Pharm HESI Exam 2026/2027 | 200 Practice Questions
& Detailed Answers | PN Pharmacology NCLEXPN
Review | A+ Guide
1. A licensed practical nurse (LPN) is preparing to administer prescribed digoxin to a client with heart
failure. Which assessment parameter requires the nurse to hold the medication and notify the charge
nurse?
A) Blood pressure of 118/76 mmHg
B) Apical pulse rate of 54 beats per minute
C) Respiratory rate of 16 breaths per minute
D) Serum potassium level of 4.2 mEq/L
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate while increasing the force of
myocardial contraction. An apical pulse below 60 bpm in an adult indicates potential digoxin toxicity or
excessive bradycardia; the medication must be held and the provider notified.
2. A client taking oral warfarin for deep vein thrombosis (DVT) has an International Normalized Ratio
(INR) result of 4.8. What is the nurse's priority action?
A) Hold the dose of warfarin and notify the healthcare provider
B) Administer the prescribed dose as scheduled
C) Instruct the client to double their green leafy vegetable intake
D) Prepare an IV bolus of unfractionated heparin
Answer: A
,Rationale: The therapeutic INR range for DVT treatment is typically 2.0 to 3.0. An INR of 4.8 indicates an
increased risk of severe bleeding. The nurse should hold the dose and notify the provider for antidote or
dose adjustment orders.
3. What is the specific pharmacological antidote for an acute overdose of unfractionated heparin?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Acetylcysteine
Answer: B
Rationale: Protamine sulfate neutralizes the anticoagulant action of heparin by binding to heparin
molecules and forming a stable complex. Vitamin K is the antidote for warfarin overdose.
4. A nurse is caring for a client receiving intravenous furosemide. Which electrolyte imbalance should
the nurse monitor for most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
Answer: B
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending
loop of Henle, leading to increased excretion of potassium. Hypokalemia is a common and potentially
dangerous adverse effect.
,5. A client with diabetes mellitus takes insulin daily and is prescribed propranolol (Inderal). Which
information should the nurse provide to this client?
A) "Propranolol will increase your blood sugar levels."
B) "Propranolol masks the rapid heart rate that signals hypoglycemia."
C) "You will need to decrease your insulin dose."
D) "Propranolol has no effect on diabetes management."
Answer: B
Rationale: Propranolol is a nonselective betablocker that can mask the adrenergic symptoms of
hypoglycemia, such as tachycardia and palpitations. The client should be educated to recognize other
signs of hypoglycemia, such as sweating and confusion.
6. A client has a positive skin test for tuberculosis. What prophylactic drug should the practical nurse
(PN) expect to be prescribed?
A) Rifampin
B) Isoniazid (INH)
C) Pyrazinamide
D) Ethambutol
Answer: B
Rationale: Isoniazid (INH) is the drug of choice for prophylactic treatment of latent tuberculosis
infection. It is typically prescribed for 6 to 9 months to prevent the development of active TB disease.
, 7. Amitriptyline hydrochloride (Elavil) is prescribed for an adult female client who is clinically depressed.
Five days after beginning the drug, the client is admitted to the hospital because of suicidal ideation. She
tells the PN that the drug is not working because she is not feeling any better. Which explanation should
the PN provide?
A) "You should feel better within 24 hours."
B) "Antidepressant medications typically take 2 to 4 weeks to become effective."
C) "The medication is not working; we need to change it."
D) "You should take a higher dose."
Answer: B
Rationale: Tricyclic antidepressants like amitriptyline typically require 2 to 4 weeks of continuous
therapy before therapeutic effects are observed. Early in treatment, the risk of suicide may actually
increase, so close monitoring is essential.
8. Phenytoin (Dilantin) is prescribed for a client who has a seizure disorder. Which statement by the
client indicates that the instruction about this drug has been effective?
A) "I can stop taking this medication when my seizures stop."
B) "I know that I should never stop taking this medication abruptly."
C) "I only need to take this medication when I have a seizure."
D) "I can take this medication with milk."
Answer: B
Rationale: Phenytoin is an anticonvulsant that must be taken consistently to maintain therapeutic levels.
Abrupt discontinuation can precipitate withdrawal seizures or status epilepticus. Clients should be
educated never to stop the medication suddenly.
