1
HESI Pharmacology Exam Practice 2025 (NCLEX-PN) | 200+ Real
Questions with Verified A+ Answers & Rationales | 2 Full Versions
Included
Question 1
A licensed practical nurse (LPN) is caring for a client recently diagnosed with congestive heart
failure (CHF) who has been prescribed furosemide 40 mg PO daily. On assessment, the client
reports muscle cramps, weakness, and palpitations. Which of the following actions should the
nurse take first?
A. Notify the provider to adjust the dose of furosemide
B. Assess the client’s potassium level
C. Encourage increased fluid intake
D. Administer potassium chloride as prescribed
Correct Answer: B. Assess the client’s potassium level
Rationale: Furosemide is a loop diuretic that can cause hypokalemia, leading to symptoms such
as muscle cramps, weakness, and cardiac arrhythmias. The nurse should first verify if the client’s
potassium is low before taking further action. Administering potassium or adjusting medications
without lab confirmation is inappropriate.
, 2
Question 2
A patient receiving gentamicin IV for a severe urinary tract infection begins complaining of
tinnitus and difficulty hearing. What is the nurse’s priority action?
A. Reduce the IV infusion rate
B. Notify the healthcare provider immediately
C. Administer diphenhydramine
D. Instruct the client to drink more fluids
Correct Answer: B. Notify the healthcare provider immediately
Rationale: Gentamicin is an aminoglycoside antibiotic known for ototoxicity, which can be
irreversible. Early symptoms include tinnitus and hearing loss. The medication should be
stopped, and the provider notified to prevent permanent damage.
Question 3
A client taking lithium carbonate for bipolar disorder has been experiencing nausea, tremors, and
frequent urination. The LPN checks the latest lab and finds the lithium level is 1.8 mEq/L. What
should the nurse do next?
A. Hold the dose and notify the provider
B. Administer the next dose with food
C. Document findings and recheck levels in 12 hours
D. Encourage hydration with 3 liters of water per day
, 3
Correct Answer: A. Hold the dose and notify the provider
Rationale: Therapeutic lithium levels range from 0.6–1.2 mEq/L. A level of 1.8 mEq/L indicates
toxicity. Symptoms such as nausea and tremors are early signs. The nurse must hold the dose and
alert the provider immediately to prevent worsening toxicity.
Question 4
A nurse is administering insulin lispro to a diabetic client 10 minutes before breakfast. The client
refuses to eat after the injection. What is the nurse’s best initial response?
A. Administer dextrose IV
B. Offer a high-protein snack instead of a full meal
C. Monitor for signs of hypoglycemia
D. Encourage the client to eat to prevent hypoglycemia
Correct Answer: D. Encourage the client to eat to prevent hypoglycemia
Rationale: Insulin lispro is a rapid-acting insulin with an onset of action of 15 minutes. If the
patient refuses to eat, hypoglycemia is a serious risk. The nurse should strongly encourage the
client to eat or offer an alternative to prevent a dangerous drop in blood sugar.
Question 5
A client with hypertension is prescribed captopril. The nurse educates the client on possible side
effects. Which client statement indicates a need for further teaching?
, 4
A. “I should rise slowly to avoid dizziness.”
B. “A dry cough is normal and not serious.”
C. “I need to monitor my blood pressure regularly.”
D. “I should avoid potassium supplements.”
Correct Answer: B. “A dry cough is normal and not serious.”
Rationale: While a dry, persistent cough is a common side effect of ACE inhibitors like
captopril, it is not considered harmless if it affects compliance or quality of life. The client
should notify the provider as a different medication may be considered.
6. A patient taking lithium carbonate for bipolar disorder reports nausea, tremors, and confusion.
Which action should the nurse take first?
A. Administer an antiemetic
B. Withhold the next dose of lithium
C. Encourage the patient to drink more fluids
D. Document the findings and reassess in 4 hours
Correct Answer: B. Withhold the next dose of lithium
Rationale: Nausea, tremors, and confusion are signs of lithium toxicity. The nurse should first
withhold the next dose to prevent further toxicity and notify the healthcare provider. Monitoring
and possible serum lithium level testing are necessary. Lithium has a narrow therapeutic range
(0.6–1.2 mEq/L), and toxicity can occur easily.
