• PN HESI
Pharmacology 09/11/2026
Exam
2026 PN HESI Pharmacology 3 Proctored Exam
Review | Comprehensive Practice Question Bank
& Verified Answers (Next Gen NCLEX Update)
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (Toradol) 30 mg IV q6h. Which
action should the nurse implement?
A) Administer both medications according to the prescription.
B) Hold the ketorolac to prevent an antagonistic effect.
C) Hold the morphine to prevent an additive drug interaction.
D) Contact the healthcare provider to clarify the prescription. - Correct Answer :A) Administer both medications
according to the prescription.
Morphine and ketorolac (Toradol) can be administered concurrently (A), and may produce an additive analgesic
effect, resulting in the ability to reduce the dose of morphine, as seen in this prescription. Toradol is an
antiinflammatory analgesic, and does not have an antagonistic effect with morphine (B), like an agonist-
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
antagonist medication would have. An additive analgesic effect is desirable (C), because it allows a reduced dose
of morphine. This prescription does not require any clarification, and can be administered safely as written (D).
Which method of medication administration provides the client with the greatest first-pass effect?
A) Oral.
B) Sublingual.
C) Intravenous.
D) Subcutaneous. - Correct Answer :A) Oral.
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism in the liver. After
oral (A) medications are absorbed from the gastrointestinal tract, the drug is carried directly to the liver via the
hepatic portal circulation where hepatic inactivation occurs and reduces the bioavailability of the drug.
Alternative method of administration, such as sublingual (B), IV (C), and subcutaneous (D) routes, avoid this first-
pass effect.
The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which instruction should the nurse
include in this client's discharge teaching plan?
A) Quit taking the medication if dizziness occurs.
B) Do not get up quickly. Always rise slowly.
C) Take the medication with food only.
D) Increase your intake of potassium-rich foods. - Correct Answer :B) Do not get up quickly. Always rise slowly.
An expected side effect of nitrates is orthostatic hypotension and the nurse should address how to prevent it--
by rising slowly (B). Dizziness is expected, and the client should not quit taking the medication without notifying
the healthcare provider (A). (C and D) are not indicated when taking this medication.
Which client should the nurse identify as being at highest risk for complications during the use of an opioid
analgesic?
A) An older client with Type 2 diabetes mellitus.
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
B) A client with chronic rheumatoid arthritis.
C) A client with a open compound fracture.
D) A young adult with inflammatory bowel disease. - Correct Answer :D) A young adult with inflammatory bowel
disease.
The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease (D) is at risk for
toxic megacolon or paralytic ileus related to slowed peristalsis, a side effect of morphine. Adverse effects of
morphine do not pose as great a risk for (A, B, and C) as the client with bowel disease.
A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment finding indicates
that the desired effect of the medication has been achieved?
A) Client denies recent episodes of angina.
B) Change in peripheral edema from +3 to +1.
C) Client denies recent nausea or vomiting.
D) Blood pressure has changed from 180/120 to 140/70. - Correct Answer :D) Blood pressure has changed from
180/120 to 140/70.
Catapres acts as a centrally-acting analgesic and antihypertensive agent. (D) indicates a reduction in
hypertension. Catapres does not affect (A, B, or C), so these findings do not indicate desired outcomes of
Catapres.
Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)?
A) Headache, hypertension, and blurred vision.
B) Wheezing, hypotension, and AV block.
C) Vomiting, dilated pupils, and papilledema.
D) Tinnitus, muscle weakness, and tachypnea. - Correct Answer :B) Wheezing, hypotension, and AV block.
(B) represents the most serious adverse effects of beta-blocking agents. AV block is generally associated with
bradycardia and results in potentially life-threatening decreases in cardiac output. Additionally, wheezing
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
secondary to bronchospasm and hypotension represent life-threatening respiratory and cardiac disorders. (A, C,
and D) are not associated with beta-blockers.
A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which
medication prescription decreases both preload and afterload?
A) Nitroglycerin.
B) Propranolol (Inderal).
C) Morphine.
D) Captopril (Capoten). - Correct Answer :A) Nitroglycerin.
Nitroglycerin (A) is a nitrate that causes peripheral vasodilation and decreases contractility, thereby decreasing
both preload and afterload. (B) is a beta adrenergic blocker that decreases both heart rate and contractility, but
only decreases afterload. Morphine (C) decreases myocardial oxygen consumption and preload. Capoten (D) is
an angiotensin converting enzyme (ACE) inhibitor that acts to prevents vasoconstriction, thereby decreasing
blood pressure and afterload.
A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse
effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the
healthcare provider?
A) Tinnitus and dizziness.
B) Tachycardia and chest pain.
C) Dry skin and intolerance to cold.
D) Weight gain and increased appetite. - Correct Answer :B) Tachycardia and chest pain.
Thyroid replacement hormone increases the metabolic rate of all tissues, so common signs and symptoms of
toxicity include tachycardia and chest pain (B). (A, C, and D) do not indicate a thyroid hormone toxicity.
The nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related
side effects. The nurse should prepare the client for which side effect that is most likely to persist during long-
term use of opioids?
P 4
Pharmacology 09/11/2026
Exam
2026 PN HESI Pharmacology 3 Proctored Exam
Review | Comprehensive Practice Question Bank
& Verified Answers (Next Gen NCLEX Update)
An adult client has prescriptions for morphine sulfate 2.5 mg IV q6h and ketorolac (Toradol) 30 mg IV q6h. Which
action should the nurse implement?
