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HESI & NGN Pharmacology Practice Exam – Version 2 | 100 Questions with Rationales 2025/2026

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Enhance your exam readiness with Version 2 of the HESI and Next Generation NCLEX (NGN) Pharmacology Practice Exam. This 100-question test features comprehensive rationales for each answer, covering drug classes, mechanisms of action, side effects, therapeutic uses, and essential nursing considerations. Perfect for nursing students preparing for HESI RN, NGN, or NCLEX-RN exams. Updated to reflect the latest 2025/2026 standards.

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HESI + NGN PHARMACOLOGY
Course
HESI + NGN PHARMACOLOGY











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Institution
HESI + NGN PHARMACOLOGY
Course
HESI + NGN PHARMACOLOGY

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Uploaded on
November 29, 2025
Number of pages
54
Written in
2025/2026
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Exam (elaborations)
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HESI + NGN PHARMACOLOGY PRACTICE EXAM —
VERSION 2 (100 QUESTIONS)
🟦 PART I — NGN-STYLE CASE STUDIES (25 QUESTIONS)
=============================
📘 CASE STUDY 1 — ACUTE MI + CARDIAC MEDS (5 QUESTIONS)


Patient: 67-year-old male admitted with STEMI.
Meds: IV nitroglycerin, metoprolol, aspirin, atorvastatin.


1. (Matrix: Match medication to primary therapeutic effect)


Nitroglycerin


Metoprolol


Aspirin


Atorvastatin


Effects:


↓ Myocardial oxygen demand


↓ Cholesterol


Vasodilation


Antiplatelet action


Answer:

,HESI + NGN PHARMACOLOGY PRACTICE EXAM —
VERSION 2 (100 QUESTIONS)
Nitroglycerin → Vasodilation
Metoprolol → ↓ myocardial O₂ demand
Aspirin → Antiplatelet action
Atorvastatin → ↓ cholesterol


Rationale: Each drug plays a different role in MI management.


2. (Multiple-response)


Which findings indicate nitroglycerin complication?


A. Severe headache


B. SBP 78 mmHg


C. Skin flushing


D. Chest pain improved


E. Unrelieved chest pain after 3 doses


Answer: B, E
Rationale: Hypotension + persistent chest pain = emergency.


3. (Cloze)


Before giving the next dose of metoprolol, the nurse must check the
patient’s _______.

,HESI + NGN PHARMACOLOGY PRACTICE EXAM —
VERSION 2 (100 QUESTIONS)

Answer: Heart rate
Rationale: Hold if HR < 60.


4.


Which combination increases bleeding risk?


A. Aspirin + ibuprofen


B. Atorvastatin + metoprolol


C. Nitroglycerin + vitamin D


D. Aspirin + lisinopril


Answer: A


5. (Priority)


Which new symptom requires immediate intervention?


A. Headache


B. Nausea


C. New S3 heart sound

, HESI + NGN PHARMACOLOGY PRACTICE EXAM —
VERSION 2 (100 QUESTIONS)
D. Flushed skin


Answer: C
Rationale: S3 = worsening HF after MI.


📘 CASE STUDY 2 — COPD EXACERBATION (5 QUESTIONS)


Patient: 74-year-old with COPD flare.
Meds: Albuterol nebulizer, IV methylprednisolone, tiotropium.


6. (Matrix: Expected vs Unexpected)


Findings:


HR 124


Blood glucose 256


White patches in mouth


Tremors


SpO₂ 92% on 2 L


Expected:
Unexpected:


Answer:

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