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2025 NGN HESI RN PHARMACOLOGY REAL EXAMS (4
VERSIONS) WITH 300+ QUESTIONS AND 100% CORRECT
ANSWERS WITH RATIONALES | RN HESI PHARMACOLOGY
WITH NGN LATEST 4 VERSIONS 2025/2026 ALREADY
GRADED A+ LATEST COMPLETE SOLTION
1. A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement
provided by the client requires additional instruction by the nurse?
Decrease cigarette use to a pack per day.
2. A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level.
The nurse should assess the client for the onset of which problem?
Muscle tenderness.
3. An increase in which serum laboratory value indicates to the nurse that a prescription for
atorvastatin is having the desired effect for a client at risk for coronary artery disease?
HDL (High-density lipoprotein)
4. NGN
History and Physical:
The client is a 36-year-old female with moderate persistent asthma. She takes
fluticasone/salmeterol 250 mcg/50 mcg 1 inhalation twice daily and albuterol 90 mcg/inhalation
2 inhalations every 4-6 hours as needed.
Nurses notes: The client states that she has had more severe asthma symptoms than usual in the
past week. Her forced expiratory volume has been 60-65% even with multiple doses of albuterol
for several days in a row. She came to the hospital feeling dizzy, lightheaded, and complaining
of "heart palpitations". Upon assessment, no wheezes were found. Her oxygen saturation is 99%.
Review H and P, and nurse's note. Identify from the choices below which condition the client is
most likely experiencing, two actions the nurse should take to address that condition, and two
parameters the nurse should monitor to assess the client's progress.
Potential Condition: Methemoglobinemia
5.
History and Physical:
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The client is a 36-year-old female with moderate persistent asthma. She takes
fluticasone/salmeterol 250 mcg/50 mcg 1 inhalation twice daily and albuterol 90 mcg/inhalation
2 inhalations every 4-6 hours as needed. Nurses notes: The client states that she has had more
severe asthma symptoms than usual in the past week. Her forced expiratory volume has been 60-
65% even with multiple doses of albuterol for several days in a row. She came to the hospital
feeling dizzy, lightheaded, and complaining of "heart palpitations". Upon assessment, no
wheezes were found. Her oxygen saturation is 99%.
Review H and P, and nurse's note. Identify from the choices below which condition the client is
most likely experiencing, two actions the nurse should take to address that condition, and two
parameters the nurse should monitor to assess the client's progress.
Actions to Take: Draw blood for a CBC + Administer methylene blue
6.
History and Physical:
The client is a 36-year-old female with moderate persistent asthma. She takes
fluticasone/salmeterol 250 mcg/50 mcg 1 inhalation twice daily and albuterol 90 mcg/inhalation
2 inhalations every 4-6 hours as needed.
Nurses notes: The client states that she has had more severe asthma symptoms than usual in the
past week. Her forced expiratory volume has been 60-65% even with multiple doses of albuterol
for several days in a row. She came to the hospital feeling dizzy, lightheaded, and complaining
of "heart palpitations". Upon assessment, no wheezes were found. Her oxygen saturation is 99%.
Review H and P, and nurse's note. Identify from the choices below which condition the client is
most likely experiencing, two actions the nurse should take to address that condition, and two
parameters the nurse should monitor to assess the client's progress.
Parameters to Monitor: Methemoglobin level + HR and rhythm
7. The nurse provide discharge instructions to a client who has been prescribed gabapentin 300
mg by mouth three times a day for post herpetic neuralgia. Which symptoms should the nurse
tell the client to report to the healthcare provider?
Gastric irritation
8. A client with chronic lower back pain has been taking non-steroidal anti- inflammatory
(NSAID) drug ibuprofen by mouth twice a day for several months. Which assessment is most
important for the nurse to complete?
Determine presence of abdominal pain
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9. The nurse administers risedrineate to a client with osteoporosis at 0700. The client asks for a
glass of milk to drink with the medication. Which action should the nurse take?
Instruct the client that it is necessary to take nothing but water with the medication.
10. Which action should the nurse implement to assess the effectiveness of calcium channel
blocker amlodipine?
Measure the clients blood pressure
11. A client is receiving tamsulosin an alpha adrenergic - blocking agent for the management of
urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important
for the nurse to provide?
Stand and sit up slowly
12. A client with chemotherapy induced nausea receives a prescription for metoclopramide.
Which adverse effect is most important for the nurse to report?
Involuntary movements
13. A client is receiving orlistat as part of a weight management program. Which ongoing
assessment should be included in the plan of care to determine the effectiveness of the
medication?
