HESI PN PHARMACOLOGY (3 LATEST VERSIONS) ACTUAL
EXAM NEWEST 2025 EACH VERSION CONTAINS 55
QUESTIONS AND CORRECT DETAILED ANSWERS
Question 1
A client is prescribed furosemide. The LPN/LVN should monitor for which of
the following electrolyte imbalances?
A) Hyperkalemia
B) Hyponatremia
C) Hypercalcemia
D) Hypermagnesemia
E) Hypophosphatemia
Correct Answer: B) Hyponatremia
Rationale: Furosemide is a loop diuretic that promotes the excretion
of sodium, potassium, and chloride. Therefore, clients taking
furosemide are at risk for hyponatremia (low sodium), hypokalemia,
and hypochloremia. While potassium loss is also a major concern,
hyponatremia is a direct effect of sodium excretion.
Question 2
An LPN/LVN is administering insulin glargine to a client with type 1 diabetes
mellitus. Which of the following statements about insulin glargine is correct?
A) It is a rapid-acting insulin given before meals.
B) It has a peak action of 2-4 hours.
C) It has no peak action and provides continuous glucose control.
D) It can be mixed with regular insulin in the same syringe.
E) It is given intravenously for emergencies.
Correct Answer: C) It has no peak action and provides continuous
glucose control.
Rationale: Insulin glargine is a long-acting (basal) insulin with a
relatively flat absorption profile, meaning it has no pronounced
peak action. It provides a steady, continuous supply of insulin over
24 hours, mimicking natural basal insulin secretion. It should not be
mixed with other insulins and is given subcutaneously.
Question 3
A client is prescribed warfarin. The LPN/LVN should understand that warfarin
works by interfering with the synthesis of which vitamin-dependent clotting
factors?
A) Vitamin A
B) Vitamin B12
C) Vitamin C
D) Vitamin K
,E) Vitamin D
Correct Answer: D) Vitamin K
Rationale: Warfarin is an anticoagulant that works by blocking the
synthesis of Vitamin K-dependent clotting factors (Factors II, VII, IX,
X) in the liver. This mechanism is why Vitamin K is the antidote for
warfarin overdose.
Question 4
Which of the following vital signs should the LPN/LVN assess before
administering a beta-blocker (e.g., metoprolol)?
A) Blood pressure and heart rate.
B) Respiratory rate and temperature.
C) Pain level and oxygen saturation.
D) Blood glucose and urine output.
E) Level of consciousness and pupil response.
Correct Answer: A) Blood pressure and heart rate.
Rationale: Beta-blockers primarily decrease heart rate and blood
pressure. The LPN/LVN must assess these vital signs before
administration. If the heart rate is too low (e.g., <60 bpm) or blood
pressure is too low (e.g., systolic <90-100 mmHg, depending on
client baseline), the medication should be held, and the charge
nurse/provider notified.
Question 5
A client is prescribed digoxin. The LPN/LVN should monitor for which of the
following signs of digoxin toxicity?
A) Tachycardia
B) Hypertension
C) Yellow-green halos around lights
D) Increased appetite
E) Diarrhea
Correct Answer: C) Yellow-green halos around lights
Rationale: Visual disturbances, such as yellow-green halos, blurred
vision, or diplopia, are classic signs of digoxin toxicity. Other
common signs include gastrointestinal symptoms (nausea, vomiting,
anorexia) and cardiac arrhythmias (e.g., bradycardia, premature
ventricular contractions).
Question 6
Which medication is an antidote for an opioid overdose?
A) Flumazenil
,B) Naloxone
C) Atropine
D) Protamine sulfate
E) Vitamin K
Correct Answer: B) Naloxone
Rationale: Naloxone (Narcan) is a pure opioid antagonist that rapidly
reverses the respiratory and central nervous system depression
caused by opioid overdose by competitively binding to opioid
receptors.
Question 7
A client with asthma is prescribed albuterol via metered-dose inhaler (MDI).
Which of the following instructions should the LPN/LVN provide?
A) "Rinse your mouth with water after each use."
B) "This medication is for long-term control, use it daily."
C) "Take one slow, deep inhalation while pressing the canister, then hold your
breath."
D) "Shake the inhaler vigorously once per week."
E) "This medication may cause your urine to turn orange-red."
Correct Answer: C) "Take one slow, deep inhalation while pressing the
canister, then hold your breath."
Rationale: Correct MDI technique for albuterol (a rescue inhaler)
involves taking a slow, deep inhalation while pressing the canister,
holding the breath for 5-10 seconds to allow medication deposition,
and then exhaling slowly. Rinsing the mouth is for steroid inhalers.
