• PN HESI
Pharmacology 09/11/2026
Exam
2026 PN HESI Pharmacology 1 Proctored Exam
Review | Comprehensive Practice Question Bank
& Verified Answers (Next Gen NCLEX Update)
In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the drug is performing as
intended?
A) An increase in urine output.
B) Two or three soft stools per day.
C) Watery, diarrhea stools.
D) Increased serum bilirubin. - Correct Answer :B) Two or three soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through the stool. Two to three
stools a day indicate that lactulose is performing as intended (B). (A) would be expected if the patient received a
diuretic. (C) would indicate an overdose of lactulose and is not expected. Lactulose does not affect (D).
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the hands.
The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best
response for the nurse to provide?
A) The frequency of the dosing is necessary to increase the effectiveness.
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
D) Systemic corticosteroids are the next drugs of choice for pain relief. - Correct Answer :C) Another type of
nonsteroidal antiinflammatory drug may be indicated.
Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is the best response. Naproxen
is usually prescribed every 8 hours, so (A) is not indicated. The peak for naproxen is one to two hours, not (B).
Corticosteroids are not indicated for osteoarthritis (D).
Which instruction(s) should the nurse give to a female client who just received a prescription for oral
metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
A) Increase fluid intake, especially cranberry juice.
B) Do not abruptly discontinue the medication; taper use.
C) Check blood pressure daily to detect hypertension.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time. - Correct Answer :A) Increase fluid intake,
especially cranberry juice.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time.
Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A) are recommended for
prevention and treatment of urinary tract infections, which frequently accompany vaginal infections. It is not
necessary to taper use of this drug (B) or to check the blood pressure daily (C), as this condition is not related to
hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction with ingestion of alcohol, so the
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
client should be instructed to avoid alcohol (D). All sexual partners should be treated at the same time (E) and
condoms should be used until after treatment is completed to avoid reinfection (F).
A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m. dose. What
action should the nurse take to alleviate this side effect?
A) Change the time of the dose.
B) Hold the 9 p.m. dose.
C) Administer the dose with a snack.
D) Administer an antiemetic with the dose. - Correct Answer :C) Administer the dose with a snack.
Administering oral doses with food (C) helps minimize GI discomfort. (A) would be appropriate only if changing
the time of the dose corresponds to meal times while at the same time maintaining an appropriate time interval
between doses. (B) would disrupt the dosing schedule, and could result in a nontherapeutic serum level of the
medication. (D) should not be attempted before other interventions, such as (C), have been proven ineffective
in relieving the nausea.
A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and the
nurse notes edema at the site. Which intervention is most important for the nurse to implement?
A) Assess for erythema.
B) Administer the antidote.
C) Apply warm compresses.
D) Discontinue the IV fluids. - Correct Answer :D) Discontinue the IV fluids.
Doxorubicin is an antineoplastic agent that causes inflammation, blistering, and necrosis of tissue upon
extravasation. First, all IV fluids should be discontinued at the site (D) to prevent further tissue damage by the
vesicant. Erythema is one sign of infiltration and should be noted, but edema and pain at the infusion site require
stopping the IV fluids (A). Although an antidote may be available (B), additional fluids contribute to the trauma
of the subcutaneous tissues. Depending on the type of vesicant, warm or cold compresses (C) may be
prescribed after the infusion is discontinued.
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
A client with congestive heart failure (CHF) is being discharged with a new prescription for the angiotensin-
converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instruction should include
reporting which problem to the healthcare provider?
A) Weight loss.
B) Dizziness.
C) Muscle cramps.
D) Dry mucous membranes. - Correct Answer :B) Dizziness.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversing
vasoconstriction common in heart failure. This vasodilation can cause hypotension and resultant dizziness (B).
(A) is desired if fluid overload is present, and may occur as the result of effective combination drug therapy such
as diuretics with ACE inhibitors. (C) often indicates hypokalemia in the client receiving diuretics. Excessive
diuretic administration may result in fluid volume deficit, manifested by symptoms such as (D).
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a client
with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's
serum potassium level is 5.9 mEq/L. What action should the nurse take first?
A) Withhold the scheduled dose.
B) Check the client's apical pulse.
C) Notify the healthcare provider.
D) Repeat the serum potassium level. - Correct Answer :A) Withhold the scheduled dose.
The nurse should first withhold the scheduled dose of Cozaar (A) because the client is hyperkalemic (normal
range 3.5 to 5 mEq/L). Although hypokalemia is usually associated with diuretic therapy in heart failure,
hyperkalemia is associated with several heart failure medications, including ARBs. Because hyperkalemia may
lead to cardiac dysrhythmias, the nurse should check the apical pulse for rate and rhythm (B), and the blood
pressure. Before repeating the serum study (D), the nurse should notify the healthcare provider (C) of the
findings.
The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The
client reports that she can't hear the nurse's questions because her ears are ringing. What action should the
nurse implement?
P 4
Pharmacology 09/11/2026
Exam
2026 PN HESI Pharmacology 1 Proctored Exam
Review | Comprehensive Practice Question Bank
& Verified Answers (Next Gen NCLEX Update)
In evaluating the effects of lactulose (Cephulac), which outcome should indicate that the drug is performing as
intended?
A) An increase in urine output.
B) Two or three soft stools per day.
