HESI RN PHARMACOLOGY
STUDY GUIDE
NCLEX (NGN), Case-based Scenarios
400+ Qs & Ans to Pass the Exam
This hesi test contains:
passing score Guarantee
400+ Ques and Ans
Format Set of Multiple-choice
questions with incorporating Next Generation
NCLEX (NGN) and Case studies questions
Expert-Verified Explanations & Solutions
,━━━━━━━━━━━
1. NGN-Style Ques on
The nurse is caring for an adult client who is taking digoxin. Which
laboratory value should be reported to the healthcare provider
immediately?
A. Sodium level: 140 mEq/L
B. Digoxin level: 1.0 ng/mL
C. Potassium level: 3.2 mEq/L
D. Crea nine level: 0.9 mg/dL
Answer: C. Potassium level: 3.2 mEq/L
Expert-Verified Explana on:
• Hypokalemia (K+ < 3.5 mEq/L) in a client who takes digoxin can
precipitate digoxin toxicity and dangerous cardiac dysrhythmias.
• Even if the digoxin level is within normal limits, a low potassium level
increases the risk of toxicity.
• The normal potassium range is 3.5 to 5.0 mEq/L; 3.2 mEq/L is
abnormally low and warrants immediate no fica on of the healthcare
provider.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
2.
The healthcare provider prescribes the an bio c tetracycline HCl for an
adult client. Which instruc on should the nurse include in the teaching
plan for this client?
A. “Take the medica on with milk products to reduce GI upset.”
B. “Protect the skin from sunlight while taking the drug.”
C. “Discon nue the medica on once symptoms subside.”
D. “Lie flat for 30 minutes aBer taking a dose.”
Answer: B. “Protect the skin from sunlight while taking the drug.”
Expert-Verified Explana on:
• Tetracyclines can cause photosensi vity, so advising the client to avoid
direct sunlight or wear protec ve clothing helps reduce sunburn risk.
• They should also be taken on an empty stomach (except if GI upset is
severe) and not with milk products (which can reduce absorp on).
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
3.
The nurse is administering sodium polystyrene sulfonate to a client with
acute kidney injury (AKI). Which lab finding indicates that the
medica on has been effec ve?
A. Serum glucose: 92 mg/dL
B. Serum potassium: 3.8 mEq/L
C. Serum hemoglobin: 15 g/dL
D. Serum ammonia: 60 mcg/dL
Answer: B. Serum potassium: 3.8 mEq/L
Expert-Verified Explana on:
• Sodium polystyrene sulfonate (Kayexalate) helps eliminate potassium
by exchanging sodium for potassium in the GI tract.
• A potassium value of 3.8 mEq/L is within normal range (3.5–5.0
mEq/L), indica ng the drug was effec ve in lowering potassium.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
4.
A client with a fungal infec on of the toenail reports applying an over-
the-counter triple an bio c ointment daily for two weeks without
improvement. Which ac on should the nurse take?
A. Suggest the client apply the ointment twice a day.
B. Assess if the client has used any herbal remedies.
C. Instruct the client to obtain a prescrip on for oral terbinafine.
D. Encourage the client to soak the foot in warm water.
Answer: C. Instruct the client to obtain a prescrip on for oral
terbinafine.
Expert-Verified Explana on:
• Fungal nail infec ons (onychomycosis) typically do not respond to
an bacterial ointments.
• Oral an fungals such as terbinafine are oBen required for adequate
penetra on and extended therapy.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
5.
A client with a history of long-term use of ibuprofen receives a
prescrip on for misoprostol. Which finding indicates that the
medica on was effec ve?
A. Decreased inflamma on in joints
B. Relief of epigastric pain
C. Normalized bowel movements
D. Improved urinary output
Answer: B. Relief of epigastric pain
Expert-Verified Explana on:
• Misoprostol is prescribed to help protect the gastric mucosa from
NSAID-induced ulcers by reducing acid and increasing mucus
produc on.
• Evidence of efficacy is oBen a reduc on in epigastric discomfort or
ulcer symptoms.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
6.
A client with anemia secondary to chronic kidney disease (CKD) started
a prescrip on for epoe n alfa two months ago. Which finding indicates
that the medica on is effec ve?
