HESI PN PHARMACOLOGY EXAM
Medication Safety, Drug Classifications, and
Nursing Considerations – Questions with
Answers and Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on the
HESI PN Pharmacology examination. Topics include medication safety, cardiovascular medications,
endocrine and diabetes medications, anti-infectives, neurological and psychiatric medications,
gastrointestinal and renal medications, and patient education.
1. A practical nurse is preparing to administer digoxin to a client with heart
failure. Which assessment finding should cause the nurse to hold the medication
and notify the healthcare provider?
A. Apical pulse of 54 beats/min
B. Respiratory rate of 18/min
C. Blood pressure of 128/76 mm Hg
D. Temperature of 98.6°F (37°C)
Correct Answer: A — Apical pulse of 54 beats/min
Rationale: Digoxin can cause bradycardia. The nurse should assess the apical pulse
before administration and generally withhold digoxin when the adult apical pulse
is below the prescribed safe threshold, commonly 60 beats/min, and notify the
provider according to agency policy .
,2. A client taking digoxin reports anorexia, nausea, and vomiting. The nurse
recognizes these as:
A. Signs of worsening heart failure
B. Gastrointestinal side effects of a new medication
C. Earliest indicators of digoxin toxicity
D. Expected therapeutic response
Correct Answer: C — Earliest indicators of digoxin toxicity
Rationale: Anorexia, nausea, and vomiting are the earliest indicators of digoxin
toxicity. Other signs include visual disturbances (yellow-green halos, blurred
vision), bradycardia, and cardiac arrhythmias .
3. A client is receiving IV furosemide. What rate of administration is correct to
prevent ototoxicity?
A. Push over 1-2 minutes at maximum rate of 20 mg/min
B. Push over 30 seconds
C. Infuse over 1 hour
D. Rapid IV bolus
Correct Answer: A — Push over 1-2 minutes at maximum rate of 20 mg/min
,Rationale: IV furosemide should be administered slowly over 1-2 minutes, not
exceeding 20 mg/min, to prevent ototoxicity. Rapid administration can cause
hearing loss .
4. A client on warfarin has an INR of 5.2. What is the priority nursing action?
A. Administer vitamin K immediately
B. Hold the next dose and notify the provider
C. Continue the medication as prescribed
D. Increase the dose to achieve therapeutic range
Correct Answer: B — Hold the next dose and notify the provider
Rationale: The therapeutic INR range for most indications is 2 to 3. An INR of 5.2
indicates supratherapeutic anticoagulation with increased bleeding risk. The
priority action is to hold the dose and notify the provider .
5. A client receiving continuous IV heparin has an aPTT of 110 seconds. What is
the priority action?
A. Continue the infusion as prescribed
B. Stop the infusion and prepare to administer protamine sulfate
, C. Increase the infusion rate
D. Draw a stat platelet count
Correct Answer: B — Stop the infusion and prepare to administer protamine
sulfate
Rationale: Therapeutic aPTT target for heparin therapy is 1.5 to 2.5 times the
control value (typically 60-80 seconds). An aPTT of 110 seconds indicates high
bleeding risk requiring immediate intervention .
6. A client is prescribed warfarin. Which laboratory value should the practical
nurse monitor to evaluate therapeutic effectiveness?
A. aPTT
B. PT/INR
C. Bleeding time
D. Platelet count
Correct Answer: B — PT/INR
Rationale: Warfarin is an anticoagulant monitored by PT/INR. The therapeutic INR
range is typically 2.0 to 3.0. aPTT is used for heparin monitoring .
Medication Safety, Drug Classifications, and
Nursing Considerations – Questions with
Answers and Rationales
Instructions: This exam contains multiple-choice questions covering the core content tested on the
HESI PN Pharmacology examination. Topics include medication safety, cardiovascular medications,
endocrine and diabetes medications, anti-infectives, neurological and psychiatric medications,
gastrointestinal and renal medications, and patient education.
1. A practical nurse is preparing to administer digoxin to a client with heart
failure. Which assessment finding should cause the nurse to hold the medication
and notify the healthcare provider?
A. Apical pulse of 54 beats/min
B. Respiratory rate of 18/min
C. Blood pressure of 128/76 mm Hg
D. Temperature of 98.6°F (37°C)
Correct Answer: A — Apical pulse of 54 beats/min
Rationale: Digoxin can cause bradycardia. The nurse should assess the apical pulse
before administration and generally withhold digoxin when the adult apical pulse
is below the prescribed safe threshold, commonly 60 beats/min, and notify the
provider according to agency policy .
,2. A client taking digoxin reports anorexia, nausea, and vomiting. The nurse
recognizes these as:
A. Signs of worsening heart failure
B. Gastrointestinal side effects of a new medication
C. Earliest indicators of digoxin toxicity
D. Expected therapeutic response
Correct Answer: C — Earliest indicators of digoxin toxicity
Rationale: Anorexia, nausea, and vomiting are the earliest indicators of digoxin
toxicity. Other signs include visual disturbances (yellow-green halos, blurred
vision), bradycardia, and cardiac arrhythmias .
3. A client is receiving IV furosemide. What rate of administration is correct to
prevent ototoxicity?
A. Push over 1-2 minutes at maximum rate of 20 mg/min
B. Push over 30 seconds
C. Infuse over 1 hour
D. Rapid IV bolus
Correct Answer: A — Push over 1-2 minutes at maximum rate of 20 mg/min
,Rationale: IV furosemide should be administered slowly over 1-2 minutes, not
exceeding 20 mg/min, to prevent ototoxicity. Rapid administration can cause
hearing loss .
4. A client on warfarin has an INR of 5.2. What is the priority nursing action?
A. Administer vitamin K immediately
B. Hold the next dose and notify the provider
C. Continue the medication as prescribed
D. Increase the dose to achieve therapeutic range
Correct Answer: B — Hold the next dose and notify the provider
Rationale: The therapeutic INR range for most indications is 2 to 3. An INR of 5.2
indicates supratherapeutic anticoagulation with increased bleeding risk. The
priority action is to hold the dose and notify the provider .
5. A client receiving continuous IV heparin has an aPTT of 110 seconds. What is
the priority action?
A. Continue the infusion as prescribed
B. Stop the infusion and prepare to administer protamine sulfate
, C. Increase the infusion rate
D. Draw a stat platelet count
Correct Answer: B — Stop the infusion and prepare to administer protamine
sulfate
Rationale: Therapeutic aPTT target for heparin therapy is 1.5 to 2.5 times the
control value (typically 60-80 seconds). An aPTT of 110 seconds indicates high
bleeding risk requiring immediate intervention .
6. A client is prescribed warfarin. Which laboratory value should the practical
nurse monitor to evaluate therapeutic effectiveness?
A. aPTT
B. PT/INR
C. Bleeding time
D. Platelet count
Correct Answer: B — PT/INR
Rationale: Warfarin is an anticoagulant monitored by PT/INR. The therapeutic INR
range is typically 2.0 to 3.0. aPTT is used for heparin monitoring .