HESI Pharmacology Exam Practice 2025 (NCLEX-PN) | 200+ Real
Questions with Verified A+ Answers & Rationales | 2 Full Versions
Included
Question 1
A licensed practical nurse (LPN) is caring for a client recently diagnosed with congestive heart
failure (CHF) who has been prescribed furosemide 40 mg PO daily. On assessment, the client
reports muscle cramps, weakness, and palpitations. Which of the following actions should the
nurse take first?
A. Notify the provider to adjust the dose of furosemide
B. Assess the client’s potassium level
C. Encourage increased fluid intake
D. Administer potassium chloride as prescribed
Correct Answer: B. Assess the client’s potassium level
Rationale: Furosemide is a loop diuretic that can cause hypokalemia, leading to symptoms such
as muscle cramps, weakness, and cardiac arrhythmias. The nurse should first verify if the client’s
potassium is low before taking further action. Administering potassium or adjusting medications
without lab confirmation is inappropriate.
, 2
Question 2
A patient receiving gentamicin IV for a severe urinary tract infection begins complaining of
tinnitus and difficulty hearing. What is the nurse’s priority action?
A. Reduce the IV infusion rate
B. Notify the healthcare provider immediately
C. Administer diphenhydramine
D. Instruct the client to drink more fluids
Correct Answer: B. Notify the healthcare provider immediately
Rationale: Gentamicin is an aminoglycoside antibiotic known for ototoxicity, which can be
irreversible. Early symptoms include tinnitus and hearing loss. The medication should be
stopped, and the provider notified to prevent permanent damage.
Question 3
A client taking lithium carbonate for bipolar disorder has been experiencing nausea, tremors, and
frequent urination. The LPN checks the latest lab and finds the lithium level is 1.8 mEq/L. What
should the nurse do next?
A. Hold the dose and notify the provider
B. Administer the next dose with food
C. Document findings and recheck levels in 12 hours
D. Encourage hydration with 3 liters of water per day
, 3
Correct Answer: A. Hold the dose and notify the provider
Rationale: Therapeutic lithium levels range from 0.6–1.2 mEq/L. A level of 1.8 mEq/L indicates
toxicity. Symptoms such as nausea and tremors are early signs. The nurse must hold the dose and
alert the provider immediately to prevent worsening toxicity.
Question 4
A nurse is administering insulin lispro to a diabetic client 10 minutes before breakfast. The client
refuses to eat after the injection. What is the nurse’s best initial response?
A. Administer dextrose IV
B. Offer a high-protein snack instead of a full meal
C. Monitor for signs of hypoglycemia
D. Encourage the client to eat to prevent hypoglycemia
Correct Answer: D. Encourage the client to eat to prevent hypoglycemia
Rationale: Insulin lispro is a rapid-acting insulin with an onset of action of 15 minutes. If the
patient refuses to eat, hypoglycemia is a serious risk. The nurse should strongly encourage the
client to eat or offer an alternative to prevent a dangerous drop in blood sugar.
Question 5
A client with hypertension is prescribed captopril. The nurse educates the client on possible side
effects. Which client statement indicates a need for further teaching?
, 4
A. “I should rise slowly to avoid dizziness.”
B. “A dry cough is normal and not serious.”
C. “I need to monitor my blood pressure regularly.”
D. “I should avoid potassium supplements.”
Correct Answer: B. “A dry cough is normal and not serious.”
Rationale: While a dry, persistent cough is a common side effect of ACE inhibitors like
captopril, it is not considered harmless if it affects compliance or quality of life. The client
should notify the provider as a different medication may be considered.
6. A patient taking lithium carbonate for bipolar disorder reports nausea, tremors, and confusion.
Which action should the nurse take first?
A. Administer an antiemetic
B. Withhold the next dose of lithium
C. Encourage the patient to drink more fluids
D. Document the findings and reassess in 4 hours
Correct Answer: B. Withhold the next dose of lithium
Rationale: Nausea, tremors, and confusion are signs of lithium toxicity. The nurse should first
withhold the next dose to prevent further toxicity and notify the healthcare provider. Monitoring
and possible serum lithium level testing are necessary. Lithium has a narrow therapeutic range
(0.6–1.2 mEq/L), and toxicity can occur easily.
