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# HESI RN PHARMACOLOGY PROCTORED EXAM
TEST BANK 2026
## COMPLETE PRACTICE EXAM | NGN-STYLE
QUESTIONS WITH DETAILED RATIONALES
## UPDATED FOR 2026 NCLEX/HESI STANDARDS |
FIRST-TIME PASS GUARANTEE
## Table of Contents
| Section | Topic | Questions |
|---------|-------|-----------|
| 1 | Cardiovascular Medications | 20 |
| 2 | Respiratory Medications | 15 |
| 3 | Endocrine Medications | 20 |
| 4 | Neurological & Psychiatric Medications | 20 |
| 5 | Antibiotics & Anti-Infectives | 20 |
| 6 | Gastrointestinal & Renal Medications | 15 |
| 7 | Pain Management & Opioids | 15 |
| 8 | Anticoagulants & Thrombolytics | 15 |
| 9 | Medication Administration & Safety | 15 |
| 10 | Comprehensive NGN Case Studies | 20 |
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# SECTION 1: CARDIOVASCULAR MEDICATIONS
## (Questions 1–20)
**1.** A client with heart failure is prescribed digoxin. Which assessment finding
indicates a therapeutic response?
A) Increased heart rate and decreased urine output
B) Decreased shortness of breath and decreased peripheral edema
C) Increased appetite and weight gain
D) Decreased blood pressure and increased heart rate
**Answer:** B) Decreased shortness of breath and decreased peripheral edema
**Rationale:** Digoxin increases myocardial contractility (positive inotropic
effect), improving cardiac output. This leads to reduced pulmonary congestion
(less dyspnea) and decreased peripheral edema as the heart pumps more
effectively. Options A, C, and D are inconsistent with therapeutic response and
may indicate adverse effects .
---
**2.** The nurse is administering digoxin to a client with an apical pulse of 52
beats per minute. Which action should the nurse take?
A) Administer the dose and document the finding
B) Administer the dose with food
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C) Hold the dose and notify the healthcare provider
D) Administer half the dose and recheck the pulse in one hour
**Answer:** C) Hold the dose and notify the healthcare provider
**Rationale:** Digoxin should be withheld when the apical pulse is below 60
beats/min in adults. Administering the medication could worsen bradycardia and
precipitate serious arrhythmias. The provider must be notified for further direction.
Halving the dose is outside the nurse's scope without a provider order .
---
**3.** A client with heart failure is prescribed digoxin. Which laboratory finding
indicates an increased risk for digoxin toxicity?
A) Serum potassium 3.2 mEq/L
B) Serum sodium 140 mEq/L
C) Serum calcium 9.5 mg/dL
D) Serum magnesium 2.0 mEq/L
**Answer:** A) Serum potassium 3.2 mEq/L
**Rationale:** Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin
toxicity by enhancing drug binding to cardiac cells. Even with a therapeutic
digoxin level, low potassium can precipitate toxicity. Normal potassium range is
3.5-5.0 mEq/L .
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---
**4.** A client receiving a blood transfusion develops chills, fever, and back pain.
What is the nurse's priority action?
A) Slow the transfusion rate
B) Stop the transfusion immediately
C) Administer antipyretics
D) Notify the laboratory
**Answer:** B) Stop the transfusion immediately
**Rationale:** Chills, fever, and back pain are signs of a hemolytic transfusion
reaction. The immediate priority is to stop the transfusion, maintain IV access with
normal saline through new tubing, and then notify the provider. This is a life-
threatening emergency .
---
**5.** Which IV solution is compatible with packed red blood cells?
A) 5% Dextrose and water
B) 0.9% Normal saline
C) Lactated Ringer's solution
# HESI RN PHARMACOLOGY PROCTORED EXAM
TEST BANK 2026
## COMPLETE PRACTICE EXAM | NGN-STYLE
QUESTIONS WITH DETAILED RATIONALES
## UPDATED FOR 2026 NCLEX/HESI STANDARDS |
FIRST-TIME PASS GUARANTEE
## Table of Contents
| Section | Topic | Questions |
|---------|-------|-----------|
| 1 | Cardiovascular Medications | 20 |
| 2 | Respiratory Medications | 15 |
| 3 | Endocrine Medications | 20 |
| 4 | Neurological & Psychiatric Medications | 20 |
| 5 | Antibiotics & Anti-Infectives | 20 |
| 6 | Gastrointestinal & Renal Medications | 15 |
| 7 | Pain Management & Opioids | 15 |
| 8 | Anticoagulants & Thrombolytics | 15 |
| 9 | Medication Administration & Safety | 15 |
| 10 | Comprehensive NGN Case Studies | 20 |
,2|Page
# SECTION 1: CARDIOVASCULAR MEDICATIONS
## (Questions 1–20)
**1.** A client with heart failure is prescribed digoxin. Which assessment finding
indicates a therapeutic response?
A) Increased heart rate and decreased urine output
B) Decreased shortness of breath and decreased peripheral edema
C) Increased appetite and weight gain
D) Decreased blood pressure and increased heart rate
**Answer:** B) Decreased shortness of breath and decreased peripheral edema
**Rationale:** Digoxin increases myocardial contractility (positive inotropic
effect), improving cardiac output. This leads to reduced pulmonary congestion
(less dyspnea) and decreased peripheral edema as the heart pumps more
effectively. Options A, C, and D are inconsistent with therapeutic response and
may indicate adverse effects .
---
**2.** The nurse is administering digoxin to a client with an apical pulse of 52
beats per minute. Which action should the nurse take?
A) Administer the dose and document the finding
B) Administer the dose with food
,3|Page
C) Hold the dose and notify the healthcare provider
D) Administer half the dose and recheck the pulse in one hour
**Answer:** C) Hold the dose and notify the healthcare provider
**Rationale:** Digoxin should be withheld when the apical pulse is below 60
beats/min in adults. Administering the medication could worsen bradycardia and
precipitate serious arrhythmias. The provider must be notified for further direction.
Halving the dose is outside the nurse's scope without a provider order .
---
**3.** A client with heart failure is prescribed digoxin. Which laboratory finding
indicates an increased risk for digoxin toxicity?
A) Serum potassium 3.2 mEq/L
B) Serum sodium 140 mEq/L
C) Serum calcium 9.5 mg/dL
D) Serum magnesium 2.0 mEq/L
**Answer:** A) Serum potassium 3.2 mEq/L
**Rationale:** Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin
toxicity by enhancing drug binding to cardiac cells. Even with a therapeutic
digoxin level, low potassium can precipitate toxicity. Normal potassium range is
3.5-5.0 mEq/L .
, 4|Page
---
**4.** A client receiving a blood transfusion develops chills, fever, and back pain.
What is the nurse's priority action?
A) Slow the transfusion rate
B) Stop the transfusion immediately
C) Administer antipyretics
D) Notify the laboratory
**Answer:** B) Stop the transfusion immediately
**Rationale:** Chills, fever, and back pain are signs of a hemolytic transfusion
reaction. The immediate priority is to stop the transfusion, maintain IV access with
normal saline through new tubing, and then notify the provider. This is a life-
threatening emergency .
---
**5.** Which IV solution is compatible with packed red blood cells?
A) 5% Dextrose and water
B) 0.9% Normal saline
C) Lactated Ringer's solution
