HESI RN PHARMACOLOGY WITH NGN
QUESTIONS & CORRECT ANSWERS LATEST
2025
A client taking atorvastatin develops an increased serum creatine
phosphokinase (CK) level. The nurse should assess the client for the onset
of which problem?
A. Muscle tenderness
B. Nausea and vomiting
C. Excessive bruising
D. Peripheral edema
ANSWER: A. Muscle tenderness
• Statins (e.g., atorvastatin) can cause myopathy, which may progress to
rhabdomyolysis in severe cases. An elevated CK level often signifies muscle
injury. Muscle tenderness, especially in large muscle groups, is one of the earliest
clinical signs of myopathy. If untreated, severe myopathy can become life-
threatening.
,2) An increase in which serum laboratory value indicates to the nurse that a
prescription for atorvastatin is having the desired effect for a client at risk
for coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein)
ANSWER: C. HDL (High-density lipoprotein)
Atorvastatin lowers LDL primarily but can also modestly raise HDL (“good
cholesterol”). An increase in HDL is protective and a sign that therapy is
working. Therapeutic success can also include a decrease in LDL.
3) [NGN - Case Study]
Patient Data — History & Physical:
• 36-year-old female with moderate persistent asthma on
fluticasone/salmeterol twice daily, albuterol as needed
• Reports more severe symptoms, frequent albuterol use, FEV₁ of 60–65%
• Complaints: dizziness, palpitations, no wheezes, O₂ sat 99%
Tasks:
Identify the likely condition
1) State two actions to take.
State two parameters to monitor
,Likely Condition:
Methemoglobinemia Actions to Take
(two examples):
• Draw blood for a CBC
• Administer methylene blue
Parameters to Monitor (two examples):
• Methemoglobin level
• Heart rate and rhythm
Explanation:
• Methemoglobin forms when hemoglobin is oxidized and cannot carry O₂
effectively. Patients can present with dizziness, palpitations, and normal pulse
oximetry readings despite feeling unwell. Methylene blue is the antidote.
Heart rate/rhythm should be monitored because hypoxia can affect cardiac
status.
2) A client prescribed gabapentin 300 mg by mouth three times a day for
postherpetic neuralgia is being discharged. Which symptoms should the nurse
tell the client to report immediately to the healthcare provider?
A. Sexual dysfunction
B. Gastric irritation
C. Rapid weight gain
D. Photosensitivity
ANSWER: B. Gastric irritation
• Gabapentin commonly causes gastrointestinal upset (e.g., nausea, dyspepsia).
Significant or prolonged GI irritation warrants provider notification. Adjustments
in dosage or medication administration time may be needed to ensure
compliance and comfort.
, 3) A client with chronic lower back pain has been taking the NSAID
ibuprofen twice daily for several months. Which assessment is most
important for the nurse to complete?
A. Assess back pain using a numeric scale
B. Palpate the volume of pedal pulses
C. Determine presence of abdominal pain
D. Evaluate ongoing sleep patterns
ANSWER: C. Determine presence of abdominal pain
Explanation:
• Chronic NSAID therapy (like ibuprofen) increases the risk of peptic ulcer disease
and GI bleeding. Abdominal pain can be an early indicator. Teaching the client
about recognizing signs such as black, tarry stools or discomfort in the epigastric
region is essential.
4) The nurse administers risedronate at 0700 to a client with osteoporosis. The
client requests milk to drink with the medication. Which action should the
nurse take?
A. Instruct the client that only water is permitted with the medication
B. Assign a UAP to bring a glass of low-fat milk
C. Withhold the medication until the client’s breakfast arrives
D. Consult with the pharmacist about scheduling the dose one hour after
the client eats
ANSWER: A. Instruct the client that only water is permitted with the medication
• Risedronate and other bisphosphonates must be taken with plain water on an
empty stomach. Food or other beverages, including milk, interfere with
absorption and increase the risk of esophageal irritation. The client should
remain upright for at least 30 minutes after taking the drug.