C) Watery, diarrhea stools.
D) Increased serum bilirubin. - Correct Answer :B) Two or three soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through the stool. Two to three
stools a day indicate that lactulose is performing as intended (B). (A) would be expected if the patient received a
diuretic. (C) would indicate an overdose of lactulose and is not expected. Lactulose does not affect (D).
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the hands.
The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best
response for the nurse to provide?
A) The frequency of the dosing is necessary to increase the effectiveness.
B) Therapeutic blood levels of this drug are reached in 4 to 6 weeks.
C) Another type of nonsteroidal antiinflammatory drug may be indicated.
D) Systemic corticosteroids are the next drugs of choice for pain relief. - Correct Answer :C) Another type of
nonsteroidal antiinflammatory drug may be indicated.
Individual responses to nonsteroidal antiinflammatory drugs are variable, so (C) is the best response. Naproxen
is usually prescribed every 8 hours, so (A) is not indicated. The peak for naproxen is one to two hours, not (B).
Corticosteroids are not indicated for osteoarthritis (D).
Which instruction(s) should the nurse give to a female client who just received a prescription for oral
metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
A) Increase fluid intake, especially cranberry juice.
B) Do not abruptly discontinue the medication; taper use.
C) Check blood pressure daily to detect hypertension.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time. - Correct Answer :A) Increase fluid intake,
especially cranberry juice.
D) Avoid drinking alcohol while taking this medication.
E) Use condoms until treatment is completed.
F) Ensure that all sexual partners are treated at the same time.
Correct selections are (A, D, E, and F). Increased fluid intake and cranberry juice (A) are recommended for
prevention and treatment of urinary tract infections, which frequently accompany vaginal infections. It is not
necessary to taper use of this drug (B) or to check the blood pressure daily (C), as this condition is not related to
hypertension. Flagyl can cause a disulfiram-like reaction if taken in conjunction with ingestion of alcohol, so the
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
client should be instructed to avoid alcohol (D). All sexual partners should be treated at the same time (E) and
condoms should be used until after treatment is completed to avoid reinfection (F).
A client receiving albuterol (Proventil) tablets complains of nausea every evening with her 9 p.m. dose. What
action should the nurse take to alleviate this side effect?
A) Change the time of the dose.
B) Hold the 9 p.m. dose.
C) Administer the dose with a snack.
D) Administer an antiemetic with the dose. - Correct Answer :C) Administer the dose with a snack.
Administering oral doses with food (C) helps minimize GI discomfort. (A) would be appropriate only if changing
the time of the dose corresponds to meal times while at the same time maintaining an appropriate time interval
between doses. (B) would disrupt the dosing schedule, and could result in a nontherapeutic serum level of the
medication. (D) should not be attempted before other interventions, such as (C), have been proven ineffective
in relieving the nausea.
A client receiving Doxorubicin (Adriamycin) intravenously (IV) complains of pain at the insertion site, and the
nurse notes edema at the site. Which intervention is most important for the nurse to implement?
A) Assess for erythema.
B) Administer the antidote.
C) Apply warm compresses.
D) Discontinue the IV fluids. - Correct Answer :D) Discontinue the IV fluids.
Doxorubicin is an antineoplastic agent that causes inflammation, blistering, and necrosis of tissue upon
extravasation. First, all IV fluids should be discontinued at the site (D) to prevent further tissue damage by the
vesicant. Erythema is one sign of infiltration and should be noted, but edema and pain at the infusion site require
stopping the IV fluids (A). Although an antidote may be available (B), additional fluids contribute to the trauma
of the subcutaneous tissues. Depending on the type of vesicant, warm or cold compresses (C) may be
prescribed after the infusion is discontinued.
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
A client with congestive heart failure (CHF) is being discharged with a new prescription for the angiotensin-
converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instruction should include
reporting which problem to the healthcare provider?
A) Weight loss.
B) Dizziness.
C) Muscle cramps.
D) Dry mucous membranes. - Correct Answer :B) Dizziness.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by reversing
vasoconstriction common in heart failure. This vasodilation can cause hypotension and resultant dizziness (B).
(A) is desired if fluid overload is present, and may occur as the result of effective combination drug therapy such
as diuretics with ACE inhibitors. (C) often indicates hypokalemia in the client receiving diuretics. Excessive
diuretic administration may result in fluid volume deficit, manifested by symptoms such as (D).
The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a client
with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's
serum potassium level is 5.9 mEq/L. What action should the nurse take first?
A) Withhold the scheduled dose.
B) Check the client's apical pulse.
C) Notify the healthcare provider.
D) Repeat the serum potassium level. - Correct Answer :A) Withhold the scheduled dose.
The nurse should first withhold the scheduled dose of Cozaar (A) because the client is hyperkalemic (normal
range 3.5 to 5 mEq/L). Although hypokalemia is usually associated with diuretic therapy in heart failure,
hyperkalemia is associated with several heart failure medications, including ARBs. Because hyperkalemia may
lead to cardiac dysrhythmias, the nurse should check the apical pulse for rate and rhythm (B), and the blood
pressure. Before repeating the serum study (D), the nurse should notify the healthcare provider (C) of the
findings.
The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The
client reports that she can't hear the nurse's questions because her ears are ringing. What action should the
nurse implement?
P 4