A. Hemoglobin level increased to 12 g/dL
B. Platelet count doubled
C. BUN decreased by 10%
D. Serum potassium lowered
Answer: A. Hemoglobin level increased to 12 g/dL
Expert-Verified Explana on:
• Epoe n alfa s mulates red blood cell produc on, leading to an
increase in hemoglobin in anemic clients with CKD.
• A hemoglobin of around 11–12 g/dL oBen indicates treatment
success.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
7. “Case Study” Style
A client receiving amphotericin B for a fungal infec on has a lab value of
hematocrit 35%. Which ac on is most important for the nurse to take?
A. Administer PRN oxygen.
B. Report the hematocrit of 35% immediately to the provider.
C. Increase the IV rate of amphotericin B.
D. Encourage the client to ambulate in the hallway.
Answer: B. Report the hematocrit of 35% immediately to the provider.
Expert-Verified Explana on:
• Amphotericin B can cause bone marrow suppression leading to
anemia. A lower hematocrit might indicate significant anemia.
• Promptly no fying the healthcare provider helps address poten al
hematologic complica ons.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
8.
A client with pep c ulcer disease receives a new prescrip on for
cime dine. Which statement by the client requires addi onal
instruc on?
A. “I will take this medica on with meals.”
B. “I can keep taking my antacids at least 1 hour apart from cime dine.”
C. “I will avoid smoking, as it interferes with ulcer healing.”
D. “I will take the medica on 1 hour aBer antacids.”
Answer: D. “I will take the medica on 1 hour aBer antacids.”
Expert-Verified Explana on:
• Cime dine absorp on can be reduced if antacids are taken too close
in me. Ideally, antacids should be separated by at least 1 hour before
or aBer H2 blockers, but cime dine is best absorbed without immediate
antacid use.
• The statement “I will take it 1 hour aBer antacids” might lead to
decreased effec veness.
, ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
9.
A client with chronic low back pain has been taking ibuprofen by mouth
twice a day for several months. Which assessment is most important?
A. Ask about muscle strength changes.
B. Check for presence of abdominal pain.
C. Assess for any urinary reten on.
D. Inves gate changes in visual acuity.
Answer: B. Check for presence of abdominal pain.
Expert-Verified Explana on:
• Chronic NSAID use can cause gastric irrita on, ulcers, and GI bleeding.
Abdominal pain may be an early warning sign.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
STUDY GUIDE
NCLEX (NGN), Case-based Scenarios
400+ Qs & Ans to Pass the Exam
This hesi test contains:
passing score Guarantee
400+ Ques and Ans
Format Set of Multiple-choice
questions with incorporating Next Generation
NCLEX (NGN) and Case studies questions
Expert-Verified Explanations & Solutions
,━━━━━━━━━━━
1. NGN-Style Ques on
The nurse is caring for an adult client who is taking digoxin. Which
laboratory value should be reported to the healthcare provider
immediately?
A. Sodium level: 140 mEq/L
B. Digoxin level: 1.0 ng/mL
C. Potassium level: 3.2 mEq/L
D. Crea nine level: 0.9 mg/dL
Answer: C. Potassium level: 3.2 mEq/L
Expert-Verified Explana on:
• Hypokalemia (K+ < 3.5 mEq/L) in a client who takes digoxin can
precipitate digoxin toxicity and dangerous cardiac dysrhythmias.
• Even if the digoxin level is within normal limits, a low potassium level
increases the risk of toxicity.
• The normal potassium range is 3.5 to 5.0 mEq/L; 3.2 mEq/L is
abnormally low and warrants immediate no fica on of the healthcare
provider.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
2.
The healthcare provider prescribes the an bio c tetracycline HCl for an
adult client. Which instruc on should the nurse include in the teaching
plan for this client?
A. “Take the medica on with milk products to reduce GI upset.”
B. “Protect the skin from sunlight while taking the drug.”
C. “Discon nue the medica on once symptoms subside.”
D. “Lie flat for 30 minutes aBer taking a dose.”
Answer: B. “Protect the skin from sunlight while taking the drug.”
Expert-Verified Explana on:
• Tetracyclines can cause photosensi vity, so advising the client to avoid
direct sunlight or wear protec ve clothing helps reduce sunburn risk.
• They should also be taken on an empty stomach (except if GI upset is
severe) and not with milk products (which can reduce absorp on).
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
3.
The nurse is administering sodium polystyrene sulfonate to a client with
acute kidney injury (AKI). Which lab finding indicates that the
medica on has been effec ve?
