HESI Pharmacology Exam — 2026/2027
HESI PHARMACOLOGY EXAMINATION
2026/2027 Edition
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Complete Practice Exam
55 Multiple-Choice Questions
Exact Official Count: 55 Questions
Passing Score: 75–80% (41–44/55 Correct)
Testing Time: 75 Minutes
ATI Level Benchmarks: Level 1 (41–46) | Level 2 (47–51) | Level 3 (52–55)
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Assessment Technologies Institute (ATI) / HESI
Aligned with NCSBN CJMM & Next Generation NCLEX (NGN) Standards
Academic Paper
100% Verified | Graded A+
, HESI Pharmacology Exam — 2026/2027
Table of Contents
1. Introduction and Exam Overview
2. Practice Questions
2.1 Medication Administration & Safety (Q1–Q7)
2.2 Pharmacokinetics & Pharmacodynamics (Q8–Q14)
2.3 Drug Classifications & Prototype Medications (Q15–Q21)
2.4 Adverse Effects & Nursing Interventions (Q22–Q28)
2.5 Drug Interactions & Contraindications (Q29–Q34)
2.6 Special Populations Considerations (Q35–Q40)
2.7 Patient Education & Health Promotion (Q41–Q45)
2.8 NGN-Style Clinical Judgment Items (Q46–Q50)
2.9 Scenario-Based Application (Q51–Q55)
3. Answer Key Summary
4. References
1. Introduction and Exam Overview
This HESI Pharmacology Exam practice document for 2026/2027 reflects the standardized competency
assessment used to evaluate proficiency in pharmacological principles for pre-licensure nursing students.
The official examination consists of exactly 55 multiple-choice questions administered in a computer-
based, proctored format via the ATI/HESI testing platform. Candidates are allotted 75 minutes to
complete the examination, and a passing score of 75–80% (41–44 out of 55 correct) is typically required
per nursing program policy. ATI Level Benchmarks categorize performance as Level 1 (41–46 correct),
Level 2 (47–51 correct), and Level 3 (52–55 correct).
The exam measures knowledge across nine core domains essential for safe, effective, evidence-based
medication management practice. These domains include medication administration and safety (rights of
medication administration, dosage calculations, IV therapy, high-alert medications, and error
prevention); pharmacokinetics and pharmacodynamics (ADME principles, half-life, therapeutic index,
and drug-receptor interactions); drug classifications and prototype medications (anti-infectives,
cardiovascular agents, CNS drugs, and endocrine medications); adverse effects and nursing interventions
(side effects vs. serious reactions, black box warnings, and monitoring parameters); drug interactions and
contraindications (food-drug and drug-drug interactions, CYP450 effects, and pregnancy/lactation
considerations); special populations (pediatric dosing, geriatric pharmacology, and renal/hepatic
adjustments); patient education and health promotion (adherence strategies, self-administration, and
safety recognition); NGN-style clinical judgment items aligned with the NCSBN Clinical Judgment
Measurement Model (CJMM); and scenario-based application integrating pharmacological principles
with safe nursing practice.
All examination content is aligned with current HESI testing blueprints, the NCSBN Clinical Judgment
Measurement Model (CJMM), and Next Generation NCLEX (NGN) standards. Question types include
standard multiple-choice, select-all-that-apply (SATA), ordered response, calculation-based items, and
NGN-style items such as case studies, bowtie items, trend items, and matrix items. This practice set is
designed to prepare candidates across all tested domains with pharmacologically accurate questions,
detailed rationales with drug mechanisms and nursing implications, and realistic clinical scenarios.
Remediation following the practice exam should include structured review using HESI Review Module
content, Active Learning Templates, and focused pharmacology content review for items answered
incorrectly.
Examination Structure Summary
Format Questions Time Limit Passing Score Delivery
Computer- 55 75 minutes 75–80% (41– ATI/HESI
, HESI Pharmacology Exam — 2026/2027
based MC + 44/55) Platform
NGN
ATI Level Benchmarks
Level Score Range Interpretation
Level 1 41–46 correct Meets minimum competency
Level 2 47–51 correct Exceeds minimum competency
Level 3 52–55 correct Superior competency
2. Practice Questions
2.1 Medication Administration & Safety (Q1–Q7)
This domain assesses competency in safe medication administration practices, including the rights of
medication administration, dosage calculations using ratio/proportion and dimensional analysis
methods, IV therapy management (flow rates, compatibility, and complications such as infiltration and
phlebitis), high-alert medication protocols for insulin, heparin, opioids, and anticoagulants, and error
prevention strategies including barcode scanning and independent double-checks.
