medica ons can cause significant
hypotension, including orthosta c hypotension.
• Assessing blood pressure in both posi ons helps iden fy orthosta c
changes, a priority concern.
─────────────────────────────────────────────────────────
QUESTION BANKS
NCLEX (NGN), & Case-based Scenarios
400+ Qs & Ans to Pass the Exam
This hesi contains:
passing score Guarantee
400+ Ques and Ans
Format Set of Multiple-choice
questions with incorporating Next Generation
NCLEX (NGN) and Case studies questions
Expert-Verified Explanations & Solutions
, Preview Questions Below
Get the Complete PDF After Purchase
"If you require further clarification or in need of any study
resources, feel free to Message me."
,─────────────────────────────────────────────────────────
QUESTION 1 (NGN-Style: Pre-Administra on Assessment)
─────────────────────────────────────────────────────────
Before administering a laxa ve to a bedfast (bedridden) client, it is
most important for the nurse to perform which assessment?
A. Observe the skin integrity of the client's rectal and sacral areas
B. Assess the client's strength in moving and turning in the bed
C. Evaluate the client's ability to recognize the urge to defecate
D. Determine the frequency and consistency of bowel movements
Answer: D
Verified Ra onale:
• Before giving a laxa ve, the nurse must ensure the client is not
already experiencing diarrhea or frequent loose stools.
• If the client’s bowel movements are already frequent or watery,
administering a laxa ve could exacerbate fluid and electrolyte
imbalances.
• While checking skin integrity, assessing strength, and evalua ng
recogni on of urge are also appropriate assessments, they are lower
priority when weighing whether or not to administer a laxa ve.
• By determining the frequency and consistency of bowel movements
first, the nurse gathers cri cal informa on to decide if giving a laxa ve
is safe or if it should be held.
─────────────────────────────────────────────────────────
QUESTION 2 (Case Study: Herbal Supplement Teaching)
,─────────────────────────────────────────────────────────
A female client with mul ple sclerosis reports having decreased
fa gue and improved memory since she began using the herbal
supplement ginkgo biloba. Which informa on is most important for
the nurse to include in the teaching plan for this client?
A. Aspirin and nonsteroidal an -inflammatory drugs interact with
ginkgo
B. Nausea and diarrhea can occur when using this supplement
C. Anxiety and headaches increase with use of ginkgo
D. Ginkgo biloba use should be limited and not taken during pregnancy
Answer: A
Verified Ra onale:
• Ginkgo biloba has blood-thinning proper es and can increase
bleeding risk, especially when combined with aspirin or NSAIDs.
• Nausea, diarrhea, anxiety, and headaches may be side effects, but the
poten al for serious bleeding poses a higher clinical priority.
• While pregnancy precau ons (D) are also relevant, the most cri cal
immediate teaching is about dangerous interac ons with
an coagulants, aspirin, or NSAIDs.
─────────────────────────────────────────────────────────
QUESTION 3 (NGN-Style: Combina on Therapy)
─────────────────────────────────────────────────────────
In explaining the benefits of the combina on an -infec ve drug co-
trimoxazole (TMP-SMZ, e.g., Bactrim) to a client receiving the
,medica on for a urinary tract infec on, which ra onale is most
accurate?
A. Each drug could cause damage to the kidneys if taken separately.
B. One drug reduces the risk of side effects caused by the other.
C. While one drug provides relief, the other fights the infec on.
D. The two drugs work together to reduce resistance of the bacterial
infec on.
Answer: D
Verified Ra onale:
• TMP and SMZ work synergis cally to inhibit bacterial growth in two
consecu ve steps of folic acid synthesis, which reduces the chance of
bacterial resistance.
• Answers A, B, and C do not accurately reflect why these two drugs are
combined.
• The synergy boosts overall effec veness and decreases the likelihood
of bacteria developing resistance.
─────────────────────────────────────────────────────────
QUESTION 4 (Case Study: Side Effects of An psycho cs)
─────────────────────────────────────────────────────────
A client being treated with haloperidol (Haldol) for schizophrenia
complains of jaw ghtness and a s ff neck. Which interven on should
the nurse implement first?
A. Give a PRN dose of diphenhydramine (Benadryl)
,B. Assess for other types of sensory hallucina ons
C. Massage the client's neck un l the muscles relax
D. Obtain a 12-lead electrocardiogram (ECG)
Answer: A
Verified Ra onale:
• Jaw ghtness and a s ff neck can be early signs of acute dystonia,
which is an extrapyramidal symptom (EPS) and can oAen be reversed
with an an cholinergic or an histamine such as Benadryl.
• Hallucina ons (B) are unrelated to the complaint of s ff neck and jaw
ghtness—these are signs of a medica on side effect rather than a
psycho c symptom.