QUESTIONS & CORRECT ANSWERS LATEST
2025
A client taking atorvastatin develops an increased serum creatine
phosphokinase (CK) level. The nurse should assess the client for the onset
of which problem?
A. Muscle tenderness
B. Nausea and vomiting
C. Excessive bruising
D. Peripheral edema
ANSWER: A. Muscle tenderness
• Statins (e.g., atorvastatin) can cause myopathy, which may progress to
rhabdomyolysis in severe cases. An elevated CK level often signifies muscle
injury. Muscle tenderness, especially in large muscle groups, is one of the earliest
clinical signs of myopathy. If untreated, severe myopathy can become life-
threatening.
,2) An increase in which serum laboratory value indicates to the nurse that a
prescription for atorvastatin is having the desired effect for a client at risk
for coronary artery disease?
A. LDL (Low-density lipoprotein)
B. Triglycerides
C. HDL (High-density lipoprotein)
D. VLDL (Very low-density lipoprotein)
ANSWER: C. HDL (High-density lipoprotein)
Atorvastatin lowers LDL primarily but can also modestly raise HDL (“good
cholesterol”). An increase in HDL is protective and a sign that therapy is
working. Therapeutic success can also include a decrease in LDL.
3) [NGN - Case Study]
Patient Data — History & Physical:
• 36-year-old female with moderate persistent asthma on
fluticasone/salmeterol twice daily, albuterol as needed
• Reports more severe symptoms, frequent albuterol use, FEV₁ of 60–65%
• Complaints: dizziness, palpitations, no wheezes, O₂ sat 99%
Tasks:
Identify the likely condition
1) State two actions to take.
State two parameters to monitor
,Likely Condition:
Methemoglobinemia Actions to Take
(two examples):
• Draw blood for a CBC
• Administer methylene blue
Parameters to Monitor (two examples):
• Methemoglobin level
• Heart rate and rhythm
Explanation:
• Methemoglobin forms when hemoglobin is oxidized and cannot carry O₂
effectively. Patients can present with dizziness, palpitations, and normal pulse
oximetry readings despite feeling unwell. Methylene blue is the antidote.
Heart rate/rhythm should be monitored because hypoxia can affect cardiac
status.
2) A client prescribed gabapentin 300 mg by mouth three times a day for
postherpetic neuralgia is being discharged. Which symptoms should the nurse
tell the client to report immediately to the healthcare provider?
A. Sexual dysfunction
B. Gastric irritation
C. Rapid weight gain
D. Photosensitivity
ANSWER: B. Gastric irritation
• Gabapentin commonly causes gastrointestinal upset (e.g., nausea, dyspepsia).
Significant or prolonged GI irritation warrants provider notification. Adjustments
in dosage or medication administration time may be needed to ensure
compliance and comfort.
, 3) A client with chronic lower back pain has been taking the NSAID
ibuprofen twice daily for several months. Which assessment is most
important for the nurse to complete?
A. Assess back pain using a numeric scale
B. Palpate the volume of pedal pulses
C. Determine presence of abdominal pain
D. Evaluate ongoing sleep patterns
ANSWER: C. Determine presence of abdominal pain
Explanation:
• Chronic NSAID therapy (like ibuprofen) increases the risk of peptic ulcer disease
and GI bleeding. Abdominal pain can be an early indicator. Teaching the client
about recognizing signs such as black, tarry stools or discomfort in the epigastric
region is essential.
4) The nurse administers risedronate at 0700 to a client with osteoporosis. The
client requests milk to drink with the medication. Which action should the
nurse take?
A. Instruct the client that only water is permitted with the medication
B. Assign a UAP to bring a glass of low-fat milk
C. Withhold the medication until the client’s breakfast arrives
D. Consult with the pharmacist about scheduling the dose one hour after
the client eats
ANSWER: A. Instruct the client that only water is permitted with the medication
• Risedronate and other bisphosphonates must be taken with plain water on an
empty stomach. Food or other beverages, including milk, interfere with
absorption and increase the risk of esophageal irritation. The client should
remain upright for at least 30 minutes after taking the drug.
