HESI LPN Pharmacology Exit Exam 2026–2027 | Realistic Practice
Questions with Answers and Rationales | Comprehensive LPN
NCLEX-PN Prep
1. A nurse is preparing to administer lithium to a client with bipolar disorder.
Which lab value should be monitored most closely?
A. Serum potassium
B. Serum lithium level ✅
C. Blood glucose
D. Serum calcium
Answer: B. Serum lithium level
Rationale: Lithium has a narrow therapeutic index; monitoring serum levels is
essential to prevent toxicity.
2. A client is prescribed hydrochlorothiazide. Which condition should the nurse
monitor for?
A. Hyperkalemia
B. Hypokalemia ✅
C. Hypermagnesemia
D. Hypernatremia
Answer: B. Hypokalemia
Rationale: Thiazide diuretics increase potassium excretion, increasing the risk of
hypokalemia.
3. A client taking nitroglycerin reports a headache after administration. What
should the nurse do?
A. Administer acetaminophen ✅
B. Withhold the nitroglycerin
C. Notify the provider immediately
D. Encourage the client to rest
,Answer: A. Administer acetaminophen
Rationale: Headache is a common side effect of nitroglycerin due to vasodilation;
acetaminophen can relieve the discomfort.
4. A client is prescribed a beta-blocker. Which condition may be contraindicated?
A. Asthma ✅
B. Hypertension
C. Angina
D. Tachycardia
Answer: A. Asthma
Rationale: Beta-blockers can cause bronchoconstriction and exacerbate asthma
symptoms.
5. Which instruction should a nurse provide to a client starting prednisone
therapy?
A. Discontinue abruptly if feeling well
B. Take with food ✅
C. Avoid fluids
D. Take only in the evening
Answer: B. Take with food
Rationale: Taking prednisone with food reduces gastrointestinal irritation and risk
of ulcers.
6. A nurse is administering vancomycin. Which adverse effect should be
monitored?
A. Red man syndrome ✅
B. Hyperglycemia
C. Hypotension only
D. Constipation
,Answer: A. Red man syndrome
Rationale: Rapid IV administration of vancomycin can cause flushing,
hypotension, and rash (Red man syndrome).
7. Which laboratory value is most important to monitor for a client on heparin
therapy?
A. INR
B. aPTT ✅
C. Serum potassium
D. Serum calcium
Answer: B. aPTT
Rationale: Heparin therapy requires monitoring of activated partial
thromboplastin time to prevent bleeding or subtherapeutic dosing.
8. A client taking amiodarone should be assessed for which complication?
A. Hypothyroidism ✅
B. Hyperglycemia
C. Hypertension
D. Hypocalcemia
Answer: A. Hypothyroidism
Rationale: Amiodarone contains iodine and can interfere with thyroid function,
causing hypo- or hyperthyroidism.
9. Which client statement indicates understanding of insulin therapy?
A. “I should store insulin at room temperature for 6 months.”
B. “I will rotate injection sites.” ✅
C. “I can take insulin only when I feel hyperglycemic.”
D. “I do not need to monitor blood sugar while on insulin.”
, Answer: B. “I will rotate injection sites.”
Rationale: Rotating injection sites prevents lipodystrophy and ensures consistent
absorption.
10. A client receiving warfarin should avoid which of the following foods?
A. Bananas
B. Leafy green vegetables ✅
C. Apples
D. Rice
Answer: B. Leafy green vegetables
Rationale: Foods high in vitamin K can reduce the effectiveness of warfarin.
11. A nurse teaches a client prescribed statins. Which statement indicates
understanding?
A. “I should take this medication on an empty stomach at night.” ✅
B. “I can take it with grapefruit juice.”
C. “I do not need to monitor liver function.”
D. “I should take a double dose if I miss one.”
Answer: A. “I should take this medication on an empty stomach at night.”
Rationale: Statins are best absorbed in the evening; grapefruit juice can increase
toxicity risk.
12. A client is prescribed digoxin. Which symptom suggests toxicity?
A. Constipation
B. Visual changes ✅
C. Fever
D. Hypertension
Answer: B. Visual changes
Rationale: Visual disturbances, such as yellow-green halos, are common signs of
digoxin toxicity.