• Massage (C) does not address the underlying dystonia.
• An ECG (D) is not indicated at this moment because the presenta on
is not sugges ve of cardiac e ology.
─────────────────────────────────────────────────────────
QUESTION 5 (NGN-Style: Insulin Administra on Safety)
─────────────────────────────────────────────────────────
Which interven on is most important for the nurse to implement for a
client who is receiving lispro (Humalog) insulin?
A. Check blood glucose levels every six hours
B. Provide meals at the same me that insulin is given
C. Assess for hypoglycemia between meals
D. Keep an oral glucose solu on at the bedside
,Answer: B
Verified Ra onale:
• Lispro (Humalog) is a rapid-ac ng insulin that begins working within
about 15 minutes. Therefore, the client’s meal or snack should be ready
and available to prevent hypoglycemia.
• Checking blood glucose (A) regularly is correct in principle but not the
most cri cal immediate ac on with rapid-ac ng insulin.
• Monitoring for hypoglycemia (C) and having a glucose source (D) are
important for any insulin therapy, but ensuring the pa ent has a meal
immediately available (B) is the top priority to avoid rapid
hypoglycemia.
─────────────────────────────────────────────────────────
QUESTION 6 (Case Study: NSAID Use & Anemia)
─────────────────────────────────────────────────────────
A client who takes NSAIDs daily for rheumatoid arthri s is being
treated for anemia. Which interven on is most important for the
nurse to include in the plan of care?
A. Observe for gastrointes nal bleeding
B. Monitor liver func on test results
C. Protect the skin from bruising
D. Provide and encourage high-iron dietary selec ons
Answer: A
Verified Ra onale:
,• Chronic NSAID use can cause GI bleeding, which may manifest as
anemia.
• New-onset anemia in a client taking NSAIDs makes GI blood loss
highly suspect and the highest priority.
• Monitoring liver func on (B) is important but not as immediate.
• Although preven ng skin trauma (C) and promo ng iron intake (D) are
beneficial, iden fying GI bleeding is paramount.
─────────────────────────────────────────────────────────
QUESTION 7 (Case Study: Vancomycin and Hospital-Acquired Infec ons)
─────────────────────────────────────────────────────────
When trea ng a pa ent with a hospital-acquired infec on (HAI) using
vancomycin, what is the priority nursing ac on?
A. Report the HAI to Medicare
B. Assess the pa ent’s response
C. Obtain a WBC count
D. Ensure to obtain a peak and trough
Answer: D
Verified Ra onale:
• Monitoring vancomycin levels (peak and trough) is essen al to ensure
therapeu c dosing and to minimize nephrotoxicity and ototoxicity.
• While assessing response (B) and obtaining labs (C) are important, the
precise measurement of peak and trough remains the cri cal ac on to
guide safe and effec ve dosing.
,─────────────────────────────────────────────────────────
QUESTION 8 (Basic Dosage Calcula on)
─────────────────────────────────────────────────────────
The healthcare provider orders 1000 mL of D5W to infuse over 12
hours. At how many mL/hour will you set the IV pump?
A. 75 mL/hr
B. 83 mL/hr
C. 100 mL/hr
D. 125 mL/hr
Answer: B (83 mL/hr)
Verified Ra onale:
• Calcula on: 1000 mL ÷ 12 hours = 83.3 mL/hr (rounded to 83 mL/hr).
─────────────────────────────────────────────────────────
QUESTION 9 (Teaching Reinforcement: Rifampin)
─────────────────────────────────────────────────────────
What further teaching is needed when rifampin (Rifadin) is given for
TB?
A. “Rifampin can reduce the effec veness of oral contracep ves.”
B. “Rifampin can cause discolora on of body fluids, such as sweat and
urine.”
C. “I should expect my urine and saliva to turn red–orange.”
D. “I can keep wearing my contact lenses without any staining issues.”
, Answer: D indicates further teaching is needed.
Verified Ra onale:
• Rifampin can stain contact lenses and bodily fluids (tears, sweat,
urine) can turn orange, red, or brown. This can ruin contact lenses
permanently.
• The other statements are correct instruc ons.
─────────────────────────────────────────────────────────
QUESTION 10 (NGN-Style: Priority Assessment in ED Client)
─────────────────────────────────────────────────────────
A client with erec le dysfunc on reports conges on, dizziness, and
nausea. Which nursing assessment takes priority?
A. Muscle and back pain
B. Breath sounds
C. Palpate for abdominal disten on
D. Measure blood pressure standing and lying down
Answer: D
Verified Ra onale:
• Many erec le dysfunc on medica ons can cause significant
hypotension, including orthosta c hypotension.
• Assessing blood pressure in both posi ons helps iden fy orthosta c
changes, a priority concern.
─────────────────────────────────────────────────────────