Body mass index
14. Before administering the initial dose of sumatriptan succinate to a client with a migraine
headache, it is most important to determine if the client's history includes which problem?
Coronary artery disease
15. Before administering a laxative to a bed fast client, it is most important for the nurse to
perform which assessment?
Determine the frequency and consistency of bowel movement
16. The nurse is caring for a client who takes methotrexate for rheumatoidarthritis and is now
prescribed adalimumab. Which instructions should the nurse provide the client?
Have a chest x-ray prior to your first dose
17. The nurse is reviewing the history and physical examination of a client who will be receiving
asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse
regarding the administration of the medication if which of the following is documented in the
client's history? Pancreatitis
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18. Hormone replacement therapy with levothyroxine sodium is prescribed for a client with
hypothyroidism. The nurse should instruct the client to report which symptom because it
indicates that the client is taking too much of the hormonal agent, levothyroxine?
Restlessness
19. The nurse initiates an infusion of piperacillin-tazobactam for a client witha urinary tract
infection. Five minutes into the infusion, the client reports not feeling well. Which client
manifestation should the nurse identify as a reason to stop the infusion?
Scratchy throat.
20. The nurse administers naloxone to a client with opioid-induced respiratory depression. One
hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute,
oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse
implement?
Administer a second dose of naloxone
21. Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal
toenail infection, which assessment finding is most important for the nurse to address?
Reported history of alcoholism.
22. A client is diagnosed with myasthenia gravis receives a prescription forthe anticholinesterase
medication pyridostigmine. Which intervention should the nurse implement when preparing to
administer this medication?
Administer the medication thirty minutes prior to meals.
23. A client with benign prostatic hyperplasia receives a new prescriptionof tamsulosin. Which
intervention should the nurse perform to monitor for an adverse reaction?
Measure blood pressure.
24. After administering oral doses of calcitriol and calcium carbonate to a client with
hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5
mmol/L). Which action should the nurse implement?
Hold both medications until contacting the healthcare provider.
25. Rivastigmine, a cholinesterase inhibitor, is prescribed for a female client with early stage
Alzheimer's disease. The client's daughter tells the nurse that she plans to start administering the
drug when her mother's symptoms are no longer manageable, in hopes that her mother will not
have to go to a nursing home. How should the nurse respond?
2025 NGN HESI RN PHARMACOLOGY REAL EXAMS (4
VERSIONS) WITH 300+ QUESTIONS AND 100% CORRECT
ANSWERS WITH RATIONALES | RN HESI PHARMACOLOGY
WITH NGN LATEST 4 VERSIONS 2025/2026 ALREADY
GRADED A+ LATEST COMPLETE SOLTION
1. A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement
provided by the client requires additional instruction by the nurse?
Decrease cigarette use to a pack per day.
2. A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level.
The nurse should assess the client for the onset of which problem?
Muscle tenderness.
3. An increase in which serum laboratory value indicates to the nurse that a prescription for
atorvastatin is having the desired effect for a client at risk for coronary artery disease?
HDL (High-density lipoprotein)
4. NGN
History and Physical:
The client is a 36-year-old female with moderate persistent asthma. She takes
fluticasone/salmeterol 250 mcg/50 mcg 1 inhalation twice daily and albuterol 90 mcg/inhalation
2 inhalations every 4-6 hours as needed.
Nurses notes: The client states that she has had more severe asthma symptoms than usual in the
past week. Her forced expiratory volume has been 60-65% even with multiple doses of albuterol
for several days in a row. She came to the hospital feeling dizzy, lightheaded, and complaining
of "heart palpitations". Upon assessment, no wheezes were found. Her oxygen saturation is 99%.
Review H and P, and nurse's note. Identify from the choices below which condition the client is
most likely experiencing, two actions the nurse should take to address that condition, and two
parameters the nurse should monitor to assess the client's progress.
Potential Condition: Methemoglobinemia
5.
History and Physical:
,2|Page
The client is a 36-year-old female with moderate persistent asthma. She takes
fluticasone/salmeterol 250 mcg/50 mcg 1 inhalation twice daily and albuterol 90 mcg/inhalation
2 inhalations every 4-6 hours as needed. Nurses notes: The client states that she has had more
severe asthma symptoms than usual in the past week. Her forced expiratory volume has been 60-
65% even with multiple doses of albuterol for several days in a row. She came to the hospital
feeling dizzy, lightheaded, and complaining of "heart palpitations". Upon assessment, no
wheezes were found. Her oxygen saturation is 99%.