Albuterol is for acute symptoms, not long-term control, and should
be shaken before each use.
Question 8
A client is prescribed metformin for type 2 diabetes mellitus. The LPN/LVN
should instruct the client to report which of the following adverse effects
immediately?
A) Metallic taste
B) Diarrhea
C) Unexplained muscle pain or weakness
D) Nausea
E) Mild headache
Correct Answer: C) Unexplained muscle pain or weakness
Rationale: While metallic taste, diarrhea, and nausea are common
side effects of metformin, persistent or unexplained muscle pain or
weakness can be a symptom of lactic acidosis, a rare but serious
, and potentially fatal complication of metformin, especially in clients
with impaired renal function. This requires immediate medical
attention.
Question 9
Which medication is a proton pump inhibitor (PPI) commonly used to treat
gastroesophageal reflux disease (GERD) and prevent stress ulcers?
A) Ranitidine
B) Famotidine
C) Pantoprazole
D) Metoclopramide
E) Sucralfate
Correct Answer: C) Pantoprazole
Rationale: Pantoprazole is a proton pump inhibitor (PPI) that
significantly reduces gastric acid production. PPIs are highly
effective for GERD, peptic ulcer disease, and stress ulcer
prophylaxis. Ranitidine and famotidine are H2 receptor blockers,
and sucralfate is a mucosal protectant.
Question 10
A client is prescribed a liquid antibiotic. The LPN/LVN should instruct the
client to:
A) Mix the antibiotic with other medications.
B) Discard any unused portion after 24 hours.
C) Shake the suspension well before each dose.
D) Take the antibiotic with grapefruit juice.
E) Stop taking the antibiotic once symptoms improve.
Correct Answer: C) Shake the suspension well before each dose.
Rationale: Liquid antibiotic suspensions often separate into layers
upon standing. Shaking the bottle well before each dose ensures
that the medication is evenly distributed and the client receives the
correct dosage. Instructions regarding duration of use and specific
interactions (like grapefruit juice) are also crucial.
Question 11
A client is prescribed warfarin. The LPN/LVN should understand that the
effectiveness of warfarin is monitored by which laboratory test?
A) Activated Partial Thromboplastin Time (aPTT)
B) Platelet count
C) International Normalized Ratio (INR)
D) D-dimer
EXAM NEWEST 2025 EACH VERSION CONTAINS 55
QUESTIONS AND CORRECT DETAILED ANSWERS
Question 1
A client is prescribed furosemide. The LPN/LVN should monitor for which of
the following electrolyte imbalances?
A) Hyperkalemia
B) Hyponatremia
C) Hypercalcemia
D) Hypermagnesemia
E) Hypophosphatemia
Correct Answer: B) Hyponatremia
Rationale: Furosemide is a loop diuretic that promotes the excretion
of sodium, potassium, and chloride. Therefore, clients taking
furosemide are at risk for hyponatremia (low sodium), hypokalemia,
and hypochloremia. While potassium loss is also a major concern,
hyponatremia is a direct effect of sodium excretion.
Question 2
An LPN/LVN is administering insulin glargine to a client with type 1 diabetes
mellitus. Which of the following statements about insulin glargine is correct?
A) It is a rapid-acting insulin given before meals.
B) It has a peak action of 2-4 hours.
C) It has no peak action and provides continuous glucose control.
D) It can be mixed with regular insulin in the same syringe.
E) It is given intravenously for emergencies.
Correct Answer: C) It has no peak action and provides continuous
glucose control.
Rationale: Insulin glargine is a long-acting (basal) insulin with a
relatively flat absorption profile, meaning it has no pronounced
peak action. It provides a steady, continuous supply of insulin over
24 hours, mimicking natural basal insulin secretion. It should not be
mixed with other insulins and is given subcutaneously.
Question 3
A client is prescribed warfarin. The LPN/LVN should understand that warfarin
works by interfering with the synthesis of which vitamin-dependent clotting
factors?
A) Vitamin A
B) Vitamin B12
C) Vitamin C
D) Vitamin K
,E) Vitamin D
Correct Answer: D) Vitamin K
Rationale: Warfarin is an anticoagulant that works by blocking the
synthesis of Vitamin K-dependent clotting factors (Factors II, VII, IX,
X) in the liver. This mechanism is why Vitamin K is the antidote for
warfarin overdose.
Question 4
Which of the following vital signs should the LPN/LVN assess before
administering a beta-blocker (e.g., metoprolol)?
A) Blood pressure and heart rate.
B) Respiratory rate and temperature.