& Detailed Answers | PN Pharmacology NCLEXPN
Review | A+ Guide
1. A licensed practical nurse (LPN) is preparing to administer prescribed digoxin to a client with heart
failure. Which assessment parameter requires the nurse to hold the medication and notify the charge
nurse?
A) Blood pressure of 118/76 mmHg
B) Apical pulse rate of 54 beats per minute
C) Respiratory rate of 16 breaths per minute
D) Serum potassium level of 4.2 mEq/L
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate while increasing the force of
myocardial contraction. An apical pulse below 60 bpm in an adult indicates potential digoxin toxicity or
excessive bradycardia; the medication must be held and the provider notified.
2. A client taking oral warfarin for deep vein thrombosis (DVT) has an International Normalized Ratio
(INR) result of 4.8. What is the nurse's priority action?
A) Hold the dose of warfarin and notify the healthcare provider
B) Administer the prescribed dose as scheduled
C) Instruct the client to double their green leafy vegetable intake
D) Prepare an IV bolus of unfractionated heparin
Answer: A
,Rationale: The therapeutic INR range for DVT treatment is typically 2.0 to 3.0. An INR of 4.8 indicates an
increased risk of severe bleeding. The nurse should hold the dose and notify the provider for antidote or
dose adjustment orders.
3. What is the specific pharmacological antidote for an acute overdose of unfractionated heparin?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Acetylcysteine
Answer: B
Rationale: Protamine sulfate neutralizes the anticoagulant action of heparin by binding to heparin
molecules and forming a stable complex. Vitamin K is the antidote for warfarin overdose.
4. A nurse is caring for a client receiving intravenous furosemide. Which electrolyte imbalance should
the nurse monitor for most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
Answer: B
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending
loop of Henle, leading to increased excretion of potassium. Hypokalemia is a common and potentially
dangerous adverse effect.
,5. A client with diabetes mellitus takes insulin daily and is prescribed propranolol (Inderal). Which
information should the nurse provide to this client?
A) "Propranolol will increase your blood sugar levels."
B) "Propranolol masks the rapid heart rate that signals hypoglycemia."
C) "You will need to decrease your insulin dose."
D) "Propranolol has no effect on diabetes management."
Answer: B
Rationale: Propranolol is a nonselective betablocker that can mask the adrenergic symptoms of
hypoglycemia, such as tachycardia and palpitations. The client should be educated to recognize other
signs of hypoglycemia, such as sweating and confusion.
6. A client has a positive skin test for tuberculosis. What prophylactic drug should the practical nurse
(PN) expect to be prescribed?
A) Rifampin
B) Isoniazid (INH)
C) Pyrazinamide
D) Ethambutol
Answer: B
Rationale: Isoniazid (INH) is the drug of choice for prophylactic treatment of latent tuberculosis
infection. It is typically prescribed for 6 to 9 months to prevent the development of active TB disease.
, 7. Amitriptyline hydrochloride (Elavil) is prescribed for an adult female client who is clinically depressed.
Five days after beginning the drug, the client is admitted to the hospital because of suicidal ideation. She
tells the PN that the drug is not working because she is not feeling any better. Which explanation should
the PN provide?
A) "You should feel better within 24 hours."
B) "Antidepressant medications typically take 2 to 4 weeks to become effective."
C) "The medication is not working; we need to change it."
D) "You should take a higher dose."
Answer: B
Rationale: Tricyclic antidepressants like amitriptyline typically require 2 to 4 weeks of continuous
therapy before therapeutic effects are observed. Early in treatment, the risk of suicide may actually
increase, so close monitoring is essential.
8. Phenytoin (Dilantin) is prescribed for a client who has a seizure disorder. Which statement by the
client indicates that the instruction about this drug has been effective?
A) "I can stop taking this medication when my seizures stop."
B) "I know that I should never stop taking this medication abruptly."
C) "I only need to take this medication when I have a seizure."
D) "I can take this medication with milk."
Answer: B
Rationale: Phenytoin is an anticonvulsant that must be taken consistently to maintain therapeutic levels.
Abrupt discontinuation can precipitate withdrawal seizures or status epilepticus. Clients should be
educated never to stop the medication suddenly.