A. Serum glucose: 92 mg/dL
B. Serum potassium: 3.8 mEq/L
C. Serum hemoglobin: 15 g/dL
D. Serum ammonia: 60 mcg/dL
Answer: B. Serum potassium: 3.8 mEq/L
Expert-Verified Explana on:
• Sodium polystyrene sulfonate (Kayexalate) helps eliminate potassium
by exchanging sodium for potassium in the GI tract.
• A potassium value of 3.8 mEq/L is within normal range (3.5–5.0
mEq/L), indica ng the drug was effec ve in lowering potassium.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
4.
A client with a fungal infec on of the toenail reports applying an over-
the-counter triple an bio c ointment daily for two weeks without
improvement. Which ac on should the nurse take?
A. Suggest the client apply the ointment twice a day.
B. Assess if the client has used any herbal remedies.
C. Instruct the client to obtain a prescrip on for oral terbinafine.
D. Encourage the client to soak the foot in warm water.
Answer: C. Instruct the client to obtain a prescrip on for oral
terbinafine.
Expert-Verified Explana on:
• Fungal nail infec ons (onychomycosis) typically do not respond to
an bacterial ointments.
• Oral an fungals such as terbinafine are oBen required for adequate
penetra on and extended therapy.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
5.
A client with a history of long-term use of ibuprofen receives a
prescrip on for misoprostol. Which finding indicates that the
medica on was effec ve?
A. Decreased inflamma on in joints
B. Relief of epigastric pain
C. Normalized bowel movements
D. Improved urinary output
Answer: B. Relief of epigastric pain
Expert-Verified Explana on:
• Misoprostol is prescribed to help protect the gastric mucosa from
NSAID-induced ulcers by reducing acid and increasing mucus
produc on.
• Evidence of efficacy is oBen a reduc on in epigastric discomfort or
ulcer symptoms.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
6.
A client with anemia secondary to chronic kidney disease (CKD) started
a prescrip on for epoe n alfa two months ago. Which finding indicates
that the medica on is effec ve?
A. Hemoglobin level increased to 12 g/dL
B. Platelet count doubled
C. BUN decreased by 10%
D. Serum potassium lowered
Answer: A. Hemoglobin level increased to 12 g/dL
Expert-Verified Explana on:
• Epoe n alfa s mulates red blood cell produc on, leading to an
increase in hemoglobin in anemic clients with CKD.
• A hemoglobin of around 11–12 g/dL oBen indicates treatment
success.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
7. “Case Study” Style
A client receiving amphotericin B for a fungal infec on has a lab value of
hematocrit 35%. Which ac on is most important for the nurse to take?
A. Administer PRN oxygen.
B. Report the hematocrit of 35% immediately to the provider.
C. Increase the IV rate of amphotericin B.
D. Encourage the client to ambulate in the hallway.
Answer: B. Report the hematocrit of 35% immediately to the provider.
Expert-Verified Explana on:
• Amphotericin B can cause bone marrow suppression leading to
anemia. A lower hematocrit might indicate significant anemia.
• Promptly no fying the healthcare provider helps address poten al
hematologic complica ons.
,━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
8.
A client with pep c ulcer disease receives a new prescrip on for
cime dine. Which statement by the client requires addi onal
instruc on?
A. “I will take this medica on with meals.”
B. “I can keep taking my antacids at least 1 hour apart from cime dine.”
C. “I will avoid smoking, as it interferes with ulcer healing.”
D. “I will take the medica on 1 hour aBer antacids.”
Answer: D. “I will take the medica on 1 hour aBer antacids.”
Expert-Verified Explana on:
• Cime dine absorp on can be reduced if antacids are taken too close
in me. Ideally, antacids should be separated by at least 1 hour before
or aBer H2 blockers, but cime dine is best absorbed without immediate
antacid use.
• The statement “I will take it 1 hour aBer antacids” might lead to
decreased effec veness.
, ━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
9.
A client with chronic low back pain has been taking ibuprofen by mouth
twice a day for several months. Which assessment is most important?
A. Ask about muscle strength changes.
B. Check for presence of abdominal pain.
C. Assess for any urinary reten on.
D. Inves gate changes in visual acuity.
Answer: B. Check for presence of abdominal pain.
Expert-Verified Explana on:
• Chronic NSAID use can cause gastric irrita on, ulcers, and GI bleeding.
Abdominal pain may be an early warning sign.
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━━━━━━━━