Review H and P, and nurse's note. Identify from the choices below which condition the client is
most likely experiencing, two actions the nurse should take to address that condition, and two
parameters the nurse should monitor to assess the client's progress.
Actions to Take: Draw blood for a CBC + Administer methylene blue
6.
History and Physical:
The client is a 36-year-old female with moderate persistent asthma. She takes
fluticasone/salmeterol 250 mcg/50 mcg 1 inhalation twice daily and albuterol 90 mcg/inhalation
2 inhalations every 4-6 hours as needed.
Nurses notes: The client states that she has had more severe asthma symptoms than usual in the
past week. Her forced expiratory volume has been 60-65% even with multiple doses of albuterol
for several days in a row. She came to the hospital feeling dizzy, lightheaded, and complaining
of "heart palpitations". Upon assessment, no wheezes were found. Her oxygen saturation is 99%.
Review H and P, and nurse's note. Identify from the choices below which condition the client is
most likely experiencing, two actions the nurse should take to address that condition, and two
parameters the nurse should monitor to assess the client's progress.
Parameters to Monitor: Methemoglobin level + HR and rhythm
7. The nurse provide discharge instructions to a client who has been prescribed gabapentin 300
mg by mouth three times a day for post herpetic neuralgia. Which symptoms should the nurse
tell the client to report to the healthcare provider?
Gastric irritation
8. A client with chronic lower back pain has been taking non-steroidal anti- inflammatory
(NSAID) drug ibuprofen by mouth twice a day for several months. Which assessment is most
important for the nurse to complete?
Determine presence of abdominal pain
,3|Page
9. The nurse administers risedrineate to a client with osteoporosis at 0700. The client asks for a
glass of milk to drink with the medication. Which action should the nurse take?
Instruct the client that it is necessary to take nothing but water with the medication.
10. Which action should the nurse implement to assess the effectiveness of calcium channel
blocker amlodipine?
Measure the clients blood pressure
11. A client is receiving tamsulosin an alpha adrenergic - blocking agent for the management of
urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important
for the nurse to provide?
Stand and sit up slowly
12. A client with chemotherapy induced nausea receives a prescription for metoclopramide.
Which adverse effect is most important for the nurse to report?
Involuntary movements
13. A client is receiving orlistat as part of a weight management program. Which ongoing
assessment should be included in the plan of care to determine the effectiveness of the
medication?
Body mass index
14. Before administering the initial dose of sumatriptan succinate to a client with a migraine
headache, it is most important to determine if the client's history includes which problem?
Coronary artery disease
15. Before administering a laxative to a bed fast client, it is most important for the nurse to
perform which assessment?
Determine the frequency and consistency of bowel movement
16. The nurse is caring for a client who takes methotrexate for rheumatoidarthritis and is now
prescribed adalimumab. Which instructions should the nurse provide the client?
Have a chest x-ray prior to your first dose
17. The nurse is reviewing the history and physical examination of a client who will be receiving
asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse
regarding the administration of the medication if which of the following is documented in the
client's history? Pancreatitis
, 4|Page
18. Hormone replacement therapy with levothyroxine sodium is prescribed for a client with
hypothyroidism. The nurse should instruct the client to report which symptom because it
indicates that the client is taking too much of the hormonal agent, levothyroxine?
Restlessness
19. The nurse initiates an infusion of piperacillin-tazobactam for a client witha urinary tract
infection. Five minutes into the infusion, the client reports not feeling well. Which client
manifestation should the nurse identify as a reason to stop the infusion?
Scratchy throat.
20. The nurse administers naloxone to a client with opioid-induced respiratory depression. One
hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute,
oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse
implement?
Administer a second dose of naloxone
21. Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal
toenail infection, which assessment finding is most important for the nurse to address?
Reported history of alcoholism.
22. A client is diagnosed with myasthenia gravis receives a prescription forthe anticholinesterase
medication pyridostigmine. Which intervention should the nurse implement when preparing to
administer this medication?
Administer the medication thirty minutes prior to meals.
23. A client with benign prostatic hyperplasia receives a new prescriptionof tamsulosin. Which
intervention should the nurse perform to monitor for an adverse reaction?
Measure blood pressure.
24. After administering oral doses of calcitriol and calcium carbonate to a client with
hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5
mmol/L). Which action should the nurse implement?
Hold both medications until contacting the healthcare provider.
25. Rivastigmine, a cholinesterase inhibitor, is prescribed for a female client with early stage
Alzheimer's disease. The client's daughter tells the nurse that she plans to start administering the
drug when her mother's symptoms are no longer manageable, in hopes that her mother will not
have to go to a nursing home. How should the nurse respond?
