• PN HESI
Pharmacology 09/11/2026
Exam
2026 PN HESI Pharmacology 4 Proctored Exam
Review | Comprehensive Practice Question Bank
& Verified Answers (Next Gen NCLEX Update)
A male client scheduled for a total laryngectomy and radical neck dissection for cancer of the larynx asks the PN
if he will ever be able to speak. Which response is bets for the PN to provide?
A. Breathing occurs through a permanent neck opening which prevents normal speech.
B. Permanent removal of the voice box requires rehabilitation for esophageal speech.
C. Due to removal of the vocal cords, communication requires the use of sign language.
D. Once the breathing hole in the neck heals, the ability to speak requires a device. - Correct Answer :B.
Permanent removal of the voice box requires rehabilitation for esophageal speech.
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
A total laryngectomy includes removal of the larynx and pre-epiglottis region resulting in a permanent
tracheostomy and loss of normal speech abilities. Rehab is required to learn to speak using a prosthesis,
esophageal speech, or an electrolarynx.
A client is wearing a continuous 24-hour Holter monitor for elevation of heart rhythm disturbances. What info
should the PN reinforce with this client?
A. Remove the electrodes to shower or bathe
B. Keep a diary of activities as long as the monitor is worn.
C. Exercise as much as possible while the monitor is in place.
D. Call the assigned number if an episode of irregular heartbeats occurs. - Correct Answer :B. Keep a diary of
activities as long as the monitor is worn.
Nursing care for a client with a Holter monitor includes preparation of the skin, placement of the electrodes and
leads, and activities of daily living, so the client should be informed of the importance of keeping an accurate
record of activities and symptoms
The PN is caring for a client who is receiving a therapeutic dose of warfarin (Coumadin). The client asks the PN to
explain the effect of eating green leafy vegetables. What info should the PN provide?
A. The high content of vitamin K in green leafy vegetables decreases Coumadin's action.
B. Green vegetables are high in fiber and cellulose that decrease the absorption of Coumadin.
C. These foods have a natural anticoagulant effect that potentiates the effect of Coumadin.
D. Dietary intake of green leafy vegetables alters the bowel bacteria's production of vitamin K. - Correct Answer
:A. The high content of vitamin K in green leafy vegetables decreases Coumadin's action.
Coumadin works as an anticoagulant by blocking hepatic utilization of vitamin K in the production of
prothrombin, which is a component of the blood clotting cascade. Green leafy vegetables are high in vitamin K,
which counteracts the anticoagulant effect of Coumadin.
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
The PN is reviewing the effects of NSAIDs (nonsteroidal anti-inflammatory drugs) with a client who has acute
gastritis. What info is correct about the action of NSAIDs?
A. Causes histamine receptor stimulation that increases the release of hydrochloric acid.
B. Inhibits the synthesis of prostaglandins that normally protect the stomach lining.
C. Activates an inflammatory response which increases the drug's absorption.
C.
D. Stimulates parietal cells to release pepsin leading to digestion of ingested foods. - Correct Answer :B. Inhibits
the synthesis of prostaglandins that normally protect the stomach lining
NSAIDs inhibit the synthesis of prostaglandins which protect the stomach lining.
After undergoing exploratory laparotomy and bowel resection, a client with an NG tube to suction complains of
nausea and stomach distention. The PN irrigates the tube, but the irrigating fluid does not return. What action
should the PN implement?
A. Notify the healthcare provider.
B. Auscultate for bowel sounds.
C. Reposition the tube and check for placement.
D. Remove the tube and replace it with a new one. - Correct Answer :C. Reposition the tube and check for
placement.
Patency and position of a NGT are checked frequently to evaluate for dislodgement or NGT obstruction with
mucous, sediment, or blood clots. The placement should be verified and repositioned in the stomach to obtain a
return of the normal saline used to irrigate the NGT.
A client with advanced cirrhosis is prescribed lactulose (Cephulac) 30 ml QID. The client complains that the
medicine is causing diarrhea. Which therapeutic response of the medication should the PN provide the client?
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
A. Promotes fluid loss.
B. Prevents constipation.
C. Excretes ammonia to improve cerebral function.
D. Reduces the risk for gastrointestinal bleeding. - Correct Answer :C. Excretes ammonia to improve cerebral
function.
To treat portal-systemic encephalopathy, lactulose causes the movement of serum ammonia, which
accumulates due to hepatic dysfunction in cirrhosis, into the gut and results in diarrhea due to the osmotic
movement of water.
The PN is reinforcing the discharge instructions for a female client with cystitis. Which statement indicates to the
PN that the client understands measures to prevent urinary tract infections (UTI)?
A. "I will limit my fluid intake to 1000 ml/day to prevent symptoms of frequency and urgency."
B. "Every 2 to 3 hours during waking hours, I will drink a glass of water and empty my bladder."
C. "I will use an antiseptic vaginal deodorant spray to reduce perineal bacterial growth."
D. After each bowel movement, I will wash my perineal area with soap and water. - Correct Answer :B. "Every 2
to 3 hours during waking hours, I will drink a glass of water and empty my bladder."
Measures to reduce the risk of UTI include liberal fluid intake, frequent bladder emptying, and hygienic measures
to prevent ascending bacterial contamination of the bladder. The client's statement that best indicates
understanding includes maintaining a regular and frequent fluid intake and urination every 2 to 3 hours during
the day.
The PN is caring for a client with chronic kidney disease (CKD). What info should the PN reinforce about
medication management?
