1|Page
EVOLVE HESI PHARMACOLOGY 3 FULL
EXAMS**COMPREHENSIVE PRACTICE
EXAMINATION SET**2025-2026 EDITION | 180
QUESTIONS | DETAILED
RATIONALES**GRADED A+ | NEXT
GENERATION NCLEX (NGN) STYLE**
## TABLE OF CONTENTS
| **Exam 1** | Foundational Pharmacology & Safety | 60 questions |
| **Exam 2** | Medication Administration & Monitoring | 60 questions |
| **Exam 3** | Advanced Pharmacotherapeutics & NGN Case Studies |
60 questions |
---
# EXAM 1: FOUNDATIONAL PHARMACOLOGY & SAFETY
## Cardiovascular Medications (Questions 1-15)
,2|Page
**1. A client with heart failure (HF) develops hyperaldosteronism and
spironolactone is prescribed. Which instruction should the nurse include
in this client's plan of care?**
A) Monitor skin for excessive bruising
B) Cover your skin before going outside
C) Limit intake of high-potassium foods
D) Replace salt with a salt substitute
**Correct Answer: C**
**Rationale:** Spironolactone is a potassium-sparing diuretic. It can
cause hyperkalemia, so clients should limit high-potassium foods
(bananas, oranges, potatoes, salt substitutes). Option A relates to
anticoagulants; Option B relates to photosensitizing drugs; Option D
would increase potassium further.
---
**2. The nurse is making early morning rounds when a client begins
exhibiting symptoms of an acute asthma attack. The nurse administers a
PRN prescription for a beta-2 receptor agonist agent. Which client
response should the nurse expect? (Select all that apply)**
,3|Page
A) Tachycardia
B) Increased blood pressure
C) Rapid resolution of wheezing
D) Improved pulse oximetry values
E) Reduced fever and airway inflammation
**Correct Answer: C, D**
**Rationale:** Beta-2 agonists (albuterol, levalbuterol) cause
bronchodilation, leading to rapid resolution of wheezing and improved
oxygenation. Tachycardia is a side effect, not a therapeutic response.
These medications do not consistently increase BP or reduce
inflammation (steroids do that).
---
**3. A client is prescribed metoprolol (Lopressor SR). What assessment
is most important for the nurse to obtain before administration?**
A) Temperature
B) Apical pulse and blood pressure
C) Respiratory rate
D) Oxygen saturation
, 4|Page
**Correct Answer: B**
**Rationale:** Metoprolol is a beta-1 selective blocker that decreases
heart rate and contractility, lowering BP. The nurse must assess heart rate
(hold if <60 bpm) and BP (hold if systolic <90-100 mmHg) before each
dose.
---
**4. A client is receiving digoxin and furosemide. Which assessment
finding requires immediate nursing intervention?**
A) Apical pulse of 62 bpm
B) Serum potassium of 3.2 mEq/L
C) Urine output of 30 mL/hr
D) Digoxin level of 1.2 ng/mL
**Correct Answer: B**
**Rationale:** Hypokalemia (K <3.5) potentiates digoxin toxicity even
at therapeutic levels. Normal digoxin level is 0.8-2.0 ng/mL. The nurse
should notify the provider, hold the next digoxin dose if severe
hypokalemia, and prepare for potassium replacement.
EVOLVE HESI PHARMACOLOGY 3 FULL
EXAMS**COMPREHENSIVE PRACTICE
EXAMINATION SET**2025-2026 EDITION | 180
QUESTIONS | DETAILED
RATIONALES**GRADED A+ | NEXT
GENERATION NCLEX (NGN) STYLE**
## TABLE OF CONTENTS
| **Exam 1** | Foundational Pharmacology & Safety | 60 questions |
| **Exam 2** | Medication Administration & Monitoring | 60 questions |
| **Exam 3** | Advanced Pharmacotherapeutics & NGN Case Studies |
60 questions |
---
# EXAM 1: FOUNDATIONAL PHARMACOLOGY & SAFETY
## Cardiovascular Medications (Questions 1-15)
,2|Page
**1. A client with heart failure (HF) develops hyperaldosteronism and
spironolactone is prescribed. Which instruction should the nurse include
in this client's plan of care?**
A) Monitor skin for excessive bruising
B) Cover your skin before going outside
C) Limit intake of high-potassium foods
D) Replace salt with a salt substitute
**Correct Answer: C**
**Rationale:** Spironolactone is a potassium-sparing diuretic. It can
cause hyperkalemia, so clients should limit high-potassium foods
(bananas, oranges, potatoes, salt substitutes). Option A relates to
anticoagulants; Option B relates to photosensitizing drugs; Option D
would increase potassium further.
---
**2. The nurse is making early morning rounds when a client begins
exhibiting symptoms of an acute asthma attack. The nurse administers a
PRN prescription for a beta-2 receptor agonist agent. Which client
response should the nurse expect? (Select all that apply)**
,3|Page
A) Tachycardia
B) Increased blood pressure
C) Rapid resolution of wheezing
D) Improved pulse oximetry values
E) Reduced fever and airway inflammation
**Correct Answer: C, D**
**Rationale:** Beta-2 agonists (albuterol, levalbuterol) cause
bronchodilation, leading to rapid resolution of wheezing and improved
oxygenation. Tachycardia is a side effect, not a therapeutic response.
These medications do not consistently increase BP or reduce
inflammation (steroids do that).
---
**3. A client is prescribed metoprolol (Lopressor SR). What assessment
is most important for the nurse to obtain before administration?**
A) Temperature
B) Apical pulse and blood pressure
C) Respiratory rate
D) Oxygen saturation
, 4|Page
**Correct Answer: B**
**Rationale:** Metoprolol is a beta-1 selective blocker that decreases
heart rate and contractility, lowering BP. The nurse must assess heart rate
(hold if <60 bpm) and BP (hold if systolic <90-100 mmHg) before each
dose.
---
**4. A client is receiving digoxin and furosemide. Which assessment
finding requires immediate nursing intervention?**
A) Apical pulse of 62 bpm
B) Serum potassium of 3.2 mEq/L
C) Urine output of 30 mL/hr
D) Digoxin level of 1.2 ng/mL
**Correct Answer: B**
**Rationale:** Hypokalemia (K <3.5) potentiates digoxin toxicity even
at therapeutic levels. Normal digoxin level is 0.8-2.0 ng/mL. The nurse
should notify the provider, hold the next digoxin dose if severe
hypokalemia, and prepare for potassium replacement.