C) Pain level and oxygen saturation.
D) Blood glucose and urine output.
E) Level of consciousness and pupil response.
Correct Answer: A) Blood pressure and heart rate.
Rationale: Beta-blockers primarily decrease heart rate and blood
pressure. The LPN/LVN must assess these vital signs before
administration. If the heart rate is too low (e.g., <60 bpm) or blood
pressure is too low (e.g., systolic <90-100 mmHg, depending on
client baseline), the medication should be held, and the charge
nurse/provider notified.
Question 5
A client is prescribed digoxin. The LPN/LVN should monitor for which of the
following signs of digoxin toxicity?
A) Tachycardia
B) Hypertension
C) Yellow-green halos around lights
D) Increased appetite
E) Diarrhea
Correct Answer: C) Yellow-green halos around lights
Rationale: Visual disturbances, such as yellow-green halos, blurred
vision, or diplopia, are classic signs of digoxin toxicity. Other
common signs include gastrointestinal symptoms (nausea, vomiting,
anorexia) and cardiac arrhythmias (e.g., bradycardia, premature
ventricular contractions).
Question 6
Which medication is an antidote for an opioid overdose?
A) Flumazenil
,B) Naloxone
C) Atropine
D) Protamine sulfate
E) Vitamin K
Correct Answer: B) Naloxone
Rationale: Naloxone (Narcan) is a pure opioid antagonist that rapidly
reverses the respiratory and central nervous system depression
caused by opioid overdose by competitively binding to opioid
receptors.
Question 7
A client with asthma is prescribed albuterol via metered-dose inhaler (MDI).
Which of the following instructions should the LPN/LVN provide?
A) "Rinse your mouth with water after each use."
B) "This medication is for long-term control, use it daily."
C) "Take one slow, deep inhalation while pressing the canister, then hold your
breath."
D) "Shake the inhaler vigorously once per week."
E) "This medication may cause your urine to turn orange-red."
Correct Answer: C) "Take one slow, deep inhalation while pressing the
canister, then hold your breath."
Rationale: Correct MDI technique for albuterol (a rescue inhaler)
involves taking a slow, deep inhalation while pressing the canister,
holding the breath for 5-10 seconds to allow medication deposition,
and then exhaling slowly. Rinsing the mouth is for steroid inhalers.
Albuterol is for acute symptoms, not long-term control, and should
be shaken before each use.
Question 8
A client is prescribed metformin for type 2 diabetes mellitus. The LPN/LVN
should instruct the client to report which of the following adverse effects
immediately?
A) Metallic taste
B) Diarrhea
C) Unexplained muscle pain or weakness
D) Nausea
E) Mild headache
Correct Answer: C) Unexplained muscle pain or weakness
Rationale: While metallic taste, diarrhea, and nausea are common
side effects of metformin, persistent or unexplained muscle pain or
weakness can be a symptom of lactic acidosis, a rare but serious
, and potentially fatal complication of metformin, especially in clients
with impaired renal function. This requires immediate medical
attention.
Question 9
Which medication is a proton pump inhibitor (PPI) commonly used to treat
gastroesophageal reflux disease (GERD) and prevent stress ulcers?
A) Ranitidine
B) Famotidine
C) Pantoprazole
D) Metoclopramide
E) Sucralfate
Correct Answer: C) Pantoprazole
Rationale: Pantoprazole is a proton pump inhibitor (PPI) that
significantly reduces gastric acid production. PPIs are highly
effective for GERD, peptic ulcer disease, and stress ulcer
prophylaxis. Ranitidine and famotidine are H2 receptor blockers,
and sucralfate is a mucosal protectant.
Question 10
A client is prescribed a liquid antibiotic. The LPN/LVN should instruct the
client to:
A) Mix the antibiotic with other medications.
B) Discard any unused portion after 24 hours.
C) Shake the suspension well before each dose.
D) Take the antibiotic with grapefruit juice.
E) Stop taking the antibiotic once symptoms improve.
Correct Answer: C) Shake the suspension well before each dose.
Rationale: Liquid antibiotic suspensions often separate into layers
upon standing. Shaking the bottle well before each dose ensures
that the medication is evenly distributed and the client receives the
correct dosage. Instructions regarding duration of use and specific
interactions (like grapefruit juice) are also crucial.
Question 11
A client is prescribed warfarin. The LPN/LVN should understand that the
effectiveness of warfarin is monitored by which laboratory test?
A) Activated Partial Thromboplastin Time (aPTT)
B) Platelet count
C) International Normalized Ratio (INR)
D) D-dimer
