HESI Pharmacology Evolve Practice
Exam Test Bank 2025/2026: Complete
100 A+ Graded Questions and Verified
Answers with Rationales for First-
Attempt Success
Question 1
A 19-year-old male client who has sustained a severe head injury is intubated and
placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent
the client from "fighting" the ventilator, the health care provider administers
pancuronium bromide IV, with adjunctive opioid analgesia. What medication should be
immediately accessible for a potential complication with this drug?
A. Dantrolene sodium
B. Neostigmine bromide
C. Succinylcholine bromide
D. Epinephrine
Correct Answer: B. Neostigmine bromide
Rationale: Pancuronium is a neuromuscular blocking agent that causes paralysis. A
potential complication is prolonged paralysis or the need to reverse its effects.
,Neostigmine is an anticholinesterase agent that acts as an antagonist to reverse the
respiratory muscle paralysis caused by non-depolarizing neuromuscular blockers like
pancuronium. It is often given with atropine to prevent bradycardia .
Question 2
The nurse is preparing to administer digoxin (Lanoxin), 0.125 mg PO, to an adult client
with heart failure and notes that the digoxin serum level in the laboratory report is 1
ng/mL. Which action should the nurse take?
A. Discontinue the digoxin.
B. Notify the health care provider.
C. Administer the digoxin.
D. Reverify the digoxin level.
Correct Answer: C. Administer the digoxin.
Rationale: The therapeutic serum range for digoxin is generally 0.5 to 2 ng/mL. A level
of 1 ng/mL is within the therapeutic range, indicating the dose is appropriate for
maintaining the desired effect. Therefore, administering the medication is the correct
action .
Question 3
,A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen
elixir, 650 mg PO every 4 hours PRN. The nurse calls the health care provider to report
that the client has developed diarrhea. Which change in prescriptions should the nurse
anticipate?
A. Change the acetaminophen to ibuprofen.
B. Change the elixir to an injectable route.
C. Decrease the dose of vitamin C.
D. Begin treatment with an antibiotic.
Correct Answer: C. Decrease the dose of vitamin C.
Rationale: High doses of vitamin C (ascorbic acid) are known to cause gastrointestinal
disturbances, including diarrhea. Since the client is on a high daily dose, this is the most
likely cause. The provider would likely decrease the dose to alleviate this side effect .
Question 4
When providing nursing care for a client receiving pyridostigmine bromide for
myasthenia gravis, which nursing intervention has the highest priority?
A. Monitor the client frequently for urinary retention.
B. Assess respiratory status and breath sounds often.
C. Monitor blood pressure each shift to screen for hypertension.
D. Administer most medications after meals to decrease gastrointestinal irritation.
, Correct Answer: B. Assess respiratory status and breath sounds often.
Rationale: Pyridostigmine is a cholinesterase inhibitor used to improve muscle strength
in myasthenia gravis. The most critical risk for these patients is respiratory muscle
weakness and potential for a myasthenic or cholinergic crisis, both of which can
compromise the airway. Therefore, frequent assessment of respiratory status is the
highest priority .
Question 5
A client is prescribed a loop diuretic. Which assessment is most important for the nurse
to perform before administration?
A. Temperature
B. Respiratory rate
C. Blood pressure and potassium level
D. Oxygen saturation
Correct Answer: C. Blood pressure and potassium level.
Rationale: Loop diuretics (e.g., furosemide) work by inhibiting sodium and water
reabsorption, which can lead to significant fluid loss. The two most critical risks
associated with their use are hypotension (from excessive fluid loss)
and hypokalemia (from potassium excretion). Checking these values helps ensure safe
administration .
Exam Test Bank 2025/2026: Complete
100 A+ Graded Questions and Verified
Answers with Rationales for First-
Attempt Success
Question 1
A 19-year-old male client who has sustained a severe head injury is intubated and
placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent
the client from "fighting" the ventilator, the health care provider administers
pancuronium bromide IV, with adjunctive opioid analgesia. What medication should be
immediately accessible for a potential complication with this drug?
A. Dantrolene sodium
B. Neostigmine bromide
C. Succinylcholine bromide
D. Epinephrine
Correct Answer: B. Neostigmine bromide
Rationale: Pancuronium is a neuromuscular blocking agent that causes paralysis. A
potential complication is prolonged paralysis or the need to reverse its effects.
,Neostigmine is an anticholinesterase agent that acts as an antagonist to reverse the
respiratory muscle paralysis caused by non-depolarizing neuromuscular blockers like
pancuronium. It is often given with atropine to prevent bradycardia .
Question 2
The nurse is preparing to administer digoxin (Lanoxin), 0.125 mg PO, to an adult client
with heart failure and notes that the digoxin serum level in the laboratory report is 1
ng/mL. Which action should the nurse take?
A. Discontinue the digoxin.
B. Notify the health care provider.
C. Administer the digoxin.
D. Reverify the digoxin level.
Correct Answer: C. Administer the digoxin.
Rationale: The therapeutic serum range for digoxin is generally 0.5 to 2 ng/mL. A level
of 1 ng/mL is within the therapeutic range, indicating the dose is appropriate for
maintaining the desired effect. Therefore, administering the medication is the correct
action .
Question 3
,A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen
elixir, 650 mg PO every 4 hours PRN. The nurse calls the health care provider to report
that the client has developed diarrhea. Which change in prescriptions should the nurse
anticipate?
A. Change the acetaminophen to ibuprofen.
B. Change the elixir to an injectable route.
C. Decrease the dose of vitamin C.
D. Begin treatment with an antibiotic.
Correct Answer: C. Decrease the dose of vitamin C.
Rationale: High doses of vitamin C (ascorbic acid) are known to cause gastrointestinal
disturbances, including diarrhea. Since the client is on a high daily dose, this is the most
likely cause. The provider would likely decrease the dose to alleviate this side effect .
Question 4
When providing nursing care for a client receiving pyridostigmine bromide for
myasthenia gravis, which nursing intervention has the highest priority?
A. Monitor the client frequently for urinary retention.
B. Assess respiratory status and breath sounds often.
C. Monitor blood pressure each shift to screen for hypertension.
D. Administer most medications after meals to decrease gastrointestinal irritation.
, Correct Answer: B. Assess respiratory status and breath sounds often.
Rationale: Pyridostigmine is a cholinesterase inhibitor used to improve muscle strength
in myasthenia gravis. The most critical risk for these patients is respiratory muscle
weakness and potential for a myasthenic or cholinergic crisis, both of which can
compromise the airway. Therefore, frequent assessment of respiratory status is the
highest priority .
Question 5
A client is prescribed a loop diuretic. Which assessment is most important for the nurse
to perform before administration?
A. Temperature
B. Respiratory rate
C. Blood pressure and potassium level
D. Oxygen saturation
Correct Answer: C. Blood pressure and potassium level.
Rationale: Loop diuretics (e.g., furosemide) work by inhibiting sodium and water
reabsorption, which can lead to significant fluid loss. The two most critical risks
associated with their use are hypotension (from excessive fluid loss)
and hypokalemia (from potassium excretion). Checking these values helps ensure safe
administration .