Q1. The nurse is preparing to administer insulin glargine (Lantus) to a patient with type 1
diabetes. Which action is most important for the nurse to take before administration?
A. Mix the insulin glargine with regular insulin in the same syringe
B. Verify the dose with an independent double-check
C. Administer the insulin 30 minutes before breakfast
D. Assess the patient's current blood glucose level only
Correct Answer: B
Rationale: Insulin is a high-alert medication requiring an independent double-check to prevent dosing
errors that could lead to life-threatening hypoglycemia or hyperglycemia. Insulin glargine must NEVER
be mixed with any other insulin in the same syringe because it is a long-acting insulin with a specific pH
and precipitation mechanism that would be disrupted. Unlike rapid or short-acting insulin, glargine
does not have a specific timing requirement relative to meals because it provides basal coverage over 24
hours. While blood glucose monitoring is important, it is not the 'most important' safety action before
administering a high-alert medication.
Q2. A provider orders heparin 25,000 units in 500 mL D5W to infuse at 1,200 units/hour.
The IV pump should be set to how many mL/hour? (Round to the nearest whole number.)
[Calculation]
A. 20 mL/hour
B. 24 mL/hour
C. 28 mL/hour
D. 32 mL/hour
Correct Answer: B
Rationale: Using dimensional analysis: (1,200 units/hour) x (500 mL / 25,000 units) = (1,200 x 500) /
25,000 = 600,,000 = 24 mL/hour. Alternatively, using ratio-proportion: 25,000 units / 500
mL = 1,200 units / X mL; 25,000X = 600,000; X = 24 mL/hour. This calculation is essential for safe
heparin administration as heparin is a high-alert medication; even small infusion rate errors can lead
to serious bleeding or thrombotic complications.
HESI PHARMACOLOGY EXAMINATION
2026/2027 Edition
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━
Complete Practice Exam
55 Multiple-Choice Questions
Exact Official Count: 55 Questions
Passing Score: 75–80% (41–44/55 Correct)
Testing Time: 75 Minutes
ATI Level Benchmarks: Level 1 (41–46) | Level 2 (47–51) | Level 3 (52–55)
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
━━━━
Assessment Technologies Institute (ATI) / HESI
Aligned with NCSBN CJMM & Next Generation NCLEX (NGN) Standards
Academic Paper
100% Verified | Graded A+
, HESI Pharmacology Exam — 2026/2027
Table of Contents
1. Introduction and Exam Overview
2. Practice Questions
2.1 Medication Administration & Safety (Q1–Q7)
2.2 Pharmacokinetics & Pharmacodynamics (Q8–Q14)
2.3 Drug Classifications & Prototype Medications (Q15–Q21)
2.4 Adverse Effects & Nursing Interventions (Q22–Q28)
2.5 Drug Interactions & Contraindications (Q29–Q34)
2.6 Special Populations Considerations (Q35–Q40)
2.7 Patient Education & Health Promotion (Q41–Q45)
2.8 NGN-Style Clinical Judgment Items (Q46–Q50)
2.9 Scenario-Based Application (Q51–Q55)
3. Answer Key Summary
4. References
1. Introduction and Exam Overview
This HESI Pharmacology Exam practice document for 2026/2027 reflects the standardized competency
assessment used to evaluate proficiency in pharmacological principles for pre-licensure nursing students.
The official examination consists of exactly 55 multiple-choice questions administered in a computer-
based, proctored format via the ATI/HESI testing platform. Candidates are allotted 75 minutes to
complete the examination, and a passing score of 75–80% (41–44 out of 55 correct) is typically required
per nursing program policy. ATI Level Benchmarks categorize performance as Level 1 (41–46 correct),
Level 2 (47–51 correct), and Level 3 (52–55 correct).
