NSG 124 –PHARMACOLOGY HESI PRACTICE EXAM 75 Questions | NSG124 All Units | Answers & Rationale Included 2026 Summer Semester

NSG124 Pharmacology 2026 Summer Semester Comprehensive Study HERZING UNIVERSITY 1. A nurse is preparing to administer a drug with a narrow therapeutic index. Which action is most important? A. Give the drug at the prescribed time only B. Monitor the patient's drug serum levels closely C. Encourage the patient to take extra doses if symptoms worsen D. Administer the drug with meals to improve absorption Answer: B. Monitor the patient's drug serum levels closely Rationale: Narrow therapeutic index (TI) drugs have a small margin between effective and toxic doses. Examples include digoxin, lithium, warfarin, and phenytoin. Close monitoring of serum levels is essential to prevent toxicity. 2. Which factor most significantly affects drug distribution in an older adult patient? A. Increased renal blood flow B. Decreased protein binding due to lower albumin levels C. Increased gastric acid production D. Faster hepatic metabolism Answer: B. Decreased protein binding due to lower albumin levels Rationale: Older adults often have lower albumin levels, which means fewer protein-binding sites for drugs. This results in more free (active) drug in circulation, increasing both the drug effect and the risk for toxicity. 3. A nurse is teaching a patient about the first-pass effect. Which statement by the patient indicates understanding? A. My IV medication will be partially broken down before it enters my bloodstream B. Oral medications may be significantly reduced in potency before reaching my bloodstream C. My kidneys are responsible for the first-pass effect D. Taking medication with food eliminates the first-pass effect Answer: B. Oral medications may be significantly reduced in potency before reaching my bloodstream Rationale: First-pass metabolism occurs in the liver when an orally administered drug is metabolized before it reaches systemic circulation. This can significantly reduce the bioavailability of oral drugs. 4. A nurse is preparing to give a medication classified as a LASA drug. What is the most appropriate safety action? A. Administer it quickly to prevent errors B. Use tall man lettering and verify with a second nurse C. Crush the tablet to make it easier to swallow D. Document the administration after all other medications are given Answer: B. Use tall man lettering and verify with a second nurse Rationale: Look-alike/sound-alike (LASA) medications pose a significant medication error risk. Tall Man Lettering (capitalizing differing letters) and independent double-checks are key safety strategies recommended by ISMP. 5. Which patient statement indicates understanding of the '10 Rights of Medication Administration'? A. I should take twice the dose if I feel my symptoms are severe B. I have the right to understand why I am receiving this medication C. Medications ordered by the doctor are always safe for me D. I should not question a nurse who gives me an unfamiliar medication Answer: B. I have the right to understand why I am receiving this medication Rational