A) Administer both medications according to the prescription.
B) Hold the ketorolac to prevent an antagonistic effect.
C) Hold the morphine to prevent an additive drug interaction.
D) Contact the healthcare provider to clarify the prescription. - Correct Answer :A) Administer both medications
according to the prescription.
Morphine and ketorolac (Toradol) can be administered concurrently (A), and may produce an additive analgesic
effect, resulting in the ability to reduce the dose of morphine, as seen in this prescription. Toradol is an
antiinflammatory analgesic, and does not have an antagonistic effect with morphine (B), like an agonist-
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
antagonist medication would have. An additive analgesic effect is desirable (C), because it allows a reduced dose
of morphine. This prescription does not require any clarification, and can be administered safely as written (D).
Which method of medication administration provides the client with the greatest first-pass effect?
A) Oral.
B) Sublingual.
C) Intravenous.
D) Subcutaneous. - Correct Answer :A) Oral.
The first-pass effect is a pharmacokinetic phenomenon that is related to the drug's metabolism in the liver. After
oral (A) medications are absorbed from the gastrointestinal tract, the drug is carried directly to the liver via the
hepatic portal circulation where hepatic inactivation occurs and reduces the bioavailability of the drug.
Alternative method of administration, such as sublingual (B), IV (C), and subcutaneous (D) routes, avoid this first-
pass effect.
The nitrate isosorbide dinitrate (Isordil) is prescribed for a client with angina. Which instruction should the nurse
include in this client's discharge teaching plan?
A) Quit taking the medication if dizziness occurs.
B) Do not get up quickly. Always rise slowly.
C) Take the medication with food only.
D) Increase your intake of potassium-rich foods. - Correct Answer :B) Do not get up quickly. Always rise slowly.
An expected side effect of nitrates is orthostatic hypotension and the nurse should address how to prevent it--
by rising slowly (B). Dizziness is expected, and the client should not quit taking the medication without notifying
the healthcare provider (A). (C and D) are not indicated when taking this medication.
Which client should the nurse identify as being at highest risk for complications during the use of an opioid
analgesic?
A) An older client with Type 2 diabetes mellitus.
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
B) A client with chronic rheumatoid arthritis.
C) A client with a open compound fracture.
D) A young adult with inflammatory bowel disease. - Correct Answer :D) A young adult with inflammatory bowel
disease.
The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease (D) is at risk for
toxic megacolon or paralytic ileus related to slowed peristalsis, a side effect of morphine. Adverse effects of
morphine do not pose as great a risk for (A, B, and C) as the client with bowel disease.
A client is receiving clonidine (Catapres) 0.1 mg/24hr via transdermal patch. Which assessment finding indicates
that the desired effect of the medication has been achieved?
A) Client denies recent episodes of angina.
B) Change in peripheral edema from +3 to +1.
C) Client denies recent nausea or vomiting.
D) Blood pressure has changed from 180/120 to 140/70. - Correct Answer :D) Blood pressure has changed from
180/120 to 140/70.
Catapres acts as a centrally-acting analgesic and antihypertensive agent. (D) indicates a reduction in
hypertension. Catapres does not affect (A, B, or C), so these findings do not indicate desired outcomes of
Catapres.
Which symptoms are serious adverse effects of beta-adrenergic blockers such as propranolol (Inderal)?
A) Headache, hypertension, and blurred vision.
B) Wheezing, hypotension, and AV block.
C) Vomiting, dilated pupils, and papilledema.
D) Tinnitus, muscle weakness, and tachypnea. - Correct Answer :B) Wheezing, hypotension, and AV block.
(B) represents the most serious adverse effects of beta-blocking agents. AV block is generally associated with
bradycardia and results in potentially life-threatening decreases in cardiac output. Additionally, wheezing
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
secondary to bronchospasm and hypotension represent life-threatening respiratory and cardiac disorders. (A, C,
and D) are not associated with beta-blockers.
A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which
medication prescription decreases both preload and afterload?
A) Nitroglycerin.
B) Propranolol (Inderal).
C) Morphine.
D) Captopril (Capoten). - Correct Answer :A) Nitroglycerin.
Nitroglycerin (A) is a nitrate that causes peripheral vasodilation and decreases contractility, thereby decreasing
both preload and afterload. (B) is a beta adrenergic blocker that decreases both heart rate and contractility, but
only decreases afterload. Morphine (C) decreases myocardial oxygen consumption and preload. Capoten (D) is
an angiotensin converting enzyme (ACE) inhibitor that acts to prevents vasoconstriction, thereby decreasing
blood pressure and afterload.
A 43-year-old female client is receiving thyroid replacement hormone following a thyroidectomy. What adverse
effects associated with thyroid hormone toxicity should the nurse instruct the client to report promptly to the
healthcare provider?
A) Tinnitus and dizziness.
B) Tachycardia and chest pain.
C) Dry skin and intolerance to cold.
D) Weight gain and increased appetite. - Correct Answer :B) Tachycardia and chest pain.
Thyroid replacement hormone increases the metabolic rate of all tissues, so common signs and symptoms of
toxicity include tachycardia and chest pain (B). (A, C, and D) do not indicate a thyroid hormone toxicity.
The nurse is teaching a client with cancer about opioid management for intractable pain and tolerance related
side effects. The nurse should prepare the client for which side effect that is most likely to persist during long-
term use of opioids?
P 4