The exam measures knowledge across nine core domains essential for safe, effective, evidence-based
medication management practice. These domains include medication administration and safety (rights of
medication administration, dosage calculations, IV therapy, high-alert medications, and error
prevention); pharmacokinetics and pharmacodynamics (ADME principles, half-life, therapeutic index,
and drug-receptor interactions); drug classifications and prototype medications (anti-infectives,
cardiovascular agents, CNS drugs, and endocrine medications); adverse effects and nursing interventions
(side effects vs. serious reactions, black box warnings, and monitoring parameters); drug interactions and
contraindications (food-drug and drug-drug interactions, CYP450 effects, and pregnancy/lactation
considerations); special populations (pediatric dosing, geriatric pharmacology, and renal/hepatic
adjustments); patient education and health promotion (adherence strategies, self-administration, and
safety recognition); NGN-style clinical judgment items aligned with the NCSBN Clinical Judgment
Measurement Model (CJMM); and scenario-based application integrating pharmacological principles
with safe nursing practice.
All examination content is aligned with current HESI testing blueprints, the NCSBN Clinical Judgment
Measurement Model (CJMM), and Next Generation NCLEX (NGN) standards. Question types include
standard multiple-choice, select-all-that-apply (SATA), ordered response, calculation-based items, and
NGN-style items such as case studies, bowtie items, trend items, and matrix items. This practice set is
designed to prepare candidates across all tested domains with pharmacologically accurate questions,
detailed rationales with drug mechanisms and nursing implications, and realistic clinical scenarios.
Remediation following the practice exam should include structured review using HESI Review Module
content, Active Learning Templates, and focused pharmacology content review for items answered
incorrectly.
Examination Structure Summary
Format Questions Time Limit Passing Score Delivery
Computer- 55 75 minutes 75–80% (41– ATI/HESI
, HESI Pharmacology Exam — 2026/2027
based MC + 44/55) Platform
NGN
ATI Level Benchmarks
Level Score Range Interpretation
Level 1 41–46 correct Meets minimum competency
Level 2 47–51 correct Exceeds minimum competency
Level 3 52–55 correct Superior competency
2. Practice Questions
2.1 Medication Administration & Safety (Q1–Q7)
This domain assesses competency in safe medication administration practices, including the rights of
medication administration, dosage calculations using ratio/proportion and dimensional analysis
methods, IV therapy management (flow rates, compatibility, and complications such as infiltration and
phlebitis), high-alert medication protocols for insulin, heparin, opioids, and anticoagulants, and error
prevention strategies including barcode scanning and independent double-checks.
Q1. The nurse is preparing to administer insulin glargine (Lantus) to a patient with type 1
diabetes. Which action is most important for the nurse to take before administration?
A. Mix the insulin glargine with regular insulin in the same syringe
B. Verify the dose with an independent double-check
C. Administer the insulin 30 minutes before breakfast
D. Assess the patient's current blood glucose level only
Correct Answer: B
Rationale: Insulin is a high-alert medication requiring an independent double-check to prevent dosing
errors that could lead to life-threatening hypoglycemia or hyperglycemia. Insulin glargine must NEVER
be mixed with any other insulin in the same syringe because it is a long-acting insulin with a specific pH
and precipitation mechanism that would be disrupted. Unlike rapid or short-acting insulin, glargine
does not have a specific timing requirement relative to meals because it provides basal coverage over 24
hours. While blood glucose monitoring is important, it is not the 'most important' safety action before
administering a high-alert medication.
Q2. A provider orders heparin 25,000 units in 500 mL D5W to infuse at 1,200 units/hour.
The IV pump should be set to how many mL/hour? (Round to the nearest whole number.)
[Calculation]
A. 20 mL/hour
B. 24 mL/hour
C. 28 mL/hour
D. 32 mL/hour
Correct Answer: B
Rationale: Using dimensional analysis: (1,200 units/hour) x (500 mL / 25,000 units) = (1,200 x 500) /
25,000 = 600,,000 = 24 mL/hour. Alternatively, using ratio-proportion: 25,000 units / 500
mL = 1,200 units / X mL; 25,000X = 600,000; X = 24 mL/hour. This calculation is essential for safe
heparin administration as heparin is a high-alert medication; even small infusion rate errors can lead
to serious bleeding or thrombotic complications.