A. Oral iron supplements reverse chronic anemia in CKD.
B. Calcium supplements are needed to maintain serum levels.
P 4
Pharmacology 09/11/2026
Exam
2026 PN HESI Pharmacology 4 Proctored Exam
Review | Comprehensive Practice Question Bank
& Verified Answers (Next Gen NCLEX Update)
A male client scheduled for a total laryngectomy and radical neck dissection for cancer of the larynx asks the PN
if he will ever be able to speak. Which response is bets for the PN to provide?
A. Breathing occurs through a permanent neck opening which prevents normal speech.
B. Permanent removal of the voice box requires rehabilitation for esophageal speech.
C. Due to removal of the vocal cords, communication requires the use of sign language.
D. Once the breathing hole in the neck heals, the ability to speak requires a device. - Correct Answer :B.
Permanent removal of the voice box requires rehabilitation for esophageal speech.
P 1
, • PN HESI
Pharmacology 09/11/2026
Exam
A total laryngectomy includes removal of the larynx and pre-epiglottis region resulting in a permanent
tracheostomy and loss of normal speech abilities. Rehab is required to learn to speak using a prosthesis,
esophageal speech, or an electrolarynx.
A client is wearing a continuous 24-hour Holter monitor for elevation of heart rhythm disturbances. What info
should the PN reinforce with this client?
A. Remove the electrodes to shower or bathe
B. Keep a diary of activities as long as the monitor is worn.
C. Exercise as much as possible while the monitor is in place.
D. Call the assigned number if an episode of irregular heartbeats occurs. - Correct Answer :B. Keep a diary of
activities as long as the monitor is worn.
Nursing care for a client with a Holter monitor includes preparation of the skin, placement of the electrodes and
leads, and activities of daily living, so the client should be informed of the importance of keeping an accurate
record of activities and symptoms
The PN is caring for a client who is receiving a therapeutic dose of warfarin (Coumadin). The client asks the PN to
explain the effect of eating green leafy vegetables. What info should the PN provide?
A. The high content of vitamin K in green leafy vegetables decreases Coumadin's action.
B. Green vegetables are high in fiber and cellulose that decrease the absorption of Coumadin.
C. These foods have a natural anticoagulant effect that potentiates the effect of Coumadin.
D. Dietary intake of green leafy vegetables alters the bowel bacteria's production of vitamin K. - Correct Answer
:A. The high content of vitamin K in green leafy vegetables decreases Coumadin's action.
Coumadin works as an anticoagulant by blocking hepatic utilization of vitamin K in the production of
prothrombin, which is a component of the blood clotting cascade. Green leafy vegetables are high in vitamin K,
which counteracts the anticoagulant effect of Coumadin.
P 2
, • PN HESI
Pharmacology 09/11/2026
Exam
The PN is reviewing the effects of NSAIDs (nonsteroidal anti-inflammatory drugs) with a client who has acute
gastritis. What info is correct about the action of NSAIDs?
A. Causes histamine receptor stimulation that increases the release of hydrochloric acid.
B. Inhibits the synthesis of prostaglandins that normally protect the stomach lining.
C. Activates an inflammatory response which increases the drug's absorption.
C.
D. Stimulates parietal cells to release pepsin leading to digestion of ingested foods. - Correct Answer :B. Inhibits
the synthesis of prostaglandins that normally protect the stomach lining
NSAIDs inhibit the synthesis of prostaglandins which protect the stomach lining.
After undergoing exploratory laparotomy and bowel resection, a client with an NG tube to suction complains of
nausea and stomach distention. The PN irrigates the tube, but the irrigating fluid does not return. What action
should the PN implement?
A. Notify the healthcare provider.
B. Auscultate for bowel sounds.
C. Reposition the tube and check for placement.
D. Remove the tube and replace it with a new one. - Correct Answer :C. Reposition the tube and check for
placement.
Patency and position of a NGT are checked frequently to evaluate for dislodgement or NGT obstruction with
mucous, sediment, or blood clots. The placement should be verified and repositioned in the stomach to obtain a
return of the normal saline used to irrigate the NGT.
A client with advanced cirrhosis is prescribed lactulose (Cephulac) 30 ml QID. The client complains that the
medicine is causing diarrhea. Which therapeutic response of the medication should the PN provide the client?
P 3
, • PN HESI
Pharmacology 09/11/2026
Exam
A. Promotes fluid loss.
B. Prevents constipation.
C. Excretes ammonia to improve cerebral function.
D. Reduces the risk for gastrointestinal bleeding. - Correct Answer :C. Excretes ammonia to improve cerebral
function.
To treat portal-systemic encephalopathy, lactulose causes the movement of serum ammonia, which
accumulates due to hepatic dysfunction in cirrhosis, into the gut and results in diarrhea due to the osmotic
movement of water.
The PN is reinforcing the discharge instructions for a female client with cystitis. Which statement indicates to the
PN that the client understands measures to prevent urinary tract infections (UTI)?
A. "I will limit my fluid intake to 1000 ml/day to prevent symptoms of frequency and urgency."
B. "Every 2 to 3 hours during waking hours, I will drink a glass of water and empty my bladder."
C. "I will use an antiseptic vaginal deodorant spray to reduce perineal bacterial growth."
D. After each bowel movement, I will wash my perineal area with soap and water. - Correct Answer :B. "Every 2
to 3 hours during waking hours, I will drink a glass of water and empty my bladder."
Measures to reduce the risk of UTI include liberal fluid intake, frequent bladder emptying, and hygienic measures
to prevent ascending bacterial contamination of the bladder. The client's statement that best indicates
understanding includes maintaining a regular and frequent fluid intake and urination every 2 to 3 hours during
the day.
The PN is caring for a client with chronic kidney disease (CKD). What info should the PN reinforce about
medication management?
A. Oral iron supplements reverse chronic anemia in CKD.
B. Calcium supplements are needed to maintain serum levels.
P 4