Questions with Answers and Rationales | Comprehensive LPN
NCLEX-PN Prep
1. A nurse is preparing to administer lithium to a client with bipolar disorder.
Which lab value should be monitored most closely?
A. Serum potassium
B. Serum lithium level ✅
C. Blood glucose
D. Serum calcium
Answer: B. Serum lithium level
Rationale: Lithium has a narrow therapeutic index; monitoring serum levels is
essential to prevent toxicity.
2. A client is prescribed hydrochlorothiazide. Which condition should the nurse
monitor for?
A. Hyperkalemia
B. Hypokalemia ✅
C. Hypermagnesemia
D. Hypernatremia
Answer: B. Hypokalemia
Rationale: Thiazide diuretics increase potassium excretion, increasing the risk of
hypokalemia.
3. A client taking nitroglycerin reports a headache after administration. What
should the nurse do?
A. Administer acetaminophen ✅
B. Withhold the nitroglycerin
C. Notify the provider immediately
D. Encourage the client to rest
,Answer: A. Administer acetaminophen
Rationale: Headache is a common side effect of nitroglycerin due to vasodilation;
acetaminophen can relieve the discomfort.
4. A client is prescribed a beta-blocker. Which condition may be contraindicated?
A. Asthma ✅
B. Hypertension
C. Angina
D. Tachycardia
Answer: A. Asthma
Rationale: Beta-blockers can cause bronchoconstriction and exacerbate asthma
symptoms.
5. Which instruction should a nurse provide to a client starting prednisone
therapy?
A. Discontinue abruptly if feeling well
B. Take with food ✅
C. Avoid fluids
D. Take only in the evening
Answer: B. Take with food
Rationale: Taking prednisone with food reduces gastrointestinal irritation and risk
of ulcers.
6. A nurse is administering vancomycin. Which adverse effect should be
monitored?
A. Red man syndrome ✅
B. Hyperglycemia
C. Hypotension only
D. Constipation
,Answer: A. Red man syndrome
Rationale: Rapid IV administration of vancomycin can cause flushing,
hypotension, and rash (Red man syndrome).
7. Which laboratory value is most important to monitor for a client on heparin
therapy?
A. INR
B. aPTT ✅
C. Serum potassium
D. Serum calcium
Answer: B. aPTT
Rationale: Heparin therapy requires monitoring of activated partial
thromboplastin time to prevent bleeding or subtherapeutic dosing.
8. A client taking amiodarone should be assessed for which complication?
A. Hypothyroidism ✅
B. Hyperglycemia
C. Hypertension
D. Hypocalcemia
Answer: A. Hypothyroidism
Rationale: Amiodarone contains iodine and can interfere with thyroid function,
causing hypo- or hyperthyroidism.
9. Which client statement indicates understanding of insulin therapy?
A. “I should store insulin at room temperature for 6 months.”
B. “I will rotate injection sites.” ✅
C. “I can take insulin only when I feel hyperglycemic.”
D. “I do not need to monitor blood sugar while on insulin.”
, Answer: B. “I will rotate injection sites.”
Rationale: Rotating injection sites prevents lipodystrophy and ensures consistent
absorption.
10. A client receiving warfarin should avoid which of the following foods?
A. Bananas
B. Leafy green vegetables ✅
C. Apples
D. Rice
Answer: B. Leafy green vegetables
Rationale: Foods high in vitamin K can reduce the effectiveness of warfarin.
11. A nurse teaches a client prescribed statins. Which statement indicates
understanding?
A. “I should take this medication on an empty stomach at night.” ✅
B. “I can take it with grapefruit juice.”
C. “I do not need to monitor liver function.”
D. “I should take a double dose if I miss one.”
Answer: A. “I should take this medication on an empty stomach at night.”
Rationale: Statins are best absorbed in the evening; grapefruit juice can increase
toxicity risk.
12. A client is prescribed digoxin. Which symptom suggests toxicity?
A. Constipation
B. Visual changes ✅
C. Fever
D. Hypertension
Answer: B. Visual changes
Rationale: Visual disturbances, such as yellow-green halos, are common signs of
digoxin toxicity.
